Sustaining digital health engagement in emerging markets: a telemedicine study in post-COVID-19 Indonesia

Purpose This study aims to investigate the factors influencing Indonesian consumers’ telemedicine retention intention in the post-COVID-19 period. Whereas most work examines initial adoption, this research emphasizes the drivers of long-term engagement and retention within an emerging market context. Design/methodology/approach Drawing on the Push-Pull-Mooring (PPM) framework, this study conceptualizes telemedicine retention intention as shaped by three sets of factors: push (limitations of traditional healthcare systems), pull (benefits of telemedicine) and mooring (behavioral inertia). Data were collected from 509 Indonesian telemedicine users and analyzed via partial least squares structural equation modeling (PLS-SEM) to examine both direct and moderating effects. Findings The results show that both push and pull factors significantly influence consumers’ intention to continue using telemedicine services. Inertia, defined as attachment to traditional in-person care, exhibits a dual role and in our sample shows a small positive direct association with retention. Moderation analysis further reveals that inertia reduces the influence of push factors while enhancing the effect of pull factors. These findings highlight user convenience, affordability and technological reliability as crucial for maintaining long-term engagement with digital health services. Originality/value This study extends the application of the PPM model to the healthcare domain in an emerging market context, offering insights into postadoption behavior in digital health. It clarifies the dual role of consumer inertia and proposes a habit-driven perspective on telemedicine retention. The findings advance theory and inform practice for sustaining digital healthcare services in Southeast Asia.