Lack Of Standards For Ehr Health And Social Care Essay Free Essays

string(49) " the footing of likert graduated table from 1-5\." In 21st century Information Technology played an sole function in upper limit of the Fieldss ; nevertheless, health care is one noticeable exclusion. Harmonizing to surveies, U.S. We will write a custom essay sample on Lack Of Standards For Ehr Health And Social Care Essay or any similar topic only for you Order Now infirmaries and multiple-facility wellness systems are â€Å" merely get downing to round out their clinical webs, but are much farther along than physician patterns. † ( David B. Meinert ) While many inmate or infirmary installations migrating from paper charts to electronic records, but a small advancement has been made in the ambulatory or outpatient scene. Vast bulk medical professionals including doctors have been loath to utilize electronic medical records and go on to trust on paper records. Paper medical records are informations rich by nature, but information is hapless as doctors and other wellness attention suppliers have limited clip to delve through volumes of paper to recover information, use it in decision-making and/or portion it with patients. EMR/EHR systems hold enormous promise for non merely bettering the measure and quality of clinical informations that can be recorded, but more significantly the ability to entree wellness attention informations to bette r quality of attention. This survey will seek to see the perceptual experience of medical professionals towards Electronic medical record. Study has been done as a comparative survey among two different types of scenes that is hospital which are utilizing EMR ( paperless infirmaries that is category A ) and infirmaries which are holding their ain information system where the paper-based medical records are scanned and used ( Category B infirmaries ) . Electronic Medical Record ( EMR ) Harmonizing to the Healthcare Information and Management Systems Society ( HIMSS ) , an EMR is a constituent of an electronic wellness record which is owned by the health care supplier. ( Dr. Chris Hobson ) This engineering, when to the full developed, meets provider demands for real-time informations entree and rating in medical attention. EMR besides provides the mechanism for longitudinal informations storage and entree. The content of an EMR is correspondent to the paper record, but the electronic format creates useable informations in medical result surveies, improves the efficiency of attention, and makes for more efficient communicating among suppliers and easier direction of wellness programs. ( Electronic Medical Record: The Link to a Better Future, Texas Medical Association ) Electronic Health Record ( EHR ) is an electronic version of a patient ‘s medical history, that is maintained by the supplier over clip, These have been used extensively by general practicians in many developed states and include patient designation inside informations, medicines and prescription coevals, laboratory consequences and in some instances all healthcare information recorded by the physician during each visit by the patient. ( Electronic wellness records: manual for developing states. WHO ) EHRs are the following measure in the continued advancement of health care that can beef up the relationship between patients and clinicians.A The informations, seasonableness and handiness of it, will enable suppliers to take better determinations and provide quality attention. For illustration, the EHR can better patient attention by: Reducing the incidence of medical mistake by bettering the truth and lucidity of medical records. Making the wellness information available, cut downing duplicate of trials, cut downing holds in intervention, and patients good informed to take better determinations. Reducing medical mistake by bettering the truth and lucidity of medical records. Background: Hospital information systems ( HIS ) and Electronic Medical Records ( EMRs ) are considered requirements for the efficient bringing of high quality wellness attention in infirmaries. However, a big figure of legal and practical restraints influence on the design and debut of such systems ( Dick RS, Steen EB ) Hence, many EMR execution undertakings do non take at presenting the EMR and extinguishing the paper-based opposite number in one measure ( Laerum H ) . As a start, the EMR is introduced along with its paper-based opposite number, and both are kept updated. In such environments, wellness attention workers have to cover with a intercrossed electronic and paper-based solution. This likely limits the usage of EMR ( Laerum H ) . Furthermore, mistakes are prone to develop due to cumbersome care of the medical record information in double storage media. In many states, most hospital EMR undertakings have non passed beyond this stage ( Dick RS, Steen EB ) Electronic Medical Records- the altering tendency: aˆ? Paper based records are being bit by bit replaced by computing machine based records ( which is in being in the West since 2 decennaries ) aˆ? It has non achieved the same incursion in health care as in finance or other industry. Deployment varies in states Aims: To reexamine already bing information system of both class of infirmaries To happen out existent versus perceptual troubles while utilizing EMR both classs infirmaries To analyze the overall perceptual experience of infirmaries about EMR To mensurate satisfaction from EMR in class A infirmary To bring forth a checklist for betterment Methodology: Overview: Assorted surveies which has been done globally has been surveies to happen out statement of job, since no such survey has been found in Indian context, so all premises from other states has been considered as relevant. Sing the less version of EMR usage, this survey tries to happen out existent versus perceptual advantages, disadvantages and functionality etc to acquire the clear image. Sample: entire four infirmaries have been selected under two different scenes for comparing. Each scene has two infirmaries of same sort. For easiness both scenes have been given name class A and class B. Class A infirmary are EMR user infirmary while class B infirmary are holding their ain infirmary information system in topographic point along with the paper record. For easiness footings category A and B in whole papers alternatively of EMR user and EMR nonuser infirmaries Sample size: Excluding 4 IT caputs, entire 120 responses has been collected form clinical staffs, which includes physicians, occupants, caputs of sections and nurses etc. Thirty responses from each infirmary have been collected. Questionnaire: questionnaires had been used for roll uping informations from both category infirmaries. Questions are of near ended, rated on the footing of likert graduated table from 1-5. You read "Lack Of Standards For Ehr Health And Social Care Essay" in category "Essay examples" Response recording has besides been done for happening out the jobs, so that better suggestions can be made. Interviewing: in deepness interviews has been taken by IT caputs of all the four infirmaries to understand all the factors from their point of position, and to understand their return on different jobs addressed by their