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These results have revealed the need for a dynamic approach to the design of telemedicine use, especially when it targets a variety of end-users. Hence, the importance of conducting studies before using telemedicine, and attempting to identify which of the above-mentioned predictors exert an influence and how.

Purpose – The purpose of this study is to analyse how tourists form the cognitive, affective and unique images of a tourism destination, taking into account that: travellers use user-generated content (UGC) as one of the more important sources of information about the destination, sources of information influence on travellers’ motivation to visit some destination and motivations influence on the dimensions of the destination image. Design/methodology/approach – Taking into account the works of Beerli and Martin (2004), Seabra et al. (2007) and Qu et al. (2011), this paper proposes an integrative model that shows how different types of information sources influence on individuals’ motivations, as well as the different dimensions of the image of the tourist destination are influenced by tourists’ motivations. Moreover, the design and validation of new scales of measures, adapted to the new tourist profile 2.0, is proposed. The model is empirical tested by analysis of 541 national and international tourists, as well as residents in Mallorca: data were analysed using a structural equations model. Findings – The results confirm the strength and robustness of the constructed theoretical model, and contrasting the assumptions made in the work. Likewise, also confirms the validity and adequacy of the proposed new scales of measurement to the current reality of the tourism sector. The principal conclusions obtained are: motivations for visiting a place are influenced by information sources consulted by tourists, among which social media can be included; cognitive image is influenced by travellers’ motivations; and affective image is influenced by cognitive one. From these results, some managerial recommendations are suggested. Research limitations/implications – The present study offers important contributions for both researchers and managers in the field of destination brand image management. At theoretical level, the work provides a deep review of the literature, that has permitted the construction of a strong and robust theoretical model, as well as the design and validation of new measurement tools. Both are designed from the rigour and precision that provides scientific research, allowing the understanding and analysis of the current situation of the tourism sector. On the other hand, the work has important implications on a practical level, providing strategic management and travellers destination marketing organization stakeholders. Originality/value – This study constitutes an initial, but also newness approach to this line of research. The construction of a theoretical model that: contemplates UGC as information source, and considers the direct and moderating relationships between different variables such as information sources, motivations and the various dimensions of the image.

BackgroundThe aim of the study presented in this article is to analyse the determinants of telemedicine use. To that end, the study makes two basic contributions. First, it considers six working hypotheses in the context of technology acceptance models (TAMs). Second, it uses data obtained for three samples of physicians from three different countries (Spain, Colombia and Bolivia). Obtaining and comparing evidence on an international scale allows determinants of telemedicine use to be evaluated across different contexts.MethodsIn Bolivia, the survey was conducted in hospitals and health care centres of the urban and rural districts of the municipality of Sucre, in a population comprising a total of 350 physicians. In Spain, the survey population consisted of medical professionals of all profiles affiliated with health care within the Canary Islands Health Service, comprising a total of 356 physicians. Finally, in Colombia, it was conducted in the Society of Surgery Service at San José Hospital of Bogotá, in a population comprising a total of 184 physicians. Using an extended TAM and survey data from 510 physicians (113 in Spain, 118 in Colombia and 279 in Bolivia), binary logistic regression analysis was performed.ResultsIn the three samples, it was found that the physician's level of information and communication technology (ICT) use in his/her personal life was the variable that had the highest explanatory power regarding telemedicine use. In the Spanish sample, the physicians' perceived ease-of-use of ICTs in clinical practice and propensity to innovate were the two other variables that determined telemedicine use, whereas in the Colombian and Bolivian samples, it was the level of optimism about ICTs.ConclusionThe results facilitated a more complete model that includes personal, usability, and innovatory aspects in the explanation of Telemedicine use in Spain, whereas the results for the Latin American samples indicated a more primary model in the explanation of Telemedicine use, which was completed by an optimism factor that did not emerge in the Spanish sample.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0128-6) contains supplementary material, which is available to authorized users.

PurposeCulture makes firms unique and, depending on the implemented pattern of social and managerial culture, technology, and innovation, it can have an important influence on the personality and behaviour of the firm. Although a cultural model of market orientation encourages product innovation and fosters cooperative relationships with clients, few studies analyse this important relationship from a service perspective. This research seeks to investigate the relevance of market orientation for the firm's client cooperation relationships in developing radical innovations in the service sector.Design/methodology/approachA descriptive investigation uses 433 Spanish service firms that introduced radical innovations in their product fields in the past two years. The paper conducted four discriminant analyses: one for the total sample of firms and three for the sub‐samples defined by the extent to which firms use information and communication technologies (ICTs) in their activities.FindingsThe four models reveal that customer orientation, competitor orientation, and inter‐functional coordination provide means to differentiate between firms that cooperate with their clients to innovate and firms that do not. In each model, the significance and weight of the three variables change, depending on the degree to which the firms use ICT. Therefore, the distinction between firms that cooperate and those that do not is possible mainly for the total sample of firms. For the sub‐samples, not all MO dimensions can discriminate this way.Practical implicationsThis study offers important contributions for both researchers and managers in the field of service innovation. It identifies explicitly the relationship between market orientation and cooperation, which makes it possible to extend the study and enhance comprehension of this concept to the relationship that the firm has with other agents in the value chain. Market orientation, as an inter‐firm phenomenon, may favour the design of market orientation strategies that offer superior value to the market. On the other hand, the empirical analysis shows which factors (philosophical principles, strategic implications of proactive market orientation) have the highest discriminatory power for innovative firms, according to their sector of activity. This work also identifies market orientation as an element that fosters a cooperation strategy.Originality/valueDespite the importance of market orientation for developing cooperative relationships with clients, few studies analyse the relevance of these relationships in the firm's service innovation process. The findings thus offer a valuable contribution by showing the relevance of this relationship in developing new service innovations. Furthermore, the application of Spanish ICT contributes to existing research in Spain.

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