Towards consistent modes of e-health implementation: structurational analysis of a telecare programmes limited success

Telecare is the use of information and communication systems to facilitate care delivery to individuals in their homes. Although the expectations of telecare are high, its implementation has proved complex. This case study demonstrates this complexity through a structurational analysis of a telecare implementation process. The paper shows how structuration concepts enable a combined analysis of actors' interactions with a technology and of the interaction among these actors from different institutional contexts. In this example, fragmented multi-actor agency induced an inconsistent implementation mode, leading to unsuccessful telecare appropriation. This paper concludes with a preliminary proposal for more consistent telecare implementation modes. These modes may better support the actors' reflexive monitoring and dialogue and inform further research.