Abstract
Background: Pediatrician workforce shortages have aroused great attention from health authorities in China. Telemedicine services have been known to enhance the management of children's health, yet the rate of adoption and usage in Chinese hospitals still at a quite low level, and the factors influencing the acceptance of telemedicine services remains unclear.Objective: The purpose of this empirical study was to evaluate the reliability and validity of a technology acceptance measurement instrument applied in healthcare, to investigate the perception of telemedicine services on the provider-side and demand-side, and to determine the factors that may drive individuals to adopt telemedicine services.Methods: A cross-sectional survey study based at Shanghai Children's Hospital, Shanghai Jiao Tong University, was conducted in March 2020. A total of 456 valid responses were obtained by convenience sampling. The internal consistency of items was assessed by Cronbach's alpha (α), composite reliability (CR) and average variance extracted (AVE) to evaluate both the reliability and validity of the questionnaire. Structural equation modeling analysis was used to test and verify the interrelationships among relevant variables.Results: Price value is the strongest predictor (β = 0.30, p = 0.02), facilitating conditions (β = 0.28, p = 0.01) and hedonic motivation (β = 0.13, p = 0.04) also have significantly positive direct effects on telemedicine acceptance. The results showed the perception of child patients' families were significantly more acceptable to telemedicine services than pediatricians (t = −2.99, p < 0.01). Participants with no prior experience and lower education may be more willing to adopt telemedicine.Conclusion: Telemedicine will likely continue to have an integral role in pediatric health care delivery, and the findings can assist policy makers and hospital administrators in determining the more valued characteristics of telemedicine services from a behavioral perspective. Future attention will be paid to the pricing, training and service quality of telemedicine in China.
Highlights
Telemedicine refers to the use of health information exchanged from one site to another via information and communications technology (ICT) for the health and education of the patient or medical personnel with the intention of evaluating, diagnosing, treating, educating or managing patients [1, 2]
Discriminant validity was confirmed when the square root of the average variance extracted (AVE) for each construct was larger than the corresponding interconstruct correlations [27]
The findings indicate that family member of pediatric patients reported a more positive and optimistic perception toward telemedicine services vs. pediatricians in all subscales of measurement
Summary
Telemedicine refers to the use of health information exchanged from one site to another via information and communications technology (ICT) for the health and education of the patient or medical personnel with the intention of evaluating, diagnosing, treating, educating or managing patients [1, 2]. There has been a growing need, but few studies have explored factors affecting the willingness to use telemedicine services in pediatric hospitals. To achieve this goal, the measurement instrument based on the unified theory of the acceptance and use of technology 2 (UTAUT 2), which is recognized as the most comprehensive theory in measuring individual technology acceptance [7, 8], was employed to investigate the interrelationships between the constructs and behavioral intention and to estimate the significance of path coefficients so that we could better understand the factors that may influence the willingness to accept telemedicine services. Telemedicine services have been known to enhance the management of children’s health, yet the rate of adoption and usage in Chinese hospitals still at a quite low level, and the factors influencing the acceptance of telemedicine services remains unclear
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