Social dilemmas in a telemedicine network: experience with the implementation of the Norwegian Pathology Network

The implementation process for the Norwegian Pathology Network (PatNet) was explored. Fourteen departments of pathology in Norwegian university and local hospitals that subscribed to PatNet were investigated. Sociological theory was applied to analyse the obstacles to implementation in terms of coordination and cooperation. Successful collective action requires that the dilemma between collective and individual interests is resolved. The establishment of PatNet has not accomplished this to a sufficient degree. The originators of PatNet expected that easy access to the network combined with comprehensive information and discussion within the network would attract users. More information and discussions were meant to be produced by users and thus attract further users. In this way the network was expected to run by itself. However, this strategy did not work. New strategies to handle the dilemma concerning collective and individual interests have not been discussed openly. The present study suggests that an open discussion among pathologists to explore and highlight this dilemma would be useful.