THE "FEAR FACTOR" in critical care tele-pediatrics

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.