OBJECTIVE: Even though abundant studies and models have tried to explain and predict the adoption and use of new information systems, the research on the adoption of Diabetes Management Systems in multiple clinical settings is relatively scarce. This paper addresses this issue by outlining Georgetown University's experience with implementing its MyCareTeam diabetes telemedicine application, which is a web.based, interactive diabetes management application.

METHODS: Case study is used to explore the influencial factors on web.based diabetes telemedicine systems in multiclinical setting. The experience of the Georgetown University deploying MyCareTeam system in six different geographical areas was analyzed by secondary literature review and interviews.

RESULTS: This study finds several problems and possible resolutions to expand the telemedicine systems of single institution into the multiple clinical settings. The application systems must be able to transfer data from diverse medical devices and integrate with web.based diabetes management application. Therefore, the system needs to support diverse data transfer type, diverse cable, and different network environment. In addition, there is a need for more dedicated technical and operational support, to prevent frequent turnover among the overburdened nurses who currently interact remotely with telemedicine patients.

CONCLUSIONS: To apply currently developed telemedicine technology into the real clinical settings, the proposed technical as well as organizational infrastructure should be established. The findings of this study will be guideline for multi.center diabetes management system in Korea.