OBJECTIVES: The comprehensive implementation of telemedical applications still lags behind expectations in Germany. One of the main barriers to innovation is a lack of both a willingness to adapt and user’s acceptance. Processes of adoption and acceptance are characterized by a network of different factors which influence attitude and behavior which differ in severity depending on each user group. One key factor for accepting and adopting an innovation is the economic framework. We therefore examined the influence of economic factors influencing the attitudes of physicians in Germany towards telemonitoring. METHODS: In the first step fundamental determinants of adoption and acceptance were identified using a systematic literature review and transferred to a theoretical effect model. This model was used to create a quantitative questionnaire which was then used to interview online 201 outpatient and inpatient physicians from different fields of medicine. The participants (84.3% male, mean age 53 years) were asked to assess the empirically based economic attributes of telemonitoring regarding its implementation. RESULTS: The results show a lack of information regarding the financial risks of using telemedical technology, as only 14% of those interviewed said they felt sufficiently informed about the subject. Barriers to using telemedicine technology include missing arrangements for reimbursement, uncertain financial advantages and missing business models. In addition, the cost of implementation are indistinct for a broad majority of interviewees. On the other hand, in most queried dimension the user see a potential financial benefit due to telemedicine. The positive effects expected from telemonitoring were rated much better rated by those who already used telemonitoring in their professional life. CONCLUSIONS: In addition to a more precise legal framework, information security and quality-based guidelines, more emphasis must be placed on economic issues. It is also imperative that physicians be better informed about all aspects of telemedicine.