School of Business, East China University of Science and Technology , Shanghai, China .
Telemed J E Health. 2018 Jan;24(1):77-85. doi: 10.1089/tmj.2016.0268. Epub 2017 Jul 7.
e-Consultation provides a new way to deliver healthcare services online. With the help of e-Consultation services, patients can gain access to nationwide medical expertise that otherwise would not be available to them. As an online delivery approach, e-Consultation also provides a choice for patients to receive medical advice from online doctors immediately, no matter how far away from the hospital they may be or how late in the day it is. However, the adoption and usage of e-Consultation is still far from satisfactory. Therefore, understanding why and when patients use e-Consultation services are important research questions.
Considering that the choice of a healthcare provider is a serious decision, this research uses the trust perspective to explain the e-Consultation service adoption phenomenon. Specifically, trust is conceptualized as a second-order construct consisting of two dimensions: competence and integrity. In addition, e-Consultation is viewed as a supplementary resource to traditional off-line consultation services, and disease type as a contextual factor is hypothesized to focus the context where e-Consultation services are more suitable. A scenario-based survey was conducted to test the proposed research model. We obtained a total of 190 valid questionnaires.
Our results indicated that trust (p < 0.01) had a positive effect on the intention to use an e-Consultation service. Meanwhile, our results also indicated that the higher the disease is in rarity (p < 0.05), severity (p < 0.01), or urgency (p < 0.05), the lesser the positive effect of trust is on the intention to use an e-Consultation service.
Trust is the major driving force of an e-Consultation service adoption. When the disease is high in rarity, severity, or urgency, an off-line healthcare provider is less capable of providing meaningful, qualified, and immediate service. Therefore, there is a decreased positive effect of trust on the intention to use an e-Consultation service for those diseases.
电子咨询提供了一种在线提供医疗服务的新方式。借助电子咨询服务,患者可以获得全国范围内的医学专业知识,否则这些知识对他们来说是无法获得的。作为一种在线交付方式,电子咨询也为患者提供了一种选择,无论他们离医院有多远,或者一天中的时间有多晚,他们都可以立即从在线医生那里获得医疗建议。然而,电子咨询的采用和使用仍然远不能令人满意。因此,了解患者为什么以及何时使用电子咨询服务是重要的研究问题。
考虑到选择医疗服务提供者是一个严肃的决定,本研究从信任的角度来解释电子咨询服务的采用现象。具体来说,信任被概念化为由两个维度组成的二阶结构:能力和正直。此外,电子咨询被视为传统线下咨询服务的补充资源,并且假设疾病类型作为情境因素,将重点关注电子咨询服务更适用的情境。我们进行了基于场景的调查来测试所提出的研究模型。我们共获得了 190 份有效问卷。
我们的结果表明,信任(p<0.01)对使用电子咨询服务的意愿有积极影响。同时,我们的结果还表明,疾病的稀有性(p<0.05)、严重性(p<0.01)或紧迫性(p<0.05)越高,信任对使用电子咨询服务的意愿的积极影响就越小。
信任是电子咨询服务采用的主要驱动力。当疾病的稀有性、严重性或紧迫性较高时,线下医疗服务提供者提供有意义、合格和即时服务的能力就会降低。因此,对于这些疾病,信任对使用电子咨询服务的意愿的积极影响就会降低。