With the growing number of aging population and chronic illnesses, how to help elderly residents access the health care service timely is a challenge for health care institutions in Taiwan. Recent advances in information, communication and biomedical technologies have combined to allow the development of various types of telemedicine technology designed to enhance or expand the health care services of elderly residents. However, most telecare studies focused only on medical care or development of technology rather than on comprehensive evaluation of residents’ (or patients’) perception about service processes. The purpose of this study was to explore rural residents’ perceptions and usage intention of a telecare system after they have used it. Results from this exploratory study showed that most elderly people have never heard or touched telecare systems before the study was conducted. However, the general perceptions of such systems included improvement of interacting with medical staffs, safety protection, convenient care, and one needed item of services in daily life. Especially, the mostly risk perception was privacy risk, that is, data confidentiality and individual privacy. Generally, most elderly residents evaluated their telecare experiences and perceptions as being positive. Besides, most elderly resident were willing to use the telecare system without fees. However, they felt risky about confidentiality and privacy toward this technology. To improve trustworthy perception of this novel technology, telecare providers should implement appropriate safeguards to protect patient health information exchanged in a telecare setting. Also, the physicians/nurses should take the time to communicate with the residents, especially in the form of education, about the benefits of technology. To optimize the effectiveness of this promising technique, more research on the relationship between residents’ (or patients’) perceptions and influences of technology will need to be conducted continually in future.