Patient empowerment and involvement in telemedicine

Objective: Telemedicine is a rapidly expanding area, and this article discusses the implications of patient empowerment and user involvement in relation to frail patients. Our aim is to critique the mechanical way telemedicine is being implemented in the health sector. Methods: We present the basic ideas of empowerment and user involvement behind telemedicine, exemplifying them with a case of user resistance to telemedicine. Four logics of empowerment are employed to identify the underlying rationale in specific cases of telemedicine. The case comes from a large evaluation of new welfare technology products. The data consist mainly of written documents and an interview. Results: Telemedicine is often considered a way to increase empowerment and user involvement in healthcare. The majority of the geriatric patients in the described case refused to engage in telemedicine, preferring instead to be hospitalized. The case appeared to be driven primarily by a professional logic of empowerment. User involvement and empowerment are discussed in terms of their demands and implication for users, such as 1) intrusion on the private sphere, i.e., the home and 2) the question of the responsibility for treatment and 3) the expectation, that the capabilities and resources of patients and relatives may increase. Conclusions: Although telemedicine is acknowledged as relevant, a mechanical approach too often hampers empowerment for the patient. Some patient groups may not feel safe using telemedicine, in which case user involvement and empowerment are not possible.