Investigating Continuance Intention for Telehealth Visits in Children's Hospitals: Survey-Based Study

Telehealth visits are remote health care consultations conducted using digital technologies, such as video calls, phone calls, or web-based platforms. This type of service offers numerous benefits for both health care users and health care providers. Users save time and money by avoiding traveling to health care facilities. At the same time, health care providers can expand access to care for users in remote areas and enhance the continuity of care. These advantages are even more evident in pediatric settings, where attending in-person services must align with the commitments of the patient (eg, school activities) and the caregiver. Although the potential benefits of telehealth visits for users and health care providers were already known before the COVID-19 pandemic, its widespread adoption only occurred during it. Having experienced its benefits, hospitals are now, in the postpandemic phase, determined to maintain and strengthen their remote service offerings. It has, therefore, become crucial for them to understand the factors influencing users' intention to continue using telehealth visits (or "continuance intention"), even now after the access restrictions to health care facilities imposed during the COVID-19 pandemic have been lifted. However, the literature lacks comprehensive, valid, and reliable models explaining users' continuance intention toward telehealth visit services.

This study aims to investigate the variables impacting users' continuance intention toward telehealth visits and identify suggestions for improvement.

Two models of variables impacting users' continuance intention toward telehealth visits were developed. The first model applied to all users undergoing telehealth visits, while the second one applied only to patients who received a telehealth visit using videoconferencing tools. The models were created based on the literature and a qualitative study comprising interviews with physicians with extensive experience in telehealth visits. The models were then tested using partial least squares structural equation modeling on 477 responses obtained by administering a survey to guardians of patients who had received at least 1 telehealth visit in a major European children's hospital.

Both models showed that the variable information quality positively influenced the variables continuance intention and perceived usefulness and that perceived usefulness positively influenced continuance intention. The first model was robust to the medical specialty and the channel used to deliver the visit. The second model also showed that systems quality positively influenced information quality.

This study has identified and tested 2 comprehensive, valid, and reliable models on the variables influencing users' continuance intention toward telehealth visits. Moreover, the study's results provide insights for hospitals to improve telehealth visit services.