Paper short abstract:

While studying nursing teams using videoconferencing, we uncovered two different framings: one based on the organizations’ expectations and the other shaped by a newly evolving care practice. These framings do not align and the organizations’ framing may turn blind to what is actually happening.

Paper long abstract:

Videoconferencing is increasingly used in mental health care. We are studying nursing teams using videoconferencing for patients with severe mental illnesses. The organizations where we are performing this research each have made their own choices regarding the videoconferencing technology, such as dedicated videoconferencing screens, videoconferencing software, and iPads with pre-installed videoconferencing apps. These technologies have in common that they provide videoconferencing functionality, and hence they may be regarded as equivalent. In fact, they are largely regarded as equivalent because video conferencing is framed by policy makers and health care organizations as a cost-effective means to replace face to face contact.

Studying the actual use of videoconferencing technology has shown us otherwise. Due to the technology new care practices arise. In our study a client who frequently denied professionals access to the house, used an iPad to show the nurse around. The lack of user-friendliness of the dedicated videoconferencing screens called for an installation team; this team was composed of former clients, creating new work opportunities for them in the process.

Thus, we have uncovered two different framings: one based on the organizations' prior expectations and the other shaped by a newly evolving care practice. These framings do not align well and the organizations' framing may turn blind to what is actually happening. We therefore ask the question: how can health care organizations, policy makers and even the health care research community be persuaded to adjust their framing in such a way that care practices are recognized for their diversity?