The Role of Sustainability in Telemedicine Services: The Case of the Greek National Telemedicine Network
Abstract
:1. Introduction
- What is the current theoretical background that arises from the literature review regarding telemedicine and sustainability?
- What are the potential challenges?
- Can a mutual conceptual framework be created with respect to the characteristics of the current governance model of telemedicine?
2. Theoretical Background
2.1. Methodology of Our Research
2.2. Challenges and Expected Positive Outcomes of Telemedicine
2.3. The National Telemedicine Network in Greece (EDIT)
- Sixty-six Patient-Doctor Telemedicine Stations (PDTS), situated in hospitals, health centers, and multipurpose regional clinics.
- Twenty-one Consultant Telemedicine Stations (CTS), located across 12 regional and tertiary hospitals in the 2nd Greek Health Region (HR), as well as in the National Emergency Centre (NEC).
- Over 170 Home Care Stations (HCS) installed in patient homes or social care facilities within the 2nd Greek HR’s jurisdiction.
- Three hundred and fifty-five new Patient–Doctor Telemedicine Stations (PDTS) to be deployed in selected healthcare facilities across the country.
- Thirty-five additional Consultant Telemedicine Stations (CTS), strategically placed based on healthcare facility capacity and operational needs.
- Five Telemedicine Training Centers, equipped with both CTS and PDTS technology, to train healthcare professionals in university hospitals nationwide.
- Three thousand Home Monitoring Systems (HCS), integrated with EDIT and its supporting software, to improve remote patient monitoring.
- Three new regional Control Centers and a centralized Command and Control Center at the Ministry of Health to oversee telemedicine operations.
3. Results
3.1. Fundamental Pillars of a Proper Sustainable Telemedicine Framework
3.2. The Proposed Methodology for Developing a Sustainability Plan in Telemedicine Services in Greece
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
EDIT | National Telemedicine Network in Greece |
HCOs | Healthcare organizations |
SDGs | Sustainable Development Goals |
ICT | information and communication technology |
PDTS | Patient-Doctor Telemedicine Stations |
CTS | Consultant Telemedicine Stations |
HR | Health Region |
DTI | Digital Transformation and Innovation |
QA | Quality assurance |
SOP | Standard operating procedure |
IRO | Impact—risk and opportunities |
KPIs | Key performance indicators |
ESG | Environmental, Social, and Governance |
Appendix A
Environment (E) Aspect | ||
Code | Factor | Proposed KPI |
EC001 | Energy Efficiency and Renewable Energy | Percentage of total energy from renewable sources. |
EC002 | Waste Management and Reduction | Percentage of medical waste recycled or safely treated. |
EC003 | Water Conservation and Management | Volume of water used per patient per day. |
EC004 | Transportation and Mobility | Percentage reduction in fuel-based transportation emissions. |
EC005 | Reduction in Hazardous Chemicals | Percentage of non-toxic, biodegradable cleaning products used. |
Social (S) Aspect | ||
Code | Factor | Proposed KPI |
SC001 | Patient Safety and Quality of Care | Number of adverse events per 1000 patients. |
SC002 | Health Equity and Accessibility | Percentage of underserved patients receiving care. |
SC003 | Community Engagement and Public Health Programs | Number of community health initiatives per year. |
SC004 | Ethical Patient Treatment and Informed Consent | Percentage of patients receiving informed consent before procedures. |
SC005 | Patient Rights and Complaint Handling | Average resolution time for patient complaints. |
Governance (G) Aspect | ||
Code | Factor | Proposed KPI |
GC001 | Regulatory Compliance | Number of compliance violations per year. |
GC002 | Patient Safety and Quality Care | Hospital-acquired infection rate (HAI) per 1000 patient days. |
GC003 | Data Governance and Security | Percentage of staff trained on data security protocols annually. |
GC004 | Stakeholder Engagement and Transparency | Patient satisfaction score (measured via surveys). |
