Does Telecare Improve Interorganisational Collaboration?
BACKGROUND
Previous studies have suggested that telecare can improve interorganisational collaboration within fragmented health care systems, yet this outcome has not been examined in a large-scale setting. This study explores the effects of a large-scale interorganisational telecare programme in Denmark based on home-monitoring on collaboration in a telecare network between municipalities, hospitals, and general practitioners.


METHODS
Semi-structured interviews and observations of collaborating health professionals from the municipalities, hospitals, and general practitioners were undertaken and then repeated a year later. Collaboration was analysed both at the interorganisational network level and within each part of the network, including its interrelations.


RESULTS
Collaboration between municipalities and general practitioners was initially intensified as a result of implementing telecare, though this changed over time as the first start-up obstacles were overcome and the patients became more active in their treatment. Conversely, collaboration betweenhospitals and municipalitiesandhospitals and general practitionerswas unaffected by telecare.


CONCLUSIONS
Changes in collaboration among municipal nurses, general practitioners, and hospital staff were related to dependency structures and municipalities' newly gained central role in a telecare network. While the telecare network was initially characterised by asymmetrical dependency structures, these were partially equalised over time because of the municipalities' new position in the network.
Center of Organization, Management and Administration, Department of Sociology and Social Work, Aalborg University, Kroghstraede 7, 9220 Aalborg, Denmark.
Jannie Kristine Bang
JK
Christensen
dependency structures; home monitoring; horizontal integration; interorganisational collaboration; intersectorial collaboration; telecare