Background: Establishment of telemedicine programs as tool to help restructuring healthcare system in post-conflict countries as well other developing countries in a sustainable fashion, and to rebuild their health care systems to meet the needs of citizens. Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs.

Methods: A program known as “Initiate-Build-Operate-Transfer” (IBOT), is a comprehensive, four-pronged strategy that allows for development and implementation of successful sustainable telemedicine system not only in post conflict countries but countries in transition and developing countries.

Results: Using IBOT strategy, we have built three national programs (Kosovo, Albania and Cabo Verde) in all 46 hospitals of these three countries. Currently we have partnered to build telemedicine in Vietnam building telemedicine.

Conclusion: IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the healthcare infrastructure.