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This was a cross sectional study using mixed methods for data collection. Two semi-structured questionnaires were developed to collect quantitative data; first, for core, e-learning, and clinical readiness (Additional file 1), and second for technology readiness (Additional file 2). One health facility at the RRH and HC-IV levels was selected from each of three regions (Western, Northern and Eastern) using multi-stage random sampling. Mulago hospital, which functions as an HC-IV, GH and referral hospital for the Central region, was purposively identified for the study.

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To further assess core readiness, Focus Group Discussions (FGDs) were conducted with patients at Out-Patient Departments (OPD) at the identified HFs (Additional file 3). Convenience sampling was used to select the OPD patients, with patients invited by word of mouth to participate in the study. Each FGD comprised six to eight participants with seven FGDs conducted. Written notes were made of the discussions because participants had reservations about audio recording. Contemporaneous notes from the moderator and an assistant were used to ensure key points of the discussion and quotes were correctly and accurately documented. The discussions were summarised and data coded according to major themes, and sub-themes identified.

Despite moderate to high telemedicine knowledge, Technology Readiness at HC IVs was poor, and at some individual HC-IVs having an ICT budget, an ICT section, or access to ICT consultancy services did not equate to provision of any Internet related access and services. All RRHs were reported to have ICT budgets, an ICT section, and Internet access. Only one RRH in Western Region, had access to a web-portal, official email services, a network enabled for voice and data, anti-virus protection, and ICT security and therefore could be considered technology ready. The NRH was well provisioned with budget staff, services and security (Table 5).

VMK, MM and RES conceptualized the need to conduct this study. VMK collected data and VMK and MM analysed the data. VMK, MM & RES conducted further data analysis and revised the paper. All authors read through and approved the paper for final submission.

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated.

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