Introduction
Researchers and clinicians increasingly rely on validated tools to evaluate digital health solutions. Consequently, the Telehealth Usability Questionnaire (TUQ) has emerged as a leading instrument since its publication in 2016. Developed by Bambang Parmanto and colleagues, the TUQ has garnered more than 700 citations on Google Scholar. Moreover, it provides a comprehensive assessment of telehealth implementations across videoconferencing, computer-based, and mobile platforms.
Therefore, this article offers researchers and authors of scientific studies a detailed overview of the TUQ, including its structure, psychometric properties, applications, scoring methods, and available translations.
Key Features of the Telehealth Usability Questionnaire (TUQ)
Purpose and Use
Overall, the primary purpose of the TUQ is to evaluate the usability of telehealth implementations and services. In addition, this includes assessing both the quality of the telehealth system/user interface and the quality of the telehealth interaction between patients/clients and clinicians. Consequently, by utilizing the TUQ, clinicians and researchers can effectively identify patients who may experience technological barriers during remote care. Ultimately, this leads to more targeted interventions and improved patient management. Therefore, the questionnaire provides crucial insights into how system reliability and design factors influence the overall experience and interpretation of digital healthcare delivery.
Target Population
Notably, the TUQ is validated for use with adults aged 18 and older, including:
Young adults (18–24 years)Middle-aged adults (25–44 years)Older adults (45–64 years)Older people (65+ years)Consequently, it suits diverse telehealth users in clinical, research, and remote care settings.
Structure
Importantly, the TUQ consists of 21 items, each designed to capture different facets of digital health usability. Furthermore, these items typically load onto six main subscales:
Usefulness: 3 items covering perceived access to healthcare services, time savings, and meeting healthcare needs.Ease of Use & Learnability: 3 items addressing how simple it is to learn and operate the platform.Interface Quality: 4 items focusing on interface pleasantness, formatting, and overall functionality.Interaction Quality: 4 items evaluating communication with the clinician and similarity to in-person interactions.Reliability: 3 items covering audio/video clarity and recovery from system errors.Satisfaction & Future Use: 4 items detailing comfort with telehealth communication and willingness to use services again.Moreover, these distinct domains allow for a nuanced understanding of a patient's digital care experience, facilitating tailored system interventions.
Scoring Method
Each of the 21 items on the TUQ is rated on a 7-point agreement Likert scale
1 ("Strongly Disagree")7 ("Strongly Agree")Plus a "Not Applicable" (N/A) optionFurthermore, usability is determined by calculating the total score and then finding the average of responses across all questionnaire statements. Similarly, subscale scores are calculated by averaging the items within each respective subscale.
Importantly, higher overall average scores indicate higher perceived usability of the telehealth system. Notably, official cut-off scores are not provided in the literature; scores are typically interpreted dimensionally rather than categorically.
Administration Format
The TUQ is a self-administered questionnaire, making it straightforward and efficient to handle. Furthermore, the questionnaire can be administered via:
Paper-based formatsDigital (online) environmentsMoreover, it typically takes 5 to 10 minutes for patients to complete. Therefore, this brevity makes it highly practical for use in busy clinical settings and large-scale research studies.
Applications of the Telehealth Usability Questionnaire (TUQ)
Notably, The TUQ has broad applications in both clinical and research domains:
Monitoring: Clinicians can reliably track a patient's comfort and system stability over time, particularly during ongoing remote treatment interventions.Research Endpoint: The TUQ functions as a valuable outcome measure in clinical trials and observational studies investigating the feasibility and acceptability of digital care across diverse patient populations.Languages and availability
The TUQ is available in multiple languages, including:
EnglishArabicGermanPortugueseTurkishFilipinoIndonesianOther LanguagesTherefore, this extensive linguistic availability enhances its utility in multicultural clinical settings and facilitates international research collaborations.
Reliability and Validity
Notably, the TUQ demonstrates highly reliable and valid properties. The original validation study reported good to excellent internal consistency, with Cronbach’s α ≥ 0.79 (raw) and ≥ 0.81 (standardized) across subscales. Moreover, various international studies have further supported its convergent validity, showing appropriate correlations with related measures of technology acceptance.
