Investigating Telemedicine Approaches: a 10-Country Comparison

  • Authors

    • Mohd Khanapi Abd Ghani
    • Salama A Mostafa
    • Aida Mustapha
    • Hannani Aman
    • Mazin A Abed Mohamed
    • Mustafa Musa Jaber
  • Telemedicine system, framework, Patient health records, continuous and seamless
  • This paper investigates and appraises the current state of knowledge and practice and the existing telemedicine approaches in ten countries, namely China, Taiwan, Hong Kong, Singapore, Japan, South Korea, Canada, the U.K, Australia and New Zealand. The literature dealing with telemedicine development approaches was reviewed, compared and contrasted between Malaysia and the 10-country. Based on our analysis results, the suitable approaches and technologies were discussed. If no suitable approach is found, it will be possible to elicit the most relevant approach and best practice and to learn from any possible weaknesses.



  • References

    1. [1] Román, I., Roa, L.M., Reina-Tosina, J. and Madinabeitia, G., 2006. Demographic management in a federated healthcare environment. International journal of medical informatics, 75(9), pp.671-682.

      [2] Friedman, C.P. and Wyatt, J., 2005. Evaluation methods in biomedical informatics. Springer Science & Business Media.

      [3] Yin, R.K., 2017. Case study research and applications: Design and methods. Sage publications.

      [4] Koch, S., 2006. Home telehealth—current state and future trends. International journal of medical informatics, 75(8), pp.565-576.

      [5] World Health Organization, 2010. WHO statistical information system: core health indicators.

      [6] Schütz, H., Wiedemann, P.M., Hennings, W., Mertens, J. and Clauberg, M., 2006. Comparative risk assessment: concepts, problems and applications. John Wiley & Sons.

      [7] M. B. Alazzam, A. S. H. Basari, A. S. Sibghatullah, M. R. Ramli, M. M. Jaber, and M. H. Naim, “Pilot study of EHRs acceptance in Jordan hospitals by UTAUT2,†J. Theor. Appl. Inf. Technol., 2016.

      [8] Moehr, J.R., Schaafsma, J., Anglin, C., Pantazi, S.V., Grimm, N.A. and Anglin, S., 2006. Success factors for telehealth—a case study. International Journal of Medical Informatics, 75(10-11), pp.755-763.

      [9] Ministry of Health Malaysia (1997), Telemedicine Blueprint : Telemedicine Flagship Application. Copyright 1997 Government of Malaysia.

      [10] Mohan, J. and Yaacob, R.R.R., 2004. The Malaysian Telehealth Flagship Application: a national approach to health data protection and utilisation and consumer rights. International Journal of Medical Informatics, 73(3), pp.217-227.

      [11] M. K. A. Ghani and M. M. Jaber, “Willingness to Adopt Telemedicine in Major Iraqi Hospitals : A Pilot Study,†Int. J. Telemed. Appl., vol. 2015, no. 3, pp. 1–7, 2015.

      [12] Whitten, P. and Sypher, B.D., 2006. Evolution of telemedicine from an applied communication perspective in the United States. Telemedicine Journal & e-Health, 12(5), pp.590-600.

      [13] Coiera, E., 2015. Guide to health informatics. CRC press.

      [14] Sullivan, P. and Lugg, D.J., 1995. Telemedicine between Australia and Antarctica: 1911-1995 (No. 951616). SAE Technical Paper.

      [15] Wittson, C.L., Affleck, D.C. and Johnson, V., 1961. Two-way television in group therapy. Mental hospitals.

      [16] Kvedar, J., Coye, M.J. and Everett, W., 2014. Connected health: a review of technologies and strategies to improve patient care with telemedicine and telehealth. Health Affairs, 33(2), pp.194-199.

      [17] Bashshur, R. and Lovett, J., 1977. Assessment of telemedicine: results of the initial experience. Aviation, space, and environmental medicine, 48(1), p.65.

