Barriers have challenged widespread telemedicine adoption by health care organizations for 40 years. These barriers have been technological, financial, and legal and have also involved business strategy and human resources. The article canvasses recent trends—events and activities in each of these areas as well as US health reform activities that might help to break down these barriers. The key to telemedicine success in the future is to view it as an integral part of health care services and not as a stand-alone project. Telemedicine must move from experimental and separate to integrated and equivalent to other health services within health care organizations. Furthermore, telemedicine serves as vital connective tissue for expanding health care organization networks.

Health care is a critical contributor to the socioeconomic development of a country. Telemedicine systems can improve health care within such countries. This study develops a telemedicine adoption and use model that embraces psychosocial, behavioral, work process, and organizational-related variables that impact a physician’s adoption and continuance of use of telemedicine. Two hundred and five questionnaires from medical professions at the Black Lion Hospital, Addis Ababa, Ethiopia, were used in this study. The study found that “Facilitating conditions,” “Compatibility with medical practice” and “Compatibility with physicians preferred work style” are the most prominent constructs in the study context. These findings suggest that the external environment in which a telemedicine system is used will have a significant impact on its use. Therefore, when a telemedicine system is transferred from a developed country to a less-developed country, we will likely see different issues arise in the adoption and use of the system.

Four case studies were conducted in Georgia, Pennsylvania, Ohio, and Wisconsin to uncover factors that played key roles in state telemedicine initiatives. Factors that affect the success of state telemedicine initiatives include telecommunications infrastructure, correctional facilities, need for a champion, user buy-in, competition in the healthcare market, timing of the government's action, and financial support for the initiatives. How these factors affect state telemedicine networks, the level of importance of the various factors, and potential state actions to leverage or dampen the effects of the various factors are reviewed.

The externalization of tacit knowledge is an important phase for knowledge creation, diffusion & utilization. The purpose of this study is to explore how different forms of tacit knowledge are externalized by taking a participatory agricultural research group as a case study for the surfacing, codifying and transferring of tacit knowledge. We conducted a qualitative case study that used semi-structured interviews, focus group discussions, observation and document analysis. The study revealed that the dominant forms of tacit knowledge externalized in this participatory agricultural research group fall under a low degree of tacitness (practical skills, lived experiences, rules-ofthumb and expertise) and a medium degree of tacitness (judgments, insights, practical intelligence and indigenous knowledge). Tacit knowledge externalization mechanisms identified include metaphor, storytelling, dialogue, apprenticeship or mentoring, experimentation and evaluation, observation, learning by doing, lessons learnt, modeling technique, localization and on-farm demonstration. A tacit knowledge externalization framework is proposed for the study context.