Assessing adoption of telemedicine using diffusion of innovation theory: Findings from California's San Joaquin Valley

Background: Telemedicine adoption in California's San Joaquin Valley, a region with a large underserved population, has been slow. Studies have identified various macro variables including inadequate infrastructure, confusion about reimbursement and lack of funding as probable causes. However, not much attention has been placed on user's adoptability traits or how the perception of telemedicine by users may influence its adoption. A plausible explanation can be deduced from Rogers' theory of ‘diffusion of innovation' which asserts that decisions of adoption of a new technology depend on five key aspects of an innovation: relative advantage, compatibility, complexity, trialability and observability.

Objective: The purpose of the study is to assess the adoption of telemedicine by healthcare providers in San Joaquin Valley California through the key measures of diffusion of innovation theory.

Methods: The study developed a questionnaire based on Roger's diffusion of innovation framework to understand the dynamic interactions between the characteristics of telemedicine and the social system in which it is practiced. Interviews of 32 health care providers working in various healthcare settings and familiar with telemedicine were conducted. Qualitative iterative strategy was undertaken for analyzing the data.

Results: It was found that the type of innovation decision involved in the adoption of telemedicine was important in determining its adoption. Providers paid more importance to compatibility and trialability issues compared to other factors. While age played an important role in adoption, healthcare providers irrespective of age and gender paid more attention to the relative advantages of using telemedicine in their decision making.

Discussion: The diffusion theory can serve as a useful framework to understand the channels through which providers make telemedicine adoption decisions. The findings from the study can be helpful for policy-makers in channeling their efforts to encourage wider use of telemedicine to improve access to healthcare services in underserved regions.