      [18] Garshnek, V. and Burkle Jr, F.M., 1999. Applications of telemedicine and telecommunications to disaster medicine: historical and future perspectives. Journal of the American Medical Informatics Association, 6(1), pp.26-37.

      [19] Garshnek, V. and Burkle Jr, F.M., 1999. Telecommunications systems in support of disaster medicine: applications of basic information pathways. Annals of emergency medicine, 34(2), pp.213-218.

      [20] Garshnek, V., 1991. Applications of space communications technology to critical human needs: Rescue, disaster relief, and remote medical assistance. Space communications, 8(3-4), pp.311-317.

      [21] Ferguson, E.W., Doarn, C.R. and Scott, J.C., 1995. Survey of global telemedicine. Journal of medical systems, 19(1), pp.35-46.

      [22] M. K. A. Ghani, and M. M. Jaber, “The Effect of Patient Privacy on Telemedicine Implementation in Developing Countries: Iraq Case Study,†Res. J. Appl. Sci. Eng. Technol., vol. 11, no. 11, 2015.

      [23] Norris, A.C. and Norris, A.C., 2002. Essentials of telemedicine and telecare (p. 106). Chichester: Wiley.

      [24] Jankharia, B., 2001. Current status and history of teleradiology in India. International journal of medical informatics, 61(2-3), pp.163-166.

      [25] Gómez, E.J., del Pozo, F., Ortiz, E.J., Malpica, N. and Rahms, H., 1998. A broadband multimedia collaborative system for advanced teleradiology and medical imaging diagnosis. IEEE Transactions on information technology in biomedicine, 2(3), pp.146-155.

      [26] Warren, S., Craft, R.L., Parks, R.C., Gallagher, L.K., Garcia, R.J. and Funkhouser, D.R., 1999. A proposed information architecture for telehealth system interoperability (No. SAND99-0864C). Sandia National Labs., Albuquerque, NM (US); Sandia National Labs., Livermore, CA (US).

      [27] Al-Qirim, N., 2006. The case of telepsychiatry adoption and diffusion in a healthcare organization in New Zealand. Journal of Cases on Information Technology (JCIT), 8(1), pp.31-48.

      [28] M. K. A. Ghani, M. M. Jaber, and N. Suryana, “Barriers Faces Telemedicine Implementation in the Developing Countries : Toward Building Iraqi Telemedicine Framework,†ARPN J. Eng. Appl. Sci., vol. 10, no. 4, pp. 1562–1567, 2015.

      [29] Cooper, D.R., Schindler, P.S. and Sun, J., 2006. Business research methods (Vol. 9). New York: McGraw-Hill Irwin.

      [30] Ministry of Health Malaysia (1997b), Concept Request for Proposal for Lifetime Health Plan - Schedule B: Network Infrastructure. Copyright 1997 Government of Malaysia.

      [31] Government of Malaysia (2007), Available at, (Accessed February 12, 2018).

      [32] Wu, J.H., Wang, S.C. and Lin, L.M., 2007. Mobile computing acceptance factors in the healthcare industry: A structural equation model. International journal of medical informatics, 76(1), pp.66-77.

      [33] Wootton, R., Craig, J. and Patterson, V., 2006. Introduction to telemedicine. CRC Press.

      [34] Linhoff, M., 2002, April. Mobile computing in medical and healthcare industry. In Mobile Computing in Medicine (pp. 217-225).

      [35] Anantharaman, V. and Han, L.S., 2001. Hospital and emergency ambulance link: using IT to enhance emergency pre-hospital care. International journal of medical informatics, 61(2-3), pp.147-161.

      [36] Rasid, M.F.A. and Woodward, B., 2005. Bluetooth telemedicine processor for multichannel biomedical signal transmission via mobile cellular networks. IEEE transactions on information technology in biomedicine, 9(1), pp.35-43.

      [37] Donnay, F., 2000. Maternal survival in developing countries: what has been done, what can be achieved in the next decade. International Journal of Gynecology & Obstetrics, 70(1), pp.89-97.

