The Effect of Culture on the Design of a Telemedicine System in Tanzania
Culture, Telemedicine, Health-Care, Tanzania, International Project Team
Delivering health care at a distance using information and communication technology (ICT) is being touted as the new frontier for delivering health care in developing countries. It is a new science called telemedicine whose development has been driven by the latest in technology to the exclusion of many other important considerations. In health care, there is mounting evidence that the introduction of new technologies invariably creates turbulence within an organization, primarily because the new organizational structures associated with the technological innovation are not assimilated within the existing organizational system. When viewed systemically, telemedicine is a collection of interactive subsystems — medicine, technology, social systems, funding mechanisms, physical infrastructure and culture — the successful integration of which becomes the major challenge in the design and implementation of a successful telemedicine system. The designers of a telemedicine system must be cognizant of existing patterns of social organization and the likely effect the introduction of new technology will have on those patterns. In addition, these new forms of social organization are likely to be different from place to place and country to country. Thus, when telemedicine systems are internationalized, they must function within a complex set of multiple cultural environments within which these different social systems operate. Information must be interpreted within a context of knowledge which, if not consistent between societies, prevents information transfer from taking place. Telemedicine systems fail for many reasons, but a major contributing factor is the failure of designers to facilitate the interaction of incompatible cultural subsystems that prevent the transfer of knowledge from one cultural context to another. In this paper the authors address the impact of cultural subsystems on the design of telemedicine systems for the delivery of international health care, using their work in Tanzania for illustration.
Paper Presentation in English
Effect of Cultural Diversity on the Design of a Telemedicine System in Tanzania, The
Dr. James Katzenstein
Executive Director, HealthSpan International Foundation
Dr Katzenstein serves as an international consultant, educator and organization systems design expert to bring telehealth solutions to the developing world. His consulting strategy brings together an international group of equal partners from whom solutions to problems within the developing world emerge. They then provide access to knowledge and skills from both the developed and the developing world to make these solutions a reality. He utilizes an educational infrastructure, low-technology communications systems, and a collaborative knowledge-sharing model for developing countries to become more self-reliant. He has done extensive research and testing of these concepts in connection with the Fielding Institute and at Mission Mikocheni Hospital in Dar es Salaam, Tanzania. He is a member of the American Telemedicine Association (ATA) and vice-chair of the Human Factors Special Interest Group (SIG) within the ATA. Dr Katzenstein teaches strategy and entrepreneurship at The Graziadio School of Business, Pepperdine University, and is an adjunct professor of business at California University, Dominguez Hills. His extensive business experience in senior management positions at companies such as Keebler Foods, Laura Scudder's Inc., A&P Grocery Company and General Cinema brings a unique perspective to the application of organization systems design in the business environment. Dr Katzenstein holds a doctorate in organizational systems from the Fielding Graduate Institute, as well as an MA in Organization Development and a Masters in Business Administration. He currently resides in Mission Viejo with his wife Grace, and they have four grown children living in various parts of the United States.
Dr. Barbara Chrispin
Professor of Management and Chair of the Department of Management, College of Business Administration and Public Policy, California State University, Dominguez Hills
Dr Chrispin is a Professor of Management and Chair of the Department of Management at California State University, Dominguez Hills, which is located in the Los Angeles area. She received her B. S. degree in Engineering Psychology and her M. S. degree in Technical Education from the University of Illinois and her Ph. D. degree in Education and the Applied Behavioral Sciences at UCLA. She has over 30 years of university teaching, administration, and research experience and has traveled extensively around the world. She has conducted research on the off-shore production facilities in Mexico, human resource practices in Brazil and Italy and, most recently, cross-cultural management practices in Tanzania. Her major research and teaching interest are in the areas of comparative management, organizational behavior and systems development.