Client acceptance of telemedicine

This dissertation analyzes the patterns and determinants of expressed willingness to use telemedicine. Data were collected from three counties in rural Georgia: Dodge, Appling, and Elbert. Dodge County (experimental) already had a telemedicine facility. Appling County (experimental) did not have telemedicine but was slated for telemedicine in the near future. Elbert County (control) did not and will not have telemedicine. A research model is proposed based on the diffusion of innovation literature. The study focuses on determining the effects of the following five groups of predictors on expressed willingness to use telemedicine for minor and serious health problems: perceived attributes of telemedicine, knowledge of (exposure to) telemedicine, socio-demographic characteristics, felt needs/problems, and attitudes toward technology. The statistical significance of their effects on willingness to use telemedicine is established with logistic regression, and subsequently confirmed and quantified with a path analysis utilizing linear regression. In general, the acceptance level is high for both minor (76%) and serious health problems (82%). The study reveals that perceived attributes of telemedicine are the most important predictors of willingness to use telemedicine for both minor and serious problems. A positive perception of telemedicine has a positive influence on willingness to use it. While knowledge of telemedicine has both direct and indirect effects on willingness to use telemedicine for serious problems, it has only an indirect effect, mediated by the perception of telemedicine, in the case of minor problems. Contrary to expectation, felt needs/problems have a negative influence on willingness to use telemedicine. The effect of socio-demographic characteristics on willingness varies depending on the type of health problems. Although they do not have direct effects on willingness, attitudes toward technology have an indirect effect on willingness mediated by perceived attributes of telemedicine. The findings show that, in general, the proposed research model and the diffusion of innovation paradigm appear to be appropriate for studying expressed willingness to use telemedicine.