Abstract
We have investigated the factors which make telemedicine centres sustainable. A pilot study was carried out at two university telemedicine centres in Brazil: the Faculty of Odontology and the Faculty of Medicine at the University of São Paulo. Both centres were supported by long-term government grants. One centre delivered clinical telemedicine services in audiology and odontology, and the other centre delivered clinical services in dermatology, surgery, cardiology, medicine and second-opinions for primary care. A semi-structured interview script was drawn up and after consensus among four referees, interviews were carried out with one telemedicine coordinator from each centre. Analysis of the results showed that telemedicine sustainability is a multidimensional matter, not simply a financial one. The results of the interviews led us to refine our construct of telemedicine sustainability into seven different macro-group perspectives. These were: Institutional, Functional, Scientific, Financial, Renovation, Relational and Social. This construct allowed us to convert strategic and logical factors into a graphical representation. This graphical representation provides a snapshot of the performance of a telemedicine centre at a particular moment. The next step is to create a theoretical model of sustainability for testing in ten other centres in different regions of Brazil, including Amazonia.
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