**6. Conclusion**

In this chapter a telemedicine service maturity model (TMSMM) is presented. This TMSMM is developed in response to the need for a framework according to which the maturity of existing and proposed telemedicine projects can be measured with the purpose of supporting decision making towards sustained telemedicine services.

The TMSMM was developed by following an iterative process involving telemedicine practitioners from five different South African provincial departments of health (DoH). With each iteration a cross-functional group was involved in workshop format. Self-assessment maturity models, like the TMSMM proved to be particularly effective with cross-functional and interdisciplinary groups.

This descriptive maturity model can be used as basis for the development of a prescriptive and eventually comparative maturity model for which the following design principles applies [39]: Firstly, decision calculus is included the assist in the evaluation of different alternatives. Secondly, an adoption methodology is included which features a procedure model, advice on how to concretize and adapt improvement measures.
