Telemedicine and changes in the distribution of tasks between levels of care

The present investigation, which was part of a larger study, was designed to answer the question 'Has telemedicine produced changes in the distribution of tasks between the general practitioner and specialist, or between the local hospital and university/central hospital?' Qualitative interviews were carried out with 30 persons involved in four telemedicine services in Norway: teledermatology, tele-otolaryngology, telepsychiatry, and a telepathology frozen-section service. The results indicated that telemedicine does not produce large changes in the distribution of tasks. The reported effects were largest and most complex for telepsychiatry, followed by teledermatology. Local variations in how telemedicine is practised may explain the variation in the findings between telemedicine applications.