      [38] Baker, L.C., Johnson, S.J., Macaulay, D. and Birnbaum, H., 2011. Integrated telehealth and care management program for Medicare beneficiaries with chronic disease linked to savings. Health Affairs, 30(9), pp.1689-1697.

      [39] K. D. Saifuldun Mostafa, Hayder Saad, Mustafa Musa Jaber, Mohammed Hasan Ali, “The Design Trends of Keystream Generator for Stream Cipher for High Immunity Attacks,†in Advanced Computer and Communication Engineering Technology, Springer International Publishing, 2016, pp. 877–889.

      [40] Abd Ghani, M.K., Bali, R.K., Naguib, R.N., Marshall, I.M. and Wickramasinghe, N.S., 2008. Electronic health records approaches and challenges: a comparison between Malaysia and four East Asian countries. International Journal of Electronic Healthcare, 4(1), pp.78-104.

      [41] National Health Services (2006c), Connecting for Health - Fact sheets: N3., Availabe at, (Accessed 17 May 2018).

      [42] National Health Services (2007), The NHS Care Records Service Better information for better, safer care, Availabe at, (Accessed July 19, 2018).

      [43] Mykkänen, J., Porrasmaa, J., Rannanheimo, J. and Korpela, M., 2003. A process for specifying integration for multi-tier applications in healthcare. International Journal of Medical Informatics, 70(2-3), pp.173-182.

      [44] Berler, A., Pavlopoulos, S. and Koutsouris, D., 2004, September. Design of an interoperability framework in a regional healthcare system. In Engineering in Medicine and Biology Society, 2004. IEMBS'04. 26th Annual International Conference of the IEEE (Vol. 2, pp. 3093-3096). IEEE.

      [45] Ghani, M., Bali, R., Naguib, R., Marshall, I. and Wickramasinghe, N., 2010. Critical issues for implementing a lifetime health record in the Malaysian public health system. International Journal of Healthcare Technology and Management (IJHTM), 11(1/2), pp.113-130.

      [46] Hu, P.J.H., Wei, C.P. and Cheng, T.H., 2002, January. Investigating telemedicine developments in Taiwan: implications for telemedicine program management. In System Sciences, 2002. HICSS. Proceedings of the 35th Annual Hawaii International Conference on (pp. 8-pp). IEEE.

      [47] Chen, H.S., Guo, F.R., Chen, C.Y., Chen, J.H. and Kuo, T.S., 2001. Review of telemedicine projects in Taiwan. International Journal of Medical Informatics, 61(2-3), pp.117-129.

      [48] HPBonline (2007), Singapore Health Promotion Board Online: Vision, mission & values, Availabe at, (Accessed January 5, 2018).

      [49] Chew, S.J., Cheng, H.M., Lam, D.S.C., Cheng, A.C.K., Leung, A.T.S., Chua, J.K.H., Yu, C.P., Balakrishnan, V. and Chan, W.K., 1998. OphthWeb-cost-effective telemedicine for ophthalmology. Hong Kong Medical Journal, 4, pp.300-304.

      [50] SingHealth (2007), Continue Medical Education, Availabe at, (Accessed February 10, 2017).

      [51] Tay-Yap, J. and Hawamdeh, S., 2001. The impact of the Internet on healthcare in Singapore. Journal of Computer-Mediated Communication, 6(4), p.JCMC645.

      [52] Lun, K.C., 1999. Health informatics in the Asia Pacific region. International journal of medical informatics, 55(1), pp.3-7.

      [53] [53] Holliday, I. and Tam, W.K., 2004. E-health in the East Asian tigers. International Journal of Medical Informatics, 73(11-12), pp.759-769.

      [54] Mohammed, M.A., Ghani, M.K.A., Hamed, R.I. and Ibrahim, D.A., 2017. Review on Nasopharyngeal Carcinoma: Concepts, methods of analysis, segmentation, classification, prediction and impact: A review of the research literature. Journal of Computational Science, 21, pp.283-298.

