Sex, lies and videotropes

Sex, lies and videotropes: Narrative and commitment in high technology teams
Journal of Applied Management Studies; Abingdon; Jun 1997; Nic Beech; James McCalman;

Copyright Carfax Publishing Company Jun 1997

Abstract:
Human resource management (HRM) seeks to engender employee commitment through workplace strategies including the use of teams. A paper examines the narratives used in high technology teams in 2 organizations: Reuters and Health Care International. It was found that the narrative element of the organizational discourse of the teams had an impact on the in-group ties and the level and direction of commitment. The cases illustrate the need for HRM theory and practice to pay increased attention to the role of narrative in affirming group membership or, conversely, sowing the seeds of discord.

Introduction

The symbolic and narrative elements of human resource management (HRM) have been identified as fundamental to its nature and operations (Keenoy & Anthony, 1992; Storey, 1992). However, despite recent interest in sociolinguistic analysis (Kamoche, 1995; Watson, 1995; Oswick & Grant, 1996) with few exceptions (Donnellon, 1996) the issue of language and symbolic elements of culture in teamworking has not been a central element of research. It is our contention that narrative, and stories in particular, reciprocally influence the cultures of teams, and impact on their identity, meaning and modes of performance. In teams centred on the implementation of high technology applications it will be argued that the expression of purposeful narratives through the use of technology are influential on team commitment.

It will be argued that meaning is neither objective nor fixed, and that, given the rhetorical nature of management (Gowler & Legge, 1983) the 'plastic' quality of meaning is accentuated in the business environment. The construction and deconstruction of meaning takes place through group cultural processes (Legge, 1995), and key to this is the operation of stories which provide the plastic quality in relating values, beliefs and norms to historical 'facts' (Brown, 1995).

High technology in a workplace context tends to generate stories. Part of the reason for this is the place that it holds within organisational discourse. To adapt an Orwellian phrase, 'high technology good-low technology bad'. This has an impact on group norms. This paper sets out to illustrate how stories concerning high technology are not just about high technology but act as part of a discourse which determines behaviour and interaction in organisations.

We will also attempt to theorise how technology may in the future be used to illustrate lack of conformity to the organisational whole. Individuals ('informationalists') who develop informational skills may gain power from their skills rather than their hierarchical position. They will have status as a result of their ability to establish world-wide relationships based on the relationship rather than authority-based power.

We use the terms sex, lies and videotropes in a deliberate sense to evoke controversy over the management claims and ambitions related to technology. In this sense, 'sex' relates to the perceived management popularity of high technology system applications, 'lies' relates to the consequences and pragmatic implementation which contrast with the 'sexy' rhetoric, and 'videotropes' concerns how these contradictions can be absorbed in a discourse which permits multiple layers of meaning in both language and practice. In particular, the application of video conferencing is seen to be influential in the two cases examined below. Our argument here is discussed further by detailing what we mean by sex, lies and videotropes.

Sex

The issues raised here cover the popularity or management concepts such as, teleworking, teleconferencing, telemedicine and computer-aided decision making. These are populist themes usually tied into new ways of working and organisational dialogues which empasise changes of culture, greater teamworking, and empowerment. For example, in both our cases technology served as a unifying force in one instance, yet in the other acted as an method of espousing and achieving corporate objectives. within the two case the technology served as a unifying force in one instance, yet in the other acted as an impediment powerful unity. The contradictions within the two case studies serve to illustrate how commitment to technology can be seen as an ironic yet powerful narrative. Lies

What concerns us most with the populist argument is how high technology implementation can actually mask a lack of organisational commitment, and in particular:

1. how management behaviours contradict the ethos of mutuality and commitment;

2. how organisational change can take place at a superficial level; and

3. how employee cynicism is reflected.

Within both organisations managers and team members were involved in the construction and deconstruction of meaning. This does not imply that some constructions were falsehoods in the sense that they did not match an external objective reality, but that other 'readers of the text' saw certain decisions and activities as contrary to the rhetoric. Thus, team members may have detected disingenuous espousal of commitment on the part of management where there was an apparent mismatch between their language and their action.

Videotropes

Words, images and interactions can be figurative to the extent that they send intended messages which are not restricted to straight-forward functionality. For example, Kamoche (1995) traces the use of the concept and language of teamworking as a totem which is used to enhance the identification of employees with the organisation. The language used is both figurative and 'inspirational', and also plain and functional. It is argued that both are needed to gain commitment and direct employees towards appropriate behaviour. In the cases of high technology teams examined below, the effectiveness of figurative language was limited. Many of the team members had a technical education and training, and placed high value on the latest and highest technology. In one organisation, video conferencing was used to enable high technology designers to alter their mind-set, and to become more committed to a team-based approach. In the other case, video conferencing was used to train and pass on high technology techniques, but the way that it operated (or failed to operate) confirmed employees' limited and devalued view of the organisation. What was significant was that the use of the video conferencing technology was in itself a symbol to the team members.

