Learning Through Telemedicine Networks

摘要

Telemedicine is advocated for its potential to improve the accessibility and quality of health care delivery while lowering costs [1]. Although the potential benefits of telemedicine have long been a subject of research and intense discussion, the results of actual implementations have been far from conclusive. Most current research, which views telemedicine as a substitute for travel and a basis for economies of scale, is rather limited in exploring the full potential of telemedicine. In this paper, we develop a new framework in which organizational learning is the theoretical basis for explaining the development and potential benefits of telemedicine. We conceptualize telemedicine as an integrated IT-enabled health care network of collaborative relationships. A well-developed telemedicine network is high in density, maintains a balance of strong and weak network ties, and is comprised of a diverse set of relationships. This type of network facilitates learning through the exchange, transfer and distribution of medical information/knowledge, the generation and dissemination of new knowledge about how to collaborate effectively via telemedicine, and the application of this knowledge in telemedicine practice. Viewing telemedicine in this light directs our attention to outcomes not emphasized in most prior research, including the diffusion of medical knowledge and expertise, and the development of collaborative knowledge shared by the health care parties. This paper develops a research model to explain how learning occurs in telemedicine practice, identify factors influencing the learning process, and indicate how thriving telemedicine networks can be built. The model focuses on flexibility of information technology, network density, strength of network ties, and network diversity as key factors having impacts on learning. It also views the acquisition, transfer and sharing of medical knowledge and the development of telemedicine collaborative knowledge as two learning processes occurring simultaneously and recursively, and reinforcing each other. Ultimately, learning is the core process that helps realize the potential of telemedicine.