clinical staff. Since none of the infirmary is utilizing EHR, so complete survey had been done about EMR merely. Data aggregation had been done as follows- Questionnaires have been used for roll uping informations from medical staff. In depth interview with IT caputs of all the four sections Reappraisal of literature related to EMR Reappraisal of the literature to understand perceptual experience of medical professionals sing EMR usage. Inclusion standards: to guarantee cogency of sample, two inquiries were set in questionnaire. Harmonizing to that who were working in infirmary for more than three months ; were eligible. Another inclusion standard was straight related to patient attention. Those who were utilizing computing machine for come ining patient information/ recovering patient information/ trial consequence retrieval etc ; were eligible. Literature reappraisal There are many maps associated with patient wellness records. This record is non merely used to document patient attention, but it besides used for entering fiscal and legal information and research and quality betterment intents. ( Young, Kathleen M. ) The conventional paper-based medical record has several restrictions. Though this traditional method is utile for entering patient ‘s inside informations for work outing medical issues, tracking down patients and for organizing in health care procedure, but it has so many disadvantages. These types of records are frequently ailing indexed and sometimes illegible, fragmented, because these records are manus written. The most disadvantageous factor of utilizing this method is that the medical record would be accessible to merely one individual at a clip. These medical records can non be made available to everyone at the same clip. Last but non least there is the job of storage of paper record, most of the times these are non stored decently, which in bend cause failure in retrieval of information, whenever required. Medical record is systematic certification of a individual patient ‘s medical history and attention across clip within one peculiar wellness attention supplier. The medical record includes a assortment of types of â€Å" notes † entered over clip by wellness attention professionals, entering observations and disposal of drugs and therapies, orders for the disposal of drugs and therapies, trial consequences, x-rays, studies, etc. The electronic wellness record ( EHR ) provides the chance for healthcare organisations to better quality of attention and patient safety. â€Å" The greatest challenge in the new universe of incorporate health care bringing is to supply comprehensive, dependable, relevant, accessible, and seasonably patient information to each member of the health care squad, whether in primary or secondary attention and whether a physician, nurse, allied wellness professional, or patient/consumer † ( Schloeffel ) An electronic medical record ( EMR ) is a computerized medical created in an organisation that delivers care, such as a infirmary or doctor ‘s office. Electronic medical records tend to be a portion of a local stand-alone wellness information system that allows storage, retrieval and alteration of records. Some definitions: Harmonizing to National Alliance for Health Information Technology ( NAHIT ) EMR: The electronic record of health-related information on an person that is created, gathered, managed, and consulted by accredited clinicians and staff from a individual organisation who are involved in the person ‘s wellness and attention. EHR: The aggregative electronic record of health-related information on an person that is created and gathered cumulatively across more than one wellness attention organisation and is managed and consulted by accredited clinicians and staff involved in the person ‘s wellness and attention. Purpose of medical record: The chief intent of medical records and medical notes is to record and pass on information about patients and their attention. If notes are non organised and completed decently, it can take to defeat, argument, clinical mishap and judicial proceeding. medical records are now used non merely as a comprehensive record of attention but besides as a beginning of informations for hospital service activity coverage, supervising the public presentation of infirmaries and for audit and research. Many of the causes of inaccurate clinical cryptography of this secondary informations are rooted in the quality of medical notes History of Electronic Medical Records: Doctors are expected to document brushs they have with patients to guarantee important information for decision-making is recorded and actions taken are besides recorded. Documentation is besides required as an archival record of what happened in instances of difference. To a great extent, physicians resent the undertaking of certification, as it detracts from their primary undertaking: taking attention of patients. Doctors besides resent the duplicate of attempt required with certification, as every medicine that is written on a prescription tablet, every lab trial ordered, every X ray ordered has to be re-written in the chart to keep a good record. Communication between practicians is hard as in many instances the information collected is fragmented, often excess and voluminous. Finally, doctors are invariably inundated with new information and have no tools to assist them integrate new techniques and interventions into their daily activities, other than utilizing their memories or holding to tote around big text editions. The thought of entering patient information electronically alternatively of on paper -the Electronic Medical Record ( EMR ) -has been around since the late 1960 ‘s, when Larry Weed introduced the construct of the Problem Oriented Medical Record into medical pattern. Until so, physician ‘s normally recorded merely their diagnosings and the intervention they provided. Weed ‘s invention was to bring forth a record that would let a 3rd party to independently verify the diagnosing. In 1972, the Regenstreif Institute developed the first medical records system. Although the construct was widely hailed as a major progress in medical pattern, doctors did non flock to the engineering. In 1991, the Institute of Medicine, a extremely respected think armored combat vehicle in the US recommended that by the twelvemonth 2000, every doctor should be utilizing computing machines in their pattern to better patient attention and made policy recommendations on how to accomplish that end. Advantages OF THE EHR: advantages of EHR can be divided as following- 1 ) Clinical results a ) Quality of attention: Improving quality of attention is one of the chief focal points of many EHR surveies. Quality of attention has been defined as â€Å" making the right thing at the right clip in the right manner to the right individual and holding the best possible consequences † , in short â€Å" a procedure for doing strategic picks in wellness systems † .A Quality of attention includes six dimensions, effectivity, efficiency, patient safety, handiness or seasonableness, just entree, and patient-centeredness or acceptableness, but most EHR research has focused on the first three. Last three constituents needed more research in their corresponding