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Top1. Introduction
COVID-19 pandemic has been transforming the traditional healthcare delivery model from facility-based to virtual care worldwide. Across the globe, healthcare planners and policymakers are racing to adopt virtual healthcare practices as health workers’ lives are at stake due to the increased risk of infection spread (Webster, 2020). Massive resistance to the use of technology in health care to ring in virtual care has gradually faded. Yet, the COVID-19 era has significant challenges to overcome. By March 30, 2020, most of the countries, including India, have embraced virtual care and issued guidelines for “telemedical” practices. Fueled by China’s and Italy’s experience, this shift among healthcare planners and governments in which hospitals are now recognized as the “super-spreader center” for coronavirus or COVID-19 “hot spots” has led to patients being largely restricted from in-person visits but to seek clinical consultative help online so as to limit the spread of Coronavirus among healthcare professionals (Webster, 2020).
Until recently, telemedicine has been promoted to ensure quality health care delivery for rural and remote areas, addressing the shortage of healthcare workers, providing access to continuing medical education, enhancing patient education and long-distance monitoring, as well as enabling second-level consultations with the super-specialists. A major change that the COVID-19 era has introduced is the push for online consultations even for first-level treatments, that is, primary consultations. The agenda for promoting telemedicine has suddenly shifted from an attempt to “reduce distance barriers via telemedicine” to “maintain distance via telemedicine”. The World Health Organization (WHO) defines telemedicine as “the delivery of health-care services, where distance is a critical factor, by all health-care professionals using information and communications technologies for the exchange of valid information for the diagnosis, treatment, and prevention of disease and injuries, research and evaluation, and the continuing education of healthcare workers, to advance the health of individuals and communities” (WHO, 2010, pp.8)1.
Post-COVID, WHO mentions “telemedicine” as an essential service for health system strengthening and public health management vis-à-vis the fight against coronavirus. This is not the first when the world has realized the potential of technology use in health care during challenging times. In 1985, the Mexico City earthquake, and in 1988, the Soviet Armenia earthquake, the deployment of telemedicine services via satellite were used to serve the medical needs of affected people (Simpson, 2013). In 2004, India has also used telemedicine services in the Andaman-Nicobar region when a tsunami created a disruption of normal life at a wider scale (Chellaiyan, et al., 2019). Put simply, telemedicine in health care is not new; however, its uptake remains poor (Kissi, et al., 2019). Since the first half of the 20th century, technology use in health care is evidenced via the electrocardiogram (ECG) transmission over telephone lines (WHO, 2010), showcasing the potential to enable virtual consultations. Today, the emergence of wireless broadband and the near-ubiquitous internet use has greatly reduced the implementation barriers to telemedicine services. Yet, the resistance among end-users remains and needs to be researched (Chellaiyan, et al., 2019; Harst, et al., 2019).
The current research aims to study key factors affecting the intention to use telemedicine services. Following the introduction, Section 2 overviews the development of telemedicine in India. The Technology Acceptance Model (TAM) and associated concepts, which provide the underlying theoretical framework for this work, are then presented in Section 3. Whereas Section 4 shifts focus to highlight the research model and hypotheses, Section 5 presents the research methodology. Next, Section 6 showcases the various study results while Section 7 rationalizes the broader understanding and associated implications of the study findings. Finally, Section 8 offers some concluding remarks with insights on the study limitations and directions for future research.