Global trends and thematic evolution in online consultation with digital health technologies: Implications for future implementation and policy development
- 1Office of Operations Management, Yuebei People's Hospital Affiliated to Shantou University Medical College, Shaoguan, China.
- 2Hospital Office, Yuebei People's Hospital Affiliated to Shantou University Medical College, Shaoguan, China.
- 3Science Research Office, Yuebei People's Hospital Affiliated to Shantou University Medical College, Shaoguan, China.
Abstract
Online consultation has become a mainstream element of digital health within telemedicine, seeing rapid growth during the COVID-19 pandemic. Video, telephone, and secure messaging are extensively used for clinical advice, assessments, and follow-ups. However, the adoption of these technologies remains inconsistent, particularly in regions with limited infrastructure and workforce capacity. Key challenges include patient engagement, integration into clinical workflows, and the efficient allocation of resources. This bibliometric analysis covers 2,426 English-language journal articles indexed in the Science Citation Index Expanded (SCI-Expanded) within the Web of Science Core Collection (WoSCC) (1990–2025). Utilizing VOSviewer and the bibliometrix package, we mapped publication growth, international collaborations, keyword co-occurrence, and thematic evolution, with country-specific trajectories examined for the leading contributors. Countries were ranked via full counting, and joinpoint regression identified inflection points in annual publication output. Publication output grew steadily over the past 35 years, accelerating significantly after 2018, with a sharp peak from 2019 to 2022. The United States, England, China, Canada, Australia, and Germany were the main contributors and central hubs in international collaboration. The thematic focus shifted from early feasibility studies to service management, quality and outcome evaluation, barriers to implementation, equity considerations, and post-pandemic integration into standard care pathways. Country-specific trends were evident: the United States focused on telemedicine models and reimbursement mechanisms, England concentrated on primary care and general practice, and China experienced rapid growth in telehealth research post-2018. The literature on online consultation has evolved from proof-of-concept studies to a system-wide focus on management, evaluation, and large-scale implementation. These variations reflect differences in health system organization, regulation, reimbursement policies, and digital readiness across countries. Long-term reimbursement strategies, interoperable digital infrastructures, and equity-oriented service design may support the sustainable implementation of online consultation services. Author summary: In this study, we examine the growing role of online consultations in digital health, particularly within telemedicine. By analysing over 2,400 research articles from 1990 to 2025, we explore how online consultations have become an important service model in healthcare worldwide. The study also highlights differences in how various countries have adopted and integrated these services. Despite widespread growth, there are still challenges, particularly in areas with limited resources, such as infrastructure and workforce capacity. Our findings indicate that sustainable online consultation services may require long-term funding models, interoperable digital systems, and service designs that promote fairness and long-term sustainability. This research is vital for healthcare leaders and policymakers, offering guidance on how to improve online consultation services and make them accessible to a wider range of patients, particularly in the post-pandemic world.
Related
- Transparency in Medical Device Applicability Determinations in Japan: An Empirical Analysis of Administrative Consultation Records and Policy Implications.
- Strategic Considerations for Video Consultation Implementation in General Practice: Qualitative Study of Organizational Interest-Holders’ Perspectives
- Strategic selection of TPD technologies based on disease pathology: from mechanistic diversity to clinical implementation
- Children’s participation in the development and evaluation of parent-led interventions for children’s mental health: a scoping review and consultation with children
- The implementation of a smart safety protection system using DL and IoT technologies
BibTeX
@article{liu2026global,
title = {{Global trends and thematic evolution in online consultation with digital health technologies: Implications for future implementation and policy development}},
author = {Jing Liu and Xiaoqian Gong and Tingting Yang and Ruoxin Xu and Liming Tan and Huizi Ye},
journal = {PLOS Digital Health},
year = {2026},
month = oct,
doi = {10.1371/journal.pdig.0001779},
url = {https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001779},
note = {CC BY},
}
RIS
TY - JOUR
TI - Global trends and thematic evolution in online consultation with digital health technologies: Implications for future implementation and policy development
AU - Jing Liu
AU - Xiaoqian Gong
AU - Tingting Yang
AU - Ruoxin Xu
AU - Liming Tan
AU - Huizi Ye
PY - 2026
DA - 2026/10/01
JO - PLOS Digital Health
DO - 10.1371/journal.pdig.0001779
UR - https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001779
AB - Online consultation has become a mainstream element of digital health within telemedicine, seeing rapid growth during the COVID-19 pandemic. Video, telephone, and secure messaging are extensively used for clinical advice, assessments, and follow-ups. However, the adoption of these technologies remains inconsistent, particularly in regions with limited infrastructure and workforce capacity. Key challenges include patient engagement, integration into clinical workflows, and the efficient allocation of resources. This bibliometric analysis covers 2,426 English-language journal articles indexed in the Science Citation Index Expanded (SCI-Expanded) within the Web of Science Core Collection (WoSCC) (1990–2025). Utilizing VOSviewer and the bibliometrix package, we mapped publication growth, international collaborations, keyword co-occurrence, and thematic evolution, with country-specific trajectories examined for the leading contributors. Countries were ranked via full counting, and joinpoint regression identified inflection points in annual publication output. Publication output grew steadily over the past 35 years, accelerating significantly after 2018, with a sharp peak from 2019 to 2022. The United States, England, China, Canada, Australia, and Germany were the main contributors and central hubs in international collaboration. The thematic focus shifted from early feasibility studies to service management, quality and outcome evaluation, barriers to implementation, equity considerations, and post-pandemic integration into standard care pathways. Country-specific trends were evident: the United States focused on telemedicine models and reimbursement mechanisms, England concentrated on primary care and general practice, and China experienced rapid growth in telehealth research post-2018. The literature on online consultation has evolved from proof-of-concept studies to a system-wide focus on management, evaluation, and large-scale implementation. These variations reflect differences in health system organization, regulation, reimbursement policies, and digital readiness across countries. Long-term reimbursement strategies, interoperable digital infrastructures, and equity-oriented service design may support the sustainable implementation of online consultation services. Author summary: In this study, we examine the growing role of online consultations in digital health, particularly within telemedicine. By analysing over 2,400 research articles from 1990 to 2025, we explore how online consultations have become an important service model in healthcare worldwide. The study also highlights differences in how various countries have adopted and integrated these services. Despite widespread growth, there are still challenges, particularly in areas with limited resources, such as infrastructure and workforce capacity. Our findings indicate that sustainable online consultation services may require long-term funding models, interoperable digital systems, and service designs that promote fairness and long-term sustainability. This research is vital for healthcare leaders and policymakers, offering guidance on how to improve online consultation services and make them accessible to a wider range of patients, particularly in the post-pandemic world.
SN - 2767-3170
ER -