Many writers on management during the 1990s have stated that we have neither a good understanding of the process of organizational learning nor a good grasp of the concept of knowledge management. In his 1990 book The Fifth Discipline, Peter Senge quoted others in asserting that “The most successful corporation of the 1990s will be something called the learning organization and the ability to learn faster than your competitors may be the only sustainable means of achieving competitive advantage”. More recently, writers such as Drucker, Davenport, Prusak, and Stewart have made similar claims when describing the drivers for managing corporate knowledge. This paper briefly looks at the overlaps and synergies between these concepts. It is argued that the discipline of knowledge management at a corporate level and the phenomenon of the learning organization are inextricably linked and should always be analysed and discussed in concert.

In 1999, the Department of Health in Western Australia began a telehealth project, which finished in 2004. The 75 videoconferencing sites funded by the project were part of a total state-wide videoconference network of 104 sites. During the period from January 2002 to December 2003, a total of 3,266 consultations, case reviews and patient education sessions took place. Clinical use grew to 30% of all telehealth activity. Educational use was approximately 40% (1,416 sessions) and management use was about 30% (1,031 sessions). The average overhead cost per telehealth session across all regions and usage types was 192 Australian dollars. Meaningful comparisons of the results of the present study with other public health providers were difficult, because many of the available Websites on telehealth were out of date. Despite the successful use of telehealth to deliver clinical services in Western Australia, sustaining the effort in the post-project phase will present significant challenges.

Between 1996 and 2003, a network of 85 telehealth videoconference sites was implemented in Western Australia (WA), together with 19 teleradiology facilities. Telehealth services have been growing steadily, and in 2002 there were over 30,000 teleradiology transmissions and 1250 clinical occasions of service via videoconference. The funding bodies, and in particular the WA Department of Health, need to know whether the aims of the project have been achieved. They must also decide whether investment should continue. A process of progressive evaluation has been implemented to identify progress to date, the benefits achieved and the potential for further development. However, it is difficult to evaluate a broad range of programmes in rural and remote locations for such an embryonic service. These difficulties are compounded by the lack of a strategy at national level to ensure consistency and compatibility not only of infrastructure, equipment and standards but also of data capture and evaluation methodologies for telehealth. This would allow comparisons across regions and states, which in turn would provide opportunities to learn from others and thus improve health-care nationally.

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