Introduction

The fourth industrial revolution is a method used to narrate the indistinct between
physical, digital, and biological worlds (Schwab, 2016). It is a blend of advances in
artificial intelligence, quantum computing, 3D and 4D printing, robotics, genetic
engineering, internet of things and cyber-physical system. It is a collective force behind
numerous products and services that are rapidly merging to modern life. The term 4IR
comes from the arrival of the steam engine in the 18th century that led to the initial
industrial revolution, permitting production to be equipped with machines, ad driving
social change as people begin to be progressively urbanized. In the 21st century, with
the advent of the internet, portable devices and other such digital devices are taking a
transformative role in healthcare and its delivery.

Improved technology has made telemedicine easier, even for those who don't consider
themselves computer servy. Telemedicine is the practice of medicine using electronic
communications, information technology or other electronic means between a
healthcare practitioner in one location and a healthcare practitioner in another location
for the purpose of facilitating, improving and enhancing clinical, educational and
scientific healthcare and research (HPCSA:2014). According to Sabria and Defi
(2021:118) guidelines on telemedicine would assist healthcare providers in delivering
healthcare services based on local circumstances especially in the pandemic era.

Telemedicine is used in a more limited sense to describe remote clinical service such
as diagnosis and monitoring. Telemedicine has improved the capacity of healthcare
providers to take care of many people without physically being there. Furthermore,
now it has proved its worth, it will be around for a long time.
Project plan: This Project aims to implement a comprehensive telemedicine
infrastructure that enables health professionals in urban centers to assist patients
located in remote areas. By leveraging the power of telemedicine and digital
technologies, this project will improve access to healthcare, enhance patient
outcomes, and addresses the challenges faced by individuals residing in underserved
regions.
Customer requirements
Every product aims to fill a specific customer need, but pinpointing what customers
actually need is more difficult than it seems. A house of quality involves collecting and
analyzing the “voice of customer” and it is a key part of the Quality Functional
Deployment technique. It’s a matrix, much like a detailed table where customer needs
meet technical requirements, providing a visual representation of the relationship
between what the customer wants and how the organization can meet those wants.
• Reliable-Seamless video consultations for patients and healthcare providers.
• Privacy and Security: Implement robust encryption and privacy measures to
protect patient data and confidentiality.
• Convenient- flexible appointment scheduling, easy access to telemedicine
appointments through online portals
• Enhanced mobility: The ability to make and receive calls from anywhere, using
any device.
• Affordability- exceptional and consistent value, safe payment processes
• User-Friendly Interface: Design an intuitive and easy-to-navigate interface for
seamless user experience.
• Real-time monitoring of vital signs during telemedicine consultations.
• Multilingual support for diverse patient populations
• Virtual support groups and wellness programs
• Quality of Care: Maintain high standards of care delivery through the
telemedicine platform.
The table below represents the House of Quality, the team collected customer
requirements and rated them on a scale of 1-5, with 5 being the most important and 1
being the least.

% customer importance rating

Customer Importance rating

Reliable 3 9%
Privacy and security 4 12%
Flexibility 3 9%
Enhanced Mobility 4 12%
User friendly 2 6%
Quality of care 4 12%
Affordability 2 6%

Design Characteristics for a Telemedicine project.

Recent policy changes during the COVID-19 pandemic have reduced barriers to
telemedicine (Sabrina & Defi:2021;118). Common barriers include technically
challenged staff, cost, lack of high-speed internet, conflicting health system priorities
and lack of political will. Telemedicine design incorporates a number of key
characteristics to ensure effective and accessible remote healthcare. It relies on
training and the development of specific skills to eliminate errors and increase the
quality of care. Here’s a breakdown of some important aspects:
• Focus on Patients and Providers- Telemedicine system should be built with
needs of both patients and healthcare providers in mind. This means
considering factors like ease of use, accessibility for those with varying
technical abilities and that support effective communication.
 • Secure communication channels- Safeguarding patient privacy is paramount.
Platforms should prioritize secure video conferencing, messaging and data
transfer protocols.
• Scalability- The platform should be able to handle increasing user volume and
ensure consistent performance to avoid disruptions during consultations.
• Multi-Modality- Offering various communication options like video calls, audio
calls send text chat caters to user preferences and data transfer protocols.
• Integration with medical records- seamless integration with electronic medical
records allows for efficient retrieval and sharing of patient information during
consultations.
• Workflow Integration- Optimizing how telemedicine fits into existing healthcare
workflows can improve efficiency for providers and staff.
• Pricing and Insurance- do they accept insurance? Are their pricing models
transparent and competitive.
• H
• Y

By following these design principles, telemedicine solutions can become valuable tools
for expanding access to quality healthcare, improving patient convenience, and
enhancing communication between patients and providers. In our example, we
assessed how the functionality of the new product compares to the range of functions
of design characteristics.

Maximize
Target
Minimize
 Integration with medical record
Secure communication chanels
Focus on patient and providers
% customer importance rating
Customer Importance rating

Workflow integration
Multi-Modality
Scalability
Reliable 3 9%
Privacy and security 4 12%
Flexibility 3 9%
Enhanced Mobility 4 12%
User friendly 2 6%
Quality of care 4 12%
Affordability 2 6%

Technical and competitor Evaluation

Telemedicine evaluations should also recognize barriers including those that are
behavioral, organizational, technical, economical and legal that might affect outcomes.
The success of telemedicine visits is often more about changing clinician and patient
expectations than about the technology itself. The technical evaluation develops a
correlation between customer requirements and design characteristics. The ranking
system used is a set of symbols for strong, medium and weak relationships, each of
the symbols represents a value of # for strong, # for medium and 1 for weak.
Relationships

Strong

Medium

Weak 1
Roof/ Correlation Matrix
The telemedicine landscape is rapidly growing, with established healthcare providers
and new startups vying for market share. The triangular “roof” matrix of the House of
Quality is to identify how the design requirements interact with each other. The
interrelations are rated as strong positive to strong negative.

Correlations
Strong positive ++
Positive +
No Correlation
Negative -
Strong Negative --
References

HPCSA Booklet No 10. General ethical guidelines for good practice in telemedicine. 2014.
www.hpcsa.co.za. Accessed 10 April 2023.

Sabrina, M.I. and Defi, I.R. (2021), Telemedicine guidelines in South East Asia- A Scoping
review. 11:581649.