Telemedicine, the use of telecommunication technologies to provide health services over some distance, has a history that spans more than five decades. Technological development and deployment have been interrelated with shifting paradigmatic views. This paper proposes that telemedicine has evolved through three generations that began with telemedicine as a communication medium to complement traditional services to a technology of automation and decision tools that expands the scope and range of health services and creates a unique health communication context. This paper provides a literature review and overviews three proposed evolutionary stages for telemedicine to date, namely synchronous versus asynchronous modalities, data transfer and storage, and automating decision making and robotics. Finally, we conclude with a discussion of the barriers for telemedicine and a call for engineers to join with social scientists and medical professionals to set an agenda for future telemedicine development.

This article reports the results from a four-year investigation of the relationships among four measures of social cognitive and communication abilities-cognitive differentiation, self-monitoring, perspective-taking, and persuasive ability-and the relationships of these measures to job leveland upward mobility in a large &st Coast insurance company. The data revealed significant relationships among all combinations of the communication-related abilities. Each was signijkantly related to job level, and three of the four were significontry related to upward mobility.Stepwise multiple-regression analyses revealed that, of the four communication-related abilities, cognitive differentiation accountedfor the most variance inpredicting job level and upward mobility. The findings suggest that communication abilities are important to the success of individuals in organizations. Persons with more developed abilities tended to be found at higher levels in the organizational hierarchy and tended to be promoted more often than persons with less developed abilities.There is little disagreement about the importance of communication in work situations. Indeed, without communication there would be no organization. Communication is the vehicle through which a new employee becomes socialized, a subordinate takes instructions, a supervisor gives instructions, a salesperson completes a transaction with a customer, or an employee interacts with other employees in social situations. Roles are defined, enacted, and coordinated through the Beverly Davenport Sypher (Ph.D., University of Michigan, 198 I) is assistant professor in the

Although both scholars and practitioners continue to privilege the “rational” aspects of organization, this article demonstrates the centrality of emotion in the organizing process. The case study method combines observation at a 911 center, interviews with dispatchers, and analysis of selected calls. Departing from most treatments of emotional labor, this article features workers who not only suffer through, cope with, and resist emotional labor but sometimes also seek it out. For these 911 dispatchers, emotional labor is a fun, exciting, and rewarding part of their work. In addition to providing a description of these neglected positive functions of emotional labor, this article speaks to a broader issue: the role of emotional labor in the construction of organizational community.

This study investigated the telemedicine program at East Carolina University School of Medicine. In-depth interviews, organizational texts, and archival records provided data for a case study that sought to understand what telemedicine is to organizational members and how they came to create this contextual reality. The goal of this study was to apply interpretive paradigmatic assumptions in the privileging of telemedicine as the very context of the organization. The findings explain how organizational members make sense of this new way of providing health care. Organizational members' talk revealed that telemedicine is multifaceted: It is access, an economic tool, education, technology, and a grant activity. With the single exception of technology, these themes emerged equally, regardless of whether the telemedicine provider was located at the urban hub site or the rural spoke site. Interestingly, members at both locations talked about critical events in relation to receipt of grant or financial support for new projects. Implications for future research are advanced.

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