Framework for the Implementation of a Telemedicine Service

Abstract

[Introduction]. This document aims to provide solutions for the successful implementation of telemedicine services (and eHealth, in general) in the health care setting. Following a literature review that identifies key theories, models, and frameworks used in the science of implementation, we introduce a theoretical framework that addresses the obstacles to incorporating and standardizing the use of telemedicine in health care institutions. This narrative review gathers qualitative information from different sources on a particular topic, and summarizes and synthesizes the literature in order to determine “what is known” about a topic (3). This theoretical framework is based on understanding the context within its broader structure, together with existing challenges and opportunities. The document introduces the reader to the reality of implementing telemedicine services in actual health care settings; analyzes interactions that occur during the process of ICT implementation and changes that occur in organizations, management models, culture, and medical care services; and, finally, reflects on key aspects related to prioritization, design, deployment, integration, and assessment. Analysis of this theoretical framework should allow for the creation of a research program that focuses on major aspects in the successful development of telemedicine, and generate proposed actions to overcome difficulties. Bearing in mind its cross-cutting nature, this report is aimed at the community of professionals (in its broadest sense) willing to work in any field related to the advancement of the health care sector, both in health and social settings, with the implementation and intensive use of ICTs. This publication consists of eight chapters. Chapter 2 provides a context for information presented later in the report, with a special emphasis on terminology and key concepts and their relationship with the subject under study. With that aim, it provides a brief summary of “state of the art” scientific publications on telemedicine and introduces the main obstacles and facilitators that should be kept in mind during implementation.