Figurative language is often used to inspire commitment, but it also functions to enable alternative interpretations by different readers of the text. We found that the use of video-conferencing did enable new understandings and interpretations, but that this facilitated both positive and negative views of the team and the organisation.

Our central theme is that stories in, and about, teams can act as both substantive and processual symbols. In order for the narrative to be generative there must be congruence between the substantive and processual elements, and between the way the symbols are read by employees, management and other relevant groups who participate in the discourse such as clients or end-users. Where there is a lack of congruence, meanings may be constructed which are degenerative of the in-group ties and levels of commitment in a team. Firstly, we consider the role of narrative in identity and commitment to teams. Secondly, the multiple symbolic functions of stories within the discourse are examined. Thirdly, the findings focus on the operation of narrative in teams in the two case study organisations, and finally we seek to draw conclusions relating to the generative and degenerative potential of storytelling. Stories using the right medium can form links of understanding between different mind-sets.

Teams, Stories and Commitment

The cases presented below will be used to argue that the self-identity of teams and their mutual commitment relate to the use of language within and about the group. Reality and language are socially constructed (Berger & Luckmann, 1966) and the social processes of meaning generation can strengthen in-group ties (Kamoche, 1995). Shared understandings increase the effect of integrative mechanisms, and group members can identify with each other by virtue of these shared meanings. This effect is emphasised where group members are distinguished from non-members by symbols such as keeping up with changes of language use which are accepted by the group, or by rejecting changes which are not accepted by the group. An example of this can be drawn from an illustration in which Watson (1995) analyses a group of personnel professionals within an organisation. The group leader rejected use of the term 'HRM', preferring to use 'personnel'. Other members then had to decide their position on the use (or not) of 'HRM'. Retaining the term 'personnel' came to have particular significance for the group, and this reflected on perceived membership. Similarly, adoption of the term 'team' for groups at work can reflect actual practice, but it can also operate figuratively, in seeking to get group members to increase their commitment to each other and the organisation through conceiving themselves as team members.

Images and perceptions which gain currency in groups and organisations create a sense of objectivity, at least partly, because they are not attributable to one person (Carroll, 1995). The processes may have formal sanctioning and be managerially promoted (Treadwell & Harrison, 1994), or they may be more informal and entail elements of negotiation (Alvesson, 1993). In either case, the apparent objectivity can increase the value placed on the discourse by group members, and can influence their acceptance of the espoused concepts. The cultural processes which occur in teams are interactions between basic assumptions, values and beliefs and artefacts (Schein, 1985). Artefacts, in this sense, include stories, metaphors, rites, rituals and symbols (Deal & Kennedy, 1988).

Symbols are important in forming views, values and understandings because they link thought and action in reinforcing cycles. Symbols can be both substantive and processual. This means that they convey both concrete images (substantive) and ways of using, or acting on, those images (processual). For example, a building can form a substantive symbol which encourages usage by a community, but the way it is used by a sub-group can have an intimidatory impact for other sub-groups (processual) such that wholecommunity use becomes very limited.

Similarly, stories within teams can act as both substantive and processual symbols. They exist, substantively, as messages of a significant event which has taken place, but they go further and, processually, send messages to group members about acceptable future thought and action. Brown (1995) gives a telling illustration of this in an organisational story which demarcates members who have to, and other members who do not have to, abide by the rules:

At the Revlon Corporation the story is told about Charles Revlon, the head of the group, who insisted that employees arrived for work on time, but seldom arrived himself much before noon. One day Charles wandered in and began to look over the sign-in sheet, only to be interrupted by the receptionist who had strict orders that the list should not be removed. Both insisted that they were in the right until finally Charles said 'Do you know who I am?' And she said 'No sir, I don t'. `Well, when you pick up your final pay cheque this afternoon, ask 'em to tell ya'. (Quoted in Brown, 1995, p. 15) The telling of such stories are not merely events, but can be rituals (Kamoche, 1995). As such, storytelling can take place at rites of passage such as entry into, movement within, or exit from the organisation or team. Rituals of this type influence not only the intended recipient of the story, but also the teller and the rest of the audience. Retelling of significant stories can have the ritualistic effect of providing observable evidence of an individual's membership of the group where they are seen as legitimate tellers of the story. Alternatively, the rituals can serve to exclude certain individuals, for example, where they are identified as breaking a group norm or value.

