Theory of use behind telehealth applications

A variety of telehealth applications have been implemented throughout the i ndustrialized world. Given that telehealth has yet to become routine in the practices of physicians, the impact of such applications on health care ma nagement remains difficult to identify. Only by becoming integrated into th e 'normal practice' of clinicians can telehealth facilitate smooth communic ations in health care delivery processes. In this paper we demonstrate the importance of developing a 'theory of use' , describing how clinicians are expected to use teleconsultation in their d aily activities. By employing Giddens' Structuration Theory, we can develop a clear vision of the utilization of telehealth, and a better framework wi th which to assess its added value for health care delivery. We illustrate this claim by referring to our research on the Quebec Inter-Regional Teleme dicine Network. In this study we compare the 'theory of use' behind the tel emedicine network with the perceptions of physicians regarding their needs in terms of communications and access to expert advice. The breach between the theory and the perceptions of physicians may help to explain how the ut ilization of telehealth could be enhanced, and how new and sustainable rout ines for its integration into the health care system might be created.