Trust and Trustworthiness: A Framework for Successful Design of Telemedicine

Trust and its antecedents have been demonstrated as a barrier to the successful adoption of numerous fields of technology, most notably e-commerce, and may be a key factor in the lack of adoption or adaptation in the field of telemedicine. In the medical arena, trust is often formed through the relationships cultivated over time via clinician and patient. Trust and interpersonal relationships may also play a significant role in the adoption of telemedicine. The idea of telemedicine has been explored for nearly 30 years in one form or another. Yet, despite grandiose promises of how it will someday significantly improve the healthcare system, the field continues to lag behind other areas of technology by 10 to 15 years. The reasons for the lack of adoption may be many given the barriers that have been observed by other researchers with regards to trust and trustworthiness. This study examined the role of trust from various aspects within telemedicine, with particular emphasis on the role that trust plays in the adoption and adaptation of a telemedicine system. Simulators examined the role of trust in the treatment and management of diabetes mellitus (common illness) in order to assess the impact and role of trust components. Surveys of the subjects were conducted to capture the trust dynamics, as well as the development of a framework for successful implementation of telemedicine using trust and trustworthiness as a foundation. Results indicated that certain attributes do influence the level of trust in the system. The framework developed demonstrated that medical content, disease state management, perceived patient outcomes, and design all had significant impact on trust of the system