Abstract. Technological progresses in the information, communication and telecommunication (ICT) industries and innovations telemedia industry have made telemedicine an increasingly viable health care delivery choice for emerging economies like South Africa. Simply stated telemedicine is the use of ICT technologies in conjunction with telemedia systems to provide health care services when distance separates the health professionals and patients. The study examines the constraints of utilisation of telemedicine in the broader health care delivery value chain. This paper discusses the challenges of managing diffusion of telemedicine technology in the rural areas of South Africa. Specific telemedicine project installations are discussed and recommendations provided to guide policy makers and health planners in South Africa.