Telemedicine’s potential to improve accessibility and quality of healthcare has been advocated for decades. However, its adoption has been fraught with problems. This paper applies a socio-technical approach, and specifically activity theory, to study the adoption and use of telemedicine by healthcare professionals (HCPs) in Sri Lanka. It depicts how contradictions in the initial activity sys-tem mediated by improvised telemedicine were addressed by the intended telemedicine application and how this motivated HCPs to adopt it. It also highlights the influence of social norms on the use of telemedicine. Based on the research findings this paper recommends that the designers of telemedicine need to consider: (a) identification of objects’ motivations to engage in the activity mediated by telemedicine, (b) norms and rules mediating the activity, (c) contradictions in the existing activity system, and (d) technological characteristics of the application. To stimulate its adoption, the new technology should help to address contradictions in the existing activity system, be congruent with social norms, whilst offering possibility of influencing social norms that are a source of contradictions.