RESUMEN
We studied a telediabetes programme that had been in operation for 10 years, to identify the factors in its sustainability. We reviewed archive documents, conducted interviews with programme administrators and primary care providers, observed diabetes consultations and surveyed patient satisfaction. Three success factors were identified: the administration took a long-term view of the value of the telemedicine service; telediabetes enabled structured use of staff time and facilities; and service delivery followed national diabetes standards and a well defined cycle of care within a long-term quality improvement programme. However, the present study did not address the three other key theoretical dimensions of systems design beyond sustainability: size, scalability and scope.