Recently, the healthcare industry has witnessed a transformative shift, with telemedicine and virtual clinics emerging at the forefront of innovation. These digital healthcare solutions have gained significant attention for their potential in offering unprecedented access, convenience, and efficiency in patient care. This study investigates the factors influencing the adoption of virtual clinics among dietitians in the Klang Valley, Malaysia. using the Technology-Organization-Environment (TOE) framework. A cross-sectional survey was conducted among 155 registered dietitians practicing in the region, using a structured questionnaire based on previous studies. The study focuses on the three main factors influencing this perception of adoption: technological compatibility, organizational readiness, and government policies. Technological compatibility emerged as the most crucial factor, indicating that virtual clinic technologies must seamlessly integrate with existing workflows to be effectively utilized. Organizational readiness, including the availability of resources, training, and support, is also vital, underscoring the need for healthcare institutions to foster a conducive environment for technology adoption. Government policies play a significant role by providing the necessary regulatory support and guidelines for the deployment of virtual clinics. The study highlights that while there are potential benefits, adoption remains limited due to various barriers. Recommendations include ensuring technological alignment with current practices, enhancing organizational preparedness through targeted training and resource allocation, and leveraging supportive government policies to promote widespread adoption. The findings contribute valuable insights for policymakers, healthcare providers, and researchers to enhance the implementation of virtual health technologies in dietetic practice, aiming to improve healthcare delivery and patient outcomes in the Klang Valley and beyond.
Ahmad, A., Jamaluddin, N. A., Hashim, N., & Sidek, M. H. M. (2020). The adoption of telehealth services in Malaysia: A systematic review. International Journal of Advanced Science and Technology, 29(6s), 1159-1169.
Ahmad, B. I., Yusof, M. M., Khair, E. Z. M., & Mahayuddin, Z. R. (2020). Telehealth in Malaysia: Prospects and potential issues in dermatology. Dermatologic Therapy, 33(4), e13328. https://doi.org/10.1111/dth.13328
Alaboudi, A., Atkins, A., Sharp, B., Balkhair, A., Alzahrani, M., & Sunbul, T. (2016). Barriers and challenges in adopting Saudi telemedicine network: The perceptions of decision makers of healthcare facilities in Saudi Arabia. Journal of Infection and Public Health, 9(6), 725–733. https://doi.org/10.1016/j.jiph.2016.09.001
Ali, O., Shrestha, A., Osmanaj, V., & Muhammed, S. (2020). Cloud computing technology adoption: an evaluation of key factors in local governments. Information Technology & People, 34(2), 666–703. https://doi.org/10.1108/itp-03-2019-0119
Almathami, H. K. Y., Win, K. T., & Vlahu-Gjorgievska, E. (2020). Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: Systematic literature review. Journal of Medical Internet Research, 22(2), e16407. https://doi.org/10.2196/16407
Alshamaila, Y., Papagiannidis, S., & Li, F. (2019). Cloud computing adoption in healthcare: A TOE framework investigation. International Journal of Medical Informatics, 131, 103966. https://doi.org/10.1016/j.ijmedinf.2019.103966
Aziz, N. A. , Ng, C. J., Saidin, H., & Saidin, N. (2019). The state of health policy and systems research in Malaysia: A scoping review. PloS One, 14(5), e0216842.
Ayoobzadeh, M. (2021). Factors influencing telehealth adoption: A TOE framework analysis of Canadian hospitals. Health Policy and Technology, 10(2), 100518. https://doi.org/10.1016/j.hlpt.2021.100518
Baral, M. M., Chittipaka, V., Pal, S. K., Mukherjee, S., & Shyam, H. (2023). Investigating the factors of blockchain technology influencing food retail supply chain management: a study using TOE framework. Statistics in Transition, 24(5), 129–146. https://doi.org/10.59170/stattrans-2023-067
Bokolo, A. J. (2021 ). Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic. Irish Journal of Medical Science, 190(1 ), 1-10.
