10.1177/1049732305284667 ARTICLE QUALITATIVE HEALTH RESEARCH / February 2006 Andreassen et al. / E-MEDIATED DOCTOR-PATIENT COMMUNICATION
Patients Who Use E-Mediated Communication
With Their Doctor: New Constructions of Trust
in the Patient-Doctor Relationship
Hege K. Andreassen
Marianne Trondsen
Per Egil Kummervold
Deede Gammon
Per Hjortdahl
The introduction of information and communication technology (ICT) into the patient-
doctor relationship represents a significant change in modern health care. Communication
via computers—e-mediated communication—is affecting the context of patient-doctor
interaction, touching core elements of the relationship. Based on data from a qualitative
study conducted among Norwegian patients who had used ICT to communicate with their
doctors, the authors argue that patients’ use of ICT and the element of trust in the patient-
doctor relationship influence each other. Furthermore, they contend that patients’ construc-
tions of trust in this relationship can be understood in light of basic mechanisms in modern
society. The study sheds light on some potential concerns and benefits as communication
technology increasingly is integrated into the patient-doctor relationship.
Keywords: information and communication technology; e-mail; trust; doctor-patient
interaction; doctor-patient relationship
S
urveys in Norway have shown that nearly half of the Norwegian population
would like the option of communicating with their doctor through information
and communication technologies (ICT) (Andreassen, Sandaune, Gammon, &
Hjortdahl, 2002). However, some authors express concern that ICT will not only be
difficult to manage and fuel unnecessary demand but might also undermine impor-
tant aspects of the patient-doctor relationship (see, e.g., Jenssen, Kleven, & Gammon,
2002, for an overview). Others have emphasized the empowering potentials for
patients, as well as effectiveness and flexibility in the interaction (Dickerson &
Brennan, 2002; Jadad, 1999; Pal, 1999; Safran, 2003; Shine, 1996; Street, 2003). The
majority of literature on e-mediated patient-doctor interaction is written from med-
ical and administrative perspectives (Katz, Moyer, Cox, & Stern, 2003; Miller, 2002;
Patt, Houston, Jenckes, Sands, & Ford, 2003). There is an apparent gap between
patients’ desire for e-communication with health care providers and providers’
willingness to use such tools when communicating with their patients (Patt et al.,
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QUALITATIVE HEALTH RESEARCH, Vol. 16 No. 2, February 2006 238-248
DOI: 10.1177/1049732305284667
© 2006 Sage Publications