Fieldss. Erstwhile patients may non adhere to outdo pattern guidelines ; even the suppliers have best purpose. This sort of state of affairs can originate due to assorted factors like- Clinicians are non cognizant with the guidelines. Clinicians may non recognize that a peculiar guideline applies to a given patient. Lack of clip during the patient visit. EHR systems proved rather effectual in managing such sort of issues and improved attachment rates. For illustration, research workers found that computerized physician reminders increased the usage of grippe and pneumococcal inoculations from practically 0 % to 35 % and 50 % , severally, for hospitalized patients ( exter PR, Perkins S, Overhage JM, et al. ) . Similarity other surveies with computerized reminders on inoculation rates, shows important better attachment to immunisation guidelines. Lower berths the hazard of disease eruptions in communities: There are many other researches have conducted that focused on other preventative services and studied consequence of EHRs on different results to better attention efficaciously. Willson et Al found in his survey on hospitalized patients that after implementing computerized reminders targeted to hospital nurses, there is 5 % decrease in the development of force per unit area ulcer after 6 months. It proves a important association between computerized reminders and hazard of disease. Effective wellness attention bringing: Research workers have besides found that there is a profound relation between EHRs and efficiency in wellness attention bringing. Here efficiency refers to the turning away of blowing resources, including supplies, medical equipment, money, thoughts, and energy. One such signifier of waste involves excess diagnostic testing. Performing excess trials is dearly-won and may take to more false-positive consequences, which will so take to even more costs. Tierney et Al found a 14.3 % lessening in the figure of diagnostic trials ordered per visit and a 12.9 % lessening in diagnostic trial costs per visit when utilizing an EHR with CDS and CPOE constituents. Other, unrelated surveies found an 18 % lessening in trials ordered for medical visits in the exigency section, a 27 % lessening in excess research lab trials of antiepileptic medicine degrees in hospitalized patients, and a 24 % decrease in excess research lab trials in a infirmary. Reduced medicine mistakes: A well-known survey group found in their survey that merely presenting CPOE system reduced serious medicine mistake by 55 % in the infirmary scene. Whereas subsequently in followup survey the same group expert found that, these medicine mistakes can be reduced every bit much as 86 % by adding CDS system together with CPOE system. A similar, more recent survey in the outpatient puting found that cybernation resulted in an mistake rate decrease from 18.2 % to 8.2 % . ( Devine EB, Hansen RN, Wilson-Norton JL, et al. ) . On the other manus many other surveies have concluded that by presenting computerised system, the figure of appropriate medicine orders affecting dosing degrees or dosing frequence can be increased. Better clinical result: Many of the surveies besides focused on clinical results. Randomized test research design used for carry oning these surveies in a clinical scene. An extra organic structure of literature has examined, observationally, comparing of public presentation in between infirmaries that implemented EHRs and other computerized capablenesss with its opposite numbers that have non. For illustration, Menachemi et Al found that Florida infirmaries with greater investings in EHR engineerings had more desirable rates on a assortment of normally used quality indexs. Patient Safety: The challenge of reading handwritten notes, orders, and prescriptions has been eliminated with the EHR. Patients ‘ chart information is clear and legible. Reports and letters to other specializers and patients are comprehensive, professional, and easy to make. Chart information is ever accessible and found in the same topographic point. Paper charts, on the other manus, can go littered with a batch of necessary but misplaced information. 2 ) Organisational results: Surveies analyzing organisational results have focused on EHR usage in both the inmate and outpatient scenes. Such results have often included increased gross, averted costs, and other benefits that are less touchable, such as improved legal and regulative conformity, improved ability to carry on research, and increased job/career satisfaction among doctors. Increased gross comes from multiple beginnings, including improved charge capture/decrease in charge mistakes, improved hard currency flow, and enhanced gross. Several writers have asserted that EHRs aid suppliers in accurately capturing patient charges in a timely mode ( Schmitt KF, Wofford DA ) Electronically available patient information generated so many efficiencies, which straight help in debaring cost. Some of these efficiency includes increased use of trials, reduced staff needed for patient direction, decreased written text costs, reduced costs associating to supplies needed to keep paper files, and the costs associating to chart pulls. EHRs besides cut down the redundant usage of trial or the demand to get off difficult transcripts of trial study to all suppliers that save money and clip of organisation. ( Chen P, Tanasijevic MJ, Schoenenberger RA, et Al ) . Surveies have besides shown that holding an EHR can cut down written text costs through electronically available structured certification processs instead than a paper file. ( Agrawal A. ) In add-on, research workers in Massachusetts have found that doctors utilizing an EHR had fewer paid malpractice claims. They found a doctor without EHR have much higher ( 10.6 % ) history of paid malpractice claims compared to those doctors with EHRs ( 6.1 % ) . This decrease is potentially the consequence of better communicating among health professionals, increased discernability and completeness of patient records, and increased attachment to clinical guidelines. 3 ) Social results: Another less touchable benefit associated with EHRs is an improved ability to carry on research. As patient informations stored electronically that makes handiness of informations much easier which leads excessively many quantitative analyses to place evidence-based best patterns more easy ( A Aspden P.A ) . Furthermore, public wellness and other interdisciplinary research workers are actively utilizing electronic clinical informations that are existent informations aggregated across populations to bring forth good research determination, which is good to society. Till today handiness of clinical informations is much limited but as suppliers will get down utilizing EHRs, this dataset will besides get down turning. Subsequently by uniting this clinical information with more informations from other beginnings like nonprescription medicine purchases and school absenteeism rates, our researches and public wellness organisation can break supervise disease eruptions and better surveillance of possible biological menaces ( Kukafka R, Ancker JS, Chan C, et Al ) . Research workers have besides found an association between EHR usage and physician