Learning and Organisational Change in Regional Agencies of Telemedicine: Implications for the Mexican Case

Abstract

The aim of this article is to analyse the technological and organisational learning processes and their relationship with organisational and institutional changes in Mexican public hospitals that have implemented telemedicine systems. A qualitative research strategy has been followed by implementing an exploratory multiple-case-study approach. The fieldwork was conducted from July 2012 to June 2015 in seven regional agencies of telemedicine (RATM) of Mexico. General information for each RATM has been updated to 2021. The implementation and use of systems of telemedicine in clinics and hospitals around the world have influenced the efficiency and effectiveness of health services, but the effects are not direct or automatic. Health organisations go through phases of internalisation of technology and this implies the development of a knowledge base, learning processes and organisational and institutional changes. The processes of learning-by-doing, learning-by-implementing and learning-by-using explain the patterns of organisational and technological change. However, there are cultural and technical constraints that make these changes slow. A natural tension between the changes achieved and the prevailing resistances is present, so the role of leaders, the creation of scenarios that foster collaboration, trust and good communication among the members of the team, a knowledge base and learning processes are crucial.