Therefore, stories can act as symbols of membership and of levels of commitment to the group. The roles individuals adopt in telling the stories, and the layers of interpretation superimposed can also carry significant messages of involvement and exclusion, genuineness and disingenuineness. Functions and Forms of Stories

Stories can function as an essential part of management conceived as a 'process of explaining' (Pye, 1995). This understanding relates to McCloskey's (1990) conceptualisation of stories as narratives which provide answers to the question 'why?' While models or metaphors may provide pictures of how things are perceived to be, stories can explain how they came to be. And thus, give reasons for the way things are. This is important in an organisational setting as group members seek reasons and justifications for their group membership.

Seven basic types of story have been identified (Martin et al., 1983). These types serve the functions of providing group members with answers to questions about how they should act and what they should expect of others. The seven types are: Can employees break the rules? Is the boss human? Can the little person rise to the top? Will I get fired? Will the organisation help me when I have to move? How will the boss react to mistakes? How will the organisation deal with obstacles?

Donnellon (1996) identifies a number of dimensions of talk within teams which can be used for categorising types of story. Identification functions are typified by language patterns using inclusive pronouns such as 'we', 'our' and 'us'. Levels of interdependence can be identified not only through explicit references (e.g. 'we can't achieve this without you') but also through levels of proposals of joint action, and expressions of need (e.g. 'I need to know your opinion before I can proceed'). Social distance can be identified through, for example, formal modes of address, excessive politeness and impersonal assertions. Conversely, social closeness tends to be characterised by casual styles, use of slang, familiar address and use of nick-names and expressions of reciprocity and empathy. Different styles of talk are appropriate, not only in different situations, but also in the context of different types of story.

Stories have been identified as symbolic representations which can increase reliability and quality (Weick, 1987). In high technology operations the complexity of problems can result in the people involved lacking sufficient sophistication to anticipate and deal with the problems. While individuals' level of sophistication can be increased through education, social systems within teams can also increase in sophistication, and thereby form the basis for complex problem solving. The key to this is a group culture which facilitates novel thought and action around a shared set of assumptions (Brown, 1995). Storytelling is a key mechanism of increasing group sophistication as it is an expression of vicarious experience which has the effect of increasing the knowledge pool available.

Therefore, it is postulated that stories, as cultural artefacts (and storytelling as ritual) can impact on the way teams perceive themselves, their reasons for being, and the appropriate modes of performance.

Research Approach

The aim of this research was to gain an understanding of the ways in which stories and storytelling about populist or sexy management applications of high technology did, or did not, act as mechanisms which enhanced commitment within teams. In order to achieve this it was necessary to record perceptions from a variety of actors involved. As well as gaining multiple views of each storytelling event, it was important that the respondents were enabled to disclose their genuine perceptions rather than `sharing' the managerially promoted image.

Research was undertaken in two organisations-Reuters and Health Care International (HCI). The research was undertaken by adopting a phenomenological approach based on grounded theory (Glaser & Strauss, 1967; Glaser, 1992). This entailed gathering information in a number of ways, semi-structured interviews, company documents, participant and non-participant observation. The findings emerged from reiterative siftings of data which were continuously fed back to participants and refined in view of the interpretation and reinterpretation.

First, semi-structured interviews in the two organisations were undertaken during 1994 and 1995. These interviews were not initially intended as an examination of storytelling but were subject-specific relating to management change and development, technology implementation and teamwork. Storytelling emerged as a powerful category which impacted on and was used to illustrate the degree of commitment, or lack of it.

Second, several policy documents on high technology applications at Reuters and HCI were analysed and discussed with members of the teams concerned.

Third, participant observation was carried out whilst one of the authors consulted and worked with Health Care International. Some of the richest and more illustrative data were gained during informal conversations. Observations were used to increase our understanding of the team interactions and to note the alignment between espoused logics and logics-in-use.

The nature of this research is interpretative, and the perceptions gained by the researchers were part of the ongoing generation, and in some cases, management of meaning.

Findings and Analysis

Reuters, High Technology and Teamworking

The following case is an illustration of the use of technology to enable virtual teamworking. Amongst other techniques, video-conferencing was used to communicate a complicated narrative in such a way that the mind-set of remote team members was changed. Such changes had been extremely difficult using more traditional technologies such as the printed word. The effective use of high technology also acted as a totem. In other words, it was a symbol which emphasised in-group ties by the groups shared relation to the technology. In this sense the technology-related discourse was similar to other espoused elements of HRM, such as teamworking (Kamoche, 1995). The discourse contained both expressive rhetoric which had an impact on attitude and enthusiasm of team members, and `plain speaking' which directed behaviour towards norms. The norms of behaviour were a further reinforcement of the discourse which gained currency among all team members.

Reuters is the world's largest news agency, and it supplies information in a variety of forms in 150 different countries. The case study team are particularly involved in the provision of financial data and news to financial dealers in key centres around the world. Financial information includes share prices, reports on companies and pertinent news. The information is used in decision making about investment and the selling and buying of stocks, shares and bonds. Information is one of the most important resources in the finance sector, and it is vital that it is relevant, correct, accessible and up-to-the-minute.