GC005 | Patient Experience and Engagement | Patient engagement index or satisfaction scores. |
Economic (EC) Aspect | ||
Code | Factor | Proposed KPI |
EcC001 | Cost Efficiency and Resource Allocation | Cost per patient treated (cost per session). |
EcC002 | Operational Budget Management | Percentage of budget variance (actual vs. planned). |
EcC003 | Cost-Effectiveness of Interventions | Amount of money that was saved due to the intervention |
EcC004 | Financial Risk Management | Percentage of revenue protected through risk management strategies |
EcC005 | Return on Investment (ROI) for Healthcare Services | ROI of preventive health programs. |
Digital Transformation and Innovation (DTI) Aspect | ||
Code | Factor | Proposed KPI |
DTI001 | Return on digital investments | RODI = Net Benefits from Digital Investments/Total Digital Investment Cost × 100 |
DTI002 | Revenue from new digital channels | Revenue from New Digital Channels = ∑Sales/Revenue from New Digital Platforms |
DTI003 | Adoption and performance metrics | User Adoption Rate = Active Users/Total Target Users × 100 |
DTI004 | Revenue from digital technology | Revenue from Digital Technology = ∑Revenue from Digital Products, Services, and Platforms |
DTI005 | Actions performed to address digital illiteracy of patients | Patients Trained = ∑ Patients Who Completed Digital Literacy Programs |
Legal Framework (LF) Aspect | ||
Code | Factor | Proposed KPI |
LF001 | Regulatory Compliance | Compliance Rate = (Telemedicine Services Compliant with Regulations/Total Telemedicine Services) × 100 |
LF002 | Licensing and Credentialing | Licensing Compliance Rate = (Licensed Providers/Total Providers) × 100 |
LF003 | Reimbursement and Payment Compliance | Reimbursement Rate = (Reimbursed Claims/Total Claims Submitted) × 100 |
Quality Assurance (QA) Aspect | ||
Code | Factor | Proposed KPI |
QA001 | Clinical Quality and Effectiveness | Diagnosis Accuracy = (Correct Diagnoses/Total Diagnoses) × 100 |
QA002 | Patient Satisfaction and Experience | PS = (Positive Responses from Patients/Total Responses) × 100 |
QA003 | Patient Outcomes and Follow-Up Care | Follow-up Rate = (Scheduled Follow-up Appointments/Total Consultations) × 100 |
Ethical Considerations (ETC) Aspect | ||
Code | Factor | Proposed KPI |
ECN001 | Patient Privacy and Confidentiality | Privacy Compliance Rate = (Compliant Systems/Total Systems) × 100 |
ECN002 | Informed Consent | Informed Consent Rate = (Patients Who Signed Consent/Total Patients) × 100 |
ECN003 | Accountability and Transparency | Documentation Transparency Rate = (Consultations Documented Clearly and Accurately/Total Consultations) × 100 |
ECN004 | Cultural Sensitivity and Respect for Diversity | Training Rate = (Providers Who Received Cultural Sensitivity Training/Total Providers) × 100 |
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Rizos, F.; Karanikas, H.; Katsapi, A.; Tsana, M.; Tsoukas, V.; Koukoulas, G.; Drakopoulos, D.; Katsiroumpa, A.; Galanis, P. The Role of Sustainability in Telemedicine Services: The Case of the Greek National Telemedicine Network. Healthcare 2025, 13, 1046. https://doi.org/10.3390/healthcare13091046
Rizos F, Karanikas H, Katsapi A, Tsana M, Tsoukas V, Koukoulas G, Drakopoulos D, Katsiroumpa A, Galanis P. The Role of Sustainability in Telemedicine Services: The Case of the Greek National Telemedicine Network. Healthcare. 2025; 13(9):1046. https://doi.org/10.3390/healthcare13091046
Chicago/Turabian StyleRizos, Fotios, Haralampos Karanikas, Angeliki Katsapi, Mariana Tsana, Vasileios Tsoukas, George Koukoulas, Dimitrios Drakopoulos, Aglaia Katsiroumpa, and Petros Galanis. 2025. "The Role of Sustainability in Telemedicine Services: The Case of the Greek National Telemedicine Network" Healthcare 13, no. 9: 1046. https://doi.org/10.3390/healthcare13091046
APA StyleRizos, F., Karanikas, H., Katsapi, A., Tsana, M., Tsoukas, V., Koukoulas, G., Drakopoulos, D., Katsiroumpa, A., & Galanis, P. (2025). The Role of Sustainability in Telemedicine Services: The Case of the Greek National Telemedicine Network. Healthcare, 13(9), 1046. https://doi.org/10.3390/healthcare13091046