Bruintjies, A. N., & Njenga, J. (2024). Factors affecting Big Data adoption in a government organisation in the Western Cape. South African Journal of Information Management, 26(1). https://doi.org/10.4102/sajim.v26i1.1690
Cichosz, S. L., Johansen, M. D., & Hejlesen, O. (2020). Toward big data analytics: Review of predictive models in management of diabetes and its complications. Journal of Diabetes Science and Technology, 14(3), 439-450. https://doi.org/10.1177/1932296819865519
Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. Management Information Systems Quarterly, 13(3), 319. https://doi.org/10.2307/249008
Deris, J. B. (2023). Utilization of telemedicine services for mental health care in Malaysia during the COVID-19 Pandemic: A Cross-Sectional Study. Journal of Community Health Provision, 3(1), 8–13. https://doi.org/10.55885/jchp.v3i1.218
Edirippulige, S., Armfield, N. R., & Smith, A. C. (2019). Sustainability of telehealth services in rural and remote Australia: Lessons from a study of telepaediatric burns services. Journal of Telemedicine and Telecare, 25(3), 193-201.
https://doi.org/10.1177/1357633X18774960
Fakih El Khoury, C., Karavetian, M., Halfens, R. J. G., Crutzen, R., Khoja, L., & Schols, J. M. G. A. (2019). The Effects of Dietary Mobile Apps on Nutritional Outcomes in Adults with Chronic Diseases: A Systematic Review and Meta-Analysis. Journal of the Academy of Nutrition and Dietetics, 119(4), 626-651. https://doi.org/10.1016/j.jand.2018.11.010
Gagnon, M., Duplantie, J., Fortin, J., & Landry, R. (2006). Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success? Implementation Science, 1(1). https://doi.org/10.1186/1748-5908-1-18
Holmner, Å., Ebi, K. L., Lazuardi, L., & Nilsson, M. (2020). Carbon footprint of telemedicine solutions--unexplored opportunity for reducing carbon emissions in the health sector. PloS One, 15(9), e0237105. https://doi.org/10.1371/journal.pone.0237105
Hossain, N., Yokota, F., Sultana, N., & Ahmed, A. (2019). Factors influencing rural end-users' acceptance of e-health in developing countries: A study on portable health clinic in Bangladesh. Telemedicine and e-Health, 25(3), 221-229.
https://doi.org/10.1089/tmj.2018.0039
Iftikhar, W., Vistro, D. M., & Mahmood, Z. (2021). Blockchain technology adoption by Malaysian Higher Education Institutes: A perspective of Integrated TAM Model and TOE Framework. Atlantis Highlights in Computer Sciences/Atlantis Highlights in Computer Sciences. https://doi.org/10.2991/ahis.k.210913.077
Ismail, M. S., & Razak, S. A. (2023). Educating Optometry Undergraduates Through Telemedicine: The Optometry Educator’s Perspectives. International Journal of Academic Research in Progressive Education and Development, 12(1).
https://doi.org/10.6007/ijarped/v12-i1/16105
Joshi, A., Kale, S., Chandel, S., & Pal, D. (2015). Likert scale: explored and explained. British Journal of Applied Science and Technology, 7(4), 396–403.
https://doi.org/10.9734/bjast/2015/14975
Kamal, S. A., Shafiq, M., & Kakria, P. (2020). Investigating acceptance of telemedicine services through an extended technology acceptance model (TAM). Technology in Society, 60, 101212. https://doi.org/10.1016/j.techsoc.2019.101212
Khatri, V., Peterson, C. B., Kyriazakos, S., & Prasad, N. R. (2020). A Review of Telemedicine Services in Finland. In 2020 32nd International Teletraffic Congress (ITC 32) (pp. 1-8). IEEE. https://doi.org/10.1109/ITC3249928.2020.00029
Kho, J., Gillespie, N., & Martin-Khan, M. (2020). A systematic scoping review of change management practices used for telemedicine service implementations. BMC Health Services Research, 20(1), 815. https://doi.org/10.1186/s12913-020-05657-w
Kiberu, V. M., Mars, M., & Scott, R. E. (2017). Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: A literature review. African Journal of Primary Health Care & Family Medicine, 9(1), e1-e10.
