Analysis of telemedicine from an organizational perspective.
OBJECTIVE
To conduct an in-depth case analysis of the University of Kansas Telemedicine Program in order to identify organizational and communications elements that may be hindering the program's effectiveness.


METHODS
A case analysis was done, employing a combination of methodologies (direct observation, interview, and survey) involving extensive data collection from telemedicine program personnel throughout the state of Kansas. Analysis of this program's organizational communication focused on structure and boundaries, definitions and goals, leadership and decision making, and membership and roles.


RESULTS
Significant organizational communication deficits were identified. These included a dearth of perceived central leadership, lack of information about the technology itself, poorly designed and cumbersome means for scheduling and utilizing telemedicine technology, absence of explicit strategic goals; and poor communication in introducing this technology to medical personnel and to the public. Other important findings were: organizational members expanded the scope of this organization beyond the providing of a simple consultation; the perception that decision making falls into the hands of almost everyone but the referring physician; and the role that language (or lack of common terminology) plays in confusion about this innovation.


CONCLUSIONS
Organizational factors may be critical determinants of success or failure of a telemedicine program. Innovations in telemedicine technology need to be matched by innovations in organizational communication and structure. Findings from this study can be applied to existing or planned programs. Examples include redefinition of the roles and responsibilities of certain personnel, increasing the efficiency and decreasing the complexity of the consultation scheduling process, clarification and formalization of leadership and decision making, and development of a universal terminology of telemedicine.
Whitten
P S
PS
Telemedicine Services, University of Kansas Medical Center, Lenexa, USA.
Allen
A
A
D000046:Academic Medical Centers; D003142:Communication; D003659:Decision Making, Organizational; D004059:Diffusion of Innovation; D006801:Humans; D007615:Kansas; D007857:Leadership; D008330:Management Audit; D017146:Models, Organizational; D015397:Program Evaluation; D017216:Telemedicine / Q000458:organization & administration*