Video or In-Clinic Consultation? Selection of Attributes as Preparation for a Discrete Choice Experiment Among Key Stakeholders

  • Irit ChudnerEmail author
  • Margalit Goldfracht
  • Hadass Goldblatt
  • Anat Drach-Zahavy
  • Khaled Karkabi
Original Research Article



Video consultations (VCs) provide increased accessibility of primary care to remote areas and overall improved care for chronic patients. They also contribute to higher patient satisfaction and improved resource management. Despite these benefits, VC integration into the health system is complex and slow. Understanding the VC-related preferences of three key stakeholders—patients, primary care physicians (PCPs) and policy makers (PMs)—is crucial for achieving optimal implementation.


The aim of this study was to select relevant attributes and levels for a discrete choice experiment (DCE) of stakeholders’ choice—VC or traditional in-clinic consultation (I-CC) in primary care.


Ten semi-structured focus group interviews and 24 semi-structured individual interviews were conducted. Data analysis was performed inductively, using a thematic content analysis method. An attribute-ranking exercise was then conducted based on the results gleaned from the interviews.


The most important attributes when choosing either VC or I-CC, for both patients and PMs, were: (1) time to next available appointment; (2) time in line before consultation; (3) relationship to PCP; and (4) quality of consultation. For PCPs, the most important attributes were: (1) time in line before consultation; (2) patient’s self-management ability; (3) consultation purpose; (4) quality of consultation.


This qualitative study identified attributes and levels for a DCE quantitative stage among three key stakeholder groups. It adds to the literature of examples of developing DCE attributes, and to literature about the stakeholder benefits in the area of telemedicine in healthcare.



The authors would like to thank all of the study participants, i.e. patients, PCPs, executive managers and PMs.

Author Contributions

IC, MG, HG, ADZ and KK contributed to the study design; IC, HG, ADZ and KK conducted the analysis and interpretation of the results and reviewed the manuscript; and IC and HG contributed to the data collection, facilitated the focus groups and interviewed PMs.

Compliance with Ethical Standards


This study was part of a larger study entitled “Family Medicine—Quo Vadis?”, funded by The Israel National Institute for Health Policy Research.

Ethical Approval

All procedures followed were in accordance with the ethical approval for the study granted by the Haifa University Ethics Committee.

Informed Consent

Informed consent was obtained from all patients and primary care practitioners in focus groups prior to being included in the study.

Conflict of interest

Irit Chudner, Hadass Goldblatt, Anat Drach-Zahavy and Khaled Karkabi declare no conflicts of interest relevant to the contents of this article.

Supplementary material

40271_2018_318_MOESM1_ESM.docx (27 kb)
Supplementary material 1 (DOCX 26 kb)
40271_2018_318_MOESM2_ESM.doc (70 kb)
Supplementary material 2 (DOC 70 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Family Medicine Department, The Ruth and Bruce Rappaport Faculty of MedicineTechnion - Israel Institute of TechnologyHaifaIsrael
  2. 2.Department of Nursing, Faculty of Social Welfare and Health SciencesUniversity of HaifaHaifaIsrael

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