satisfaction with their current pattern, A together with their calling satisfaction.A Harmonizing to many surveies, physician satisfaction should be a precedence in wellness attention organisations, because it is associated with better quality of attention, better prescribing behaviors, and increased keeping in medical patterns, peculiarly those in underserved countries. ( A Elder KT, Wiltshire JC, Rooks RN, et al.A ) Chaudhry et al noted that a big proportion of the surveies that found benefits from EHR were conducted in a selected figure of academic medical Centres in infirmary scene. Due to this ground many research workers are besides seting a inquiry about the generalisation of identified benefits of EHR in existent universe where they may neither hold similar fiscal and human resources nor a decades-long committedness to wellness information engineering. More research on the varying types and grades of benefits associated with EHR is warranted, particularly in community scenes such as physician patterns and non-academic infirmary scenes. Barriers TO THE EHR Although Electronic Health Records ( EHRs ) bring enormous benefits to patient attention and to the health-care supplier, usage of the ambulatory EHR alternatively of the paper chart did non become widespread among the independent doctors during the 1990s. Even though the motive of improved patient attention and handiness of medical informations was present, health-care suppliers were hesitating to get down utilizing this medical tool. Specii hundred grounds have been hypothesized for the deficiency of EHR execution, and they are outlined below. A Lack of Standards for EHR Systems The content within the systems did non hold uniformity for compatibility or interoperability. Assorted plans offered different characteristics and the exchange of informations was non possible. Besides, criterions for the security of confidential information through encoding or informations unity had non been set. The quality of EHR plans and computing machine webs was non sufficiently dependable to forestall downtime, therefore ensuing at times in the deficiency of entree to patient information or medical information. Data for clinical protocols, direction of patient attention, and determination support through algorithms were non yet standard for EHRs. Unknown Cost and Return on Investment Health-care suppliers found it hard to accurately cipher costs and Return on Investment ( ROI ) with the usage of an EHR. The full cost of an EHR includes the package purchase monetary value, extra computing machine hardware, execution including the preparation of staff, customization of the system, ongoing proficient support, system care, and future plan ascents. Measuring ROI includes intangible, unmeasurable, and nonfinancial information, such as improved patient attention, patient safety, and more efficient procedures. Measurable ROI includes addition in income from more accurate cryptography, greater clip efficiency as a consequence of rapid chart certification, expanded patient burden because of this efficiency, and decreased office supply costs such as paper, charts, and printing supplies. It was hard to accurately cipher costs and ROI with the usage of an EHR. Difficult to Operate Doctors perceived that it took more clip for informations entry than handwriting. A physician order signifier may hold been simpler to handwrite than to treat through a computing machine system. Learning where the information should be entered or accessed was complicated and computing machines were non ever accessible at the point of attention. System warnings and medical qui vives incorporating critical information had non been developed. The long-run benefit were hard for some health care suppliers to value over the sensed troubles of operation Significant Changes in Clinic Procedures Although an EHR can be customized for specific medical patterns, there is ever some procedure alteration required by the supplier and medical staff. An EHR may convey a more stiff construction for come ining information than tossing through a paper chart. Adapting to new criterions of operation for come ining and turn uping information can be hard ab initio. Some EHRs have specifications or specific modus operandis for practising medical specialty that the supplier may non accommodate to easy. The health-care supplier may non be able to turn to and analyse jobs in the same ways that may hold been done in the yesteryear, even though the information in an EHR is more thorough and immediately available. New tools for improved patient attention require retraining, new procedures, and alterations in the medical pattern civilization. Lack of Trust and Safety A concern for the security of the medical record stored electronically alternatively of on paper is common. Health-care suppliers may be concerned that the electronic medical record could be altered without their consent or cognition. Suppliers must hold the confidence that the medical records are safely stored for future handiness. Power outages, computing machine â€Å" clangs, † viruses, concerns about equal backup, and so on are issues suppliers must get the better of to be confident in utilizing an EHR.Use of EHR plans, peculiarly in the small- to moderate-sized patterns, is spread outing quickly. About 78 per centum of doctors in private pattern are within this market group of eight or fewer physicians. With the explosive growing of EHR execution in this section of the medical community, a great demand has been generated for both clerical and clinical support staffs that have professional preparation and exposure to the EHR. Concerns about the passage from traditional pa per charts to EHRs are now being overcome. Many of the concerns expressed about EHRs have been addressed more to the full in recent old ages. Although the motives vary from a pattern desiring to merely â€Å" go paperless † to another pattern desiring to better patient attention, medical clinics are rapidly acknowledging the unbelievable tool the EHR is conveying to the medical pattern. Disadvantages of EMR On the reverse of advantages some writers have identified several possible disadvantage of utilizing EHRs. These include fiscal issues, alterations in work flow, impermanent loss of productiveness associated with EHR acceptance, privateness and security concerns, and several unintended effects. Significant cost: A major ground for deterrence for following and implementing EHR is its cost. It includes loss of gross associated with impermanent loss of productiveness, declines in gross, acceptance and execution costs and on-going care costs. Here EHR acceptance and execution costs includes buying and installation hardware and package, change overing paper charts to electronic 1s, and preparation of end-users. Different surveies documented this cost in both inmate and outpatient scenes. Like a survey conducted in 2002 at a 280-bed ague attention infirmary, the projected entire cost for a 7-year-long EHR installing undertaking was about US $ 19 million. In the outpatient scene, early research workers estimated an mean initial cost of US $ 50,000-US $ 70,000 per doctor for a three-physician office. However, as EHR engineerings have become more platitude