      [55] Mohammed, M.A., Ghani, M.K.A., Hamed, R.I. and Ibrahim, D.A., 2017. Analysis of an electronic methods for nasopharyngeal carcinoma: Prevalence, diagnosis, challenges and technologies. Journal of Computational Science, 21, pp.241-254.

      [56] Canada Health Infoway (2006a), What we do: Overview, Availabe at, (Accessed October 15, 2017).

      [57] Canadian Medical Association (2005), IT in General Practice: A 10-country comparison, Availabe at, (Accessed August 21, 2017).

      [58] Ferrer-Roca, O. and Sosa-Iudicissa, M.C. eds., 1998. Handbook of telemedicine (Vol. 54). IOS press.

      [59] Kidd, L., Cayless, S., Johnston, B. and Wengstrom, Y., 2010. Telehealth in palliative care in the UK: a review of the evidence. Journal of Telemedicine and Telecare, 16(7), pp.394-402.

      [60] Brennan, S., 2007. The biggest computer programme in the world ever! How's it going?. Journal of Information Technology, 22(3), pp.202-211.

      [61] National Health Services (2006a), The National Programme for IT Implementation Guide, Availabe at , (Accessed 15 May 2018).

      [62] Mohamed, M., 1991. Malaysia: The Way Forward (Vision 2020). Kuala Lumpur, National Printing Department.

      [63] Ministry of Health Malaysia (2007), ICT Strategic Plan (ISP): 2006 - 2010. Unpublished document Government of Malaysia.

      [64] [64] Suleiman, A.B., 2001. The untapped potential of telehealth. International journal of medical informatics, 61(2-3), pp.103-112.

      [65] M.A. Mohammed, M.K.A. Ghani, N. Arunkumar, R.I. Hamed, M.K. Abdullah, M.A. Burhanuddin, A real time computer aided object detection of nasopharyngeal carcinoma using genetic algorithm and artificial neural network based on Haar feature fear, Future Generation Computer Systems (2018),

      [66] Ghani, M.K.A., Mohammed, M.A., Ibrahim, M.S., Mostafa, S.A. And Ibrahim, D.A., 2017. Implementing an Efficient Expert System for Services Center Management by Fuzzy Logic Controller. Journal of Theoretical & Applied Information Technology, 95(13).

      [67] Mostafa, S. A., Mustapha, A., Khaleefah, S. H., Ahmad, M. S., & Mohammed, M. A. (2018, February). Evaluating the Performance of Three Classification Methods in Diagnosis of Parkinson’s Disease. In International Conference on Soft Computing and Data Mining (pp. 43-52). Springer, Cham.

      [68] Mohammed, M.A., Ghani, M.K.A., Hamed, R.I., Mostafa, S.A., Ibrahim, D.A., Jameel, H.K. and Alallah, A.H., 2017. Solving vehicle routing problem by using improved K-nearest neighbor algorithm for best solution. Journal of Computational Science, 21, pp.232-240.

      [69] Mostafa, S. A., Mustapha, A., Mohammed, M. A., Ahmad, M. S., & Mahmoud, M. A. (2018). A fuzzy logic control in adjustable autonomy of a multi-agent system for an automated elderly movement monitoring application. International journal of medical informatics, 112, 173-184.

      [70] Mostafa, S. A., Darman, R., Khaleefah, S. H., Mustapha, A., Abdullah, N., & Hafit, H. (2018, June). A General Framework for Formulating Adjustable Autonomy of Multi-agent Systems by Fuzzy Logic. In KES International Symposium on Agent and Multi-Agent Systems: Technologies and Applications (pp. 23-33). Springer, Cham.

      [71] M.A. Mohammed et al., Neural network and multi-fractal dimension features for breast cancer classification from ultrasound images, Computers and Electrical Engineering (2018),

  • Downloads

  • How to Cite

    Khanapi Abd Ghani, M., A Mostafa, S., Mustapha, A., Aman, H., Abed Mohamed, M. A., & Musa Jaber, M. (2018). Investigating Telemedicine Approaches: a 10-Country Comparison. International Journal of Engineering & Technology, 7(3.30), 224-234.