Patients’ Adoption of E-Consultation: The Role of Perceived Usefulness and Perceived Ease of Use, Trust, and Risk Aversion: An Abstract

Abstract

E-consultation is defined as the communication between a physician and a patient for non-emergency medical issues via telecommunication devices (e.g., mobile phone) from anywhere in the world. Extant research on telemedicine has studied mainly either monitoring of severe and chronic diseases or when telemedicine is specifically targeted to geographically isolated areas. Additionally, most of the literature on telemedicine has investigated the healthcare professionals’ adoption rather than the patient’s. We build on the modified technology acceptance model (TAM) (Davis 1986) to understand adoption of e-consultations by patients in Paris, France. Not only do we focus on patients but specifically those in a large metropolis, both novel, vis-a-vis prior literature.

The study proposes that perceived usefulness and perceived ease of use affect patient’s attitude toward e-consultation and intention to use (adopt). Risk aversion and three trusts, interpersonal, technological, and in the healthcare system, will moderate the relationship between attitude and adoption. Two focus groups and an online survey were conducted. The target population is any French resident over 18 years with health insurance. Two separate focus groups were used to compare patients who did not grow up surrounded by technology (Baby Boomers (born 1946–1964)) and those who did (Generation Y (born 1977–1994)). The online survey, via Qualtrics, used convenience and snowball sampling resulting in 132 completed surveys.

A major finding suggests that both perceived usefulness and perceived ease of use are significant predictors of attitude toward innovation and intention to use. Interestingly, the moderation effect of interpersonal trust between physician and patients indicates that higher trust indeed improves intention to use. This research is, possibly, one of the first to apply the technology adoption model to understand consumers’ (patients’) adoption of a novel innovation (medical), in an industry where trust is paramount (healthcare), to a population not studied before (not suffering from chronic or severe disease nor in isolated areas). We believe, the research makes a further contribution through studying the moderating effect of the healthcare system and interpersonal trust on the relationship between attitude and the innovation and intention to use. The results support that “patient-centered communication” (Ommen et al. 2008) between physicians and patients is extremely important and using facilitators to increase trust may enhance adoption. Indeed, it is important for e-consultation providers to showcase increased overall efficiency and effectiveness in diagnoses and prognoses of diseases. Finally, our research could potentially encourage governments and policy-makers investing in telemedicine to actually improve patients’ trust in the system to enable the greatest benefits to accrue to the population at large.

References Available Upon Request