VC is beneficial for following conversations with multiple participants [24]. Thus, audio-only speakerphones AZD9291 solubility dmso between multiple participants used in a time-critical setting, may cause more interruptions than VC for the rural hospital team. Also, specialists

found discussions easier when observing, and the availability of video has been shown to dramatically Inhibitors,research,lifescience,medical influence the use of a team’s conferencing system [25]. Therefore, it is reasonable to believe that speakerphones are less likely to be used, and would have several drawbacks when compared to VC. Specialists had to leave their own working environment for participation in VC. This is usually more interruptive to their work than phone calls from a remote hospital doctor. The added benefit of more information through VC, working in a team with other specialists contributing to the case, and the cooperation with the EMD for planning of patient transportation may outweigh Inhibitors,research,lifescience,medical this disadvantage. We found VC to cause misunderstandings, Inhibitors,research,lifescience,medical when vital signs were not displayed at both hospitals. Similarly, important information can be missed when microphones are muted, or cameras inadequately focused. These issues can be solved by forcing a different setup of computer

screens, different user interfaces or by improved training. VC has been used and studied in various settings for decades. Video has been shown to support interactions within teams, but important design issues need to be met or VC systems are not used [24-26]. The overhead of setting up Inhibitors,research,lifescience,medical and planning VC meetings should not be added to the tasks of a small rural hospital team in a time critical situation. In our setup this is the responsibility of the university hospital, whose team also remotely controls all cameras. Synergies between technology and work processes are important for Inhibitors,research,lifescience,medical successful implementations of technology in health care [27]. Methodological

issues We did not tell participants to work in any particular way with either technology. This may all have limited the use of technology to it’s full potential. For example, doctors at LYB usually left the patient room to make telephone calls. This was mentioned as a drawback with telephones, but was due to tradition rather than technical limitations. Participants received very little pre-training and had hardly any time to familiarize themselves with the VC system prior to this study. Compared with years of experience of telephone communication, the comparison between the use of the two technologies is less valid. However, not all potential team members in large hospitals can have extensive training in virtual emergency teams, and we believe our study reports typical experiences of new members in such teams.