Telemedicine Adoption Among Health Care Professionals in Israeli Geriatric Medical Centers: Moderated Mediation Cross-Sectional Questionnaire Study

Abstract Background Telemedicine adoption among health care professionals is hindered by resistance to change (RTC), comprising routine-seeking, emotional reactivity, short-term focus, and cognitive rigidity, which interacts with perceived ease of use (PEU) and anxiety within the Technology Acceptance Model framework. Objective This study aimed to test a moderated mediation model in which PEU mediates the association between RTC, assessed both overall and by dimension, and intention to use telemedicine, while telemedicine-related anxiety moderates the association between PEU and intention to use. Participants were recruited from 4 governmental geriatric medical centers in Israel. Methods A cross-sectional study was conducted among 377 health care professionals from 4 Israeli governmental geriatric medical centers. Telemedicine use in the participating centers was limited, optional, and consisted mainly of remote patient monitoring. Data collection was conducted between March and June 2024. Data were collected using validated self-administered questionnaires measuring telemedicine-related anxiety, RTC with 4 dimensions (routine seeking, emotional reactivity, short-term focus, and cognitive rigidity), PEU, and intention to use telemedicine. Statistical analyses were performed using SPSS (version 28) and PROCESS Model 14 for moderated mediation analysis. Results The moderated mediation analysis revealed that RTC was negatively associated with the intention to use telemedicine through the lower PEU, with this indirect pathway being attenuated but not eliminated by high telemedicine-related anxiety. The overall indirect effect remained negative and statistically significant across all anxiety levels. Conclusions Health care professionals’ RTC reduced their intention to use telemedicine by lowering PEU, with telemedicine-related anxiety moderating but never eliminating this relationship. These findings suggest that telemedicine implementation in geriatric settings should consider both RTC and PEU. The positive indirect association observed for cognitive rigidity was unexpected and should be replicated before specific practical recommendations are made.