Systemic barriers to the quality of online healthcare consultation: A qualitative study of provider-side factors and incentive misalignment
Wei Zhang, Mengqiao Zhao, Jingjing Liu, Yanyan Chen, Longwen Wang, Yuxuan Chen, Richard EvansObjective
This study examines healthcare professionals’ perspectives to identify the organizational and systemic factors influencing Online Healthcare Consultation (OHC) service quality, clarify key challenges, and establish directions for future research.
Methods
Between October 2021 and January 2022, a qualitative study was undertaken involving healthcare professionals i.e., doctors, nurses, and hospital administrators. Twenty-five semi-structured interviews were conducted, and the data were analyzed using thematic analysis.
Results
A total of 155 initial codes were generated and subsequently grouped into 12 sub-categories under three themes: (1) healthcare professionals’ perceptions of OHC, (2) factors influencing OHC service quality, and (3) solutions for improving OHC service quality.
Conclusion
The findings demonstrate that OHC service quality is undermined by critical systemic misalignments, primarily a lack of provider motivation linked to inadequate incentive structures, an absence of regulatory oversight, and failures to support care co-production with patients possessing limited health literacy. Although healthcare professionals maintain a positive yet cautious view of OHC, recognizing its flexibility and brand effects whilst noting significant clinical risks, enhancing service quality demands a multi-stakeholder framework. This framework must align provider incentives, enhance platform functionality, and establish clear regulatory standards.