The modern development of telemedicine and telecare dates from the early 1990s when a combination of technological and service drivers created new opportunities. These drivers include advances in information and communications technologies, the need to extend healthcare access to remote and disadvantaged communities, military applications and perceived cost reduction. Governments and healthcare providers have shown considerable interest in the potential of telemedicine for reducing service costs but have been slow to provide the strategic context in which the approach can move into the mainstream. Only in the last five years or so have we seen an awareness of the strategic underpinning needed to produce this context. This paper identifies the roles of government, healthcare professionals and equipment suppliers in policy development and strategy setting and reviews the experience of several countries. The analysis seeks to determine the key principles that facilitate the mainstream development of telemedicine, and the critical success factors for the design and delivery of telemedicine and telecare services.
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