Twenty years with teledermatology in North Norway

Abstract

‘A picture is worth more than a thousand words’ - (Mann & Colven, University of Washington Medical School), that simply can justify the necessity of teledermatology. In this paper, five information technology (IT) efforts in the field of teledermatology that based on skin image transmission procedure and their historical transformations in context of the notions of information infrastructures and actor-network theory have been discussed. The main purpose of these efforts was to decentralize specialist’s services to the GP, nurses or district levels. Among the five efforts, only in one effort namely DMS Nord Troms, added telemedicine tool of the UNN creates virtual hospital, decentralized regional healthcare services.

This thesis paper tries to figure out the contents of dermatologic e-health services in North Norway from the mid 1980s onwards; the problems involved in previously non-sustainable and related some dermatological heath care services. Some of these services have been quite successful, such as Videoconferencing among UNN and Kirkenes, Hammerfest, Nordeisa etc. The paper applies some notions of theoretical approach whether they may be helpful to address the challenges in establishing sustainable telemedicine services in case of dermatology. Furthermore, the paper points out the actual strategy for establishing teledermatological services from the perspectives of different historical transformation. In this interpretive study based thesis, fifteen interviews have been conducted to illustrate the five teledermatological efforts.

Five teledermatological efforts were started with high motivation to reach their final goals. But four of them had not been sustainable due to finishing of funding or lacking control for the integrated nature of technology. The thesis concludes that e-health services of teledermatology should be very much linked into practice. The efforts should be evaluated through the lens of practice oriented processes or approaches such as information infrastructure or actor-network theory.