Reuters has a number of competitors in the financial information market. These include Bloombergs Financial Services and Dow Jones Telerate. In order to stay ahead of the competition it is necessary for Reuters to achieve high levels of customer satisfaction, and this means having products and services which are highly efficient and also easy to use. In order to ensure that customers were placed at the centre of the design process for new products and updated services Reuters established the Usability Group.

The Usability Group's mission is to make Reuters products easy to learn, intuitive to use and efficient to support. In order to do this customer reviews of products are built into the early stages of development. Customers are invited into the Usability Laboratories in which they test new applications of software on PCs which are set up to be observed by experts. The customers are videoed as they undertake the test, and they are simultaneously observed through a glass partition wall. The experts provide an analytical commentary which is recorded on the video track. The latter functions in a synchronised way with the software application under test. The customers are subsequently debriefed, and are invited to explain which aspects of the product they found easy or difficult to use.

The external customers are identified as the end users of products in the financial markets. The internal customers are the software design engineers outside the Usability Group. In order to make the external customers genuinely central to the design process it is necessary to enable software designers to fully understand their point of view and their experience. Previous approaches had given feedback to designers in the form of a written report, usually accompanied by anecdotes of difficulties experienced in testing the products. This approach had been relatively ineffective because the designers were frequently distant to the customers both geographically (the designers might be in New York, while the tester was in London), and cognitively. The software designers were highly accomplished experts in their field, and a central part of what motivated them was their subject and the nature of the products they were dealing with. As one team member said:

We are trying to do something profound-to move forward the technology... We are working in the arena of the human/computer interaction, possibly the most fascinating area we could work in. And we're at the cutting edge-so we have a sense of purpose. This motivates the whole staff.

Or as another put it:

Everyone here is an expert ... We are attempting to invent the future here.

It was clear that dealing with technology was not just something they did at work. Rather, it was part of their self-definition. And this was reinforced through group processes. Although team members were able to telework from home many came into work regularly because it was a norm or habit, and because they valued the group interaction.

I come in every day, probably through habit I suppose... It's fun coming to work. There is an informal and fun atmosphere.

Recruits to the team were selected to fit the culture.

People tend to fit in very quickly to the place and their jobs. It's good for us as we don't have to explain the culture to them, or spend time briefing them because it's the sort of thing they're used to. It's a culture where most people are experts. It's a culture of its own.

So there was a combination of several factors in the self-perception and cognitive approach of team members: they regarded themselves and each other as experts involved in cutting-edge technology, they regarded work and colleagues as part of their life-they would choose to mix with each other, and to undertake activities with technology and computers, and there were strongly expressed in-group ties. The latter were accentuated by the clear identification of in-group and out-group factions within Reuters. All of these factors had a positive impact on the commitment levels and performance of the team, however, there are dangers associated with such situations. In particular, groupthink (Janis, 1972) was a potential problem. Because there was high group cohesiveness and high confidence in their expertise there was a danger that the way they defined problems and generated solutions could become restricted. The software designers, for example, tended to produce the highest specification product they could. If problems or 'glitches' were identified, the solution was generally thought to involve even greater feats of high technology. Negative feedback from non-expert users could be devalued, the assumption being that once the user learnt how to use the latest innovation, they would realise that they did not really have a problem. In other words the problem was located in the user, and the solution was to increase their ability through training and experience. The idea that the problem may be genuine, and that the solution might lie in a lower technology arena was foreign to this mode of thinking.

The Usability Group needed to be able to bridge the gap between expert specialist designers and users whose primary skill areas were outside the computing field. This was not merely a problem of communication. The problem was one of conviction and understanding. The two groups (users and designers) operated in different cultures. They conceived problems and solutions in different ways, and so the need was to enable deeper level understanding which crossed cultural boundaries. This was achieved through an approach which had two highly significant elements. First, a scientific approach which related to the designers world-view. And second, the use of advanced technology and video conferencing to enable specialists to adopt a more holistic understanding of the problems and potential solutions.

A scientific approach is taken to the production of test data, and this makes it more acceptable to the intended recipients. A stratified sample of users is selected, so that the range of skill levels and usage types are represented. A number of areas are subsumed into the report. A questionnaire with 100 variables is used, and the scores are calculated and compared over time. This method of gathering and comparing perceptions gives the impression of objectivity. Reports are drawn up by specialists so that there is a graphical user interface evaluation, a graphic design report and a report from a cognitive psychologist who looks at the mental models. The result is a holistic evaluation of the product which combines qualitative and quantitative data.

