|dc.description.abstract||Social implications• It has been highlighted in the literature study that social issues surrounding
Telemedicine include questions such as, if health care is a right, can Telemedicine services
reasonably be withheld anywhere where there is access to telecommunications and who will be
allowed to provide telecommunication services. Some of the social issues included Telemedicine
concerns about reduced comfort of human interface between a patient and a doctor. However in
some instances patients reported being more self assured and better focused without the
physician being physically in the room. Another issue cited is that technical systems may be poorly
adapted to the human infrastructure of health care. It was mentioned that sustainable
Telemedicine programs also require attention to organisational business objectives and strategic
plans that are not always evident in current applications.
Economic implications - It has been cited that Home Telemedicine, which enables ambulatory
patients to live at home under the supervision of home health nurses, is viewed as effective in
reducing costs that may be occurred by expensive inpatient stays in nursing home facilities.
Literature states that despite its advantages, clinicians may see Telemedicine as an economic
threat due to increased competition, structural alliances, and surpluses of some categories of
health professionals. In addition, the current lack. of payment for Telemedicine service is
considered to be one of the major barriers to its deployment Most third party payers have taken a
"Wait and see" approach toward Telemedicine reimbursement. Other economic considerations
include the cost of equipment and of information transmission. It has been cited that, for rural
study determined that a major impediment to the widespread implementation of Telemedicine in
rural areas is the lack of resources for acquisition of appropriate telecommunications equipment.
Secondly an empirical study was done, and provinces were chosen (Kwazulu Natal, Mpumalanga and
Eastem Cape) to replicate the findings to a national level. This was done means of field study of which
two structured questionnaires (for health care providers and consumers) were used to diagnose and
conclude on factors to be considered for implementation of Telemedicine in South Africa. The results
of the questionnaires were processed statistically. Based on the literature study concerning the ideal
Telemedicine implementation and system, and the empirical results, it was possible to determine the
gap, problem areas and issues of Telemedicine implementation programme in South Africa. The
research c1earty showed the numerous areas for focus and improvements exist.
To bridge the present Telemedicine implementation gap that exists in South Africa, a practical and
feasible Telemedicine implementation framework. and plan was recommended. Although some
research studies have been conducted and have not yet convincingly shown the economic returns
on Telemedicine system, the recommendations presented in this study seek to show tangible
economic benefits of a practical Telemedicine system suitable for South Africa. The study shows
that the achievement is attainable through private partnership strategies such as Parastatals'
involvement in the Telemedicine implementation programme.||