clients had a positive experience with telehealth primary care visits and that, when comparing telehealth to in-person visits, clients reported less wait time, easier convenience, and similar quality between virtual and in-person visits, and they rated both their likelihood of using telehealth again and their likelihood of recommending telehealth to others as an 8.68 out of 10, on average.
In a 2023 systematic review, Kodjebacheva et al 9 found that in most studies, telehealth services received more favourable or comparable satisfaction ratings than in-person visits, but that improvements were needed in telehealthrelated technological challenges and the quality of rapport between clients, caregivers, and medical providers. A 2025 systematic review by Mehta et al 10 looking at the state of teledermatology( dermatology delivered via telehealth) with specific reference to acne vulgaris, showed that when compared to in-person care, teledermatology resulted in similar outcomes on several acne-grading scales, client satisfaction was comparable, and a large proportion of clients preferred virtual care to traditional in-person visits, although treatment compliance was found to be lower for telehealth. In another 2025 systematic review, Ibrahim et al 11 found that telemedicine demonstrated noninferior efficacy to in-person therapy for generalised anxiety disorder.
In contrast, Osman et al 12, in a 2024 Australian systematic review, found that 87 % of the studies reviewed reported unintended consequences of telehealth. These related to continuity of care, interpersonal exchange and therapeutic relationship-building. Specifically, in 86 % of studies, telehealth was viewed as hindering effective communication and client engagement, largely due to the lack of non-verbal information and, to a lesser extent, due to the increase in distractions during telehealth consultations compared to in-person consultations, particularly in the case of children or young clients. They also found that 63 % of studies reporting unintended consequences from telehealth related to issues with continuity of care, and telehealth interactions were noted as impersonal, thus undermining rapportbuilding, which affected the therapeutic client-provider relationship.
In a survey funded by the Australian Government’ s Department of Health, Disability and Ageing and conducted in late 2024 with over 5,000 adult participants( Speaking Up for Health: Findings from the 2024 National Consumer Sentiment Survey 13), when rating the overall quality of telehealth, 62 % of respondents regarded it as similar to an in-person appointment, but 27.7 % thought the overall quality of their experience was worse than an
in-person appointment. While telehealth appointments were rated as being about the same as in-person appointments by most respondents on almost all measures, only 51.7 % felt their ability to build rapport with their provider via telehealth was similar to an in-person appointment. It was notable that in this survey 38.9 % of respondents found the ability to develop a connection with their healthcare provider was not as good as it may have been at an in-person appointment.
Risks associated with telehealth
A total of 32 % of the studies identified by Osman et al 12 showed that client safety was impaired by telehealth in a number of areas. Telehealth risks can generally be categorised as those that relate to clinical, security and legal issues.
Clinical Risks
Largely because of the lack of any direct capacity to physically examine a client during a telehealth consultation, clinical risk, particularly with new clients, is elevated relative to faceto-face consultations and can have serious consequences. Issus that may arise here include such things as client misidentification, medication errors, failure to diagnose, late diagnosis, misdiagnosis or delayed treatment as well as difficulties in evaluating, identifying,
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