Wicked decision problems in remote health care: telemedicine as a tool for sensemaking

Health care providers often face different types of problems than uncertainty-those involving wicked decision problems. Whereas uncertainty reduction requires increased information processing capabilities, wicked decision problems require both increased information processing and sensemaking capabilities. Sensemaking is about interpreting and deriving meaning from multiple, conflicting cues. Case studies of three teleconsultation projects utilized for both sensemaking and information processing are presented. In addition to impacting the cost and quality of care provided in remote areas, telemedicine networks utilized to reduce uncertainty may experience lower utilization rates, while telemedicine utilized to address wicked decision problems may experience increased utilization rates.