355 Telemedicine Journal and e-Health Volume 6, Number 3, 2000 Mary Ann Liebert, Inc. Perspective Implementing Store-and-Forward Telemedicine: Organizational Issues DAVID BANGERT, Ph.D., and ROBERT DOKTOR, Ph.D. ABSTRACT This article documents a study of an organization’s cultural readiness for successful imple- mentation of a store-and-forward telemedicine system in a military health care environment. The study focused on the organization’s cultural attributes that reflect its learning propen- sity and thereby its capability to adapt effectively and utilize the new technology. Results suggest that the organization did not possess the most favorable attributes for the utilization of a new technology, and the utilization of the new system was significantly lower than ex- pected during the first 6 months of implementation. Department of Management, College of Business, University of Hawaii at Manoa, Honolulu, Hawaii. INTRODUCTION T HE U.S. MILITARY HAS COMMITTED significant resources to the development of telemedi- cine, and one major Department of Defense (DoD) facility undertaking part of the impor- tant research, prototyping, and demonstrating is the Pacific Regional Program Office at Tripler Army Medical Center in Hawaii. A lit- erature search revealed only a few well-de- signed studies that evaluated telemedicine. Most of these studies were conducted in the private sector. It may not be appropriate to generalize the findings of these to the military health system and its patient populations. Hence, there is a clear need for well-designed research in telemedicine in the military. This article describes one such research program. It provides an overview of the program, research methodology, and insights gleaned to date. This research program is designed to mea- sure the impact of telemedicine on the organi- zation. The program has two objectives. 1. To assess the impact of introducing tele- medicine to the organization. 2. To identify and assess the organizational factors, which if effectively pre-posi- tioned, will minimize resistance and max- imize acceptance and utilization of tele- medicine technology. It is difficult to anticipate the organizational changes that occur within a medical care sys- tem when new technology is introduced. These changes may range from minor to profound depending on the intrusiveness of the technol- ogy. Telemedicine technology is of the most in- trusive sort. It changes aspects of the diagnos- tic process and patient–doctor communication in the medical setting. Thus, it is hypothesized that the introduction of telemedicine will have