Telemedicine: A practice-based approach to technology

Telecardiological consultancy, enabling distant consultation between cardiologist and the general practitioner in the presence of the patient and relying on a technological infrastructure, is a new medical working practice. This article proposes a practice-based approach in order to study it as an object emerging from a local ecology of human and non-human. An analytical framework proposes three interpretative lines: a reading of practice 'from outside' (as a patterned set of activities), a reading 'from inside' (as knowing-in-practice) and a reading as a social practice (as a 'doing' of society). The article analyses the discursive practices involved in a month of telecardiological consultancies in order to understand the effects of this new practice in a Western health care context. One of these meanings is that, as telecardiology comes into use, it is inscribed more in the social practice of reassurance than in the medical one of preventing and dealing with emergencies.