Patient satisfaction and experience for virtual consultation services in the Malaysian government health clinics: A review.

Abstract

Introduction: Virtual consultation (VC) has emerged as a vital mode of healthcare delivery, particularly accelerated by the COVID-19 pandemic. The Ministry of Health (MOH) has progressively implemented VC services across government health clinics in Malaysia, guided by national digital health strategies. As VC becomes integral to primary care, evaluating patient satisfaction and experience becomes essential to ensure service quality. Despite the global availability of various tools, a lack of validated instruments remains in the context of Malaysian primary care, particularly in Malay. This narrative review aims to identify existing instruments used to assess patient satisfaction and experience with VC, evaluate their relevance and psychometric robustness, and highlight gaps in measurement, particularly for public primary care in Malaysia.

Materials and methods: A systematic search was conducted using PubMed, employing a comprehensive search strategy combining MeSH terms and text words related to "patient satisfaction," "patient experience," "surveys and questionnaires," and "telemedicine." The search was restricted to English-language publications involving adult populations and returned 876 articles. After applying the free full-text filter, 397 articles were screened. Title and abstract screening yielded 83 potentially eligible studies, from which only eight were found to involve original development or adaptation of relevant instruments and were included for further analysis.

Results: Among the seven included studies, most questionnaires were focused primarily on domains related to usability and acceptability, such as interface ease, access, and convenience. However, few instruments addressed core components of clinical care quality, including communication, diagnostic confidence, care continuity, and coordination. Furthermore, none of the reviewed questionnaires underwent complete validation and reliability assessment within the context of Malaysian primary care. Four studies were conducted in Malaysia; however, these either lacked robust validation processes or focused solely on acceptability. Additionally, no tools were validated in Malay or tailored specifically to the cultural and healthcare delivery context of Malaysia's government clinics.

Conclusion: The findings reveal a significant methodological gap in assessing patient satisfaction and experience with VC in Malaysian primary care. Existing tools largely derive from models focused on technology usability or service acceptability, with limited attention to the clinical dimensions of virtual care. Instruments such as the Telemedicine Satisfaction Questionnaire (TSQ), the Telemedicine Usability Survey (TUS) and the Service User Technology Acceptability Questionnaire (SUTAQ) offer partial frameworks but lack comprehensive validation or contextual adaptation. In Malaysia, while efforts have been made to develop VC-related surveys, these are insufficiently validated and often lack specificity for primary care. Moreover, tools currently in use do not capture the broader service quality domains emphasised by frameworks like SERVQUAL or Picker's Patient Experience Principles. As VC services expand in Malaysian public healthcare, there is an urgent need to develop and validate culturally appropriate, linguistically accessible, and psychometrically sound questionnaires to assess patient satisfaction and experience. These instruments must integrate both technological usability and the core clinical components of healthcare delivery. Such efforts are essential to guide quality improvement and ensure that VC services align with patients' needs and expectations in the primary care setting.