Secondly, the use of video conferencing is thought to be very important. Videos of the users trying out products, along with the commentary from expert observers are used as the basis for conferencing between the Usability Group and designers in various centres. The senior manager of the Usability Group said:

... there is something psychological about a developer sitting in a cubical watching a customer in a different country using their product ... because if they see it in 'real time'-they're less biased. They can't believe what the customer is doing for a while. But once the third and the fourth customers do the same thing, they come to recognise the fact that the customer has a difficulty. This is the psychological break-through for getting 'buy-in' for change. In order to gain commitment to solving the problem this process of psychological `buy-in' is vital. Presenting critical reports or making recommendations to the designers failed to achieve the same level of buy-in. Through using this approach a number of significant changes in designs had been made, and considerable improvements in customer satisfaction were reported. However, it should be acknowledged that the main measurement for improvement was satisfaction among the team, and a fall in customer complaints and requests for help. Clearly, these are multi-factorial variables which cannot be traced to a sole cause.

However, for the purposes of this paper, the important outcomes are the perceptions of the actors involved, and there was a significant enthusiasm and commitment towards the team and its purposes. People spoke of the team as their 'community', they acknowledged the social value of work, and there was a high level of mutual respect. Individuals who were likely to fit in with the ethos were very carefully selected into the team, and if someone did not fit in, their stay would be short. It was important to the identity and commitment of the team that it was at the cutting-edge, and that their expertise was valued. The technology was used as a way of accessing basic views and understandings and enabling a level of communication which had not previously existed to such an extent. This occurred because it enabled commitment to the goals and methods of the team, and the resulting view of customers changed significantly.

Health Care International and Telemedicine

HCI was an international hospital based at Clydebank near Glasgow, Scotland. HCI opened its 260 bed high technology, tertiary hospital, and 166 room 4 star residential hotel on a 47 acre site on March 4th 1994. The intention was that the hospital would incorporate the best features of US teaching hospitals and have an established patient referral network in Europe, the Middle East and North Africa.

HCI was established as a response to what was seen as a growing world-wide demand for medical facilities. Tertiary health care involved treating the most complicated medical problems, those that required a high level of technological expertise and the most up-to-date medical technology. This type of care did not come cheap and tertiary care hospitals were more expensive than general hospitals and had to serve a wider catchment area. It was estimated that 20-30% of the population required such treatment. However, there were a large number of countries that could not afford it, and others that could not keep pace with the combined effects of increasing demand for these services and the increasing cost associated with them.

Several factors contributed to the increased demand for tertiary care. New developments in medical technology and techniques permitted more advanced treatment. Public expectation regarding health and quality of life increased, and the age profile in Western countries was increasing.

The traditional market for this need had been the US where teaching hospitals dealt with both foreign and domestic patients. This had changed during the course of the 1980s when access to major US facilities was negatively affected by the increased demand for services from domestic patients. US health care to foreign patients became increasingly expensive as hospitals sought to shift the cost of under-reimbursed and free care to private paying patients. Foreign patients were being 'priced out' of the US market. HCI objectives. HCI Objectives included seeking to constantly evolve and improve global health care provision by drawing upon best practise in terms of service and appropriate technology. This meant ensuring that staff remained at the leading edge of advances in global healthcare through the provision of facilities for continued professional development.

The situation in countries in southern Europe, North Africa, the Middle East and the Gulf States was such that shortages in primary care transcended the need for tertiary care. It was felt that these countries could not afford to invest their resources in high technology hospitals even though significant needs existed. It was also difficult to attract and retain the staff required to create such facilities. These countries sought to meet patient needs more cost effectively by sending selected patients out of the country for care. This was where HCI would meet the market need by providing high quality tertiary care at competitive costs closer to the market than US hospitals.

One aspect of HCI's ability to provide tertiary care at a competitive price was its technological capacity both in health care provision and management. Related to this was the technological capability of the facility and its linkages to patient facilities abroad. Prior to the official opening of the facility, the team approach at HCI stressed allocation of technology equipment on a needs basis as opposed to a status basis. There was a central core of 150 staff and a professional core of medical staff of 20 who remained under-utilised until patient flow could be established.

This particular case study concerns HCI's attempts at introducing telemedicine and the impact it had on staff perceptions of technology. Telemedicine was defined as the use of telecommunications systems to provide access to expert advice and patient information to enable the management of patients, and the education of patients and clinical staff, irrespective of their location. An alternative definition was telecommunications-supported medical practice. Instead of moving the patient to the doctor, or vice-versa, information was transmitted digitally, saving transport, time and money. One of the most well established telemedicine facilities was at the Medical College of Georgia, which provided access to specialists in radiology, endoscopy and a range of other subjects over telecommunications lines from remote, rural clinics.

