Scoping review of user-level barriers to telemedicine adoption in healthcare

Abstract This scoping review aims to identify user-level barriers to the adoption of telemedicine within healthcare systems, with a main focus on healthcare delivery in primary care settings. While the review was conceptually anchored in primary care, studies examining telemedicine adoption across broader healthcare settings were also included where they offered transferable user-level insights relevant to primary care. This approach allowed the identification of cross-cutting barriers that span different service delivery contexts. Although the initial motivation for conducting this review stemmed from challenges observed in New Zealand’s healthcare system, all included empirical studies were carried out in other countries. The geographical diversity and variability of healthcare models represented within the international evidence base enhance the transferability of the findings, ensuring their relevance for a range of comparable health systems. A literature review of 38 studies published between 2018 and 2025 identified six main factors affecting telemedicine adoption: (1) Performance Expectancy —the perceived usefulness and impact on healthcare quality; (2) Effort Expectancy —the perceived ease of learning and using telemedicine technologies; (3) Social Influence —the effect of opinions from family, peers, and healthcare professionals; (4) Facilitating Conditions —the availability of technical infrastructure, resources, and support; (5) Trust —user confidence in the safety, reliability, and confidentiality of telemedicine platforms and providers; and (6) Individual Readiness —personal attitudes, digital literacy, and openness to technology. The novelty of this study lies in synthesising international evidence through established adoption frameworks (TAM/UTAUT) while extending them with additional constructs of trust and individual readiness . Unlike previous reviews, this study integrates consumer sentiment and equity considerations, offering a more comprehensive understanding of barriers to telemedicine adoption. The review highlights that age, digital skills, and social support strongly influence these factors, with older adults and rural populations facing greater barriers. Practical recommendations include improving digital infrastructure, targeted digital literacy education, and developing user-friendly platforms. The findings emphasise the importance of a comprehensive, multi-level approach that considers technical, organisational, and human aspects to promote successful telemedicine integration within primary and community healthcare services.