If telemedicine is to impact on and shape the hospital of the future, the challenge for strategic management will be to create and support a process where the technology's fields of application can be developed and diffused. Due to the technology's openness, this is required to occur in use of the technology, during a process of exploration and exploitation of its applications. The role of fiery spirits and supporting programmes of action are emphasised, by using Actor Network Theory as an analytical perspective on a longitudinal study of two Swedish telemedicine projects. It is concluded that fiery spirits are playing a significant role in the phase of exploring fields of application, but if applications are to be successfully exploited, the dependency of the fiery spirits has to be gradually decoupled. In this process, supporting programmes of action will facilitate the further exploitation and stabilisation of technology usage.