title: Telemedicine: technology mediated service relationship, encounter, or something else?
abstract: OBJECTIVE
  Service interactions between service providers and health care consumers happen daily in health care organizations, and can occur face-to-face or through mediating technology. We use the demanding and rich environment of telemedicine to better understand the nature of the real time service-encounter interactions among the human and technology actors engaged in the process and to inform telemedicine providers about key factors to consider in telemedicine design.
  
  
  METHODS
  We conducted a case study of medical video conferencing (MVC) for the delivery of patient healthcare (a form of telemedicine) using multiple data collection and analysis techniques involving a range of telemedicine stakeholders.
  
  
  RESULTS
  The research reveals that telemedicine requires a new kind of service relationship, an Advanced Encounter, with unique relationships between the telemedicine service providers, presenters, patients, and technology. Seven facilitating factors for the Advanced Encounter of telemedicine are identified and discussed, including the telemedicine servicescape: a set of supporting structures that are critical to telemedicine success.
  
  
  CONCLUSIONS
  Key contributions are a deep understanding of the relationships between telemedicine actors, and the organizational actions needed to deploy a technology-mediated telemedicine service.
authors.affiliation: Dept. of Health Management & Policy, School of Public Health, Secondary appointment, Decision Sciences and IT Management Dept., John Cook School of Business, Saint Louis University, Salus Center, Saint Louis, MO 63104, United States. lerougec@slu.edu
authors.forename: Cynthia
authors.initials: C
authors.lastname: LeRouge
authors.forename: Monica J
authors.initials: MJ
authors.lastname: Garfield
authors.forename: Rosann Webb
authors.initials: RW
authors.lastname: Collins
mesh_terms: D003695:Delivery of Health Care; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D008137:Longitudinal Studies; D018802:Patient-Centered Care; D013673:Technology Assessment, Biomedical; D017216:Telemedicine / Q000458:organization & administration / Q000639:trends*