What makes organizations so similar? We contend that the engine of rationalization and bureaucratization has moved from the competitive marketplace to the state and the professions. Once a set of organizations emerges as a field, a paradox arises: rational actors make their organizations increasingly similar as they try to change them. We describe three isomorphic processes-coercive, mimetic, and normative—leading to this outcome. We then specify hypotheses about the impact of resource centralization and dependency, goal ambiguity and technical uncertainty, and professionalization and structuration on isomorphic change. Finally, we suggest implications for theories of organizations and social change.

The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields (Chinese Translation)

Methodological Review: The Technology Acceptance Model: Its past and its future in health care

A meta-analysis of the comparative distance education (DE) literature between 1985 and 2002 was conducted. In total, 232 studies containing 688 independent achievement, attitude, and retention outcomes were analyzed. Overall results indicated effect sizes of essentially zero on all three measures and wide variability. This suggests that many applications of DE outperform their classroom counterparts and that many perform more poorly. Dividing achievement outcomes into synchronous and asynchronous forms of DE produced a somewhat different impression. In general, mean achievement effect sizes for synchronous applications favored classroom instruction, while effect sizes for asynchronous applications favored DE. However, significant heterogeneity remained in each subset.

/pdf/how-does-distance-education-compare-with-classroom-dh5xmepwak.pdf

How Does Distance Education Compare With Classroom Instruction? A Meta-Analysis of the Empirical Literature

https://deepblue.lib.umich.edu/bitstream/handle/2027.42/57777/Understanding%20and%20representing%20place%20in%20health%20research%20a%20relational%20approach%20.pdf?sequence=1

Understanding and representing place in health research a relational approach

The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature.

Objective: To review research into patient satisfaction with teleconsultation, specifically clinical consultations between healthcare providers and patients involving real time interactive video. Design: Systematic review of telemedicine satisfaction studies. Electronic databases searched include Medline, Embase, Science Citation Index, Social Sciences Citation Index, Arts and Humanities Citation Index, and the TIE (Telemedicine Information Exchange) database. Subjects: Studies conducted worldwide and published between 1966 and 1998. Main outcome measures: Quality of evidence about patient satisfaction. Results: 32 studies were identified. Study methods used were simple survey instruments (26 studies), exact methods not specified (5), and qualitative methods (1). Study designs were randomised controlled trial (1 trial); random patient selection (2); case-control (1); and selection criteria not specified or participants represented consecutive referrals, convenience samples, or volunteers (28). Sample sizes were20 (10 trials),100 (14), >100 (7), and not specified (1). All studies reported good levels of patient satisfaction. Qualitative analysis revealed methodological problems with all the published work. Even so, important issues were highlighted that merit further investigation. There is a paucity of data examining patients9 perceptions or the effects of this mode of healthcare delivery on the interaction between providers and clients. Conclusions: Methodological deficiencies (low sample sizes, context, and study designs) of the published research limit the generalisability of the findings. The studies suggest that teleconsultation is acceptable to patients in a variety of circumstances, but issues relating to patient satisfaction require further exploration from the perspective of both clients and providers.

https://www.bmj.com/content/bmj/320/7248/1517.full.pdf

Systematic review of studies of patient satisfaction with telemedicine.

Objectives: To systematically review cost benefit studies of telemedicine. Design: Systematic review of English language, peer reviewed journal articles. Data sources: Searches of Medline, Embase, ISI citation indexes, and database of Telemedicine Information Exchange. Studies selected: 55 of 612 identified articles that presented actual cost benefit data. Main outcome measures: Scientific quality of reports assessed by use of an established instrument for adjudicating on the quality of economic analyses. Results: 557 articles without cost data categorised by topic. 55 articles with data initially categorised by cost variables employed in the study and conclusions. Only 24/55 (44%) studies met quality criteria justifying inclusion in a quality review. 20/24 (83%) restricted to simple cost comparisons. No study used cost utility analysis, the conventional means of establishing the “value for money” that a therapeutic intervention represents. Only 7/24 (29%) studies attempted to explore the level of utilisation that would be needed for telemedicine services to compare favourably with traditionally organised health care. None addressed this question in sufficient detail to adequately answer it. 15/24 (62.5%) of articles reviewed here provided no details of sensitivity analysis, a method all economic analyses should incorporate. Conclusion: There is no good evidence that telemedicine is a cost effective means of delivering health care.

https://www.bmj.com/content/bmj/324/7351/1434.full.pdf

Systematic review of cost effectiveness studies of telemedicine interventions.

Telemedicine research addressing user satisfaction abounds in academic literature. Results from patient satisfaction studies indicate exceptionally high levels of perceived satisfaction, often above the rates of expected satisfaction for traditional forms of health delivery. Results from provider satisfaction studies are also generally quite positive; however, data from providers point to higher concerns with delivery barriers and challenges. Even though data from patient and provider satisfaction research suggests overwhelming optimism for this delivery modality, this paper urges cautious embracement of these results for several reasons. First, many of the studies exhibit serious methodological weaknesses related to design and data collection instruments. In addition, the construct of satisfaction is largely undefined and is not clear. Even recognizing these caveats, the results of the study do offer some evidence that patient satisfaction will not impede the deployment of telemedicine, but provider satisfaction merits additional study.

Patient and provider satisfaction with the use of telemedicine: overview and rationale for cautious enthusiasm.

Foreword: Evan Melrose, M.D Preface The Authors History, Definitions, and Current Applications From Telemedicine and Telehealth to E-Health Telecommunication Technologies in Health Care Clinical Applications Special Settings Computerization of Medical Records and E-Health Services Privacy, Confidentiality, Security, and Data Integrity Legal and Ethical Issues Malpractice and Risk Management A Beginner's Blueprint: How to Get Started Research: Issues, Methods, and Outcomes Visions into the Future of Health Care Appendix A: Tips from the Experts Appendix B: Vendor Agreements: A Primer Appendix C: Videoconferencing Room Requirements and Etiquette Glossary Resources References Index.

E-Health, telehealth, and telemedicine : a guide to start-up and success

As electronic commerce grows, an important socio-economic side effect will be increased competition with the traditional businesses in any given local community. Our research suggests that local merchants typically go online in order to better access distant markets, but are often unprepared to cater to remote customers and hence do not fare well. In this paper, we suggest that it is important to consider now how electronic commerce may influence the health of local economies. Despite the rhetoric that electronic commerce is free from the constraints of geography, we argue that there are good reasons to reconsider the role of physical location in making e-commerce policies. We show that using transaction cost and competitive advantage approaches, supplemented by perspectives from research on social networks and trust, it is possible to develop locally sensitive Web strategies for businesses in a given community. We highlight generic strategies that local businesses can use to leverage their physical presence in a market with electronic commerce in order to better compete with distant Web-based companies.

Pamela Whitten

Papers

Systematic review of studies of patient satisfaction with telemedicine.

Systematic review of cost effectiveness studies of telemedicine interventions.

Patient and provider satisfaction with the use of telemedicine: overview and rationale for cautious enthusiasm.

E-Health, telehealth, and telemedicine : a guide to start-up and success

Community Level Socio‐Economic Impacts of Electronic Commerce