Strategies to Reduce Uncertainty on the Diagnosis Quality in the Context of Virtual Consultation: Reviews of Virtual Consultation Systems

  • Vania Yuxi ShiEmail author
  • Sherrie KomiakEmail author
  • Paul KomiakEmail author
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 10917)


The research literature on virtual consultation is sparse while video consultation between clinician and patient are technically possible and increasingly acceptable. With virtual consultation, people can remotely visit doctors anytime anywhere and access many options of doctors. However, it’s surprising that not so many patients in real life as expected are willing to use such virtual consultation systems in spite of all the above theoretical conveniences. Based on uncertainty reduction theory, this paper investigates the strategies to reduce patients’ uncertainties about the diagnosis quality. The research question is how to reveal doctors’ consultation information to reduce patients’ uncertainty on diagnosis quality in the context of virtual consultation.

A review of existing 12 famous virtual consultation systems will be conducted. A following survey and content analysis of patients’ reviews on these systems will also be conducted regarding doctors’ diagnosis quality. We propose that demonstration of consultation process, review availability and communication naturalness can reduce patients’ uncertainty level of diagnosis quality in the context of virtual consultation.

This paper explores how to design virtual consultation systems to enhance patients’ trust and certainty on diagnosis quality before actual consultation, which shed a light on future research of online consultation quality. The results can practically facilitate healthcare providers to understand patients’ concerns on diagnosis quality of virtual consultation. They can also guide the design of virtual consultation systems industrially to reduce patients’ uncertainties on online consultation, and consequently to attract more people using these systems.