over the past decennary, the initial cost of systems has come down dramatically ( Schmitt KF ) , ( Agrawal A ) Care cost besides can be cumbersome as hardware needs to replace clip to clip and package demands to upgrade on regular footing. In add-on, suppliers must hold ongoing preparation and support for the end-users of an EHR. Harmonizing to one survey conducted on 14 solo or small-group primary attention patterns, estimated on-going EHR care costs averaged US $ 8412 per FTE supplier per twelvemonth. Out of entire cost around 91 % of this was related to hardware replacing, seller package care and support fees, and payments for information systems staff or external contractors ( Fleming NS, Culler SD, McCorkle R, et Al ) Break of work-flows for medical staff and suppliers: Another major disadvantage of implementing EHRs is break of everyday work-flow for medical-staff or supplier, which consequences to loss of impermanent productiveness. This break may be because of preparation of end-users which potentially leads to loss in gross. One survey that involved several internal medical specialty clinics estimated, a productiveness loss of 20 % in the first month, 10 % in the 2nd month, and 5 % in the 3rd month before productiveness return to its original degrees as in get downing ( Wang SJ, Middleton B, Prosser LA, et al. ) Research workers besides have estimated that EHR end-users spent around 134.2 hours on execution activities that includes acquiring and larning a new system. These hours spent on nonclinical duties had an estimated cost of US $ 10,325 per doctor ( Fleming NS, Culler SD, McCorkle R, et al. ) Hazard of patient privateness misdemeanors: Another possible drawback of EHRs is the hazard of patient privateness misdemeanors, which is an increasing concern for patients due to the increasing sum of wellness information exchanged electronically between suppliers. To face such sort of state of affairss, policymakers have taken steps to guarantee safety and privateness of patient informations. For illustration, recent statute law has imposed ordinances specifically associating to the electronic exchange of wellness information that strengthen bing Health Insurance Portability and Accountability Act privateness and security policies. Although few electronic informations are 100 % secure, the strict demands set Forth by the new statute law make it much more hard for electronic informations to be accessed unsuitably. ( Zurita L, Nohr C. Patient sentiment: EHR appraisal from the users perspective. ( Stud Health Technol Inform. ) Not merely acts do interchanging electronic wellness informations secure but besides many infirmaries and doctors are implementing rigorous regulations like no tolerance punishments for employees who entree files unsuitably. For illustration, a infirmary in Arizona terminated several employees after they unsuitably accessed the records of victims who were hospitalized after the January 2011 hiting affecting a US Congresswoman. ( Innes S. ) Although privateness will probably go on to be a concern for patients, many stairss are being taken by policymakers and single organisations to guarantee that EHRs comply with the rigorous Torahs and ordinances intended to guarantee the privateness of clinical information. Decrease face-to-face clip with patients, depersonalize brushs EHRs may do several unintended effects, such as increased medical mistakes, negative emotions, alterations in power construction, and overdependence on engineering. ( Campbell EM, Sittig DF, Ash JS, et al. ) Research workers have found an association between increased medical mistakes and CPOE due to faulty system or untrained end-user. Additionally, end-users of an EHR may see strong emotional responses as they struggle to accommodate to new engineering and breaks in their work flow. Changes in the power construction of an organisation may besides happen due to the execution of an EHR which makes it rather more machine-controlled. For illustration, a doctor may lose his or her liberty in doing patient determinations because an EHR blocks the ordination of certain trials or medicines. Overdependence on engineering may besides go an issue for suppliers as they become more reliant upon it Invention credence: The beginnings of attitude and behaviour day of the month back to every bit early as 1862, when psychologists began developing theories demoing how attitude wedged behaviour. Those surveies by societal psychologists continued and in 1925, many new theories emerged proposing that â€Å" attitudes could explicate human actions † ( Ajzen A ; Fishbein, 1980, p. 13 ) Several theoretical accounts have been developed and utilized to analyse the credence of engineering. Some of the of import theoretical accounts are as follows- Theory of Reasoned Action ( TRA ) Harmonizing to this theoretical account, a individual ‘s behaviour is determined by his/her behavioural purposes ( BI ) to execute that behaviour. That BI is itself determined by both a individual ‘s attitude toward the behaviour and subjective norm refering the behaviour. Theory of Planned Behavior ( TPB ) The theory of planned behaviour was proposed by Icek Ajzen in 1985 through his article â€Å" From purposes to actions: A theory of planned behaviour. † The theory was developed from the theory of sound action, which was proposed by Martin Fishbein together with Icek Ajzen in 1975. Harmonizing to the theory of sound action, if people evaluate the suggested behaviour as positive ( attitude ) , and if they think their important others want them to execute the behaviour ( subjective norm ) , this consequences in a higher purpose ( motive ) and they are more likely to make so. Technology Acceptance Model ( TAM ) Based on the theory of sound Action, Davis ( 1986 ) developed the Technology Acceptance Model which deals more specifically with the anticipation of the acceptableness of an information system. This theoretical account suggests that the acceptableness of an information system is determined by two chief factors: perceived usefulness and sensed easiness of usage. Perceived utility is defined as being the grade to which a individual believes that the usage of a system will better his public presentation. Perceived easiness of usage refers to the grade to which a individual believes that the usage of a system will be effortless Unified Theory of Acceptance and Use of Technology ( UTAUT ) The UTAUT purposes to explicate user purposes to utilize an information system and subsequent use behaviour. The theory holds that four key concepts ( public presentation anticipation, attempt anticipation, societal influence, and easing conditions ) are direct determiners of usage purpose and behavior. Gender, age, experience, and voluntariness of usage are posited to intercede the impact of the four key concepts on usage purpose and behaviour. Factors Affecting EMR Acceptance Acceptance is defined as the willingness within a user group to use information engineering to the undertakings it is designed to back up ( Dillon A ; Morris, 1996 ) . Many research workers have stressed the importance of credence survey. For illustration, Kirk ( 2003 ) urged pressing actions on supplying legal and societal model for credence andintroduction