With Taiwan now considered an aging society, the Health Promotion Administration (HPA) must meet a growing demand for chronic illness and geriatric care. To promote self-health management, the HPA established the “health promotion helper platform and app”. This platform acts as a foundation for holistic health management mobile cloud services, enabling users to input health-related data and check preventive health records. The health promotion helper improves transmission of personalized preventive health information to those most in need. Despite its tremendous potential, about 0.09% of the citizens in Taiwan were using the health promotion helper to access personal health records. Although several prior research studies have focused on the factors that impact the adoption of personal health records, the literature directly related to citizens’ usage behavior toward smart health management is scarce. Thus, the purpose of this study is to examine the determinants of smart health management adoption behavior. For this purpose, we propose to examine the effects of human basic needs as determinants on intrinsic and extrinsic motivation using self-determination theory as the background theory. The importance of health beliefs was also evaluated, which was especially relevant for explaining the citizens’ acceptance of smart health management. This theoretical model was empirically validated using survey data from citizens over 20 years old in Taiwan. The structural equation model was used to examine the data. The structural equation model was used to examine the data. The resulting 1020 valid questionnaires constituted a response rate of 85%. The results indicate that performance expectancy, effort expectancy, perceived playfulness, perceived susceptibility, and cues to action have positive effects on usage intention. Autonomy, competence, relatedness, and perceived playfulness are shown to have positive and direct effects on performance expectancy. Autonomy, competence, and perceived playfulness are also shown to have positive and direct effects on perceived playfulness. Autonomy, competence, and relatedness, are shown to have positive and direct effects on perceived playfulness. The results of this study provide valuable suggestions about how to promote citizens’ willingness to adopt the health promotion helper, which can be useful for associated government departments and hospitals to increase the likelihood of adopting the smart health care management. Furthermore, we hope that this study will stimulate future interest in the smart health care acceptance phenomena and motivate researchers to examine in greater depth this unexplored yet potentially fertile area of research.