The article utilizes the imagery of stretching out and expanding for exploring what happens when medical practices and health working arrangements are temporally and spatially reconfigured. Based on the tenets of contemporary practice theory, and on the back of a three years' longitudinal study of telemedicine in northern Italy, the article investigates some of the practical issues raised by the subversion of the proximity principles that still underscore most current medical practices. The study argues that in order to cope with the expansion of their activity practitioners had to face three main practical problems: they had to redistribute their work and tasks among human and non-human elements, they had to reframe the ways in which the activity was made accountable, and they had to reconfigure the relationships between all those involved. The stretching out and expanding of medical practices in space and time implies thus much more than a simple redistribution of what was already there and it triggers profound changes which included the reframing of the object and content of the activity, the emergence of new artefacts and new identities, and the modification of the geography of the power positions between all those involved.
Anderson, J.M.Empowering patients: Issues and strategies . Social Science & Medicine, 1996, 43(5), 679—705 .
2.
Bang, M. & Timpka, T.Cognitive tools in medical teamwork: The spatial arrangement of patient records. Methods of Information inMedicine, 2003, 42(4), 331—6 .
3.
Berg, M.Rationalizing medical work. Cambridge, MA: MIT Press , 1997.
4.
Blackler, F. Knowledge , knowledge work and organizations : An overview and interpretation . Organization Studies, 1995, 16(6), 1021—46 .
5.
Blackler, F. , Crump, N. & McDonald, S.Organizing processes in complex activity networks . Organization , 2000, 7, 277—301 .
6.
Boltanski, L. & Thévenot, L.On justification: Economies of worth. Princeton, NJ: Princeton University Press , 2006.
7.
Bourdieu, P.Le sens pratique. Paris: Editions de Minuit , 1980.
8.
Brauer, G.Telehealth: The delayed revolution in health care . Medical Progress through Technology, 1992, 18, 151—63 .
9.
Cartwright, L.Reach out and heal someone: Rural telemedicine and the globalization of US health care. In P . Brodwin (Ed.), Biotechnology and culture: Bodies, anxieties, ethics. Bloomington: Indiana University Press , 2000, pp. 241—63.
10.
Cicourel, A.V.The integration of distributed knowledge in collaborative medical diagnosis . In J. Galegher , R. Kraut & C. Egido (Eds), Intellectual teamwork — social and technological foundations of co-operative work. Mahwah, NJ: Erlbaum Associates , 1990, pp. 221—42.
11.
Cicourel, A.V.The interaction of cognitive and cultural models in health care delivery. In S. Sarangi & S. Roberts (Eds), Talk, work and institutional order. Discourse in medical, mediation and management settings. Berlin , New York: de Gruyter , 1999, pp. 183—225.
12.
Collin-Jacques, C. & Smith, C.Nursing on the line: Experiences from England and Quebec . Human Relations, 2005, 58, 5—32 .
13.
DeSanctis, G. & Fulk, J. (Eds) Shaping organizational form: Communication, connection, and community. Thousand Oaks, CA: Sage , 1999.
14.
DeSanctis, G. & Monge, P.Communication processes for virtual organizations . Organization Science, 1999, 10(6), 693—703 .
15.
Dopson, S.The diffusion of medical innovations: Can figurational sociology contribute ? Organization Studies, 2005, 6(8), 1125—44 .
16.
Dutton, W.The virtual organization: Tele-access in business and industry. In G . DeSanctis & J. Fulk (eds) Shaping organizational form: Communication, connection, and community. Thousand Oaks, CA: Sage , 1999, pp. 473—96.
17.
Engeström, Y.Activity theory as a framework for analyzing and redesigning work . Ergonomics, 2000, 43(7), 960—74 .
18.
Engeström, Y.Expansive learning at work: Toward an activity theoretical conceptualization . Journal of Education and Work, 2001, 14(1), 133—56 .
19.
Finn, R. & Waring, J.Organizational barriers to architectural knowledge and teamwork in operating theatres . Public Money and Management, 2006 , 26(2), 117—24 .
20.
