Joseph Tan Mengistu Kifle Victor Mbarika Chitu Okoli

I. Learning Objectives II. Introduction

III. E-Medicine Overview

A. The History of E-Medicine

B. Challenges in Diffusing E-Medicine

C. Factors Driving the Diffusion of E-Medicine

IV. E-Medicine in Canada V. E-Medicine in Ethiopia

A. Background on Ethiopia

B. Factors Affecting the Diffusion of E-Medicine in Ethiopia

1. National ICT Policies

2. ICT Infrastructures

3. Implementation Factors

4. Culture-Specific Beliefs and Values and Technological Culturation

C. Research on the Diffusion of E-Medicine in Developing Countries

The authors would like to acknowledge the contributions of students, research assistants, and colleagues from their various universities, particularly graduate students at the University of British Columbia and Wayne State University, who have contributed to the literature searches and materials used in this chapter. Any omissions or errors remain the responsibility of the authors. This work was partially supported by grants provided to Joseph Tan by the Office of the President of Wayne State University.

VI. Conclusion

VII. Chapter Questions

VIII. References

IX. E-Medicine Development in Taiwan Case

Learning Objectives

1. Define e-medicine in the context of the different periods in the development and growth of e-medicine as a concept, a discipline, and a practice

2. Review challenges faced in the history of e-medicine

3. Understand the significance of diffusing e-medicine in Canada

4. Identify factors affecting the implementation and diffusion of e-medicine in developing countries, specifically Ethiopia

5. Recognize the relationships among the factors that affect the transfer of e-medicine as well as their potential impact on the success of e-medicine implementation


E-medicine can be defined as the diffusion of medicine and health care services through the use of information and communications technologies. In mainstream medical, public health, and health services research literature, terms such as telemedicine (which literally means medicine at a distance) and telehealth are often used interchangeably to refer to e-medicine services, with the understanding that telehealth encompasses not only telemedicine services but also important e-health administrative and support services (see Chapter Seven). The application of telemedicine to deliver e-health care and e-health education is not new (Bashshur, 1997). Throughout this book, however, the term e-medicine is often used not only in a broad sense because it corresponds elegantly to the notion of e-health diffusion but also in a more restricted sense because it refers to a specific aspect of e-health diffusion: the diffusion of various specialties and subspecial-ties within the telemedicine domain. Specific examples of e-medicine include teleradi-ology, teledermatology, telepathology, tele-ophthalmology, tele-oncology, telepsychiatry, telecardiology, telenursing, and tele-accident and emergency support. E-medicine contributes to the sociopolitical, cultural, and economic infrastructure and development of a country. It can help provide multidisciplinary perspectives in health care delivery to individual citizens, selected groups and communities, and even entire populations.

In this chapter, we provide an overview of e-medicine, focusing on the history of and the driving factors in the diffusion of e-medicine technology. Next, we discuss e-medicine in Canada, focusing on the work of the Canadian federal government, provincial initiatives, and investigations by university researchers. We then highlight the diffusion of e-medicine in developing countries, pointing out the critical success factors and challenges. Finally, we move on to discuss the diffusion of e-medicine in less developed countries, using the specific case of Ethiopia and examining the factors influencing success in the implementation of e-medicine applications.

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