Abstract
Introduction: Despite the expansion of technological infrastructure and the development of telehealth services in Iran, the actual use of telemedicine remains low, and a significant portion of patients and even physicians do not show sufficient willingness to employ these services. Accordingly, this study aimed to investigate the cultural, behavioral, and ethical barriers affecting the acceptance of telehealth services from the perspective of patients and physicians in Iran.
Methods: In this mixed-method research, data were collected using a standard questionnaire based on the TAM and UTAUT models from 150 participants (60 physicians and 90 patients) and evaluated using structural equation modeling and SPSS and AMOS statistical tests. Then, 15 semi-structured interviews were conducted with participants. Finally, the data were analyzed using thematic analysis based on the Brown and Clark framework to identify deeper dimensions of cultural and behavioral barriers.
Results: Quantitative results demonstrated that perceived usefulness had the most positive impact on intention to use telemedicine, while ethical and privacy concerns and cultural barriers were the strongest deterrents. Patients were more concerned and distrustful of physicians. Qualitative results revealed four main themes, including cultural resistance, concern about the decline in the quality of non-face-to-face services, fear of information disclosure, and digital literacy challenges.
Conclusion: The acceptance of telemedicine in Iran is influenced by cultural attitudes, trust levels, and security concerns of users rather than relying on technical limitations. Therefore, the successful development of these services requires strengthening data protection laws, educating users, and implementing strategies to increase social trust.