AIS Transactions on Human-Computer Interaction


Telemedicine’s potential to improve healthcare’s accessibility and quality has been advocated for decades. However, its adoption has been fraught with problems. In this paper, we apply a socio-technical approach and, specifically, activity theory to study how healthcare professionals (HCPs) in Sri Lanka adopted and used telemedicine. We depict two application-based telemedicine services in Sri Lanka, one improvised and one intended. We found out how contradictions in how HCP used the improvised telemedicine facilitated their adoption of the intended telemedicine. We also highlight the influence that social norms have on how individuals use telemedicine and on the technological features of the digital platforms that enable shared economy services. Based on our findings, we recommend that telemedicine application designers need to consider: 1) subjects’ (a la activity theory) motivations to engage in the activity that telemedicine mediates, 2) the norms and rules that mediate the activity, 3) contradictions in the existing activity system, and 4) the application’s technological characteristics. To stimulate its adoption, new technology should help to address contradictions in existing activity systems, concur with social norms, and offer users the ability to influence social norms that can cause contradictions.





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