A systems engineering approach to telemedicine system implementation in South Africa

The South African National Department of Health (DoH) is recognizing, for more than a decade already, the potential benefit of information and communication technology (ICT) to deliver healthcare to rural areas. However, despite generous funding and proven technology, not many of telemedicine systems sustained after pilot phase. The purpose of this paper is to develop a maturity model that can be used to measure and manage the capability of a health system to sustain health care delivery after the pilot phase of a telemedicine project. Four existing frameworks are used as input to this maturity model, namely the ISO 15288 Systems Engineering Life Cycle Standards, the ISO/IEC 15504 Software Process Improvement and Capability Determination (SPICE), eHealth Readiness Instrument for developing countries and the Layered Telemedicine Implementation Model. The validity of this maturity model is tested by means of a focus group discussion, during a workshop of provincial representatives from a provincial department of health (DoH). In conclusion, follow-up work is proposed for the development and validation of future versions of this framework towards a maturity model for telemedicine projects.