The Original Validation Study linkArabic Validation Study linkGerman Validation Study linkBrazilian Portuguese Validation Study linkTurkish Validation Study linkFilipino Validation Study linkIndonesian Validation Study linkLimitations and Considerations
Despite its strengths, the TUQ has a few limitations:
Self-report measure: As a self-report questionnaire, the results may be influenced by a patient’s subjective interpretation, technical literacy, or social desirability bias.Social Desirability Bias: Respondents may alter answers to appear in a favorable light. In telehealth, patients often overreport satisfaction or minimize technical struggles to please providers or avoid looking technologically illiterate.Other Versions And Related Questionnaires
Importantly, while the original 21-item TUQ remains widely used, some research has explored modifications or shorter forms, such as:
The Telehealth Usability and Perceived Usefulness Short Questionnaire (TUUSQ)The 27-item hybrid TUQ-MAST-KZ version.Additionally, the TUQ can be used alongside other satisfaction or usability scales, like:
Telemedicine Satisfaction Questionnaire (TSQ)Telemedicine Patient Questionnaire (TMPQ)Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ)Technology Acceptance Model (TAM)IBM Post-Study System Usability Questionnaire (PSSUQ)Additional Resources
The original validation study linkYou can access the questionnaire as a PDF through this linkFor inquiries, contact primary author Bambang Parmanto at parmanto@pitt.eduUniversity of Pittsburgh Technology Licensing PageFrequently Asked Questions (FAQ)
Who can use the TUQ?Clinicians, researchers, and healthcare providers use the TUQ for adults (≥18 years) participating in or evaluating telehealth services.
How long does it take to complete the TUQ?Participants typically complete the TUQ in 5-10 minutes, supporting efficient data collection in busy research and clinical environments.
How is the TUQ administered?Teams can administer it via paper-based or digital (online) formats, offering flexibility for various study designs.
Is there any cost to using the TUQ?The TUQ is free for non-commercial education and research purposes. Importantly, commercial use or commercially sponsored research requires licensing through the University of Pittsburgh Innovation Institute.
A Word From ResRef about the Telehealth Usability Questionnaire (TUQ)
Overall, the TUQ is a practical questionnaire for assessing the usability of telehealth systems and services from the user perspective, especially in patient/clinician telehealth settings. Furthermore, The original development study reported good to excellent internal consistency across subscales, with Cronbach’s α ranging from 0.79 to 0.92. Therefore, it should be interpreted as a usability and service-evaluation tool, not as a diagnostic or clinical screening instrument, and it has no official universal cut-off scores.
References
Parmanto, B., Lewis, Jr., A. N., Graham, K. M., & Bertolet, M. H. (2016). Development of the Telehealth Usability Questionnaire (TUQ). International Journal of Telerehabilitation, 8(1), 3–10. LinkShebli, K. H., Alshehri, F. H., Alshehri, Y. S., Alshehre, Y. M., Almeheyawi, R. N., & Alzahrani, H. (2025). Cross-cultural adaptation and psychometric properties of the Arabic version of the Telerehabilitation Usability Questionnaire. Annals of Medicine, 57(1). LinkZimmermann, J., Morf, H., Scharf, F., Knitza, J., Moeller, H., Muehlensiepen, F., Nathrath, M., Orlemann, T., Voelker, T., & Deckers, M. (2024). German Version of the Telehealth Usability Questionnaire and Derived Short Questionnaires for Usability and Perceived Usefulness in Health Care Assessment in Telehealth and Digital Therapeutics: Instrument Validation Study. JMIR Human Factors, 11, e57771. LinkSantos, M. R., Malaguti, C., Cabral, L. A., Soares, A. L., Neves, L. H. G., Sena, L. dos A., Parmanto, B., Sauers, A. L., José, A., & Oliveira, C. C. (2023). The Brazilian version of the telehealth usability questionnaire (telehealth usability questionnaire Brazil): translation, cross-cultural adaptation, and psychometric properties. Revista Da Associação Médica Brasileira, 69(12). LinkÖzden, F., Özkeskin, M., Sarı, Z., Ekmekçi, Ö., & Yüceyar, N. (2021). The Reliability and Validity of the Turkish Version of the Telehealth Usability Questionnaire and the Telemedicine Satisfaction Questionnaire in Patients with Multiple Sclerosis. Neurological Sciences and Neurophysiology, 38(3), 173–179. LinkCabalonga, A. J. M., Cabangon, O. M. M., Cabra, J. A. T., Cabral, I. L. C., Cagampan, Ma. F. F., Cajano, N. L. A., Calixto, J. U., Guison-Bautista, Ma. T. T., Calimag, Ma. M. P., Fajilan, W. F., & Trogo, J. D. V. (2023). Translation, Adaptation, and Validation of the Filipino Version of the Telehealth Usability Questionnaire (TUQ-F). Journal of Medicine, University of Santo Tomas, 7(1), 1123–1137. LinkOctavius, G. S., & Yanto, T. A. (2023). Validation of Indonesian Version of Telehealth Usability Questionnaire (TUQ). Journal of Community Empowerment for Health, 6(2), 98. Link