Building the Social Infrastructures for Telemedicine Takes Time
By the team from the University of Vienna

Developing the social infrastructure or models for using telemedicine takes time. During our visits, we encountered skepticism and concerns about the impact of the technologies among staff members to which the project needs to respond. The medical staff needs to adapt workflows and change routines. Conventions for conducting and, later on, documenting telemedical consultations need to be established. Interlocutors need to find a common language. Relations of trust need to be built across the telemedical networks. Hospitals in the Aachen region have maintained telemedical links for about ten years and throughout multiple telemedical projects, using different telemedical devices. Over this time, telemedicine has become ingrained in their daily practice. We have observed that the remote consultations with clinicians at the university hospital in Aachen are a fixture in the daily schedules with other procedures built around it. The doctors have developed an internal classification of particularly “difficult”, “interesting” or “borderline” cases that they want to introduce during the telemedical consultation. The interlocutors on both sides of the screen are already a well-rehearsed team.

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However, this familiarity is only possible because the social infrastructure for doing telemedicine has grown over several years of (almost) daily telemedical consultations. Other hospital partners in the project have little to no experience with telemedicine yet. However, as ICU4Covid is only a 2-year project, it will be difficult to create social infrastructures similar to those in and around Aachen within the short time remaining in the project. Therefore, it is all the more important that the partners in the project collaborate closely to sow the seeds of viable socio-technical models for each hospital that can grow into a telemedical network connecting ICUs across Europe in the future.