Telemedicine Acceptance and Implementation in Developing Countries: Benefits, Categories, and Barriers


1 Medical Informatics Department, Faculty of Medicine,Mashhad University of Medical Sciences,Mashhad, IR Iran

2 Bio-technology Depatment, Islamic Azad University,Mashhad, IR Iran



Abstract Context: Distributing health care services in remote and rural areas have become a major health problem for many developing countries. Telemedicine presents solutions to developing countries for better disease prevention, diseasemanagement, emergency services and practicingmedicine in areaswith limited access to healthcare services and facilities. Although thewillingness of devel- oping countries to accept telemedicine and incorporate it into their health care systems is rising, due tomultidisciplinary and com- plicated characteristics of telemedicine, they will face challenges and barriers which will slow down their progress. This literature review attempts to explain the benefits, categories and barriers for acceptance and implementation of telemedicine in developing countries. Evidence Acquisition: This studywas conducted in 2016. Themain questionwas howis the general attitude to the acceptance and use of telemedicine in developing countries and what problems they are facing for the use of telemedicine. To find the solutions, we searched articles in two main databases, PubMed and Scopus, with the keywords and expressions related to the subject of the study (developing countries, telemedicine, tele-health, barriers, challenges, adoption, and acceptance). Totally, 103 articles were extracted. Duplicate articles andarticlespublishedbefore 1998were eliminatedandthe remaining oneswere screenedfor eligibility in accordance with subject of the study. The result was 47 articles from PubMed and 5 articles from Scopus. This review is based mainly on preliminary results, opinions and predictions. As limitations of our study, we limited ourselves to PubMed and Scopus databases and also reviewed articles only in English language. Results: The study did not find any article that totally disagrees with the implementation of telemedicine in developing countries. Most of the articles contain positive points associated with the use of telemedicine with respect to the barriers and challenges. Conclusions: Despite hopeful progresses in telemedicine, developing countries are facingmany problems in theirway toward suc- cessful application of telemedicine. High cost and cultural resistance are considered as themain barriers for developing countries in their approach to apply telemedicine. Developing countries must be fully aware that investment in telemedicine will not in- evitably yield clinical or economic benefits in short time. Theymust consider barriers and various outcomes of telemedicine before accepting and applying it.