Many information systems (IS) studies portray use as an indicator of system success. However, "simply saying that more use will yield more benefits without considering the nature of this use, is clearly insufficient" [1 p. 16]. Researchers are also urged to address the study context in defining components of IS success. Our research specifies the use quality construct in the context of a mission critical system deployment, namely, the use of medical video conferencing for patient examinations. This type of telemedicine encounter provides an interesting context of system use as people in various roles interact with each other and with technology. We use a multi-method field study to collect and interpret a rich set of data on telemedicine encounters. We analyze the data from the perspectives of both patients and providers in the encounter. The result of this field study is a socio-technical framework of use quality for telemedicine service encounters in which the individual use quality attributes are identified, discussed, and compared via provider and patient perspectives.