Foucault, M.L'ordre du discourse. Paris: Gallimard , 1970.
21.
Foucault, M.The birth of the clinic: An archaeology of medical perception, Trans. A.M. Sheridan Smith. New York: Vintage Books , 1975.
22.
Foucault, M. Discipline and punish : The birth of the prison. Harmondsworth : Penguin Books , 1979.
23.
Garfinkel, S.Studies in ethnomethodology. Englewood Cliffs, NJ: Prentice Hall , 1967.
24.
Gherardi, S. & Nicolini, D.Learning the trade: A culture of safety in practice . Organization , 2002, 9(2), 191—223 .
25.
Grigsby, J. , Kaehny, M. , Sandberg, E.J. , Schlenker, R.E. & Shaughnessy, P.W.Effects and effectiveness of telemedicine . Health Care Financing Review, 1995, 17(1), 115—31 .
26.
Gubrium, J.Analyzing field reality. Thousand Oaks, CA: Sage , 1988.
27.
Guinness, O.Time for truth: Living free in a world of lies, hype, and spin. Leicester: Inter Varsity Press , 2000.
28.
Hanlon, G. , Strangleman, T. , Goode, J. , Luff, D. , O'Cathain, A. & Greatbatch, D. Knowledge , technology and nursing : The case of NHS Direct . Human Relations, 2005 , 58, 147—71 .
29.
Hardill, I. & Green, A.E.Remote working: Altering the spatial contours of work and home in the new economy . New Technology, Work and Employment, 2003, 18(3), 212—22 .
30.
Hinds, P.J. & Kiesler, S. (Eds) Distributed work. Cambridge, MA: MIT Press , 2002.
31.
Hutchins, E.Cognition in the wild. Cambridge, MA: MIT Press , 1995a.
32.
Hutchins, E.How a cockpit remembers its speed . Cognitive Science, 1995b, 19, 265—88 .
33.
Kielser, S. & Cummings, J.What do we know about proximity and distance in work groups? Legacy of research . In P . Hinds & S. Kieler (Eds), Distributed work. Cambridge, MA: MIT Press , 2002, pp. 57—82.
34.
Laclau, E. & Mouffe, C. Hegemony and socialist strategy : Towards a radical democratic politics , 2nd edn. London: Verso , 2001.
35.
Latour, B.Reassembling the social: An introduction to actor-network theory. Oxford: Oxford University Press , 2005.
Law, J. Technology and heterogeneous engineering : The case of the Portuguese expansion. In W.E. Bijker , T.P. Hughes & T.J. Pinch (Eds), The social construction of technical systems: New directions in the sociology and history of technology. Cambridge, MA: MIT Press , 1987, pp. 111—34.
38.
Law, J.Notes on the theory of the actor-network: Ordering, strategy, and heterogeneity . System Practice, 1992, 5(4), 379—93 .
39.
Lehoux, P. , Sicotte, C. , Denis, J.-L. , Berg, M. & Lacroix, A.The theory of use behind telemedicine: How compatible with physicians' clinical routines ? Social Science & Medicine, 2002 , 54, 889—904 .
40.
Lynch, M.Scientific practice and ordinary action. Cambridge: Cambridge University Press , 1993.
41.
Lynch, M.Ethnomethodology and the logic of practice. In T . Schatzki , K. Knorr Cetina & E. Von Savigny (Eds), The practice turn in contemporary theory. London: Routledge , 2001, pp. 131—48.
42.
Macintyre, A.After virtue: A study in moral theory. London: Duckworth , 1981.
43.
May, C. & Ellis, N.T.When protocols fail: Technical evaluation, biomedical knowledge, and the social production of `facts' about a telemedicine clinic . Social Science & Medicine, 2001, 53(8), 989—1002 .
44.
Mitcheson, J. & Cowley, S.Empowerment or control? An analysis of the extent to which client participation is enabled during health visitor/client interactions using a structured health needs assessment tool. InternationalJournal of Nursing Studies , 2003, 40, 413—26 .
45.
