Abstract
Currently telehealth is being offered as an innovative solution to austerity, staffing issues and problems accessing care in Canada’s rural communities. Despite the current enthusiasm for telehealth in provincial and federal policy documents, many of these promises have not been realized. The Labrador region is a large and sparsely populated area that was vested with a federal “Smart Community” project to increase the region’s technological capacity, making it one of the most connected locales in the country. While telehealth was a key component of the SmartLabrador plan, there has been limited uptake of newly available technologies for the purposes of mediating distance in health care. My work critically examines the factors surrounding this lack of uptake, and takes the work of Harold Innis as a starting point when analyzing the breakdown of time and space in Labrador. Focused around qualitative field research conducted in Labrador in 2003, I explore spatialization, structuration and work practice as they relate to telehealth use and non-use in the region. I review federal and provincial telehealth policy to provide a macro context for the study, which I then link to meso and micro levels of analysis in organization structures and situated work practice. I examine telehealth in the user context from the health care provider perspective. This reveals several constraints that have limited the usage of new technologies for health communication in Labrador. The user context must be considered in the design of telehealth programs and policy if the desired outcomes for telehealth are to be realized. The barriers to telehealth use are not simply technical, but relate to issues of privacy, culture and trust. I discuss these and other barriers with a focus on the needs of the Labrador community.
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Acknowledgements
The author would like to acknowledge the contributions of the Social Sciences and Humanities Research Council Grant From Work Practice to Health Policy: Case Studies of the Canadian Health Information Highway and of community partner SmartLabrador to this research. Additionally, the author would like to thank the many health care and community development workers who generously contributed their time.
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This paper is based on research conducted in partnership with the SmartLabrador initiative, a federal Smart Community project which grew out of the grassroots Labrador Information Technology Initiative. This partnership helped me to establish contact with telehealth stakeholders in the region; paid for a portion of research travel; and provided me with an office and home base for the duration of the fieldwork. This research was conducted as part of the SSHRC funded project “From Work Practice to Public Policy: Case Studies of the Canadian Health Infostructure”.
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Peddle, K. Telehealth in Context: Socio-technical Barriers to Telehealth use in Labrador, Canada. Comput Supported Coop Work 16, 595–614 (2007). https://doi.org/10.1007/s10606-006-9030-3
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DOI: https://doi.org/10.1007/s10606-006-9030-3