of EMR. Likewise, Gefen ( 2003 ) , Zdon ( 1998 ) , Anderson ( 1997 ) , Moore ( 1996 ) , Baroudi ( 1986 ) , Bardram ( 1997 ) , Bowers ( 1995 ) , Graham ( 1996 ) , and Hubona ( 1996 ) , all discussed similar issue. Furthermore, past experiences show that the attempt to present EMR will ensue in failure and unforeseen effects if their proficient facets are over emphatic and their societal and organisational factors such as the user credence and the diffusion of information system are overlooked ( Gefen, 2003, Anderson, 1999, Moore, 1996 ) . Kirk ( 2003 ) has noted that presently there is no societal model for EMR credence. The closest model theoretical account, which measures perceived usefulness and sensed easiness of usage, that can be adopted is the Technology Acceptance Model ( TAM ) proposed by Davis ( 1989 ) . Tsiknakis ( 2002 ) , Einarson ( 1993 ) , and Neilder ( 1997 ) added that hapless presentation of patient ‘s informations can take to ill informed clinical professionals, medicine mistakes, inappropriate repeat of probe, unneeded referrals, and waste of clinical clip and other resources. Indeed, hapless presentation of patient ‘s information is an interface issue, which warrants more investigation.In obtaining the user credence of wellness attention, peculiarly its system interface, Rosenbaum ( 1998 ) proposed six successful techniques: Involving the user community in needs analysis and demands definition. Designating members of the user community who are involved in the system design as don ( people who receive first preparation and extended preparation ) . Conducting undertaking analysis of the full work procedure, non merely the partsinvolving the clinical information system. Performing user surveies of preliminary paper and pencil paradigms with typical users. Conducting iterative serviceability testing of consecutive paradigms. Visiting infirmaries and other scenes of usage to detect the work procedure, usage of predecessor systems, and beta-test installing Surveies statistics: There is scarce of surveies sing EMR usage in Indian context. Results of some relevant surveies are as follows- Consequence of a research done by Sequist et Al was as follows- The overall response rate was 56 % . Of reacting clinicians, 66 % felt that the EHR execution procedure was positive. One-third ( 35 % ) believed that the EHR improved overall quality of attention, with many ( 39 % ) feeling that it decreased the quality of the patient-doctor interaction. One-third of clinicians ( 34 % ) reported consistent usage of electronic reminders, and self-report that EHRs improve quality was strongly associated with increased use of the EHR ( odds ratio 3.03, 95 % assurance interval 1.05-8.8 ) . The bulk ( 87 % ) of clinicians felt that information engineering could potentially better quality of attention in rural and underserved scenes through the usage of tools such as on-line information beginnings, telemedicine plans, and electronic wellness records. In a survey conducted in the United States, the most normally cited barriers to utilize of EMR systems in infirmaries were unequal capital for purchase ( 74 % ) , care costs ( 44 % ) , opposition on the portion of doctors ( 36 % ) , ill-defined return on investing ( 32 % ) , and deficiency of handiness of trained staff ( 30 % ) . Hospitals that had adopted EMR systems were less likely to mention four of these five concerns ( all except doctors ‘ opposition ) as major barriers to acceptance than were infirmaries that had non adopted such systems. When most of the infirmaries or professionals speaking approximately high cost of EMR, a cost benefit analysis of EMR in primary attention done by Wang et Al shows, In the 5-year cost-benei ¬?t theoretical account ( Table 3 ) , the net benei ¬?t of implementing a full electronic medical record system was $ 86,400 per supplier. Of this sum, nest eggs in drug outgos made up the largest proportion of the benei ¬?ts ( 33 % of the sum ) . Of the staying classs, about half of the entire nest eggs came from decreased radiology use ( 17 % ) , decreased charge mistakes ( 15 % ) and betterments in charge gaining control ( 15 % ) . Though non all benei ¬?ts of an electronic medical record are mensurable in i ¬?nancial footings ; other benei ¬?ts include improved quality of attention, reduced medical mistakes, and better entree to information. CURRENT SCENARIO IN INDIA The Department of Information Technology ( DIT ) , Ministry of Communication an Information Technology ( MCIT ) have funded several undertakings during the past decennary for development of IT based Healthcare solutions. During the class of these undertakings, the demand for a standard EHR for the state has been strongly felt for interoperable health-care solutions. During the meetings of the National Knowledge Commission for making the national wellness information sciences vision for India, the demand for standard EHR with unafraid storage and entree of EHRs in a storage system crossing. TheA currentA wayA ofA developingA andA usingA healthcareA informationA storeA systemsA hasA led toA aA chaoticA stateA ofA affairsA dueA toA followingA grounds: aˆ? TheyA haveA beenA developedA independentlyA andA doA notA easilyA interoperateA withA each other. aˆ? TheyA followA theirA ownA conventionA ofA making, A maintaining, A andA storingA Electronic HealthA RecordsA ( EHRs ) A ofA patients. aˆ? IfA aA patientA isA treatedA atA differentA hospitalsA atA differentA cases, A differentA EHRs areA generatedA andA storedA forA theA sameA patientA byA theA twoA differentA information systemsA inA useA atA theA twoA hospitals.A AA singleA EHRA forA anA individualA isA desirable irrespectiveA ofA his/herA timeA andA placeA ofA intervention. aˆ? EachA systemA hasA itsA ownA wayA ofA creatingA andA managingA itsA storageA ofA EHRs. Obviously, A such A an A information A shop A is A based A on A both A relational A database engineering, A due A to its A ubiquitousness A and A adulthood A in A pull offing A big A volume A of information, A andA mediaA storageA package, A forA exampleA XrayA pictureA file awaying. DifferentA systemsA useA differentA relationalA databasesA andA differentA mediaA storage softwareA makingA dataA transferA acrossA systemsA impossible/inconvenient. aˆ? MostA ofA theA existingA systemsA useA centralizedA storage, A leadingA toA limitedA scalability andA poorA reliabilityA ( singleA pointA ofA failure ) . AsA aA consequence, A itA hasA becomeA difficultA toA exchangeA EHRsA acrossA differentA systemsA andA to haveA aA unifiedA informationA systemA toA dealA withA oneA EHRA perA person, A irrespective ofA theA timeA andA placeA ofA treatmentA ofA anA person. How to cite Lack Of Standards For Ehr Health And Social Care Essay, Essay examples

Management & Business Context Essay-Free-Samples for Students

