## 2 Results and Discussion
### Context of Benefits  
The benefits of telemedicine refer to the idea that medical treatment can be provided to people anytime, anywhere, even if the treatment is not locally available. This implies that there is a lack of medical resources and that the distribution of resources is a benefit. GPA claims that hospitalization is avoided by bringing the knowledge to the health care level to where the patient is, and SA emphasised how patients and relatives appreciate local treatment. Daily updates provide benefits such as better coordination and information about the patient when dealing with transferring patients between levels of care.  
GPA: \"We avoid hospitalization. (...) The specialists follow their patients, even though they [the patients] stay here [at the GP's centre]. We also get information about the patients we have referred. The daily updates on the patients' welfare and advice are the main benefits.\"  
SA: I have experienced both patients and relations remaining rather engaged by staying near their homes and their relatives.\"  
Sometimes, treatment is not performed locally, because the patient wants a second opinion from a specialist (GPB). Getting a second opinion by using videoconference shortens the waiting list at the hospital, moves the decision-making to the GP, and provides feedback about those considerations to the GP at the moment of treatment (GPB).  
GPB: \"The patient does not have to travel, so there are shorter waiting times. When we refer [a patient] to a specialist, it is often because we are uncertain and the patient demands it. If it is a specialist on the videoconference, we clarify a great deal. I often refer patients to a specialist, mostly to gain acceptance for what I want to do or to get advice. Most patients would have accepted it [the treatment] as long as they heard that I had considered the advice of a specialist.\"Both GPA and SA point to the regularity of videoconferencing as making it possible to follow how a patient is progressing, with the added benefit of avoiding travel.  
SA: \"We have to consider the patient from day to day, thus saving transport. It leads to less pressure on the hospital ward, and we avoid hospitalization. If we explain that it is a professional service that ensures the quality of local treatment, it seems more positive.\"  
SA: \"It also benefits us [the hospital], placing lesser pressure on our ward. We absolutely benefit from spending our time like this [in the use of daily videoconferencing]. It is a professional offer that ensures the treatment we would have given at the hospital.\"  
GPA, GPB, and SA address the daily updates, a discussion partner, and the quality that these bring to the treatment, here seen as benefiting a professional community. SA also describes the communication as offering the same treatment as would be given in the hospital. An extended community with diverse knowledge and expertise benefits the patient's treatment and the quality of care. SB said:  
SB: \"The videoconference, as compared to the telephone, relies on trust, cooperation, fellowship, and all that is really needed for a good flow of patients. The quality of cooperation in a group affects the quality of patient care.\"  
Working collaboratively changes professional patterns, and a seamless connection between healthcare levels becomes possible. This offers a new way for professionals delivering electronic healthcare, e-health, to patients.