Telemedicine Service Experience Questionnaire for Chinese Outpatients: Development and Validation Study

Clinical Snapshot

Key Findings

• P Value: Not specifically reported for factor analysis

• Effect Size: Strong factor loadings and internal consistency across all domains

• Primary Outcome: 14-item TSEQ with 4-factor structure: Service Efficiency, Post-treatment, Information Guidance, and Humanistic Care

• Nnt Or Sensitivity: Cronbach α: Service Efficiency (0.876), Post-treatment (0.840), Information Guidance (0.962), Humanistic Care (0.876)

• Confidence Interval: Not reported for psychometric parameters

Clinical Application

14-item questionnaire appears feasible for routine implementation in telemedicine workflows Would require cultural adaptation and validation for Australian healthcare system; could inform development of similar instruments for Medicare-funded telehealth services and support quality improvement initiatives aligned with RACGP telemedicine guidelines Outpatients using telemedicine services, particularly in Chinese healthcare contexts

Abstract

BACKGROUND: Telemedicine has rapidly expanded; however, standardized, telemedicine-specific patient-reported experience measures tailored to outpatient workflows are limited in many settings. OBJECTIVE: This study aimed to develop and psychometrically validate the Telemedicine Service Experience Questionnaire (TSEQ) for Chinese outpatients using telemedicine services. METHODS: We conducted a web-based survey among outpatients who completed a telemedicine consultation at Peking Union Medical College Hospital between July 1, 2021, to August 31, 2021, and who had used telemedicine services, using an adapted Chinese Patient Experience Questionnaire that encompasses 15 questions across 4 dimensions, to investigate patients' telemedicine consultation experiences. Item generation was informed by a literature review, workflow mapping, and expert review. We evaluated the factor structure using exploratory factor analysis and confirmatory factor analysis on the full sample with cross-validation. Reliability was assessed using Cronbach α and item-total correlations. RESULTS: In total, 3338 participants completed the survey (mean age 45.3, SD 17.8 y; n=2182, 65.4% female participants; n=1827, 54.8% with college education or above). The exploratory factor analysis of the final 14-item scale resulted in 4 factors. After scrutinizing the content, these factors were labeled "Service Efficiency," "Post-treatment," "Information Guidance," and "Humanistic Care," and they demonstrated good internal consistency (Cronbach α values of 0.876, 0.840, 0.962, and 0.876, respectively). Moreover, as the average variance extracted values were greater than 0.5 and the composite reliability values were greater than 0.7, the TSEQ scale has high convergent validity. Our findings suggest that the psychometric properties of the 14-item TSEQ are valid and reliable for assessing telemedicine service experience among Chinese outpatients. CONCLUSIONS: The TSEQ demonstrates a stable multidomain structure with satisfactory reliability and validity for evaluating outpatient telemedicine service experience in China. The instrument can support routine quality monitoring and guide targeted workflow improvements. Future studies should validate the TSEQ in multisite and postpandemic samples and examine measurement invariance across key subgroups.

References

1. 1.Wang, P., Zhang, K., Chen, Y., Zhao, M., Li, P., Kuang, Y., Du, Y., Zhu, W., Long, X., Shi, L., & Zhu, J. (2026). Telemedicine Service Experience Questionnaire for Chinese Outpatients: Development and Validation Study. JMIR Human Factors. https://doi.org/10.2196/60551