The Adoption of a Telehealth System: The Integration of Extended Technology Acceptance Model and Health Belief Model

Recently, telehealth has been considered a partial solution to the problems of delivering health care to remote areas as well as to areas underserved by health care professionals. However, the factors that influence patients' (or residents') adoption to use telehealth remain unclear. The purpose of the study is to integrate extended technology acceptance model (Extended TAM) and health belief model (HBM) to develop a comprehensive framework for analyzing the interaction of trust factors, technological factors, and health belief factors in telehealth. The proposed framework is validated with 365 respondents from Nantou County, which is located in central Taiwan. The findings show that each patient trust factors (social trust and institutional trust) has significantly positive effects on the technological factors (perceived ease of use and perceived usefulness separately), which in turn influence usage intention. This study also confirms that the technological factors are important mediators between trust factors and usage intention. In addition, health belief factors (perceived benefits, perceived barriers, and cues to action) are also critical direct factors affecting usage intention. In other words, trust, technology, health belief aspects will affect simultaneously behavioral intention. According to the statistical results, the proposed model fits very well for the samples. The findings of the integrative model may be used as a theoretical basis for future research and can also offer empirical foresight to the executives and managers of hospitals when they initially introduce and promote the telehealth into their surrounding community.