## 3 Discussion  
Interaction in collaborative work has been associated with the discussion between the patient and the GP [14]. Studies of interactions among physicians at different levels of care have focused on individual achievements or the inequality between them, stressing different languages [7], different levels of credibility [8], and the hieratical structures between physicians [9]. As a result, findings have focused on how the equipment is appropriate for the interactions or on who dominates and who benefits from the interaction. Data from successful collaborative work using videoconferencing provide insight into how medical discussions between levels of care produce knowledge, affecting the healthcare delivered to the patient. Collaborative work between GPs and specialists offers decision support and problem solving (Table 2). This method of collaboration provides practitioners with a new way of thinking: exchanging information and knowledge between levels of care in order to provide the best treatment for the patient locally. The patients' age matters when interacting; instead of transporting elderly patients [GPA], the GPs gets access to specialists' knowledge for a second opinion and to support their own judgment [GPA/GPB/SA/SB/SC]. By collaborating, the GPs are able to handle a variety of problems [GPB] that are outside their individual areas of expertise, but which can be solved with guidance [GPA/SA/SB]. When the physicians think collectively, instead of individually, more treatment may be performed locally [GPB]. Because videoconferencing provides visual opportunities, access to all the specialists and feedback in the moment, the interaction goes beyond that provided by the telephone [GPB]. Collaboration over distance provides multidisciplinary meetings, which offer a broader set of expertise than traditionally meetings do [SC, GPB]. The professionals not only use personal knowledge to discuss and solve problems, but also bring in EKGs, the patients, and x-rays [SB, GPB]. This also extends the opportunities created by using the telephone. Multidisciplinary collaboration is often underestimated or only focusing on in terms of how it helps the GPs. Here, the specialists provide perspectives on how such collaboration contributes to both the patients, relatives, the GPs, and themselves [SA, SB].  
The limitation of the study is the small number of GPs and specialists interviewed. Still, they were chosen based on their years of experience with interacting via videoconferencing. Here, supported by 42 observations of the meetings. These results may increase practitioners' willingness to use telemedicine in daily medical practice because telemedicine focuses on a collective achievement. GPs gain security and support by receiving advice and second opinions. Specialists receive information and get the opportunity to follow up on patients. This method of interaction challenges the traditional method of performing healthcare, which is limited to a single level of care. Working collaboratively improves health service at the local level and offers new ways of delivering medicine and e-health to elderly people in rural areas in order to meet patients' increasing demands.