Implementation and evaluation of telemedicine - a catch 22?

Problems in implementing and evaluating telemedicine may not be a surprise if the technology itself is more closely examined. It can be claimed that problems to develop a comprehensive and integrated use is a consequence of the technology´s openness. The analysis presented shows that we cannot speak about implementation in general if telemedicine usage has any impact on organizational work routines. Instead, there is a need to view the implementation of telemedicine as an implementation of different fields of application, which are resulting from a translation of generic features of telemedicine. This will also have an impact on the evaluation of telemedicine implementation, and makes the issue of when an evaluation should be done and how the result should be interpreted into an extremely complex and complicated matter. Hence, if there is a lack of understanding of consequences caused by the openness of technology, implementation and evaluation can end up in a catch 22 situation.