https://doi.org/10.4102/phcfm.v9i1.1277
Kruse, C. S., Krowski, N., Rodriguez, B., Tran, L., Vela, J., & Brooks, M. (2018). Telehealth and patient satisfaction: A systematic review and narrative analysis. BMJ Open, 7(8), e016242. https://doi.org/10.1136/bmjopen-2017-016242
Kruse, C. S., Smith, B., Vanderlinden, H., & Nealand, A. (2017). Security techniques for the electronic health records. Journal of Medical Systems, 41(8).
https://doi.org/10.1007/s10916-017-0778-4
Malhotra, N., Zisman-Ilani, Y., Zaho, C., O'Donovan, A., Kotz, M., & Mueser, K. T. (2021). Applying the technology-organization-environment (TOE) framework to understand facilitators and barriers of tele-mental health implementation in rural settings. Journal of Technology in Behavioral Science, 6(2), 287-297. https://doi.org/10.1007/s41347-020-00182-3
Matias, J. B., & Hernandez, A. A. (2019). Cloud computing adoption intention by MSMEs in the Philippines. Global Business Review, 22(3), 612–633.
https://doi.org/10.1177/0972150918818262
Mauco, K. L., Scott, R. E., & Mars, M. (2020). Validation of an e-health readiness assessment framework for developing countries. BMC Health Services Research, 20(1), 575. https://doi.org/10.1186/s12913-020-05448-3
Mohamad Shariff, A. N., & Singam, A. S. T. (2023). Telemedicine Abortion During Covid – 19 And The Challenges In Its Applicability In Malaysia. Russian Law Journal, 11(3), 964–973. https://doi.org/10.52783/rlj.v11i3.1385
Mohd Salleh, M. I., Abdullah, R., & Zakaria, N. (2020). Evaluating the effects of electronic health records system adoption on the performance of Malaysian health care providers. BMC Medical Informatics and Decision Making, 20(1), 61.
https://doi.org/10.1186/s12911-020-1075-6
Mohd Salleh, N. F., Mahayuddin, Z. R., Jaafar, M. H., Zakaria, N. Z., & Ahmad, B. I. (2020). Factors influencing the adoption of hospital information system (HIS) among medical practitioners: A cross-sectional study in Malaysia. BMC Medical Informatics and Decision Making, 20(1), 1-11. https://doi.org/10.1186/s12911-020-01264-y
Nambiar, D., Lim, H. C., Tan, L. L., & Chan, Y. H. (2019). Driving telemedicine forward in Malaysia: An analysis from an ethical perspective. Journal of Bioethical Inquiry, 16(3), 417-427. https://doi.org/10.1007/s11673-019-09937-9
Ng, S. H., Babar, M. G., Ahmed, S. I., Hasan, S. S., & Yang, W. Y. (2023). Measuring empathic behaviour among undergraduate dietetics students. Journal of Evaluation in Clinical Practice, 30(2), 153–161. https://doi.org/10.1111/jep.13913
Ngah, A. H., Ramayah, T., Ali, M. H., & Khan, M. I. (2019). Halal transportation adoption among pharmaceuticals and comestics manufacturers. Journal of Islamic Marketing, 11(6), 1619–1639. https://doi.org/10.1108/jima-10-2018-0193
Oliveira, T., Martins, R., Sarker, S., Thomas, M., & Popovi?, A. (2019). Understanding SaaS adoption: The moderating impact of the environment context. International Journal of Information Management, 49, 1-12. https://doi.org/10.1016/j.ijinfomgt.2019.02.009
Ramírez-Correa, P., Ramírez-Rivas, C., Alfaro-Pérez, J., & Melo-Mariano, A. (2020). Telemedicine Acceptance during the COVID-19 Pandemic: An Empirical Example of Robust Consistent Partial Least Squares Path Modeling. Symmetry, 12(10), 1593. https://doi.org/10.3390/sym12101593
Ramos, I., Sousa, C., Basto, M., Rodrigues, D., & Almeida, H. A. (2021). Virtual consultations in dietetic practice: A narrative overview. Journal of Telemedicine and Telecare. https://doi.org/10.1177%2F1357633X211048748
Reeves, J. J., Ayers, J. W., & Longhurst, C. A. (2021). Telehealth in the COVID-19 Era: A balancing Act to avoid harm. JMIR. Journal of Medical Internet Research/Journal of Medical Internet Research, 23(2), e24785. https://doi.org/10.2196/24785
Reilly, M. F. O., Merghani, K., & Sheehan, E. (2020). Virtualised care and COVID-19. Irish Journal of Medical Science, 190(1), 39–40. https://doi.org/10.1007/s11845-020-02269-5
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). Free Press.
