Between policy promise and lived practice: the state of telemedicine in Austrian out-patient care

Background

Telemedicine enables health care delivery across distance and is widely framed in Europe as improving access and efficiency, including in Austria’s national eHealth strategy. Yet little is known about its actual uptake in outpatient care and how it is experienced by physicians and patients.

Methods

Two nationwide online surveys were conducted among outpatient physicians (n = 379) and patients (n = 507) in Austria (Nov–Dec 2025). Comparable questionnaires assessed telemedicine use, barriers and requirements for future implementation. As telemedicine reshapes patient–physician interaction, the comparative design captures both perspectives.

Results

Similar patterns were observed. Among physicians, 52.8% reported providing telemedicine services, mainly through telephone consultations (93.5%), while more advanced formats remained limited. Among patients, 51.5% reported experience with telephone consultations, whereas only a small proportion had used other formats. Key barriers differed: for physicians, missing reimbursement, organisational challenges and legal uncertainty were central, while patients faced limited and unclear availability and a lack of suitable services. Despite this, patients valued convenience and time savings while emphasising the continued importance of personal contact.

Conclusions

Our findings provide rare comparative insights into the needs of physicians and patients regarding telemedicine and highlight the challenges of translating policy ambitions into everyday practice. While telemedicine is widely promoted to improve access and efficiency, patient willingness contrasts with limited availability and physicians’ perceived additional workload under uncertain conditions. Scaling telemedicine therefore requires aligning patient-physician interaction, reimbursement, legal frameworks and interoperable infrastructures, which should be prioritised in public health action, including care models that integrate digital and in-person care.

Key messages

• Telemedicine is already part of Austrian outpatient care, but mainly as low-threshold, telephone-based service rather than an integrated and advanced form of digital care.

• Scaling telemedicine requires more than technology: patient expectations, physician workflows, reimbursement, legal certainty and interoperable infrastructure must align.