The novel coronavirus disease-19 (COVID-19) pandemic has altered several aspects such as economy, society, and healthcare system. Healthcare systems worldwide are racing to adopt virtualized consultations and treatment approaches [1]. Telehealth programs such as virtualized consultations and treatment approaches overcome physical barriers to provide patients and caregivers access to convenient medical care [6]. As a result, the prevalence of virtual care has rapidly increased thought out the world during this COVID-19 pandemic [1]. However, there are certain concerns regarding the use of virtual healthcare system, reflecting the need of an assessment of level of satisfaction of people for these virtual interface platforms [2]. For example one study was recently conducted to assess the knowledge, perception and willingness for virtual consultation and telemedicine [10]. Authors reported that lack of training and lack of connection between information technology expert and clinicians, lack of training in patients, patient’s care about their privacy, etc were the main problems associated with virtual consultations and telemedicine.

Despite of the facts, one study was previously conducted in Saudi Arabia, where authors evaluated the physician’s willingness towards adopting telemedicine in clinical practice [10]. Authors reported that most of the participants showed positive perceptions of virtual health care and are willing to adopt it in clinical practice. However, there are several major barriers such as privacy issues, lack of training, cost and issues related to information and communication technology for the adoption of virtual health care system.

One study was conducted in British Columbia, Canada regarding the satisfaction of patients about virtual visits and patient centered care [14]. This study reported that about 93.2% of respondents saying their virtual visits were of high quality, 91.2% participants reporting their virtual visits as “very” or “somewhat” helpful to resolve their health issue, and 79% were having confidence in the security and privacy of this virtual healthcare system. This is somewhat in line with findings of our current study, where responses of majority of the participants reflect that they were comfortable and satisfied with virtual health care. These findings together support for the adaptation of virtual health care system in the clinical settings.

In current study the level of satisfaction towards virtual healthcare was high (83%). This echoes the finding of previous study published about patient satisfaction toward a virtual healthcare in endocrinology clinics in Saudi Arabia [13] Authors reported that the level of satisfaction for virtual health care system was about 80.4%. A study was conducted in Chile aimed to assess patient satisfaction with tele-neurology and it was found that the level of satisfaction was high about 97% [15]. One study evaluated usability and satisfaction of telemedicine for head and neck ambulatory visits [16]. This study reported that the patients were highly satisfied with telemedicine. Another study was aimed to characterized telemedicine and correlates it with patient’s level of satisfaction [17]. This study showed that the overall 85% of patients rated their satisfaction with their telemedicine physician five stars on scales of 0 to 5. About the problems participants faced during virtual session, long waited time was on top followed by difficult to clarify their concerns and internet connection problems. Our findings are supported by another recent study in Saudi Arabia and nearly half of the participants wanted to continue using virtual services even after the COVID-19 pandemic was over [18]. More effort should be made to increase patient awareness and knowledge about virtual clinics. Saudi Arabian citizens believe that telemedicine saves time, labour and costs and is an effective tool to treat coronavirus patients at a safe distance. [19]

Our findings are also comparable to the Argentina study which created and implemented a virtual care program for patients with URTI during the epidemiological outbreak. [20]. Based on their work, they deemed this new care strategy could help prevent hospital overcrowding, reduce long delays inattention (or at least offer the possibility of waiting at home), avoid unnecessary referrals, and limit infections in waiting rooms. The inability to meet the health-care professional face-to-face was reported by 53.8% as the most important disadvantage in another cross-sectional study conducted among patients who had experienced virtual clinics in primary healthcare centers in Riyadh, Saudi Arabia [21].

The key advantage of telemedicine is its mobility, and it presented a perfect match in the current public health policy of social distancing and cancellation of non-urgent consultations and surgeries [22]. The virtual clinic services in Saudi Arabia provides a wide range of health-care consultations in different fields such as family medicine, general surgery, ophthalmology, ENT, Obstetrics /Gynecology, dermatology, chronic diseases, pediatrics and vaccinations However, there are no current data on the exact number of virtual clinics. [23]. The Sehhaty mobile application can be used by a patient to directly book an appointment if the service is available in the healthcare facility. The “Seha Virtual Hospital”, supports a total of 130 hospitals around the country and provides specialized virtual clinics such as psychiatry, cardiac, endocrine, and diabetes clinics [24]. Other applications (TETAMMAN, TABAUD, TAWAKKALNA) that have been launched have improved the quality of using telemedicine activities and facilitated all health services [25]. This accelerated digital health innovation in Saudi Arabia and allowed patients to recognise the benefits of digital health. This has huge potential for increasing continuous patient engagement with PHCs [26].

Specific patient education experiences might be most helpful for patients in learning about virtual care. People with lived experience could be resources for educating patients and community-based knowledge sharing was also encouraged (27). Our sample size had less number of older people, the probable reason is they were less likely to have used or familiar telehealth. The results of an Australian population support this need for better support for older people to access remote modes of care (28). Willingness to use telemedicine in future was high in the recipients as well as the providers of healthcare during COVID-19 pandemic in UK(29). The findings from a Saudi study showed that 70.6% of participants were aware of the existence of virtual clinics and 34.6% of participants were post-pandemic users (30). Over 90% Saudis preferred having a virtual appointment over an in-person visit according to a recent study. About half had telephone consultations, while about a third had video calls through hospital-provided platforms; >90% found virtual appointments useful and convenient, and 97.4% were satisfied with their remote consultation experience despite the technical interruptions. (31). Telemedicine has developed rapidly during the COVID-19 pandemic, and its satisfaction measurement factors may be changed in the future. Du, Y. et al developed a scale for evaluating patient satisfaction with telemedicine by applying multidimensional constructs to capture patient satisfaction comprehensively, which involves nine dimensions, such as humanistic care, doctor-patient communication, service efficiency, diagnosis and treatment result, ease of use, system quality, usefulness, privacy and security, overall satisfaction. This scale could be a meaningful tool for future studies (32).

The limitation of this study is the implicit bias usually present in this descriptive, online voluntary response survey, and the relatively low response rate. The dropout rate of participants raises concerns about sample representativeness and potential bias. Moreover, the study’s reliance on voluntary participation introduces self-selection bias, as individuals who are more satisfied or dissatisfied with virtual healthcare may be more inclined to participate. The inclusion criteria focus primarily on technological access and comfort rather than broader factors that could influence patient satisfaction, such as socioeconomic status or health literacy. This narrow focus may limit the generalizability of the findings. Other study limitation is a small sample size and limitation of generalizability of the results due to the small sample size. We hope in the future to have all the required resources to do multicentric /nationwide studies with a larger sample size. However, as the importance of patient satisfaction continues to increase in the provision of health care, this work is considered to be an important step in this direction, particularly in Saudi Arabia.