Accepted for/Published in: JMIR Human Factors
Date Submitted: Sep 17, 2025
Date Accepted: Jul 22, 2026
User-Centred Virtual Clinic Services for Remote, Rural, and Underserved Sub-Saharan Africa: A Pilot Study
ABSTRACT
Background:
Virtual clinics allow doctors to connect to patients in difficult-to-reach locations. While this can result in improved access to care, implementing existing virtual clinics in these locations is difficult due to their contextual constraints. To address these challenges, a virtual clinic system for remote, rural, and underserved areas was developed based on user-centred design principles. To complete the user-centred design cycle, the developed system was then implemented and evaluated in the target contexts.
Objective:
The objective of this research was to conduct a pilot study with the developed user-centred virtual clinic system to evaluate its performance in resource-limited settings. Patient, doctor, and nurse feedback was collected to understand how the virtual clinic system and implementation strategy might be improved before long-term implementation.
Methods:
A pilot study was conducted at two healthcare facilities in South Africa – one underserved public primary health clinic in the city of Cape Town, and one remote occupational health clinic in the Northern Cape Province. Doctor and nurse dyads participated in using the system to consult with real patients in each clinic. Patients received both virtual and physical examinations by the same doctor, and these two consultations were compared to one another. Surveys were conducted to gather patient feedback pre- and post-virtual clinic consult. Observations of system usage were collected, and doctor and nurse participant interviews were conducted at the conclusion of each day. The qualitative data were analysed through thematic analysis to identify key themes related to the implementation of virtual clinic services in remote, rural, and underserved areas.
Results:
A total of 12 patient consultations were conducted using the virtual clinic system across the two health care facilities. Two doctors and two nurses participated in the study as users. Doctor and nurse confidence in using the system was observed to increase over time. Doctors reported confidence in the virtual consultation format to diagnose patients remotely. Patient satisfaction was demonstrated, and potential barriers to successful virtual consults were identified.
Conclusions:
The results from this pilot study indicate that virtual clinic consultation is possible in low-resource settings using the developed virtual clinic system. This system can support patients in remote, rural, and underserved areas to receive certain healthcare services from a doctor without the doctor having to be physically present in the facility. The results encourage further scaling of the system to support long-term implementation in low-resource health clinics in South Africa and other sub-Saharan African countries.
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