From Innovation Adoption to Advocacy: eWOM as the Bridge to Service Re‑intention in Digital Health Services

Author : Arisa Songchom

Abstract :This systematic review examines whether innovation adoption in digital health influences service re-intention primarily through electronic word-of-mouth (eWOM). Although telemedicine and mobile health applications have diffused rapidly, many programs struggle to convert first-time use into sustained engagement, indicating that adoption is a necessary but insufficient condition for continuance. Guided by PRISMA 2020, we searched Scopus, Web of Science, PubMed, and Google Scholar for English-language empirical studies published between 2010 and August 2025. Eligible studies analyzed relationships among adoption, eWOM (e.g., ratings, reviews, recommendations), and continuance or re-intention in healthcare contexts. Forty-two studies met the inclusion criteria. Narrative synthesis reveals three regularities: (a) adoption reliably increases the likelihood and positivity of eWOM when early experiences meet expectations; (b) positive eWOM functions as a credibility and social-proof signal that elevates perceived value and trust; and (c) eWOM exhibits a strong association with re-intention, whereas negative eWOM is linked to discontinuance. The review extends the Technology Acceptance Model and the Diffusion of Innovations by inserting a behavioral signaling layer between adoption and continuance and refines Expectation-Confirmation Theory by emphasizing experience-to-advocacy feedback loops. Practically, providers should design for shareable quality (reliability, responsiveness, privacy transparency), capture feedback systematically, and enact rapid service recovery to contain detractors. Managing eWOM is therefore pivotal to converting initial adoption into durable digital health use. [4][11][10

Keywords :Innovation adoption, electronic word-of-mouth, service re-intention, digital health, systematic review.

Conference Name :International Conference on Business and Management (ICBM-25)

Conference Place Cochin, India

Conference Date 13th Sep 2025