User Acceptance of Telemedicine by Health Care Workers a Case of the Eastern Cape Province, South Africa

The Eastern Cape province of South Africa is one of the poorest provinces in the country with vast rural areas. A telemedicine system was implemented in the province in order to improve health care services. Despite large investments from the National Department of Health, only a third of telemedicine sites in the province are operational. Technology problems, such as unreliable electricity supply and low bandwidth, was identified as barriers to the successful implementation of telemedicine in South Africa, but these issues have since been addressed. Nevertheless, the uptake of telemedicine remains poor. One of the documented barriers to the successful implementation of telemedicine is user acceptance by health care workers. This study made use of the Technology Acceptance Model (TAM) to identify the factors that influence the user acceptance of telemedicine among health care workers in a developing country such as South Africa. The study used a quantitative survey approach. A questionnaire was distributed to all the hospitals and clinics around the province where telemedicine had been implemented. The results were analyzed using SPSS 20 and the conclusions drawn from the results were presented to five experts in the field of telemedicine and Information Systems. In general, the attitude of the health care workers was positive towards telemedicine, although the present usage of the system was low. Health care workers, especially those in the rural areas, perceived the telemedicine system to be useful to improve the quality of health care services they provide. The perceived ease of use of the telemedicine system was influenced by both the educational qualification and area in which the health care workers worked. Those that did not complete high school and worked in rural areas were apprehensive about using the telemedicine system. However, the majority of the health care workers indicated that they did plan to make use of the telemedicine system in the future. Interventions focused on education should be specific for rural or urban areas. In rural areas education should focus on computer literacy skills and how to use the telemedicine system, while in urban areas the awareness of the telemedicine should be increased.