title: 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'.
authors.affiliation: Centre for Telematics and Information Technology, University of Twente, Enschede, The Netherlands. t.h.f.broens@utwente.nl
authors.forename: Tom H F
authors.initials: TH
authors.lastname: Broens
authors.forename: Rianne M H A
authors.initials: RM
authors.lastname: Huis in't Veld
authors.forename: Miriam M R
authors.initials: MM
authors.lastname: Vollenbroek-Hutten
authors.forename: Hermie J
authors.initials: HJ
authors.lastname: Hermens
authors.forename: Aart T
authors.initials: AT
authors.lastname: van Halteren
authors.forename: Lambert J M
authors.initials: LJ
authors.lastname: Nieuwenhuis
mesh_terms: D001292:Attitude to Computers; D004059:Diffusion of Innovation; D006284:Health Plan Implementation / Q000191:economics / Q000458:organization & administration; D006291:Health Policy / Q000331:legislation & jurisprudence; D006801:Humans; D011787:Quality of Health Care / Q000191:economics / Q000592:standards*; D017216:Telemedicine / Q000191:economics / Q000458:organization & administration*