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The theory of use behind telemedicine: : how compatible with physicians' clinical routines?

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  • Lehoux, P.
  • Sicotte, C.
  • Denis, J. -L.
  • Berg, M.
  • Lacroix, A.

Abstract

Since the early 1990s, telemedicine, or the use of information technology to support the delivery of health care from a distance, has increasingly gained the support of clinicians, administrators and policymakers across industrialised countries. However, the "theory of use" behind telemedicine--its rationale and the manner in which clinicians are expected to use it in their daily activities--has been only marginally investigated. In this paper we present the results of a qualitative study which examines the theory of use behind teleconsultation from the viewpoint of physicians (n=37) in six specialities, practising in Quebec (Canada) hospitals. We employ Giddens' Structuration Theory (1984) to analyse the views, communications needs and referral strategies of physicians. Two questions are explored: (1) To what extent can teleconsultation be integrated into the routines of diverse medical specialities? and (2) Why and how might clinicians use this technology? Our research indicates that specialities relying on either thorough physical examinations or specialised investigative techniques are unlikely to restructure their work routines to accommodate teleconsultation, which they view as limited. Specialities that primarily exploit images or numerical data tend to perceive teleconsultation as more useful. The perceived enabling properties of teleconsultation increase as a function of the distance the patient would have to travel to be seen directly by a consultant. The constraining properties are linked to the type of information transmitted, since physicians believe that only objective data can be safely consulted from a distance, whereas relying on the remote physician's interpretation of subjective information is deemed inappropriate. We thus conclude that the development of teleconsultation should be consolidated around applications whose theory of use is compatible with existing clinical routines, or offers opportunities to restructure clinical work according to the needs of providers and remote communities.

Suggested Citation

  • Lehoux, P. & Sicotte, C. & Denis, J. -L. & Berg, M. & Lacroix, A., 2002. "The theory of use behind telemedicine: : how compatible with physicians' clinical routines?," Social Science & Medicine, Elsevier, vol. 54(6), pages 889-904, March.
  • Handle: RePEc:eee:socmed:v:54:y:2002:i:6:p:889-904
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    Cited by:

    1. Bruni, Attila & Miele, Francesco & Piras, Enrico Maria, 2019. "‘Homemade’: Building, mending, and coordinating a care network," Social Science & Medicine, Elsevier, vol. 237(C), pages 1-1.
    2. Alanazi, Hamad & Daim, Tugrul, 2021. "Health technology diffusion: Case of remote patient monitoring (RPM) for the care of senior population," Technology in Society, Elsevier, vol. 66(C).
    3. Nicolini, Davide, 2006. "The work to make telemedicine work: A social and articulative view," Social Science & Medicine, Elsevier, vol. 62(11), pages 2754-2767, June.
    4. Kate Lyle, 2021. "Interventional STS: A Framework for Developing Workable Technologies," Sociological Research Online, , vol. 26(2), pages 410-426, June.
    5. Jelle van Gurp & Olaitan Soyannwo & Kehinde Odebunmi & Simpa Dania & Martine van Selm & Evert van Leeuwen & Kris Vissers & Jeroen Hasselaar, 2015. "Telemedicine’s Potential to Support Good Dying in Nigeria: A Qualitative Study," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-15, June.

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