How to promote telemedicine patient adoption behavior for greener healthcare?

Telemedicine is a powerful carbon reduction strategy in the health sector, reducing carbon emissions by reducing the need to travel. Widespread patient acceptance and adoption is a prerequisite for realizing the potential of telemedicine, however, barriers that prevent telemedicine from reaching its potential persist. The integrated telemedicine patient adoption model is constructed by incorporating socioeconomic factors, health behaviors, psychological characteristics, and technological factors to address the dual attributes of healthcare and technology in telemedicine. The advanced Structural Equation Model-fuzzy-set Qualitative Comparative Analysis (SEM-fsQCA) hybrid approach is then used to analyze the influencing factors of telemedicine patient adoption behavior and the complex process of their synergistic interaction, thereby revealing the impact mechanism of patient adoption behavior. The findings indicate that PLS-SEM and fsQCA are complementary analytical methods providing comparable results. The SEM-based findings indicate that perceived usefulness, trust, social influence, economic benefits, and perceived severity have significant and positive effects on the intention to use telemedicine, while perceived usefulness fully mediates the relationship between perceived ease of use and intention to use, and partially mediates the relationship between trust and intention to use. While health consciousness amplifies the effects of perceived usefulness, social influence, and perceived severity on intention to use, and the intention to use further have a positive and significant effect on adoption behavior. Additionally, the fsQCAbased results reveal multiple potential concurrent causal relationships between influencing factors and the adoption behavior, and provide five formation pathways for telemedicine patient adoption behavior. This study provides important insights for health authorities, telemedicine managers, technology companies and their staff, and offers clear suggestions for designing telemedicine adoption strategies to ensure successful patient engagement.