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Paper short abstract:

This communication will explore the emergent side of organizations that we call « organizing » and how this emergent side collides with the formal side of organization. To understand this encounter, we will scrutinize the experimental deployment of a telemedecine software between ten nursing homes and an emergency medical dispatch center in France.

Paper long abstract:

This communication will explore the emergent side of organizations that we call « organizing » after several scholars and how this emergent side collides with the formal side of organization. To understand this encounter, we will scrutinize the experimental deployment of a telemedecine software between ten nursing homes and an emergency medical dispatch center near Troyes (France).

The thesis defended here is that « organizing » (or articulation work) is needed to make telemedicine work. Nevertheless, actors can not forget the formal side of organizations (process, accountability, etc.). In other words, emergent and formal side of organizations are antagonistic in the first instance but have to become complementary : the story of the telemedecine softare studied could help to demonstrate this argument.

In order to do so, we have conducted a multi-sited ethnography (24 interviews, in situ observations, documents analysis) during six months (january/july 2014). The telemedicine toolkit concerned was a suitcase that includes devices with which the nursing home staff can perform an electrocardiograph, measure blood pressure and determine how much oxygen people have in their blood; it uses a Tablet PC to transmit the data gathered using these instruments to the emergency medical dispatch center so that the nursing home staff can discuss the situation with the regulating doctors. All the system was based on a software developed by a start-up. The purpose of the experiment was to avoid sending costly vehicles and having elderly people unnecessarily discharged at the hospital.