Recently many small and mid-sized hospitals are closing down or experiencing financial difficulties. As a result, in order to provide exceptional service that would increase their competitiveness, they implemented telemedicine service for the prescription of medicine necessary before a colonoscopy. This study is an analysis of how telemedicine service affects patient satisfaction. Through the focus group interview (FGI) of medical service providers, regarding telemedicine service and face-to-face service, it was appraised that telemedicine service was more effective than face-to-face service. Afterward, a second survey aimed at endoscopy patients was conducted in order to find out the value of telemedicine service. First, through the analysis of the three main factors of telemedicine service, conclusions were drawn(safety/reliability, convenience/rapidity, and economics). A follow-up analysis showed that convenience/rapidity had the greatest effect on telemedicine service satisfaction. Next the factors of the quality of medical service were analyzed and 3 main factors were deduced (the superiority of the external and internal environments/appropriateness, superiority of the medical team, telemedicine service). A follow-up analysis found that telemedicine service had the greatest effect on patient satisfaction. This study found that providing exceptional medical service that utilizes telemedicine service would improve patient satisfaction. Therefore, we would be able to form a strategic plan that would strengthen the competitiveness of small and mid-sized hospitals.