Gagnon Marie-Pierre, Lamothe Lise, Fortin Jean-Paul, Cloutier Alain, Godin Gaston, Gagné Camille, Reinharz Daniel
Laval University, Quebec, Canada.
J Health Organ Manag. 2005;19(1):32-56. doi: 10.1108/14777260510592121.
The purpose of this study is to explore the influence of hospitals' organisational characteristics on telehealth adoption by health-care centres involved in the extended telehealth network of Quebec (French acronym RQTE) DESIGN/METHODOLOGY/APPROACH: The article is based on a review of the literature and a questionnaire, which was administered via telephone interviews to the 32 hospitals involved in the Extended Telehealth Network of Quebec. Contingency analyses were performed to determine which organisational factors have influenced telehealth adoption. Subsequently, a multiple case study was conducted among nine hospitals representative of different categories of telehealth adopters. In-depth interviews with various actors involved in telehealth activities have permitted a deepening of one's understanding of the impact of clinical and administrative contexts on telehealth adoption.
The results from both the questionnaire and interviews support the observation made by Whitten and Adams in 2003 that telehealth programs are not isolated, but located within larger health organisations. Moreover, health-care organisations are also positioned in a larger geographical, economical and socio-political environment. Therefore, it is important to investigate the context in which telehealth projects are taking place prior to experimentation.
ORIGINALITY/VALUE: This study has highlighted the relevance of considering the characteristics and the dynamics of health-care organisations at each stage of telehealth implementation in order to take their specific needs into account.
本研究旨在探讨医院组织特征对参与魁北克远程医疗扩展网络（法语缩写为RQTE）的医疗保健中心采用远程医疗的影响。
设计/方法/途径：本文基于文献综述和一份调查问卷，该问卷通过电话访谈的方式发放给参与魁北克远程医疗扩展网络的32家医院。进行了权变分析以确定哪些组织因素影响了远程医疗的采用。随后，对代表不同类型远程医疗采用者的九家医院进行了多案例研究。对参与远程医疗活动的各类人员进行深入访谈，有助于加深人们对临床和管理背景对远程医疗采用影响的理解。
问卷调查和访谈的结果均支持了惠滕和亚当斯在2003年所提出的观点，即远程医疗项目并非孤立存在，而是存在于更大的卫生组织之中。此外，医疗保健组织也处于更大的地理、经济和社会政治环境之中。因此，在进行试验之前，调查远程医疗项目开展的背景非常重要。
原创性/价值：本研究强调了在远程医疗实施的每个阶段考虑医疗保健组织的特征和动态的相关性，以便考虑其特定需求。
