Utilization of Telemedicine Among Offshore Health Care Workers and Its Influencing Factors
Clinical Snapshot
PICO Framework
| P — Population | Offshore healthcare workers employed by a single Malaysian company providing offshore medical services |
| I — Intervention | Telemedicine utilisation (self-reported use of telemedicine in clinical practice) |
| C — Comparator | Non-utilisation of telemedicine among the same workforce |
| O — Outcomes | Prevalence of telemedicine utilisation and associated sociodemographic, attitudinal, and behavioural factors as measured by the validated Malay Telemedicine Acceptance Model (TAM) Questionnaire |
Bottom Line
This cross-sectional survey of 73 offshore healthcare workers from a single Malaysian company reports that 65.8% utilise telemedicine, with Chinese and Indian ethnicity, positive attitudes, and high behavioural intention identified as significant predictors. While the study addresses a clinically important and underexplored population, its findings must be interpreted with considerable caution. The sample size is critically small for the statistical methods employed, and the reported adjusted odds ratios exceeding 30 are almost certainly artefacts of sparse data bias or model overfitting rather than genuine effect sizes. The absence of confidence intervals for all key estimates is a serious transparency failure. Single-company recruitment limits generalisability, and important confounders — including clinical role, telemedicine infrastructure access, and prior training — are unaddressed. The cross-sectional design precludes causal inference. For Australian offshore health practitioners and occupational health policymakers, this study provides limited actionable evidence. Larger, multi-site, prospective studies using objective utilisation data and robust confounder adjustment are needed before these findings can meaningfully inform workforce development or telemedicine implementation strategies in offshore settings.
Key Findings
P Value: Ethnicity (Chinese): p=0.045; Ethnicity (Indian): p=0.037; Attitude: p=0.004; Behavioural intention: p<0.001
Effect Size: Chinese ethnicity: AOR 32.11 vs. Malay (p=0.045); Indian ethnicity: AOR 33.51 vs. Malay (p=0.037); Good attitude toward telemedicine: AOR 11.84 (p=0.004); High behavioural intention: AOR 25.80 (p<0.001)
Primary Outcome: 65.8% of offshore healthcare workers (n=73) reported using telemedicine in their clinical practice
Nnt Or Sensitivity: Not applicable for this cross-sectional prevalence and association study; no NNT, sensitivity, or specificity data reported
Confidence Interval: Not reported for any adjusted odds ratio — a critical omission
Clinical Application
The TAM framework is feasible for assessing telemedicine acceptance in occupational health settings and could be adapted for pre-deployment assessments of offshore medical personnel. However, the study's findings are insufficient to guide specific workforce or technology interventions given the methodological limitations Australia has a substantial offshore oil and gas workforce, particularly in Western Australia (Northwest Shelf, Browse Basin) and the Northern Territory, where telemedicine is a cornerstone of occupational health delivery under NOPSA/NOPSEMA regulatory frameworks. The RACGP has published standards for telehealth in remote and rural settings, and the TGA regulates software-based medical devices including telemedicine platforms. The Australian offshore context differs significantly from Malaysia in regulatory environment, workforce demographics, and infrastructure quality. This study's findings — particularly the ethnic predictors — are not directly transferable to the Australian setting. Australian offshore health practitioners should refer to NOPSEMA guidelines, RACGP Telehealth Standards, and the broader Australian telehealth evidence base rather than this single-company Malaysian study. Offshore healthcare workers in Malaysia employed by a single company; findings should not be extrapolated beyond this specific context without replication in larger, multi-site samples
Abstract
INTRODUCTION: Telemedicine has become an essential tool for providing health care to offshore workers. Despite its advancements, there is still a lack of understanding about its optimal use and the factors affecting it among health care providers in offshore settings. The objective of this work was to study and determine the level of telemedicine utilization among offshore health care workers and its associated factors in Malaysia. METHODS: In this cross-sectional study, online questionnaires were distributed to health care workers involved in offshore medical services. The questionnaire includes sociodemographic information and the validated Malay version of the Telemedicine Acceptance Model (TAM) Questionnaire. A total of 73 offshore health care workers were recruited from a local company using universal sampling. Data analysis involved descriptive statistics as well as simple and multiple logistic regression. RESULTS: A total of 65.8% of offshore health care workers reported using telemedicine in their practice. Multiple logistic regression analysis indicated that Chinese and Indian workers were significantly more likely to use telemedicine compared with Malay workers, with adjusted odds ratios of 32.11 (p = 0.045) and 33.51 (p = 0.037), respectively. Workers with a good attitude toward telemedicine had 11.84 times higher odds of utilization (p = 0.004), while those with high behavioral intention were 25.80 times more likely to use telemedicine compared with their counterparts with low behavioral intention (p < 0.001). CONCLUSIONS: A majority of offshore health care workers utilize telemedicine, with Chinese and Indian ethnicity, good attitude, and high behavioral intention significantly predicting its utilization.
References
- 1.Netto, G., & Yew, S. Q. (2026). Utilization of telemedicine among offshore health care workers and its influencing factors. Telemedicine Journal and e-Health: The Official Journal of the American Telemedicine Association. Advance online publication. https://doi.org/10.1177/15305627261440757
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