Innovative Healthcare Delivery: the Quest for Effective Telemedicine-based Services

Healthcare is a complex industry that is facing great changes in its structure, organization, service delivery and operations. One of the most impactful trends for healthcare is probably the progressive ageing of population. It creates pressures in many ways, such as reducing the pool of economically active population, posing growing problems of compliance to medication and lifestyle guidance, and increasing the number of elderly people in need of long-term care and assistance. This entails increasing costs for healthcare, in a time when the availability of both economic and human resources is decreasing (Whitten et al., 2010). Within this context, the development of new paradigms of healthcare delivery that may be sustainable over time has become an imperative (Forbes & While, 2009). With this regard, technology has drawn increasing attention as one of the emerging service delivery vehicles running on the information highway (Zajtchuk, 1996). In fact, also a cursory review of literature would identify that Information and Communication Technology (ICT) is commonly considered a major enabler for the innovation of healthcare delivery. Despite this enthusiasm, less is understood about how to make these changes factual. Technology alone, in fact, is not enough, but is the interplay of technical and organizational factors in designing and implementing technologies that lead to improved outcomes (Obstfelder et al., 2007). In this view, a sustainable technology-based healthcare service, which entails the effective introduction of the innovation into the routine processes, is mainly underpinned by human and organizational issues, and their deep interrelation with technical aspects (Gagnon et al., 2005; Aas, 2001). To this extent, and within the care innovation context, the use of ICT to support delivery of healthcare over a distance, namely “telemedicine” (Lehoux et al., 2002), was often mentioned as a shift in paradigms, which impacts on task design and delivery processes (de Bont & Bal, 2008; Gagnon et al., 2005). The assessment of telemedicine-based services has often highlighted the effects of these new technologies on quality, accessibility and service costs (Gagnon et al., 2008). However, although many demonstration projects have presented evidence about clinical benefits, cost effectiveness and high levels of patient satisfaction (Whitten et al., 2010), some of them yet failed to become part of everyday clinical routine (de Bont & Bal, 2008). This is because telemedicine-based services have been mainly considered