Question: Identify a hypothetical business opportunity that if you had the funds, time and drive you would pursue as a business start-up. This could be an idea you believe has the potential to become a business for you to own and grow. Answer: With the change in the needs and expectations of the people, there has been a rise in the products and services offered to the people. This has resulted in an increase in the level of competition in the business environment of Australia. From the analysis of the environment of Australia, it has been analysed that people in Australia are more concern for the safety of their pets when they are on a trip due to personal and professional reasons. Analysis of the need of people for pet homes for their pets has provided an idea of setting up a new business. Pet care industry is full of opportunities and is full of chances of success and growth. People are a concern for the safety and security of their pets which is the reason behind the growth of the pet care industry. Name of the pet home will be Nurture pet home which will be providing pet care services and pet sitting services in Australia. Nurture pet home will offer pet home services, pet sitting services and pick and drop services fo r the pets. The focus of Nurture pet home will be on providing quality services and taking care of the pets for ensuring their safety and security. Nurture pet home will be operating at a medium level and at different locations in Australia. Nurture pet home is planning to adopt few strategies for establishing the business in an efficient market and gaining a competitive advantage. It is planning to adopt strategic positioning strategy, web presence strategy, online advertising strategy and differentiation strategy (Salminen, 2014). All these strategies adopted by Nurture pet home will help in attracting the customers and meeting the expectations of the customers. The vision of Nurture pet home is to resolve the issues or challenges faced by the pet owners. Its motive is to enhance the standard of quality offered in the pet care industry. For the management of the different operations of the pet home, Nurture pet home has evaluated the advantages and disadvantages of different organisational structures. It is planning to adopt functional organisational structure so as to manage the operations and internal structure of the business in an effective manner. Different departments will be divided and managed by different individuals so as to ensure that operations of the pet home are conducting without any delay (Latif, et. al., 2013). Different departments in the Nurture pet home will be housekeeping, kitchen, finance, marketing, security, administration and pick-up and delivery department. Activities or operations of the pet home will be divided among these departments (Morgeson, et. al., 2012). An organisation exists in the business environment which is a combination of different internal and external factors. These internal and external environmental factors can enhance the performance of the business as well as adversely affect the performance of the business. Internal environmental factors determine the strengths and weaknesses of the business which helps in gaining the advantage of the opportunities available and coping with the threats. Internal environmental factors for Nurture pet home need to be analysed for analysing their impact on the business (Shiamwama, et. al., 2014). Internal environmental factors for Nurture pet home include the availability of finance, availability of the human resource, skills and knowledge, support from the employees, the culture of the organisation, communication process, mission and objective. There is a need to make an arrangement of the different resources including finance, human resource and skills and knowledge for executing the op erations properly (Fereidouni, et. al., 2010). Training must be provided to the employees for ensuring that quality services are provided to the pets and satisfying the expectations of the customers. Communication process must be effective for ensuring that the exchange of information is done in an effective manner. The culture of the organisation is responsible for the behaviour of the employees towards the service receivers and others in the company (Dragni?, 2014). Nurture pet home will maintain a flexible culture for encouraging and motivating employees. Nurture pet home will discuss its mission and objectives with the internal stakeholders for encouraging them and gaining their support. External environmental factors are those factors present in the environment in which business exists and are not in the control of the business. Nurture pet home will analyse these external environmental factors and dealing with these factors. External environmental factors include government ru les and regulations, competition in the market, trend and socio-culture factors, technological factors and environmental factors (Islam, et. al., 2011). Pet care industry is a growing industry and rules and regulations have been formulated for ensuring that the businesses are operating within the legal framework. Nurture pet home will ensure that rules and regulations are followed for ensuring safety and security of the pets. For gaining a competitive advantage over the others, it will offer its services through online mode. Customers can make bookings, payments and cancellations through online mode and access details of Nurture pet home through its website (Bouazza, et. al., 2015). Various risks may arise in front of a new business which must be dealt properly for eliminating the adverse impact of the risk. Nurture pet home can face various risks which can affect its performance. These risk factors include lack of skilled and trained human resource, lack of finance, failure of the planning process, market risk and safety related risks. Skills and trained human resource will be required by Nurture pet home for providing proper services to the pet. Skilled and trained employees will ensure the safety of the pets at Nurture pet home and ensure that proper records are maintained related to the pets. Regular health check-up will be performed in Nurture pet home for ensuring the health of the pets. Different pets will be kept in different cabins (Ejon Mbohwa, 2015). Finance is required for executing the operations without any delay. Lack of financial support can interrupt the operations of Nurture pet home. Nurture pet home need to analyse the sources of finance. A variety of services will be offered for enhancing the satisfaction level of the customers. Market trends will be analysed for analysing the current trends and innovations which can be implemented by Nurture pet home. Use of outdated technology can result in negative impact on the services offered. Nurture pet home will use advanced technology for improving the quality of the services offered. Forecasting will be used for eliminating the impact of unforeseen events on the performance of Nurture pet home (Islam, et. al., 2011). Nurture pet home will offer pet care services where people can leave their pets when they are on a trip, pet sitting services, pick and drop service for the comfort of the customers. Nurture pet home will offer its service through online as well as offline mode. It will adopt web presence strategy for making its presence on the internet. Customers can confirm bookings through the website of Nurture pet home and enquire about the services offered. Customer support will be provided for resolving the issues and queries of the customers. Different departments will be created for ensuring that operations are executed as per the