Methodologies for assessing telemedicine: A systematic review of reviews

► There is concern about appropriateness of methodologies for assessments of telemedicine. ► The review assesses methodologies commented in systematic reviews of telemedicine studies. ► These reviews recommend: (a) more rigorous and larger summative studies, preferably RCT's with pre defined outcome measures; (b) summative methodologies considering telemedicine as complex innovations and outcomes as partly contingent on values and contexts; and (c) formative methodologies where telemedicine is studied as ongoing collaborative achievements both producing and denominating new and effective telemedicine innovations.