Factors Influencing the Adoption of Telemedicine Services Among Specialist Physicians in University Teaching Hospitals in South West Nigeria

Telemedicine adoption among physician specialists in Nigeria has the potential to extend specialist healthcare access to underserved communities, yet uptake among physicians at major teaching hospitals remains inconsistent. This study investigates factors influencing telemedicine adoption among specialist physicians at four university teaching hospitals in South West Nigeria, including the University College Hospital, Ibadan, and Lagos University Teaching Hospital. Guided by the Unified Theory of Acceptance and Use of Technology 2 model, a survey of 210 specialist physicians across 12 clinical specialties was conducted. The model was extended with two contextual variables specific to the Nigerian healthcare environment: infrastructure reliability and regulatory clarity. Structural equation modelling revealed that performance expectancy, infrastructure reliability, and hedonic motivation are the strongest predictors of adoption intention, while effort expectancy is not statistically significant after controlling for specialty type. Specialties with established telemedicine champions, particularly radiology and dermatology, demonstrate higher adoption rates than others. Regulatory uncertainty regarding teleconsultation liability is identified as a significant barrier in qualitative responses. The study contributes a contextualised adoption model applicable to sub-Saharan healthcare systems and recommends the Nigerian Medical Association develop practice guidelines for teleconsultation standards. Keywords: telemedicine, physician adoption, UTAUT2, South West Nigeria, healthcare technology.