Mort, M. , May, C. & Williams, T.Remote doctors and absent patients: Acting at a distance in telemedicine . Science, Technology & Human Values, 2003, 28(2), 274—95 .
46.
Nicolini, D.The work to make telemedicine work: A social and articulative view . Social Science & Medicine, 2006, 62, 2754—67 .
47.
Nicolini, D. , Bruni, A. & Fasol, R.La telemedicina in letteratura [Telemedicine: A literature review]. In S . Gherardi & A. Strati (Eds), La telemedicina: tra tecnologia e organizzazione . Rome: Carocci , 2004, pp. 19—49.
48.
Nicolini, D. , Gherardi, S. & Yanow, D. (Eds) Knowing in practice. Armonk, NY: ME Sharpe , 2003.
49.
O'Cathain, A. , Goode, J. , Luff, D. , Strangleman, T. , Hanlon, G. & Greatbatch, D.Does NHS Direct empower patients ? S ocial Science & Medicine, 2005, 61(8), 1761—71 .
50.
O'Leary, M. , Orlikowski, W. & Yates, Y.A.Distributed work over the centuries: Trust and control in the Hudson's Bay Company, 1670—1826. In P.J. Hinds & S. Kiesler (Eds), Distributed work. Cambridge, MA: MIT Press , 2002, pp. 27—54.
51.
Ortner, S.Theory in anthropology since the 60s . Comparative Studies in Society and History, 1984, 26(1), 126—66 .
52.
Paterson, B.Myth of empowerment in chronic illness . Journal of Advanced Nursing, 2001, 34(5), 574—81 .
53.
Pickering, A.The mangle of practice: Agency and emergence in the sociology of science . American Journal of Sociology, 1993, 99(3), 559—89 .
54.
Reckwitz, A.Toward a theory of social practices. A development in culturalist theorizing . European Journal of Social Theory, 2002, 5(2), 243—63 .
55.
Roine, R. , Ohinmaa, A. & Hailey, D.Assessing telemedicine: A systematic review of the literature . Canadian Medical Association Journal, 2001, 165(6), 765—71 .
56.
Sarker, S. & Sahay, S.Implications of space and time for distributed work: An interpretive study of US—Norwegian systems development teams. EuropeanJournal of Information Systems, 2004, 13, 3—20 .
57.
Schatzki, T.Practice mind-ed orders. In T . Schatzki , K. Knorr Cetina & E. Von Savigny (Eds), The practice turn in contemporary theory . London: Routledge , 2001, pp. 42—55.
58.
Schatzki, T.The site of the social: A philosophical exploration of the constitution of social life and change. University Park: The Pennsylvania State University Press , 2002.
Scott, W.R.Institutions and organizations. Thousand Oaks, CA: Sage , 1995.
61.
Sinclair, S.Making doctors: An institutional apprenticeship. Oxford : Oxford University Press , 1997.
62.
Star, S.L.Power, technologies and the phenomenology of conventions: On being allergic to onions. In J . Law (Ed.), A sociology of monsters? Essays on power, technology and domination. Sociological Review Monograph. London: Routledge , 1991, pp. 26—56.
63.
Thévenot, L.Pragmatic regimes governing the engagement with the world. In T . Schatzki , K. Knorr-Cetina & E. von Savigny (Eds), The practice turn in contemporary theory. London: Routledge , 2001, pp. 56—73.
64.
Turner, B.S.Medical power and social knowledge. London: Sage , 1987.
65.
Turner, J.W. , Thomas, R. & Reinsch, L.Willingness to try a new communication technology: Perceptual factors and task situations in a health care context . Journal of Business Communication, 2003, 41, 1—21 .
66.
Wiener, C. , Fagerhaugh, S. , Strauss, A. & Suczek, B.What price chronic illness? In A . Straus (Ed.), Where medicine fails, 4th edn. New Brunswick, NJ: Transaction Books , 1984, pp. 13—36.
Woolgar, S.Five rules of virtuality. In S . Woolgar (Ed.), Virtual society? Technology, cyberbole, reality. Oxford: Oxford University Press , 2002, pp. 1—22.
