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The Complication of Presence in Telemedical Collaboration: Intersituativity and Its Organizational Consequences

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Abstract

New information and communication technologies change social relations. The article introduces a concept by Stefan Hirschauer grasping this change as a complication of presence. For Emergency Medical Services, full presence of all participants is usually considered essential; however, telemedicine, telehealth physicians, and telecooperation are also gaining ground here. The study describes the foundation and challenges of telemedical situations and analyses how they are managed by physicians, paramedics, and patients being only gradually present for each other. On the organizational level, formal guidelines become more important, and responsibilities shift toward the rescue workers on-site.

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Notes

  1. We conducted several short ethnographies, group discussions, and interviews at this EMS telemedicine provider from 2015 to 2017. This sociological research was funded by the BMBF (German Federal Ministry of Education and Research) and was a part of the interdisciplinary joint project AUDIME. The goal of this project was to provide paramedics, who were administering acute care to people in a medical emergency onsite or in an ambulance, with smart glasses in order to improve their ability to support emergency physicians practicing telemedicine. We observed the interaction enhanced by smart glasses between the emergency physicians and the paramedics during three emergency exercises, recording these on video and conducting interviews afterward. Specific aspects of the smart glasses that are not addressed in this article have been discussed in other publications, also in relation to, among other things, “cyborgization.” See zur Nieden (2017) and zur Nieden and Ellebrecht (2017).

  2. In the research project that we accompanied, this was tested via the camera on the smart glasses. In earlier attempts, the paramedics were equipped with a helmet camera.

  3. Meyer (2015) convincingly describes that the ideal situation of looking at each other during communication cannot be regarded as a global standard. He observed various non-Western cultures that use verbal signals of affirmation instead of eye contact in interactions to signal the end of a sequence, which also creates periods of time during which the speaker does not know whether he or she is being listened to.

  4. Also during our exercises with the smart glasses for AUDIME, it became clear that users not familiar with the teleinteraction format were extremely distracted and were unable to interact adequately with the patient.

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  1. Centre for Security and Society, University of Freiburg, Freiburg, Germany

    Nils Ellebrecht

  2. Department of Sociology, University of Freiburg, Freiburg, Germany

    Andrea zur Nieden

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  1. Nils Ellebrecht
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Correspondence to Nils Ellebrecht.

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Ellebrecht, N., zur Nieden, A. The Complication of Presence in Telemedical Collaboration: Intersituativity and Its Organizational Consequences. Eur J Secur Res 5, 83–103 (2020). https://doi.org/10.1007/s41125-019-00060-x

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