Quality measures of virtual care in ambulatory healthcare environments: a scoping review.

Publication date: Apr 02, 2024

Delivery of virtual care increased throughout the COVID-19 pandemic and persisted after physical distancing measures ended. However, little is known about how to measure the quality of virtual care, as current measures focus on in-person care and may not apply to a virtual context. This scoping review aims to understand the connections between virtual care modalities used with ambulatory patient populations and quality measures across the Quintuple Aim (provider experience, patient experience, per capita cost, population health and health equity). Virtual care was considered any interaction between patients and/or their circle of care occurring remotely using any form of information technology. Five databases (MEDLINE, Embase, PsycInfo, Cochrane Library, JBI) and grey literature sources (11 websites, 3 search engines) were searched from 2015 to June 2021 and again in August 2022 for publications that analysed virtual care in ambulatory settings. Indicators were extracted, double-coded into the Quintuple Aim framework; patient and provider experience indicators were further categorised based on the National Academy of Medicine quality framework (safety, effectiveness, patient-centredness, timeliness, efficiency and equity). Sustainability was added to capture the potential for continued use of virtual care. 13‚ÄČ504 citations were double-screened resulting in 631 full-text articles, 66 of which were included. Common modalities included video or audio visits (n=43), remote monitoring (n=11) and mobile applications (n=11). The most common quality indicators were related to patient experience (n=58 articles), followed by provider experience (n=25 articles), population health outcomes (n=23 articles) and health system costs (n=19 articles). The connections between virtual care modalities and quality domains identified here can inform clinicians, administrators and other decision-makers how to monitor the quality of virtual care and provide insights into gaps in current quality measures. The next steps include the development of a balanced scorecard of virtual care quality indicators for ambulatory settings to inform quality improvement.

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Concepts Keywords
Clinicians Health Equity
Distancing Patient-Centered Care
June Telemedicine


Type Source Name
disease IDO quality
disease MESH COVID-19 pandemic
disease VO population
disease VO Equity
disease VO effectiveness
disease VO efficiency
disease VO Canada
drug DRUGBANK Coenzyme M
drug DRUGBANK Trestolone
drug DRUGBANK Sulpiride
drug DRUGBANK Factor IX Complex (Human)
disease IDO process
disease VO publication
disease IDO country
disease IDO intervention
disease VO frequency
disease VO efficient
disease VO report
disease VO age
disease MESH Chronic pain
disease VO nose
disease VO effective
disease MESH Emergency
drug DRUGBANK Aspartame
disease VO organization
disease IDO site
drug DRUGBANK Ilex paraguariensis leaf
drug DRUGBANK Flunarizine
drug DRUGBANK Bismuth subgallate
disease VO NAP

Original Article

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