Cited by 288Telemedicine and Telehealth ImplementationICT in Developing CommunitiesTechnology and Human Factors in Education and Health

The DOI matches its Crossref record; 49 of the 49 references it cites were found in a registry or an index; 18 of the 94 sources its claims cite were checked for support.

Telemedicine for Developing Countries

Open access
Combi, Carlo, Pozzani, Gabriele, Pozzi, Giuseppe·2016·Applied Clinical Informatics

Abstract

BACKGROUND: Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. OBJECTIVE: We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. METHODS: We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. RESULTS: We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. CONCLUSIONS: We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries.

Overview

Integrity signals

Registry

Crossref · 10.4338/aci-2016-06-r-0089

Cites

49 of 49 references verified0 citation errors · 0 not checkable

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Claims the paper makes

69 No basis given · 38 No full text of the sources · 15 Sources not found · 12 Own result · 11 Own interpretation · 8 Partly supported · 8 Not checked yet · 5 Supported · 1 Not supported · 1 Couldn’t confirm · accuracy not yet measured

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Show all 43 claims

  • It may state two separate claims as one. 80
  • Probably not a substantial claim. 95
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  • The paper relies on this without support.

    In developing countries, telemedicine is often the only or even the only alternative to conventional health care.

    “in developing countries telemedicine in most cases is an alternative, or even the only alternative, to conventional health care.”
    “in developing countries, whose GDP is remarkably low if compared to the GDP of a developed country, no alternative seems to exist to telemedicine.”
  • The paper relies on this without support.

    Telemedicine is the only chance of medical care for people in rural locations of developing countries.

    “telemedicine is the only chance of a medical care for such people.”
  • The paper relies on this without support.

    A low percentage of citizens in developed countries rely on telemedicine as the only medical care system, while a remarkable percentage in developing countries do.

    “a low percentage of citizens in developed countries relies on telemedicine as the only medical care system: instead, a remarkable percentage of citizens in developing countries looks at telemedicine as the only medical care system”
  • The paper relies on this without support.

    Most telemedicine projects are successful as long as financial support is conspicuous, and decline after initial funding reduces.

    “It is generally observed that most telemedicine projects are successful as long as the financial support is conspicuous, and this typically occurs at project onset time: after the initial honeymoon, most projects reduce fund availability and, consequently, projects decline as time goes by.”
  • The paper relies on this without support.

    Organizational issues are critical in developing countries, while developed countries are not expected to experience them or very seldom.

    “Generally, these issues for the organization are critical in developing countries, while developed countries are not expected to experience them -or experience them very seldom.”
  • The paper relies on this without support.

    Most hardware requirements are not critical in developed countries but can be critical in rural and some urban locations of developing countries.

    “While most of these requirements are not critical for telemedicine projects in developed countries, the same requirements can be critical in rural locations, and even in some urban locations, of developing countries.”
  • The paper relies on this without support.

    Most communication requirements can be critical in developing countries, both rural and urban.

    “As for the hardware requirements, most of the communication requirements can be critical in developing countries, both rural and urban locations.”
  • The paper relies on this without support.

    Major limiting software requirements come from the client side.

    “Major limiting requirements come from the client side.”
  • The paper relies on this without support.

    If a limited budget is available, the difference between commercial software and public domain/freeware/shareware becomes extremely relevant.

    “Moreover, if a limited budget is available, the difference between commercial software and public domain/freeware/shareware becomes extremely relevant.”
  • The paper relies on this without support.

    Reduced bandwidth enables only asynchronous communications and simple textual information, while larger bandwidth enables synchronous communications and complex information including voice, sounds, still images, dynamic images and movies.

    “a reduced bandwidth enables asynchronous communications only, while synchronous communications require a larger bandwidth; a reduced bandwidth enables transmitting simple information, mainly textual one, while a larger bandwidth enables one to transmit more complex information, including voice, sounds (e.g., stethoscope), still images, dynamic images and movies.”
  • The paper relies on this without support.

    The project descriptions in the surveyed literature are accurate and complete enough to support the survey's comparisons and conclusions.

    “Success rate, even if the information is extracted from the description of the project as presented by the literature and not clearly stated, is not related to the dimension of the project.”
  • The paper relies on this without support.

    A project's success rate can be inferred from its description in the literature even when the description does not clearly state it.

    “Success rate, even if the information is extracted from the description of the project as presented by the literature and not clearly stated, is not related to the dimension of the project.”
  • The paper relies on this without support.

    The taxonomy dimensions used in Tables 1 and 2 are sufficient to categorize the projects and support the discussion's conclusions.

    “By considering the scenario summarized by ▶ Table 1 and ▶ Table 2, we are now able to draw some conclusions and then sketch out challenges, recommendations, and the lessons we learned.”
  • The paper relies on this without support.

    In most rural areas, the required ICT infrastructure is below minimal acceptable levels, impairing connection with remote centers and facilities.

    “In most rural areas the required ICT infrastructure can be below minimal acceptable levels, thus impairing any type of connection with remote centers and facilities.”
  • The paper relies on this without support.

    No organization currently handles accreditation of telemedicine service providers.

    “To the best of our knowledge, no organization is currently taking care of such accreditation procedures.”
  • The paper relies on this without support.

    No well-identified business model has been defined to ensure the sustainability of telemedicine.

    “At present, no well identified business model has been defined yet to ensure the sustainability of telemedicine.”
  • The paper relies on this without support.

