title: Measuring patient trust in telemedicine services: Development of a survey instrument and its validation for an anticoagulation web-service.
abstract: For many eServices, end-user trust is a crucial prerequisite for use. For the telemedicine context however, knowledge about the coming about and measurement of end-user trust is scarce.
  
  
  
  To develop and validate the PAtient Trust Assessment Tool (PATAT): a survey instrument to quantitatively assess patient trust in a telemedicine service.
  
  
  
  Informed by focus groups, we developed a survey that includes measurement scales for the following factors: trust in the care organization, care professional, treatment, and technology, as well as a scale that assesses a holistic view on trust in the telemedicine service. The survey was completed by 795 patients that use a telemedicine application to manage their anticoagulation treatment. Data were analyzed by means of Partial Least Squares Structural Equation Modeling (PLS-SEM).
  
  
  
  The measurement model yielded good to excellent quality measures, after the removal of one item. The causal model resulted in high explained variance (R2=0.68). Trust in healthcare professionals and the treatment had a small effect on overall trust, while trust in the technology displayed a large effect. Trust in the care organization did not result in a significant effect on overall trust.
  
  
  
  The PATAT is a valid means to assess patient trust in a telemedicine service and can be used to benchmark such a service or to elicit redesign input.
authors.affiliation: Roessingh Research and Development, Telemedicine cluster, P.O. box 310, 7500 AH, Enschede, The Netherlands; University of Twente, Biomedical Signals and Systems Group, P.O. box 217, 7500 AE, Enschede, The Netherlands. Electronic address: l.vanvelsen@rrd.nl.
authors.forename: Lex van
authors.initials: LV
authors.lastname: Velsen
authors.affiliation: Roessingh Research and Development, Telemedicine cluster, P.O. box 310, 7500 AH, Enschede, The Netherlands; University of Twente, Biomedical Signals and Systems Group, P.O. box 217, 7500 AE, Enschede, The Netherlands. Electronic address: m.tabak@rrd.nl.
authors.forename: Monique
authors.initials: M
authors.lastname: Tabak
authors.affiliation: Roessingh Research and Development, Telemedicine cluster, P.O. box 310, 7500 AH, Enschede, The Netherlands; University of Twente, Biomedical Signals and Systems Group, P.O. box 217, 7500 AE, Enschede, The Netherlands. Electronic address: h.hermens@rrd.nl.
authors.forename: Hermie
authors.initials: H
authors.lastname: Hermens
mesh_terms: D000368:Aged; D000925:Anticoagulants; D005260:Female; D017144:Focus Groups; D006282:Health Personnel; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards; D017216:Telemedicine / Q000706:statistics & numerical data; D035502:Trust
chemical_list: D000925:Anticoagulants
keywords: Survey; Telemedicine; Trust