Despite increasing investments in the U.S. healthcare system, patientsespecially those in rural areasstill face barriers in accessing healthcare services at affordable rates. Thus, there are many opportunities for the implementation of telemedicine consultation (TMC) solutions to bridge the gaps in access, cost, and quality. A TMC involves a technology-mediated interaction between an expert consultant (in the medical context, a consulting healthcare provider) and an advice-seeker in which information exchange between these individuals is pivotal in evaluating the problem. A salient concern within this context is whether the TMC system will enable consulting providers to make efficacious evaluations. We call this concept perceived e-consultation diagnosticity and define it as the perceived efficacy of the TMC system to enable consulting providers to understand and evaluate remote patients health conditions. The research draws on concepts primarily from the marketing and technology acceptance domains to develop and test a research model that theorizes substitutive effects of the evaluative process requirements, IT capabilities, and user capabilities in shaping e-consultation diagnosticity perceptions. An important contribution of this research is identifying the types of user capabilities that are relevant within the TMC context and potentially across other expert consultation contexts. We propose two new constructs, presentation and elicitation, as well as the user roles of presenter and consultant. Presenters have the capability of presentation, which reflects their ability to relay information relevant to the medical consultation process, and consultants possess the capability of elicitation, which reflects their ability to elicit information relevant to the medical consultation process. While extant research theorizes technologys role in facilitating virtual collaborative processes, we specifically theorize the users capability to compensate for weaknesses in the technology. We employ a mixed methods research design, combining qualitative and quantitative methodologies, in order to gain a more complete understanding of our research domain than what we would be able to gain by using a single method alone. Findings from our analysis suggest that both IT and user capabilities are indeed important influences of perceived e-consultation diagnosticity.