Organizational structure of telehealth care : an examination of four types of telemedicine systems

The purpose of this study is to make recommendations for a sustainable telemedicine system by examining the structural attributes of telemedicine across and within different types of organizations. A survey instrument with two categories, background questions and evaluation questions, was developed and used as a guide to interview eight key informants from four different types of telehealth systems. The eight transcribed interviews were coded using NUD*IST qualitative software. Research publications, archival documents, and government reports were collected to triangulate, or cross check, interview data. Multi-case study methodology was used as a guide to design the research, analyze date, compare results, and make recommendations. A telehealth typology is proposed as well as a simplified conceptual telehealth model and a diffusion of telemedicine model. While there are some structural differences among the different types of programs, there are many more similarities. All receive funding fiom multiple sources, and all employ a combination of full and part-time employees. Three core staff categories include administrative, medical, and technical support. Additional categories may include evaluation researchers and project coordinators.