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There is varied accounts of the history of telemedicine in the published literature as well as in popular discourse. A careful review of these accounts reveals a common characteristic, despite significant variability between them. None of the reports has seriously considered the full story of telemedicine, including its continuity in medical practice in one form or another from ancient times to the present, the enduring necessity of connectivity in the delivery of medical care, the various transformations of telemedicine over the ages, or most importantly the contexts that sustained interest in this modality of practice. These accounts do not pay adequate attention to the rich context that prompted the early experimentation in the use of telecommunication technology in the delivery of healthcare and that continues to guide its development and transformation into the future. Delving into the detailed history of telecommunications as well as accounts and analysis of various national and regional initiatives aimed only at addressing the issues of healthcare access, quality, and cost . Nonetheless, the unintended detour gives a valuable insight and a genuine appreciation of the complexity and difficulty of designing optimal health systems that serve all segments of the population and that assure equity of access to standardized care at affordable prices. Indeed, gaining a better understanding of the broader context for the initiation, development, and persistence and the unique role a telemedicine can play in redressing intransigent problems in healthcare delivery as we go forward into an increasingly complex healthcare environment. Tracing the history of long-distance communication from its humble origins in semaphore, and much later the telegraph, and radio to advanced digital communication and computer processing systems and even the recent trends in the transformation of telemedicine from simple ‘‘connectivity’’ tools to ‘‘versatility’ tools in the mainstream of medical care, such as the use of telemedicine for clinical decision support, prescription ordering, disease management, patient empowerment, and disaster preparedness / response. These new application areas appropriate in various clinical settings and environments. However, they are not limited to connecting distant participants. Hence, it raises a question whether the term ‘‘telemedicine’’ still applies to these applications under our broader discussion of the

On Redefining Telemedicine Paradigm: An Innovative Integrated Model for Efficient Implementation of Healthcare Delivery in Developing Countries