    Insurance claims may not cover telemedicine services because the delivered healthcare does not follow traditional techniques, leading to limited or null reimbursement for insured people.

    “Would a patient be taken care of by using a telemedicine system, insurance claims may not cover such circumstances as the delivered healthcare service does not follow traditional techniques.”
  • The paper relies on this without support.

    Major needs in developing countries involve infectious diseases, sexually transmitted diseases, pulmonology, and Ebola.

    “As an example, major needs in developing countries involve infectious diseases, STD (sexually transmitted diseases), pulmonology, as well as Ebola, more recently.”
  • The paper relies on this without support.

    Some resistance may persist in mid-to-low profile personnel in developing countries, negatively affecting adoption of telemedicine systems.

    “Personal resistance and opposition to using a computer system is nowadays a completely obsolete problem in developed countries, as young generations are getting more and more connected to the Internet: on the other side, some resistance may persist in mid-to-low profile personnel in developing countries, thus affecting in a negative manner the real adoption of telemedicine systems.”
  • The paper relies on this without support.

    Locally organized courses may significantly increase overall acceptance of the telemedicine system, thus increasing overall results.

    “Locally organized courses may significantly increase the overall acceptance of the telemedicine system, thus increasing the overall results.”
  • The paper relies on this without support.

    Even the most well-designed telemedicine system may result in a low quality system if connectivity with remote health care centers is poor.

    “Even the most well designed telemedicine system may result in a low quality system if the connectivity with the remote health care center(s) is poor.”
  • The paper relies on this without support.

    After the initial enthusiastic approach, everyday practice forgets about the telemedicine system.

    “While it is quite easy to have the system used at its early stage, mid-term and long-term analysis highlight that after the initial enthusiastic approach, the everyday practice forgets about the telemedicine system.”
  • The paper relies on this without support.

    Adopting standards, shared protocols and guidelines helps a lot in enabling easy communication between different health care centers.

    “As already mentioned, adopting standards, shared protocols and guidelines helps a lot in enabling easy communication between different health care centers.”
  • The paper relies on this without support.

    Large-scale projects require more time to be completed and evaluated, and thus are more prone to failures than small-scale and agile projects.

    “Large-scale projects require more time to be completed and to be evaluated, and thus are more prone to failures then small-scale and agile projects.”
  • The paper relies on this without support.

    Cost-effectiveness and user satisfaction are hardly measured.

    “Even though such parameters are hardly measured, at the end of the initial stage of the project some conclusions must be drawn.”
  • The paper relies on this without support.

    Disregarding local habits (medical, cultural, religious) causes a telemedicine project to fail even before its start.

    “Introducing some techniques which strongly differ from the local practices or that may result as offending according to the local habits or religion, must be absolutely avoided, or the project will fail even before its start.”
  • The paper relies on this without support.

    Not providing users with proper training in ICT and the specific adopted system is a major pitfall.

    “ii.Not providing the users with the proper training in ICT in general and with the specific adopted system.”
  • The paper relies on this without support.

    Abandoning local users after releasing the system, without continual assistance, training and guidance, endangers continuing use.

    “iii.Abandoning the local users after releasing the system, without providing them with a continual assistance, training and guidance.In fact, the initial enthusiasm may hide some critical aspects, which -after having become evidentmay endanger the continuing use of the system.”
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Citations

Cites

Show all 48 references

Research works printed but not linked: 7

  1. US National Library of Medicine, National Institutes of Health. PubMed. 2016. Available from: https://www.ncbi.nlm.nih.gov/pubmed
  2. Hussein, 2012, GMS Medizinische Informatik, Biometrie und Epidemiologie, 8, 1
  3. Bice SD, Dever G, Mukaida L, Norton SA, Samisone J. Telemedicine and telehealth in the Pacific islands region: A survey of applications, experiments, and issues. In Peacesat. Pacific Telecommunications Council, pp. 574-581
  4. Gori, 2010, Comput Cardiol, 37, 481
  5. Bagayoko CO, Muller H, Geissbuhler A. Telemedicine network in French-speaking Africa (RAFT). In Medical Imaging and Telemedicine. pp. 108-113
  6. Bhatta, 2015, J Nepal Health Res Counc, 13, 149
  7. Shiferaw F, Zolfo M. The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia. Global Health Act 2012; 5 · DOI · Paper page

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Metadata

Authors
Combi, C., Pozzani, G., & Pozzi, G.
Affiliations
  • University of Verona (IT)
  • Politecnico di Milano (IT)
Corresponding author
Pozzi, Giuseppe
Venue
Applied Clinical Informatics
Published
2016-10
Volume
07
Issue
04
Pages
1025-1050
ISSN
1869-0327 (ISSN-L)
OpenAlex
W2548368723
Cited by
286
References
48
Citations by year
2026: 18 · 2025: 34 · 2024: 36 · 2023: 43 · 2022: 51 · 2021: 59 · 2020: 22 · 2019: 15 · 2018: 7
FWCI
1.08
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Applied Clinical Informatics (publishedVersion, public-domain)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Virtual Community of Pathological Anatomy (University of Castilla La Mancha) (submittedVersion, public-domain)
Funders
Regione Veneto through the “Cooperazione decentrata allo sviluppo” program (CUP B48I13000590003, B42C14000270002)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
Keywords
telemedicine, developing countries, rural health care, health care access, physician shortage
MeSH terms
Developing Countries, Humans, Surveys and Questionnaires, Telemedicine

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