Telemedicine, enabled by state-of-art information technology, is rapidly gaining awareness in many countries. Despite the advanced telecommunication infrastructure, the introduction of telemedicine in Hong Kong has been slow. Hong Kong?s monopolistic health care system provides an answer for the protracted development of telemedicine in the region. This study attempts to reach a theoretical understanding of the structure of Hong Kong?s health care system. For this, we characterize the current health care industry in Hong Kong, identify the primary stakeholders of the health care system, and analyze the relationship among the stakeholders. Based on this understanding of the health care structure, we propose a causal model that describes the development path of telemedicine in Hong Kong. In addition, a current development effort for telemedicine in Hong Kong is introduced based on the case study of two telemedicine applications.