Multilevel structures and human agency in relation to email consultations: A strong structuration theory analysis of the Danish general practice setting

In recent years and throughout the developed world, policymakers have encouraged implementation of digital patient-clinician interaction. Our focus is on Danish general practice setting where email consultations were implemented as a mandatory service in 2009 now constitute 21% all practice. Drawing upon strong structuration theory (SST), our analysis sets out to explore how are represented structures macro, meso micro-levels interplay between agents plays with respect possible alignments, tensions adjustments. We analyze data from policy documents macro meso-levels, clinics’ websites (meso-level) interviews GPs patients (micro-level) (n = 53). findings show that introduction consultation new health technology key site for development practice, professional boundary adjustments within doctor-patient relationship. thus demonstrate can be considered dynamic component socio-technical network rather than static medium simple transactions or information delivery. Based these findings, we recommend that, future communication it important investigate multiple sources influence telecare practices see its intended users who actively shape their own care motivated by opinions, relationships values.