A framework for the design of user-centred teleconsulting systems.

Telemedicine projects often fail to grow beyond the pilot phase of implementation. As well as the usual barriers such as reimbursement and legislation, user acceptance of telemedicine technologies is essential. From a design-perspective, it can be hypothesized that a user-centred design approach is missing in the development of telemedicine systems. We have mapped the underlying theoretical dimensions relevant to teleconsultations. An existing framework describing teleconsultations was used as the basis for the study. The perspectives that were taken to complement this framework were: (a) doctor-patient communication; (b) technology-mediated communication; and (c) technology acceptance. A literature search found 303, 42 and 409 articles in the three areas, respectively. Abstract assessment indicated 8, 5 and 6 papers for full text evaluation. Theoretical models were retrieved for each perspective and elements were clustered to form a new framework. The findings suggest the importance of instrumental and affective communication behaviours of participants in a teleconsultation. On the same level of importance are the perceptions formed by the participants on effectiveness, efficiency and 'affectiveness' of the telemedicine system. The framework has the potential to contribute to design methodology by providing a practical tool that can be used by design professionals to consider the user at every stage of the design process, even when the context is complex and unfamiliar to the designer.