Bridging the Readiness-to-Practice Gap in Telemedicine: A Cross-Sectional Study of Outpatients at a Malaysian Public Tertiary Hospital.
TL;DR
The authors' population faces a significant readiness-to-practice gap, mainly due to age-related digital barriers and limited experience, so addressing these challenges through structured onboarding can help ensure equitable access to health care for all, thereby encouraging collective action.
Abstract
INTRODUCTION Telemedicine plays a key role in Malaysia's National Digital Health agenda, but the population's readiness at the national level in public tertiary hospitals remains poorly understood. Identifying gaps in knowledge, attitudes, and practices is crucial to ensuring fair and successful telemedicine implementation, especially in semiurban areas where digital skills vary widely.
Methods
A cross-sectional study of 255 adult outpatients was conducted at a public tertiary hospital in North-East Malaysia, focusing on those who visited the family medicine, medical, orthopedic, and surgical outpatient clinics. Systematic random sampling was used to select participants. The study utilized a validated Bahasa Malaysia questionnaire to assess patients' knowledge, attitudes, and practices regarding telemedicine. Multivariable logistic regression analysis was conducted to identify sociodemographic factors predicting each readiness domain.
Results
While 60.4% of participants demonstrated good knowledge and 75.7% held favorable attitudes, understanding how these readiness levels can guide targeted interventions remains limited. Only 16.9% had prior telemedicine experience, and 52.2% showed adequate practice readiness based on the composite score. Younger age was independently associated with greater knowledge (adjusted odds ratio [AOR] 0.95; 95% confidence interval [CI] 0.93-0.98), more favorable attitudes (AOR 0.95; 95% CI 0.92-0.97), and greater practice readiness (AOR 0.97; 95% CI 0.95-0.99). The strongest predictor of practice readiness was prior telemedicine exposure (AOR 3.11; 95% CI 1.42-7.43).
Discussion
Our population faces a significant readiness-to-practice gap, mainly due to age-related digital barriers and limited experience. Addressing these challenges through structured onboarding can help ensure equitable access to health care for all, thereby encouraging collective action.