Determinants of Patients’ Intention to Use Remote Monitoring Service for Cardiac Implantable Electronic Devices: An Extended Technology Acceptance Model Study in Taiwan

Background/Objectives: Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has been associated with potential clinical and economic benefits; however, its adoption among patients remains limited in some healthcare settings. This study examined patients’ intention to use RM services by applying an extended Technology Acceptance Model (TAM) that incorporates perceived effectiveness (PE), perceived barriers (PB), perceived threat (PT), and economic considerations, as well as the influence of socioeconomic factors. Methods: A cross-sectional survey was conducted among 104 patients with CIEDs in Taiwan using validated questionnaires. Structural equation modeling (SEM) was employed to examine the relationships among the proposed constructs. The association between intention to use and actual service utilization was explored. The correlations between sociodemographic factors and the constructs were analyzed using analysis of variance (ANOVA). Results: SEM showed that perceived effectiveness (PE), perceived usefulness (PU) and perceived ease of use (PEOU) were significantly associated with intention to use RM services, with economic considerations also having a significant contribution. Intention to use RM services further predicted actual adoption. However, PB and PT did not moderate these relationships. Sociodemographic factors influenced RM acceptance, with younger, more educated, employed, higher-income, and professionally employed patients reporting stronger perceptions and greater intention to use RM. Conclusions: This study reinforces the TAM framework in the context of health-related technology adoption. Overall, the adoption of RM services is complex and shaped by psychological, economic, and demographic factors, highlighting the need for user-friendly design, targeted education on clinical benefits, and flexible pricing and reimbursement strategies to improve equitable and sustained use.