Abstract
Rural healthcare systems in Pakistan face persistent challenges related to limited accessibility, workforce shortages, and inadequate healthcare infrastructure, leading to disparities in service delivery and patient outcomes. Telemedicine has emerged as a promising digital health innovation to address these gaps by enabling remote consultations, improving healthcare accessibility, and enhancing patient-centered care. This study examined the impact of Telemedicine Adoption on Healthcare Accessibility and Patient Satisfaction in rural Pakistan, while also investigating the mediating role of healthcare accessibility. Grounded in the Technology Acceptance Model (TAM), a quantitative cross-sectional research design was employed. Data were collected from 350 respondents including patients and healthcare providers using a structured questionnaire. The data were analyzed using Structural Equation Modeling (SEM) through SmartPLS 4, and hypotheses were tested using bootstrapping procedures. The findings revealed that telemedicine adoption significantly improved healthcare accessibility and patient satisfaction. Healthcare accessibility was also found to significantly mediate the relationship between telemedicine adoption and patient satisfaction. The study concludes that telemedicine is an effective tool for improving healthcare delivery in rural Pakistan by reducing geographical barriers and enhancing service efficiency. The findings offer valuable theoretical, managerial, and policy implications for strengthening digital health systems in developing countries