OBJECTIVES: The adoption of virtual health consultations remains at an early stage, with low utilization rate in Saudi Arabia. Understanding factors influencing their utilization may help enhance their adoption. This study aims to identify these factors and take corrective actions to increase the adoption and reduce visits to primary healthcare centers (PHCs).

METHODS: This study utilized a mixed-methods approach to understand the barriers affecting virtual consultation (VC) adoption, including qualitative interviews with patients and physicians to gain insights into experiences with and attitudes towards VCs. We held focus groups with physicians to share their experiences and concerns. We observed some VCs to assess quality and report any obstacles. Moreover, we observed the integration and workflow of VCs at PHCs. Using thematic analysis and service blueprints of the VC process to identify potential failure points, we identified barriers and developed a set of recommendations to enhance the adoption. To evaluate the results’ efficacy, we piloted these interventions in two high-volume PHCs with low baseline virtual adoption.

RESULTS: We found four overarching themes: infrastructure, walk-in visits, specialized virtual clinics, and user experience. As a result, we advised: enhancing infrastructure elements such as internet connectivity, devices, and dedicated rooms for virtual care; transitioning traditional walk-in visits to VCs where appropriate; establishing specialized virtual clinics (e.g. smoking) to meet specific patient needs and expand virtual care scope; and improving the user experience and accessibility of virtual care platform. Customizing solutions to each PHC's context yielded significant increases in VCs over one year, reaching peak adoption rates of 25.8% in PHC-1 from a baseline of 7% and 21.7% in PHC-2 from 2.8%.

CONCLUSIONS: Multiple factors influence VCs adoption in Saudi Arabia. This study offers valuable insights into patients’ and physicians’ needs to inform strategies for promoting the integration of virtual healthcare services into healthcare systems.