Telemedicine was also being piloted in countries where resources are far scarcer. For example, Satel-Life was an international non-profit organisation which used micro-satellite technology to provide health communication and information services in developing countries. A 'store-and-forward' technique was used to pass data from one ground station to another, via the satellite. The low orbiting system meant every part of the world was in range at least twice a day. This removed the service from reliance on international telecommunications systems which are prohibitively expensive. For example, a medical researcher in Nairobi would have paid $7 to fax a single page of results to the World Health Organisation HQ in Geneva. Satel-Life provided access to library facilities, and specialist consultation services with authorities at centres of excellence such as the Harvard School of Public Health. In the US, all Regional Bell Operating Companies (RBOC's) were involved in pilot telemedical studies, and there was also significant interest in Europe.

HCI considered as part of its medical technology strategy that it would benefit from the development of telemedicine capability in several ways. First, telemedicine enables a fast and accurate medical 'gate' enabling patient referral to Scotland to be established, and transmitting high quality medical information to Scotland in advance of patient transfer. This would reduce the incidence of inappropriate patient transfer. Secondly, telemedicine also facilitates improved follow up services after patients have returned to their countries of origin. Thirdly, telemedicine (teleradiology, telediagnosis, teleconsulting, etc.) may be used as the basis of an income-generating remote consulting service. Lastly, telemedicine, if used appropriately, serves as a valuable training and marketing tool, attracting physicians and patients to HCI and the referral management offices/clinics.

However, questions remain over:

1. How quickly telemedicine services will become commercially viable at 'retail' telecommunications service costs.

2. The value (to HCI) of establishing telemedicine capabilities compared to other uses of limited management time and financial resource.

3. Current state of technology (usability, stability, supportability).

However, two key factors suggest that this area of work would still be pursued at HCI: the costs of the support technology and the telecommunications costs were improving continuously. In addition, HCI felt that it would be able to leverage its unique international position to obtain significantly reduced equipment and services. And secondly, the medical need for this technology in support of providing world class medical care is debatable in Scotland, but was far more likely to be important in other HCI facilities (such as Malaysia) where attracting world class medical staff would be harder. It was therefore important to gain experience in technologically advanced countries before attempting to operate the service elsewhere.

A strategy of gradual establishment of links to patient referral management offices was recommended, along with a pilot telemedicine project, in collaboration with various partners in the software and telecommunications industries. The estimated cost of transferring a single patients' data packet, assuming hardware and software costs of the pilot project amortised over 3 years, was estimated to be at 60 per case. In addition, it was recommended that HCI continue to seek collaborative links with strategic partners in the telecommunications and information systems businesses to establish a global medical communications network.

How would telemedicine work? In essence, telemedicine allowed doctors and their patients in remote sites to transfer appropriate medical data quickly and easily, and receive results from or have discussions with the expert physician to whom the data were sent. There are a number of variations on how this might have operated, but the key variable was the involvement of anything other than basic telephone services for real-time discussion of the data between the expert physician and the referring physician and his/her patient.

Assuming the availability of suitable data capture and 'compilation' capabilities at remote sites, a packet of data, with a request for advice embedded within it, would be sent to HCI for review. This could be received and decompressed, and then added to the clinical database which is used to store HCI's patients' records. As the record arrived, the physician to whom it was being referred would be 'bleeped', and informed that a new patient was awaiting a 'teleconsultation'.

It was feasible that the reception and viewing of 'clinical data packets' would be achieved through HCI's existing medical technology systemCerner. This would obviate the requirement for the development of a novel user interface. Nevertheless, some software development was required to process the incoming data packets and to unpack them into a format suitable for deposition into the Cerner clinical database. In addition, where incoming packets contain high definition radiological images, the Cerner system was not a suitable storage location. This would necessitate further development work. Software was required to unpack the incoming data packets and route their contents to appropriate locations. It was felt that this could be achieved by acquiring and customising an existing telemedicine package. Depending on the nature of the case, it could be viewed either through a normal system terminal, or otherwise (for example, if high definition radiological images were involved) through a special 'telemedicine workstation' situated in the radiology department. To respond to the case, the physician would either write a report which is faxed back, call the referring physician and discuss the case, or schedule a videoconference at which the doctor and/or his/her patient would be present.

Thus the primary functional requirement was for a system which enabled 'packets' of clinical data to be collated and transferred to remote locations, and which supported subsequent discussion of the clinical contents of the data packet.

HCI's actual position. In the absence of telemedicine facilities, patients were transferred to Scotland after ad hoc communication between a patient or patient's representative and HCI Scotland, or as a consequence of a prior agreement between HCI and a referring centre. In all cases, some clinical and administrative data was communicated to Scotland prior to patient transfer. This 'data packet' was communicated by telephone conversations, by fax, letter or other means.

