Determinants of successful telemedicine implementations: a literature study

Abstract

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'.

On the ambiguity of Quality of Service and Quality of Experience requirements for eHealth services

“…User acceptance is considered as function of user perception of the service quality, and the most important factor for any healthcare service implementation. As Broens et al [6] present, the most important determinants for successful telemedicine implementation were reported as user acceptance (37%) and technology deployment factors (29%), leaving behind the organization (13%), policy and legislation (11%) and financing factors (10%).…”

Implementing and Sustaining Team-Based Telecare for Bipolar Disorder: Lessons Learned from a Model-Guided, Mixed Methods Analysis

“…4,5,[10][11][12] Challenges in moving CVT interventions from highly controlled demonstrations and controlled trials into general practice have been recognized since the early days of CVT. 1,2,[13][14][15][16][17] Factors contributing to this ''disjunction of research and practice '' 18 include technical, social, organizational, and policy factors, 2,13,15 as well as lack of empirical evidence on outcomes. 18,19 Such factors also affect the adoption and sustainment of pharmacological healthcare innovations generally.…”

“…20 CVT, however, is a multistakeholder process, where buy-in from a range of parties is necessary to implement and sustain the modality. For instance, Broens et al 2 empirically identified five major determinants of telehealth implementation: (1) technology, (2) acceptance, (3) financing, (4) organization, and (5) policy/ legislation. The commitment of a variety of stakeholders across determinants must align to implement and sustain telehealth, respectively: information technology staff, providers and the individuals in their care, insurance and other reimbursement mechanisms, organizational resources and leadership priorities, and a supportive or at least permissive policy environment.…”

“…The commitment of a variety of stakeholders across determinants must align to implement and sustain telehealth, respectively: information technology staff, providers and the individuals in their care, insurance and other reimbursement mechanisms, organizational resources and leadership priorities, and a supportive or at least permissive policy environment. 2 We recently reported the clinical and quality impact of a CVTbased collaborative chronic care model (CCM) for bipolar disorder deployed across multiple regions in the U.S. Department of Veterans Affairs (VA) healthcare system. 21 CCMs are multicomponent models developed initially for chronic medical illnesses treated in primary care, 22,23 which now also have a strong evidence base across a wide variety of mental health conditions.…”

Video Teleconsultation Service: Who Is Needed to Do What, to Get It Implemented in Daily Care?

“…Successful large-scale implementation, however, also requires consideration of financial arrangements, organizational issues, and governmental policy and legislation issues. 5,9,10 It is hypothesized that early identification of the stakeholders and their roles and interrelationships in the potential business could help to create a ''shared vision and understanding'' and also supports acceleration in the telehealth market. 10 Therefore, the aim of this study was to clearly understand these various stakeholders, their roles, as well as the way they need to cooperate for delivery of telemedicine services.…”