Connecting care: technology access, social determinants and telemedicine utilization in rural Northwest Georgia

Advocate Health Floyd, serving rural Northwest Georgia, offers telemedicine to expand healthcare access, yet utilization is not at full potential. Guided by the Technology Acceptance Model (TAM) and Social Determinants of Health (SDOH) frameworks, this qualitative case study explored whether low uptake stems primarily from technology perceptions or social and contextual barriers. Semi-structured interviews were conducted with 30 adult patients with access to telemedicine services. Thematic analysis identified four factors influencing utilization: individual readiness, organizational visibility and support, structural access conditions, and contextual alignment with patients’ healthcare needs. Findings suggest that telemedicine adoption is shaped less by technology perceptions or social determinants independently than by their interaction across individual, organizational, structural, and contextual dimensions. Increasing awareness, providing patient education, strengthening onboarding, and offering ongoing technical and organizational support may improve adoption. By examining patients’ lived experiences, this study offers insights into aligning digital healthcare initiatives with the social and contextual realities of rural populations..