Problems to implement and evaluate telemedicine may not be a surprise if the technology itself is more closely examined. It can be claimed that problems to develop a comprehensive and integrated use is a consequence of the technology's openness. The analysis shows that we cannot speak about implementation in general, if telemedicine usage would have any impacts on organizational work routines. Instead, there is a need to view implementation of telemedicine as an implementation of different fields of application, which are resulting from a translation of generic features of telemedicine. This will also have an impact on the evaluation of telemedicine implementation, and make the issue when an evaluation would be done and how the result would be interpreted, to an extremely complex and complicated matter. Hence, if there is a lack of understanding of consequences caused by the openness of telemedicine technology, implementation and evaluation can end up in a catch 22.