Uncertainty Communication Healthcare Virtual consultation 


  1. Andreassen, H.K., Trondsen, M., Kummervold, E., Gammon, D., Hjortdahl, P.: Patients who use e-mediated communication with their doctor: new constructions of trust in the patient-doctor relationship. Qual. Health Res. 16(2), 238–248 (2006). Scholar
  2. Antheunis, M.L., Schouten, A.P., Valkenburg, P.M., Peter, J.: Interactive uncertainty reduction strategies and verbal affection in computer-mediated communication. Commun. Res. 39(6), 757–780 (2012). Scholar
  3. Armfield, N.R., Bradford, M., Bradford, N.K.: The clinical use of Skype—for which patients, with which problems and in which settings? a snapshot review of the literature. Int. J. Med. Inform. 84, 737–742 (2015). Scholar
  4. Armfield, N.R., Gray, L.C., Smith, A.C.: Clinical use of Skype: a review of the evidence base. J. Telemed. Telecare 18(3), 125–127 (2012). Scholar
  5. Berger, C.R.: Uncertain outcome values in predicted relationships uncertainty reduction theory then and now. Hum. Commun. Res. 13(1), 34–38 (1986). Scholar
  6. Berger, C.R., Calabrese, R.J.: Some explorations in initial interaction and beyond: toward a developmental theory of interpersonal communication. Hum. Commun. Res. 1(2), 99–112 (1975). Scholar
  7. Bradac, J.J.: Theory comparison: uncertainty reduction, problematic integration, uncertainty management, and other curious constructs. J. Commun. 51(3), 456–476 (2001)CrossRefGoogle Scholar
  8. Brooks, N.P.: Telemedicine is here. World neurosurg. 95, 603–604 (2016). Scholar
  9. Daniel, W.G., Darren, F.L., Michael, L., Seamus, M., John, P.M.: Skype: A tool for functional assessment in orthopaedic research. J. Telemed. Telecare 18(2), 94–98 (2012). Scholar
  10. Ellenby, M.S., Marcin, J.P.: The role of telemedicine in pediatric critical care. Crit. Care Clin. 31(2), 275–290 (2015). Scholar
  11. Fischer, S.H., David, D., Crotty, B.H., Dierks, M., Safran, C.: Acceptance and use of health information technology by community-dwelling elders. Int. J. Med. Informatics 83, 624–635 (2014). Scholar
  12. Gardner, M.R., Jenkins, S.M., O’Neil, D.A., Wood, D.L., Spurrier, B.R., Pruthi, S.: Perceptions of video-based appointments from the patient’s home: a patient survey. Telemed. e-health 21(4), 281–285 (2015). Scholar
  13. Greenhalgh, T., Vijayaraghavan, S., Wherton, J., Shaw, S., Byrne, E., Campbell-Richards, D., Morris, J.: Virtual online consultations: advantages and limitations (VOCAL) study. BMJ Open 6(1), e009388 (2016). Scholar
  14. Hanna, L., May, C., Fairhurst, K.: The place of information and communication technology-mediated consultations in primary care: GPs’ perspectives. Fam. Pract. 29(3), 361–366 (2012). Scholar
  15. Hewitt, H., Gafaranga, J., McKinstry, B.: Comparison of face-to-face and telephone consultations in primary care: qualitative analysis. Br. J. Gen. Pract. 60(574), e201–e212 (2010). Scholar
  16. Jiang, S., Street, R.L.: Factors Influencing Communication with Doctors via the Internet: A Cross-Sectional Analysis of 2014 HINTS Survey. Health Commun. 32(2), 180–188 (2017). Scholar
  17. Jue, J.S., Spector, S.A., Spector, S.A.: Telemedicine broadening access to care for complex cases. J. Surg. Res. 220, 164–170 (2017). Scholar
  18. Klaassen, B., Van Beijnum, B.J.F., Hermens, H.J.: Usability in telemedicine systems—A literature survey. Int. J. Med. Inform. 93, 57–69 (2016). Scholar
  19. Kummervold, P.E., Chronaki, C.E., Lausen, B., Prokosch, H.U., Rasmussen, J., Santana, S., Wangberg, S.C.: eHealth trends in Europe 2005–2007: a population-based survey. J. Med. Internet Res. 10(4), e42 (2008). Scholar
  20. McKinstry, B., Hammersley, V., Burton, C., Pinnock, H., Elton, R., Dowell, J., Sheikh, A.: The quality, safety and content of telephone and face-to-face consultations: a comparative study. Qual. Saf. Health Care 19(4), 298–303 (2010)CrossRefGoogle Scholar
  21. Patterson, V., Wootton, R.: A web-based telemedicine system for low-resource settings 13 years on: insights from referrers and specialists. Glob. Health Action 6(1), 21465 (2013). Scholar
  22. Reed, K.: Telemedicine: benefits to advanced practice nursing and the communities they serve. J. Am. Acad. Nurse Pract. 17(5), 176–180 (2005). Scholar
  23. Roter, D.L., Larson, S., Sands, D.Z., Ford, D.E., Houston, T.: Can e-mail messages between patients and physicians be patient-centered? Health Commun. 23(1), 80–86 (2008). Scholar
  24. Segato, F., Masella, C.: Telemedicine services: how to make them last over time. Health Policy Technol. 6, 268–278 (2017). Scholar
  25. Shen, W., Hu, Y.J., Ulmer, J.R.: Competing for attention: an empirical study of online reviewers’ strategic behavior. MIS Q. 39(3), 683–696 (2015). Scholar
  26. Shin, S.I., Lee, K.Y., Yang, S.B.: How do uncertainty reduction strategies influence social networking site fan page visiting? examining the role of uncertainty reduction strategies, loyalty and satisfaction in continuous visiting behavior. Telematics Inform. 34, 449–462 (2017). Scholar
  27. Stern, A.: Exploring the Benefits of telehealth. Trustee 70(10), 4 (2017)Google Scholar
  28. Segura, B.T., Bustabad, S.: A new form of communication between rheumatology and primary care: the virtual consultation. Reumatología Clínica (English Edition) 12(1), 11–14 (2016). Scholar
  29. Travers, C.P., Murphy, J.F.: Neonatal telephone consultations in the National Maternity Hospital. Ir. Med. J. (2014)Google Scholar
  30. Van Velsen, L., Tabak, M., Hermens, H.: Measuring patient trust in telemedicine services: Development of a survey instrument and its validation for an anticoagulation web-service. Int. J. Med. Inform. 97, 52–58 (2017). Scholar
  31. Wald, H.S., Dube, C.E., Anthony, D.C.: Untangling the web—the impact of Internet use on health care and the physician–patient relationship. Patient Educ. Couns. 68, 218–224 (2007). Scholar
  32. Wilson, J.M., Straus, S.G., McEvily, B.: All in due time: the development of trust in computer-mediated and face-to-face teams. Organ. Behav. Hum. Decis. Process. 99(1), 16–33 (2006). Scholar
  33. Zilliacus, E., Meiser, B., Lobb, E., Dudding, T.E., Barlow-Stewart, K., Tucker, K.: The virtual consultation: practitioners’ experiences of genetic counseling by videoconferencing in Australia. Telemed. e-Health 16(3), 350–357 (2010). Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Memorial University of NewfoundlandSt. John’sCanada

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