title: Toward an understanding of diagnostic teleconsultations and their impact on diagnostic confidence.
abstract: This paper describes a four-stage model of the medical diagnostic process, and provides the results of an initial test of this emerging knowledge management theory. A study of the diagnostic teleconsultations between primary care physicians located in remote communities and specialists at the Medical College of Georgia was conducted. The study involved an analysis of the video recordings of teleconsultations and postteleconsultation telephone interviews with the specialists and physicians conducting diagnostic teleconsultations. The study revealed that the number of hypotheses generated by specialists, the overall duration of teleconsultations, and physicians' change in diagnostic confidence depended on the diagnostic stage of the specialty teleconsultation. This study demonstrated that the diagnostic stages have different behavioral and cognitive characteristics. Designers of telemedicine programs can complement these characteristics to increase the productivity of health care providers.
authors.affiliation: Department of Computer and Information Science, James J Nance College of Business Administration, Cleveland State Univeristy, Cleveland, Ohio, USA. t.randles@csuohio.edu
authors.forename: Theodore J
authors.initials: TJ
authors.lastname: Randles
authors.forename: Cherian S
authors.initials: CS
authors.lastname: Thachenkary
mesh_terms: D002983:Clinical Competence; D003933:Diagnosis; D005845:Georgia; D006801:Humans; D008511:Medicine; D017146:Models, Organizational; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D019114:Remote Consultation; D013038:Specialization