Organizing for remote consultations in health carev-vthe production process

In health care we find a very complex production process related to the complexity of disease. New telecommunications have created a novel means of contact between patient and health care worker: the remote consultation. The remote consultation is unique, with a simultaneous flow of services from different organizations. It is conceivable that analysis of the production process of remote consultations may contribute to improved organization of the work. To obtain information on the little analysed production process of remote consultations, qualitative interviews were performed with 30 persons working in teledermatology, telepsychiatry, a telepathology frozen-section service, and tele-otolaryngology. The results show that managers in organizations planning telemedicine activity do not need to prepare the personnel by organizing communication on goal formulation and content for the remote consultations. For the single health care worker a remote consultation does not require more preparation than an ordinary consultation. The variation in type of images seen on the screen here does not seem to play a major role. Evaluation of each step mainly shows that the production process of remote consultations functions well. The most frequently mentioned problems are technical problems (which should not be exaggerated), but other problems also exist. Proposals for improvements were given, such as wishing that a technician was available, and improved booking systems. The main conclusion is that no major reorganization seems to be necessary for the production process of remote consultations. This type of telecooperation works well.