Training and process change: A collaborative telehealth case study

The next generation of telehealth systems running over broadband Internet will offer opportunities to change the way clinicians provide health services. This case study is a component of a larger research project which explores the implications of broadband telehealth in a tertiary healthcare setting. The research question of this case study addresses how to train and prepare clinicians to do their job using the next generation of telehealth systems. This case study presents observations of twelve clinicians during the training sessions conducted for them as they prepared to use a research prototype telehealth system in a pilot trial at their hospital. The telehealth system was purpose-designed to address the range of needs of the clinicians involved and clinicians very rapidly understood the affordances of the system. Our observations show that the clinicians spent the bulk of the training sessions dealing with process change. They focused on three areas: collaborating with their remotely located clinical assistant, adapting their clinical practice in order to use the system and identifying areas where the telehealth system need to be changed to support their specific needs. Our observations also show that each of the senior surgeons amongst the clinicians (working in a different sub-specialty) dealt differently with the process changes. We conclude that for complex tertiary healthcare telehealth applications the distinction between training given to the clinicians and process change identified by the clinicians is worth considering when preparing clinicians to use the next generation of telehealth systems. We suggest that teams developing advanced telehealth systems consider these issues of process change as they develop ways to prepare clinicians to use their system.