Transformational Leadership and Telemedicine Acceptance: Predicting Providers’ Intention to Use Emergency Teleophthalmology

Purpose Determinants of telemedicine adoption among emergency eye care providers remain poorly understood. This study examines the role of transformational leadership in technology acceptance of live inter-provider teleophthalmology. Methods A cross-sectional online survey of 254 emergency and eye care professionals in the United States assessed perceived usefulness (PU), intention to use (IU), subjective norms (SN), self-efficacy (SE), and transformational leadership (TL) using validated scales. Confirmatory factor analysis and covariance-based structural equation modeling evaluated a modified Technology Acceptance Model in which leadership and subjective norms were specified as contextual factors influencing IU directly and indirectly through PU, with self-efficacy specified as an antecedent of PU. Results Of the 244 respondents included in analysis (96.1% completion rate), 51% were female, 31% were emergency physicians, and 19% were eye care specialists. The mean factor-based score for intention to use teleophthalmology was 3.74 (± 0.95) on a 5-point scale. The modified TAM demonstrated acceptable model fit and explained 67.5% of the variance in IU. Perceived usefulness was the strongest predictor of intention to use (β = 0.66). Transformational leadership (β = 0.37) and subjective norms (β = 0.47) showed significant positive effects on IU, largely mediated through PU. Self-efficacy was not significantly associated with PU (β = 0.18, p = 0.105). Conclusions The model predicted intention to use live teleophthalmology and identifies transformational leadership as an important driver of acceptance through both direct and indirect effects. Leadership engagement may play a supportive role in broader acceptance of teleophthalmology technology in emergency eye care.