Background: Telemedicine has emerged as a critical healthcare delivery modality, particularly accelerated by the COVID-19 pandemic. Despite its potential to improve access and reduce costs, implementation barriers persist, and patient satisfaction outcomes remain variable across different healthcare contexts.

Objective: This study investigates the technological, organizational, and patient-related barriers to telemedicine implementation and examines their impact on patient satisfaction in diverse healthcare settings.

Method: This study uses a simulated dataset created for academic training purposes. A sequential mixed-methods design was employed combining survey data from 380 patients and 120 healthcare providers with performance metrics from 25 healthcare organizations over 12 months.

Key Results: Technological barriers showed the strongest negative association with patient satisfaction (β = -0.38, p < 0.001), followed by organizational readiness barriers (β = -0.32, p < 0.001). Patient-related barriers demonstrated a weak negative relationship (β = -0.15, p > 0.05). Integrated care models showed 35% higher patient satisfaction scores.

Conclusion: Successful telemedicine implementation requires addressing technological infrastructure and organizational readiness barriers through targeted investments and change management strategies. Patient satisfaction improves most significantly when telemedicine is integrated into comprehensive care models rather than implemented as standalone services.