There were three basic options for arriving at the decision to move patients from a referring centre to HCI Scotland. First, `prior agreement' mode: if the referring physician thought the patient needed to see a specialist and the specialist had agreed to accept the referring physician's assessments of patient needs, patients were simply transferred after basic administrative/ financial arrangements were conducted. Secondly, 'letter' mode: the referring physician sent a clinical data packet (digitally, or by a courier service such as Federal Express) to the specialist, requesting an opinion on the suitability of the patient for transfer. And thirdly, 'conversation' mode: the referring physician and specialist consulted by ordinary telephone or by videophone, after transmission of a clinical data packet.

There were two broad alternatives to consider: doctor/doctor communication and doctor/patient communication. Doctor/patient remote communication would be less acceptable in countries where the general population had little familiarity with technology. However, this needed to be tested in the market, and since the technological requirements were no different, this was a logistical issue rather than a technology one.

There were many different forms in which medical information was recorded and distributed. A telemedical system would be able to support most existing forms, in addition to potentially providing new ones. The main clinical requirement was for an easy method of information capture and compilation into a transferable report. This required a large amount of development.

Relationship to the opening of HCI's clinics/referral management offices. Linking HCI's approach to telemedicine to the use of the Cerner clinical user interface offered the possibility of simultaneously linking the development of communications circuits between RMOs (Regional Medical Officers) while decoupling the development from the requirement to proceed towards advanced telemedicine at any particular pace. Since a basic level of circuit infrastructure was required in any case, evolutionary addition of functionality and bandwidth was then possible in response to market conditions and HCI's business requirements.

It was recommended that the establishment of core communications for basic administrative and financial requirements be planned, with regard to the possibility of evolutionary development of the communications infrastructure for telemedicine.

The development of a detailed project plan for a pilot telemedical facility was to be undertaken in conjunction with the development of the overall HCI international telecommunications strategy.

Proposals/recommendations. There were three broad alternatives which arose: large scale investment in a program of developing the necessary infrastructure on a 'retail' basis-i.e. buying the necessary components and either managing the systems integration effort internally at HCI or contracting it out to a firm of external consultants/technicians. a pilot project to develop the growth path for clinics other than the ones involved in the pilot.

a global system developed through the formation of a new business entity which would involve HCI as a partner or customer, in which HCI served as a test-bed for services which were provided at very low cost in return for access to the association with HCI. It was recommended that the second and third options be pursued.

What actually happened. By 1995 HCI had yet to introduce an effective Telemedicine strategy. Having determined that the facility would strive for excellence, and having agreed that telemedicine offered the means of attaining technological edge, HCI failed to implement its strategy. The 'sex' element of our paper is best illustrated by this desire to link telemedicine to HCI's stated objectives of following best practice and implementing leading edge health care. However, the 'lies' associated with this particular example were the operating principles under which HCI undertook its business.

Recognising that HCI faced serious financial difficulties from the outset, plans for telemedicine were still espoused, even though medical staff knew that there was no possibility that they would be implemented. Telemedicine was still purported to be HCI's objective even though the organisation could not afford the financial costs, the technology could not provide the services required and the organisation of patient transfers to HCI needed to be undertaken manually.

One of the benefits which was argued for telemedicine was that it would improve the physician linkages through education. This was done by the live transmission of surgery from HCI's operating theatres to its main lecture facility. This system meant that physicians could come from all over the world to watch experts undertake extremely complex operations. This would market HCI's medical excellence. In reality, HCI could never implement the live video link-up between operating theatre and lecture facility and the expertise to do so had to be bought in at great expense.

Another illustration concerns the nature of telemedicine itself. Although the concept of patient information transfer via technology was both 'sexy' and appealing, the nature of the way the patient flow was administered at HCI meant that more often than not the patient arrived at HCI carrying their own patient notes. This was not an uncommon practice and limited the applicability of technology to what was ostensibly a manual process.

These failures became the focus of informal communication and narrative, and had a negative impact on the internal and external image of HCI.

Conclusions

We would not wish to over generalise on the basis of two case studies. However, we believe that certain outcomes are indicative of areas where the theory can be engaged with, and further research profitably undertaken. The answer to the question of how you get commitment in high technology teams is clearly complex and multi-factorial. However, in the standard HRM literature while attention is focused on the role of leaders and rewards, we would suggest that it is important to also focus attention on the more subtle processes of team culture. These entail the use of symbols and stories. However, the focus here tends to be on face-to-face narration and interpretation. In the cases we examined the use of high technology was an important symbol. It was necessary to tell stories in such a way that they were accessible to the audience, and this meant adopting a mode which fitted with their expectations.

