Revisiting Project Definition/Initiation for Telemedicine: Insights from a Multi-site Case of Telestroke Services

Healthcare organizations and stakeholders are profoundly challenged in transiting a telemedicine project into a sustainable telehealth service line. While project management best practices have added values across multiple domains, a knowledge gap exists on informed execution of telehealth best practices. Project definition, or initiation, sets the strategic vision (and plan) for a project. It is the predominant stage in a project. As project initiation hugely defines project success, revisiting this stage for telemedicine may help to inform key actors on ways to achieve an optimal delivery of such services. Indeed, winning telehealth services require well-knitted intra- and inter-organizational collaboration on technology adoption across different organizational arrangements and among key stakeholders. Hence, a model redefining key project initiation components is used to drive our analysis. Drawing from collected data of a multisite telestroke implementation and anchoring on the model’s conceptualization, the authors explore in-depth how project initiation can be strategically framed within the telemedicine context. The interpretative findings from the data analysis, with each case surmising a distinct telemedicine business model, provide further insights on the collaborative uptake of telestroke programs. More specifically, the authors extend the analysis through comparative examination of key factors that promote or impede adoption via the lens of five distinct telecare business models: (1) the outsourced model; (2) the alliance model; (3) the not-for-profit private hospital network model; (4) the not-for-profit university sponsored network model; and (5) the for-profit private hospital network model. Together, the insights provided by this contribution will help efforts directed towards contextualizing key elements of project initiation in telemedicine and highlight the alignments of critical factors that can impact future telehealth efforts.