title: [Implementation of telemedicine programs in Spain: experience of the main actors involved in the decision-making process].
abstract: OBJECTIVE
  To identify the main benefits and risks related to the implementation of telemedicine programs in Spain, based on the experience of the actors influencing the decision-making process.
  
  
  METHODS
  We performed a qualitative study based on audiotaped semi-structured telephone interviews. Eleven interviews were carried out, and the perspective of four physicians, three administrators, two researchers and two telecommunications industry workers were included. Theoretical sampling was used and thematic inductive analysis was performed.
  
  
  RESULTS
  The following factors were identified as necessary to successfully resolve problems by using telemedicine programs: the commitment of the persons involved, technological aspects, economic and institutional support, acceptance by healthcare professionals and patients, the existence of protocols adjusted to the context, the need for information and training prior to the development of telemedicine programs, a forward-looking approach, routine use and full acceptance of telemedicine programs in the organization, and the need to defend equity for professionals and users.
  
  
  CONCLUSIONS
  Successfully developing a telemedicine program requires a favorable environment in which risk can be foreseen. The main key element seems to be the human factor. The factors identified in this study should be considered when developing strategies to increase the chances of success of telemedicine programs in Spain.
authors.affiliation: Servicio de Evaluación y Planificación, Servicio Canario de Salud, Sta. Cruz de Tenerife, España. vmahtani@canarias.org
authors.forename: Vinita
authors.initials: V
authors.lastname: Mahtani Chugani
authors.forename: Roberto Luis
authors.initials: RL
authors.lastname: Martín Fernández
authors.forename: Enrique
authors.initials: E
authors.lastname: Soto Pedre
authors.forename: Virginia
authors.initials: V
authors.lastname: Yanes López
authors.forename: Pedro
authors.initials: P
authors.lastname: Serrano Aguilar
mesh_terms: D006801:Humans; D016730:Program Development; D013030:Spain; D017216:Telemedicine / Q000458:organization & administration