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      A Review of Telehealth Service Implementation Frameworks

      International Journal of Environmental Research and Public Health

      MDPI

      telehealth, telemedicine, implementation, framework, model

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          Abstract

          Despite the potential of telehealth services to increase the quality and accessibility of healthcare, the success rate of such services has been disappointing. The purpose of this paper is to find and compare existing frameworks for the implementation of telehealth services that can contribute to the success rate of future endeavors. After a thorough discussion of these frameworks, this paper outlines the development methodologies in terms of theoretical background, methodology and validation. Finally, the common themes and formats are identified for consideration in future implementation. It was confirmed that a holistic implementation approach is needed, which includes technology, organizational structures, change management, economic feasibility, societal impacts, perceptions, user-friendliness, evaluation and evidence, legislation, policy and governance. Furthermore, there is some scope for scientifically rigorous framework development and validation approaches.

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          Most cited references 37

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          Technology Diffusion and Organizational Learning: The Case of Business Computing

           Paul Attewell (1992)
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            Determinants of successful telemedicine implementations: a literature study.

            Telemedicine implementations often remain in the pilot phase and do not succeed in scaling-up to robust products that are used in daily practice. We conducted a qualitative literature review of 45 conference papers describing telemedicine interventions in order to identify determinants that had influenced their implementation. The identified determinants, which would influence the future implementation of telemedicine interventions, can be classified into five major categories: (1) Technology, (2) Acceptance, (3) Financing, (4) Organization and (5) Policy and Legislation. Each category contains determinants that are relevant to different stakeholders in different domains. We propose a layered implementation model in which the primary focus on individual determinants changes throughout the development life cycle of the telemedicine implementation. For success, a visionary approach is required from the multidisciplinary stakeholders, which goes beyond tackling specific issues in a particular development phase. Thus the right philosophy is: 'start small, think big'.
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              A model for assessment of telemedicine applications: mast.

              Telemedicine applications could potentially solve many of the challenges faced by the healthcare sectors in Europe. However, a framework for assessment of these technologies is need by decision makers to assist them in choosing the most efficient and cost-effective technologies. Therefore in 2009 the European Commission initiated the development of a framework for assessing telemedicine applications, based on the users' need for information for decision making. This article presents the Model for ASsessment of Telemedicine applications (MAST) developed in this study. MAST was developed through workshops with users and stakeholders of telemedicine. Based on the workshops and using the EUnetHTA Core HTA Model as a starting point a three-element model was developed, including: (i) preceding considerations, (ii) multidisciplinary assessment, and (iii) transferability assessment. In the multidisciplinary assessment, the outcomes of telemedicine applications comprise seven domains, based on the domains in the EUnetHTA model. MAST provides a structure for future assessment of telemedicine applications. MAST will be tested during 2010-13 in twenty studies of telemedicine applications in nine European countries in the EC project Renewing Health.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                23 January 2014
                February 2014
                : 11
                : 2
                : 1279-1298
                Affiliations
                Industrial Engineering, Faculty of Engineering, North-West University, Potchefstroom Campus, Potchefstroom 2520, South Africa; E-Mail: liezl.vandyk@ 123456nwu.ac.za ; Tel.: +27-18-299-1524; Fax: +27-18-299-1320
                Article
                ijerph-11-01279
                10.3390/ijerph110201279
                3945538
                24464237
                © 2014 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                Categories
                Article

                Public health

                model, framework, implementation, telemedicine, telehealth

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