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The Virtual Clinic: Two-sided Affordances in Consultation Practice

Journal article
Authors Anna Sigridur Islind
Ulrika Lundh Snis
Tomas Lindroth
Johan Lundin
Katerina Cerna
Gunnar Steineck
Published in Computer Supported Cooperative Work: CSCW: An International Journal
Volume 28
Issue 3-4
Pages 435-468
ISSN 0925-9724
Publication year 2019
Published at Institute of Clinical Sciences, Department of Oncology
Department of Education, Communication and Learning
Department of Applied Information Technology (GU)
Pages 435-468
Language en
Keywords affordances, consultations, multi-sided affordances, practice, qualities, telecare, telehealth, two-sided affordances, virtual clinic
Subject categories Informatics


© 2019, The Author(s). Telecare has the potential to increase the quality of care while also decreasing costs. However, despite great potential, efficiency in care practices and cost reduction remain hypothetical. Within computer supported cooperative work (CSCW), one focus of telecare research has been on awareness support in distributed real-time communication in comparison to physical meetings since face-to-face consultations have been known as the “gold standard” of conducting care. Research has shown that it is hard to maintain qualities such as awareness through video-mediated meetings. In this research, the goal has not been to mimic the qualities of face-to-face consultations but rather to document the qualities of three types of patient meetings (consultations) and to understand in what kinds of situations each consultation type is a viable option. In this paper, we focus on the essential qualities of i) face-to-face consultations, ii) video-based consultations, and iii) telephone consultations and shed light on their affordances. The research contribution includes an extension of the affordance lens to incorporate socio-technical, two-sided affordances, that constitute important aspects for understanding complexity when heterogeneous actors co-existing in a practice, where affordances can differ for different “sides” in the complex practice—a view that is fruitful when dealing with heterogeneous actors and a set of analog and digital tools in a practice.

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