Clinicians' and patients' views and experiences on virtual hospital care: a systematic review of qualitative evidence.
Clinical Snapshot
PICO Framework
| P — Population | Adult patients and clinicians engaged with hospital-based virtual care services across any healthcare setting |
| I — Intervention | Hospital-based virtual care services (e.g., virtual wards, telehealth consultations, remote monitoring delivered in lieu of or as an extension of inpatient/hospital care) |
| C — Comparator | No formal comparator specified; review synthesises experiential and perceptual data rather than comparative effectiveness data |
| O — Outcomes | Patient and clinician views, experiences, perceptions, acceptability, and satisfaction with virtual hospital care; barriers and facilitators to implementation |
Bottom Line
This systematic review of qualitative evidence synthesises the experiences of 514 clinicians and 215 patients across 19 studies to identify five key themes shaping virtual hospital care: perceived value, confidence and readiness, digital and health literacy, therapeutic relationships, and infrastructure and system support. The central finding is that virtual hospital care acceptability is not determined by technology alone — it is mediated by a complex interplay of personal, interpersonal, and systemic factors that vary substantially between individuals. For senior clinicians and health system leaders, the actionable message is clear: virtual care models that are not co-designed with end-users, and that fail to account for heterogeneity in digital literacy and clinical context, are unlikely to achieve equitable outcomes. Clinician capacity-building through validated tools and structured training is identified as a modifiable priority. The evidence base, while directionally informative, remains limited by small patient numbers, high-income country predominance, and absence of longitudinal data. Australian virtual care programs — expanding rapidly under national digital health strategy — should treat these findings as implementation guidance rather than definitive evidence, and invest in longitudinal, co-designed evaluation frameworks to build a more robust evidence base.
Key Findings
P Value: Not applicable — qualitative synthesis methodology
Effect Size: Not applicable — qualitative evidence synthesis; no quantitative effect size calculated
Primary Outcome: Five synthesised themes influencing virtual hospital care experiences: (1) perceived value of virtual care, (2) clinician and patient confidence and readiness, (3) digital and health literacy, (4) therapeutic relationships in virtual settings, and (5) infrastructure and system support
Nnt Or Sensitivity: Not applicable; key implementation finding: acceptability of virtual hospital care is highly dependent on tailoring services to individual patient and clinician needs, with co-design identified as essential for equitable and successful implementation
Confidence Interval: Not applicable — qualitative synthesis methodology
Clinical Application
Implementation feasibility is contingent on addressing the five identified themes. Clinician training and validated digital tools are highlighted as modifiable enablers. Infrastructure investment (reliable connectivity, interoperable platforms) and co-design processes with end-users are identified as systemic prerequisites. The review suggests that one-size-fits-all virtual care models are unlikely to succeed without individualisation for patient digital literacy and clinical context. Australia has experienced rapid expansion of virtual care services since 2020, supported by MBS telehealth item numbers introduced during the COVID-19 pandemic and subsequently consolidated. The Australian Digital Health Agency's National Digital Health Strategy 2023–2028 and state-based virtual hospital programs (e.g., NSW Virtual Care Strategy, Queensland Virtual Emergency Department) are directly informed by the type of evidence this review synthesises. The RACGP has published telehealth guidance emphasising patient consent, digital literacy support, and therapeutic relationship maintenance — themes directly mirrored in this review's findings. TGA regulatory considerations for software-as-a-medical-device (SaMD) used in virtual monitoring are relevant to the infrastructure theme. PBS-listed medications for chronic conditions managed via virtual hospital models (e.g., heart failure, COPD, post-surgical care) are increasingly delivered through these platforms. The George Institute's Sydney base positions this research to directly influence Australian health policy and RACGP/ACSQHC guideline development. Adult patients receiving hospital-level care via virtual platforms (virtual wards, remote monitoring, telehealth-based inpatient substitution) and the multidisciplinary clinicians delivering such care across acute, subacute, and specialist hospital services
Abstract
OBJECTIVES: To appraise and synthesise the literature on patient and clinician experiences with hospital-based virtual care services. METHODS: We searched Medline, Embase, CINAHL and PsycINFO (via Ovid) in October 2023. An updated search was performed in January 2025, with alerts maintained until May 2025. We included qualitative or mixed-methods studies evaluating patient or clinician experiences of hospital-based virtual care. RESULTS: Out of 15 434 identified articles, 19 studies involving 514 clinicians and 215 patients were included. The majority of the studies were from high-income countries. Our analysis identified five themes influencing virtual hospital care experiences: perceived value, confidence and readiness, digital and health literacy, therapeutic relationships, and infrastructure and system support. DISCUSSION: The potential of virtual care services is mediated by a complex relationship between personal, interpersonal and systemic factors. The acceptability of virtual hospital care is highly dependent on tailoring services to meet the individual needs of both patients and clinicians. The findings of this review demonstrate the need to improve clinician capacity and confidence through validated virtual tools and ongoing training. CONCLUSION: To ensure virtual hospital care is successful and equitable, the virtual health model must be co-designed with its end-users. In addition to addressing systemic barriers, emphasis must be placed on refining care delivery to support the needs of diverse patients and professions. Further research, particularly in low- and middle-income countries and through longitudinal studies, is critical for informing future health policy.
References
- 1.Mohamed, A. R., Franco, M. R., Mathieson, S., March, M., Marcelo, A., Machado, G., & Ferreira, M. (2026). Clinicians' and patients' views and experiences on virtual hospital care: a systematic review of qualitative evidence. BMJ Health & Care Informatics. https://doi.org/10.1136/bmjhci-2025-101753
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