Symbols and stories functioned to increase in-group ties, and were effective in the processes of the generation of meaning by groups. This generation could be either in a positive or negative direction from an organisational viewpoint, but in either case it was powerful in reinforcing the attitudes of the groups involved. In Reuters the narrative symbols engendered and reinforced positive team attitudes and feelings both through their substantive content and their processual operation. Further, the different readers of the text, although coming from divergent mind-sets were able to gain congruence of meaning, and this added to the strength of interactions and relationships. Conversely, in HCI, there was a contradiction between the espoused substantive symbols and their processual implementation. As a result, employees and customers developed a sceptical reading of the symbols, and the overall effect was degenerative. There was a need to beware of trendy language and trendy technology for its own sake, particularly when it did not function effectively. This had the effect of confirming sceptical attitudes. In addition, where the symbols did increase in-group ties there was the need to beware of dysfunctional integration causing narrowness of vision and group think.

Finally, the stories or symbols of, for example, customer problems and technology problems, were significant, but to these communities of discourse users the mode of the symbol was also vital. The rhetoric of high technology needed to be accompanied by the reality of its effective use. This supports the understanding that the discourse in use is not merely about the language and rhetoric. Rather it is the linked action, cognition and expression. What appears to be a necessary (but not necessarily sufficient) factor in achieving commitment in the high technology teams was a matching and mutual reinforcement between these three key elements.

[Reference]

Alvesson, M. (1993) Cultural-ideological modes of management control: a theory and a case of a professional service company, in: S. Deetz (Ed.) Communication Yearbook No. 16 (Newbury Park, CA, Sage).

Berger, P. & Luckmann, T. (1966) The Social Construction of Reality (Harmondsworth, Penguin).

Brown, A. (1995) Organisational Culture (London, Pitman).

Carroll, C. (1995) Rearticulating organisational identity: exploring corporate images and employee identification, Management Learning, 26(4), pp. 463-482.

Deal, T. & Kennedy, A. (1988) Corporate Cultures: the rites and rituals of corporate life (London, Penguin).

Donnellon, A. (1996) Team Talk: the power of language in team dynamics (Boston, MA: Harvard Business School Press).

Glaser, B. G. & Strauss, A. L. (1967) The Discovery of Grounded Theory (Chicago, Aldine). Glaser, B. G. (1992) Basics of Grounded Theory Analysis (Mill Valley, CA, Sociology Press).

Gowler, D. & Legge, K. (1983) The meaning of management and the management of meaning: a view from social anthropology, in: M. J. Earl (Ed.) Perspectives on Management (Oxford, OUP).

Guest, D. E. (1989) Personnel and HRM: can you tell the difference? Personnel Management, 21(1), pp. 48-51.

Guest, D. E. (1992) Employee commitment and control, in: J. F. Hartley, & G. M. Stephenson (Eds) Employee Relations (Oxford, Blackwell).

Janis, I. L. (1972) Victims of Groupthink (Boston, Haughton Miffin).

Kamoche, K. (1995) Rhetoric, ritualism and totemism in HRM, Human Relations, 48(4), pp. 367-386.

Keenoy, T. & Anthony, P. (1992) HRM: metaphor, meaning and morality, in: P. Blyton & P. Turnbull (Eds) Reassessing Human Resource Management (London, Sage).

Martin, J., Feldman, M. S., Hatch, M. J. & Sitkin,. S. B. (1983) The uniqueness paradox in organisational stories, Administrative Science Quarterly, 28, pp. 438-453.

Legge, K. (1995) Human Resource Management: rhetorics and realities (London, MacMillan). McCloskey, D. N. (1990) Storytelling in economics, in: C. Nash (Ed.) Narrative in Culture (London, Routledge).

Oswick, C. & Grant, D. (1996) Organisation Development: metaphorical explorations (London, Pitman). Pye, A. (1995) Strategy through dialogue and doing: a game of 'Mornington Crescent?' Management Learning, 26(4), pp. 445-462.

Schein, E. H. (1985) Organizational Culture and Leadership (San Francisco, CA, Jossey Bass).

Storey, J. (1992) Developments in the Management of Human Resources (Oxford, Blackwell).

Treadwell, D. F. & Harrison, T. M. (1994) Conceptualizing and assessing organizational image: model images, commitment and communication, Communication Monographs, 61, pp. 63-85.

Walton, R. E. (1985) From control to commitment in the workplace, Harvard Business Review, 2, March-April, pp. 77-84.

Watson, T. J. (1995) In search of HRM, Personnel Review, 24(4), pp. 6-16.

Weick, K. E. (1987) Organizational culture as a source of high reliability, California Management Review, 29(2), pp. 112-127.

[Author note]
NIC BEECH & JAMES McCALMAN Strathclyde Graduate Business School, University of Strathclyde, 199 Cathedral Street, Glasgow G4 OQU, Scotland, UK