The Eastern Cape province of South Africa is one of the poorest provinces in the country
with vast rural areas. A telemedicine system was implemented in the province in order to
improve health care services. Despite large investments from the National Department of
Health, only a third of telemedicine sites in the province are operational. Technology
problems, such as unreliable electricity supply and low bandwidth, was identified as barriers
to the successful implementation of telemedicine in South Africa, but these issues have since
been addressed. Nevertheless, the uptake of telemedicine remains poor. One of the
documented barriers to the successful implementation of telemedicine is user acceptance by
health care workers. This study made use of the Technology Acceptance Model (TAM) to
identify the factors that influence the user acceptance of telemedicine among health care
workers in a developing country such as South Africa. The study used a quantitative survey
approach. A questionnaire was distributed to all the hospitals and clinics around the province
where telemedicine had been implemented. The results were analyzed using SPSS 20 and the
conclusions drawn from the results were presented to five experts in the field of telemedicine
and Information Systems. In general, the attitude of the health care workers was positive
towards telemedicine, although the present usage of the system was low. Health care workers,
especially those in the rural areas, perceived the telemedicine system to be useful to improve
the quality of health care services they provide. The perceived ease of use of the telemedicine
system was influenced by both the educational qualification and area in which the health care
workers worked. Those that did not complete high school and worked in rural areas were
apprehensive about using the telemedicine system. However, the majority of the health care
workers indicated that they did plan to make use of the telemedicine system in the future.
Interventions focused on education should be specific for rural or urban areas. In rural areas
education should focus on computer literacy skills and how to use the telemedicine system,
while in urban areas the awareness of the telemedicine should be increased.