Implementing telemedicine technologies through an unlearning context in a homecare setting

Despite the opportunities the health sector will offer as a result of the design and development of a technology infrastructure, the fact is that hospitals have been slow to adopt telemedicine technologies, largely because very few organisations are prepared to face this challenge. A possible explanation for the efficiency and effectiveness gaps of services provided by Hospital-in-the-Home Units (HHUs) may relate to the advantages and disadvantages of the knowledge processes that these units exhibit as a result of their different structural properties. This paper investigates the approaches that HHUs have used to update the knowledge of physicians and their members' knowledge of technology, and relates them to an unlearning context (UC) and improvement in the quality of health services. These relationships are examined through an empirical investigation of 55 doctors and 62 nurses belonging to 44 HHUs. The research findings suggest that the key benefits of a UC in HHUs are clear. It enables them to identify and replace poor practices and also avoids the reinvention of the wheel; it enables cost reduction by minimising unnecessary work caused by the use of poor methods and it enables improvements adopting new telemedicine technologies.