Fig. 1.

Diagram showing the structure in layers adopted for the analysis of the Telehealth complex socio-technical systems (CSTS). Telehealth system cannot be considered in isolation but at a layer within the hierarchical scale of layers. The lowest layer L1 refers to the components which are used to build-up the upper layer L2 of the entities subsystems. These entities subsystems are constitutive parts of the L3 Telehealth system. In turn the Telehealth system forms part of the layer L4 healthcare organization that is part of the top layer L5 of healthcare ecosystem at society. One layer L (n) can display emergent properties that cannot be discerned from the isolated knowledge of the elements of the lower level L (n-1). Patient safety is one emergent property