| Knowledge creation is potentially the most important wealth generating mechanism in today's economy (Nonaka, 1991 & 1994; Quinn, 1992; Inkpen, 1996; Senge, 1990a), yet little empirical research has been done on how to stimulate the creation of knowledge. Although ideas may begin with an individual, it is the interaction between individuals that allows these ideas to grow into knowledge (Nonaka, 1994; Boland and Tenkasi, 1995). Communication networks aid in the interaction of individuals and are thus essential to knowledge creation (King, 1996). Policies that govern the telecommunications industry will significantly impact how these communication networks evolve. Although there is substantial research on telecommunications policy at the national level, very little has been done at the state level, where a major initiative has been the creation of a telemedicine industry. Telemedicine is in its infancy, and as such it is facilitating the creation of knowledge about the process of delivering medical services and building the foundations for future innovations.; This dissertation studied the creation of knowledge by examining the effects of state government telemedicine policy on the creation of knowledge using a multiple time-series analysis of secondary data, followed by four focused case studies. Factors that impact the success of state telemedicine initiatives were uncovered, and support was found for Nonaka's modes of knowledge creation. The knowledge creation cycle found in the telemedicine systems brings to light the manner in which knowledge about a system is created and evolves, resulting in system enhancements and adoption. Using knowledge creation as a tens facilitates comprehension of how users' understanding of an IT system matures and develops after implementation. The findings suggest that systems development should embrace a longer development cycle that explicitly recognizes that a new race a longer development cycle that explicitly recognizes that a new system spawns a knowledge creation cycle, and this new knowledge should be incorporated in system enhancements. |
