Title

THE "FEAR FACTOR" IN CRITICAL CARE TELE-PEDIATRICS

Abstract

How do emotions affect telemedicine adoption and usage for critical-care episodes? We report on

early findings from a grounded theory approach in a multiple-case study of critical care telepediatrics (research in progress). Thus far our findings suggest that specialists believe that generalist

clinicians at remote “spoke” hospitals are anxious and fearful when performing in a high stress crisis

situation involving an acutely ill or gravely injured child, leading to tunneling of attention

(overlooking important clinical details). The specialists at tertiary care “hub” hospitals feel they are

able to keep an emotional distance from the situation and they also report feeling less anxious because

they have had extensive training for these acute care situations. Both emotional distance and higher

skill level seem to help the specialists to take in more clinically-relevant information and use this to

guide the generalists. The generalists’ fear of negative evaluation by the specialists, or embarrassment

in front of other clinicians, may have some impact on their decision to use tele-pediatrics, but does not

seem to be a salient concern during critical care episodes. These findings suggest that emotions do

play a role in telemedicine use and possibly also in other forms of technology-mediated interorganizational collaboration.

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