Ross, J. W., Beath, C. M., & Goodhue, D. L. (1996). Develop long-term competitiveness through IT assets. Sloan Management Review, 38(1), 31-42.
Sabrina, M. I., & Defi, I. R. (2021b). Telemedicine guidelines in South East Asia—A scoping review. Frontiers in Neurology, 11. https://doi.org/10.3389/fneur.2020.581649
Snoswell, C. L., Chelberg, G., De Guzman, K. R., Haydon, H. H., Thomas, E. E., Caffery, L. J., ... & Smith, A. C. (2020). Direct-to-patient telehealth services in Australia and their relationship with longitudinal health care costs. Journal of Telemedicine and Telecare, 26(7-8), 419-428. https://doi.org/10.1177/1357633X19869406
Stamenova, V., Budhwani, S., Soobiah, C., Fujioka, J., Khan, R., Liu, R., Halperin, I., Bhatia, R. S., & Desveaux, L. (2022). Hospital-based ambulatory clinic adoption of video and telephone visits before and during the COVID-19 pandemic: a convergent mixed-methods study. Journal of Integrated Care, 30(4), 413–433. https://doi.org/10.1108/jica-01-2022-0011
Sukardi, Hasyim, & Supriyantoro. (2021). Using the Technology-Organization-Environment Framework approach in the acceptance of telemedicine in the health care industry. European Journal of Business and Management Research, 6(3), 47–54. https://doi.org/10.24018/ejbmr.2021.6.3.837
Thong, H. K., Wong, D. K. C., Gendeh, H. S., Saim, L., Athar, P. P. B. S. H., & Saim, A. (2021). Perception of telemedicine among medical practitioners in Malaysia during COVID-19. Journal of Medicine and Life, 14(4), 468–480. https://doi.org/10.25122/jml-2020-0119
Tornatzky, L. G., & Fleischer, M. (1990). The processes of technological innovation. Lexington
Vasista, S., & Yap, H. W. (2018). Investigating the determinants of mHealth acceptance in rural areas of Thailand: A multi-group study. International Journal of Innovation and Technology Management, 15(6), 1850043.
https://doi.org/10.1142/S0219877018500430
Zhu, K., Kraemer, K. L., & Xu, S. (2006). The process of innovation assimilation by firms in different countries: A Technology Diffusion Perspective on E-Business. Management Science, 52(10), 1557–1576. https://doi.org/10.1287/mnsc.1050.0487
Yin, C. W., Hao, Y., Zhao, Y., & Xu, X. (2022). Exploring factors influencing patients' intention to use telemedicine services: An extended technology acceptance model. International Journal of Environmental Research and Public Health, 19( 5), 2672.
Bawazir, A. A., Lee, H. P., Abidin, S. M. S. Z., Tang, W. N., & Manayokhen, K. (2024). The Perception of Virtual Clinics Adoption among Dietitians in Klang Valley, Malaysia. International Journal of Academic Research in Business and Social Sciences, 14(12), 4518–4532.
Copyright: © 2024 The Author(s)
Published by Knowledge Words Publications (www.kwpublications.com)
This article is published under the Creative Commons Attribution (CC BY 4.0) license. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this license may be seen at: http://creativecommons.org/licences/by/4.0/legalcode
