The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management.

Owing to the COVID-19 pandemic, many countries’ physicians in the world have used telehealth to visit patients via telehealth. The study aimed to integrate the theory of planned behavior (TPB), the technology acceptance model (TAM), and self-determination theory (SDT) to explore the adoption behavior of a telehealth system. A convenient sample of residents was drawn from the population of Nantou County in Taiwan and analyzed via structural equation modeling. The findings revealed that attitude, perceived behavioral control, perceived usefulness, and perceived autonomy support jointly have significantly positive effects on continuance intention. Results also confirmed that perceived autonomy support, perceived ease of use, and perceived usefulness jointly have significantly positive effects on attitude. Furthermore, this study also showed that a crucial mediators’ role is played by perceived ease of use, perceived usefulness, and attitude. The conclusions and practical implications of the research will hopefully provide health organizations and institutions with some innovative insights and foresights, which in turn will promote better practices and services of telehealth technology.

Tele-heatlhcare services extending healthcare services from medical perspective of treatment and diagnosis to enhance holistic wellness of individuals, have been widely recognized by healthcare providers. This study explored the trust in the healthcare providers to generate the trust-based service value chain framework in tele-healthcare services. We report the results of survey from 1304 members of a district hospital in 7 villages in two townships of a county in the middle of Taiwan. Four motivations were identified from literature review in the study, which are the perception of tele-healthcare value, the perception of medical value, social influence, and effort expectancy. These motivators were used to predict the intention of using tele-healthcare services provided by the service provider. We employed trust as a mediator in this framework. From the statistical analysis, we obtain the following results: (1) the relationship between effort expectancy and intention to use is mediated by the trust in the service provider (2) Social influence insignificantly affects trust; however, it significantly affects the intention to use tele-healthcare services; (3) The perceived benefits and medical value are significantly mediated by calculation-based trust in the service provider. From these findings, we suggest that trust built is critical for service value co-creation stage in tele-healthcare services.

The purpose of the study is to integrate Self Efficacy with the Health Belief Model in order to explore the usage intention model of Telecare systems. The proposed framework is validated with respondents from Nantou County, which is located in Taiwan. This study emphasizes that hospital managers should pay more attention to understanding the five concepts of health belief of elderly (Perceived Susceptibility, Perceived Severity, Perceived Benefits, Perceived Barriers and Cues to Action), and improving Self Efficacy of elderly. We adopted the questionnaire survey for data collection, and examined our hypotheses by applying the structural equation modeling (SEM) method to validate the model. The integrative viewpoint implies that a successful telecare system is not only an information system but also a medical service provider/department to the patients/residents. The findings may be used as a theoretical basis for future research and can also offer empirical foresight to the executives and managers of hospitals when they initially introduce and promote the telecare systems into their surrounding community.

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