plans (Smart Insights, 2016). Differentiation strategy will be adopted for differentiating the services offered by its competitors. This strategy will help in focusing on enhancing the quality of the services for attracting customers and enhancing the satisfaction level of the customers. For the marketing of the services offered, Nurture pet home will use social me dia platforms and print media so as to make the people aware of the services offered by Nurture pet home. Positioning strategy will help in placing the services offered in the market in an effective manner for enhancing the customer base of the company. Market research will be done for analysing the trend prevailing in the market. Training and guidance will be provided to the employees for ensuring that they are performing the roles and responsibilities assigned to them in an effective manner. Nurture pet home will focus on optimum utilisation of the resources available in an effective manner for generating the desired outcome and attaining the objectives set (Salminen, 2014). Organisations divide the operations of the business into different functions or departments on the basis of the nature of the operation. These functions help in executing the operations in a better manner and ensuring that the activities are carried out in the right direction. Nurture pet home will divide the operations into different departments and functions. This will be done for ensuring that all operations are performed and no operation is missed out. Different departments of Nurture pet home include housekeeping, kitchen, finance, administration, customer support, pick-up and delivery department, marketing and security (Anantatmula, 2010). Housekeeping department will be responsible for the cleaning of the pet home and ensure that the cabins of the pets are properly arranged. Kitchen department will ensure that quality food is offered to the pets and their health conditions will be considered for preparing food. The finance department will ensure that funds are arranged for con ducting the operations of the business. Administration department will be responsible for the management of the operations of Nurture pet home. Pick and drop department will keep track of the pets Nurture pet home will have to pick or drop. Customer support department will ensure that the issues of the customers are handled in a proper manner. The marketing department will ensure effective promotion of the services offered. Security department will be responsible for the safety of the pet home (Blenko, et. al., 2010). References Anantatmula, V. S. (2010). Project Manager Leadership Role in Improving Project Performance. Engineering Management Journal, 22, 1. Blenko, M. W., Mankins, M. Rogers, P. (2010). The Decision-Driven Organization. HBR. Bouazza, A. B., Ardjouman, D. Abada, O. (2015). Establishing the Factors Affecting the Growth of Small and Medium-sized Enterprises in Algeria. American International Journal of Social Science, 4 (2). Dragni?, D. (2014). Impact of Internal and External Factors on the Performance of Fast-Growing Small and Medium Businesses. Management, 19, 1, 119-159. Ejon, J. A. Mbohwa, C. (2015). Financial Challenges Faced By Smmes in Gauteng South Africa. International Association for Management of Technology IAMOT 2015 Conference Proceedings. Fereidouni, H. G., Masron, T. A., Nikbin, D. Amiri, R. E. (2010). Consequences of External Environment on Entrepreneurial Motivation in Iran. Asian Academy of Management Journal, 15, 2, 175196. Islam, A., Keawchana, T. Yusuf, D. H. M. (2011). Factors Affecting Business Success of Small Medium Enterprises (SMEs) in Thailand. Asian Social Science, 7 (5). Latif, K. I., Baloch, Q. B. Khan, M. N. (2013). Structure, Corporate Strategy and the Overall Effectiveness of the Organisation. Abasyn Journal of Social Sciences, 5 (2). Morgeson, F. P., DeRue, D. S. Karam, E. P. (2012). Leadership in Teams: A Functional Approach to Understanding Leadership Structures and Processes. Journal of Management, 36 (1), 5-39. Salminen, J. (2014). Startup Dilemmas - Strategic Problems of Early-Stage Platforms on the Internet. Turku School of Economics. Shiamwama, S. M., Ombayo, J. A. Mukolwe, M. S. (2014). Internal Factors Affecting the Performance of Businesses of Retirees in Kakamega Municipality. International Journal of Business, Humanities and Technology, 4 (2). Smart Insights. (2016). The 11 step startup launch marketing plan. Smart Insights. Yu, C. Zhang, T. (2010). Internal Factors Affecting the Organizational Internationalization Process: Evidence from Huawei Case Study. University of Halmstad.

Managing Innovation at Nypro, Inc.

Table of Contents Introduction Nypro Inc.’s Competitive Edge Nypro’s strategy Knowledge management Strategy development Recommendation References Introduction Nypro Inc. is a plastic injection molding company which was established in 1955 as Nypro products cooperation and the performance of the company was average, similar to other companies in the plastic injection molding industry. Only when Gordon Lankton joined the company as general manager in 1962 did the company improve in performance and sales.Advertising We will write a custom critical writing sample on Managing Innovation at Nypro, Inc. specifically for you for only $16.05 $11/page Learn More Nypro Inc.’s Competitive Edge In comparison to other companies, Nypro has numerous competitive advantages that have made the company unique. Nypro has fostered internal competition rather than external competition to perpetuate growth and innovation, basically this means that Nypro competes within its self rather than with other companies. The competition is also broad in its implementation beginning within each of the 21 Nypro plants. Employees in these plants are subdivided into teams, and these teams are assigned a similar project to work on (Voorheis 1998). Members of the most successful team are then rewarded through the stock program depending on their consistent performance. Additionally, aggressive competition has been nurtured between all of Nypro’s 21 plants to encourage innovation. Performance statistics are collected on a quarterly basis and the performance results of all plants are distributed to all plants. The successful procedures of the best plants are emphasized together with the failures of the plant that performed worst. This way, plants have the opportunity to learn from each other and implement successful procedures while avoiding errors committed by other plants. A good example is the Burlington North Carolina plant which used de dicated hoses to supply different viscous plastic to each machine reducing on impurities and cleaning costs; soon after, every Nypro plant was copying the innovation and using dedicated hoses (Voorheis 1998). Nypro’s strategy Nypro has been able to formulate an intricate yet successful strategy to govern how organizational procedures, manufacturing, sales and product developments are managed. The first step into crafting the strategy was the selection of prime locations for their plants. Plants are located in metropolitan environments where their products are readily accessible to clients. In addition, these plants specialize in the manufacturing of custom injection plastics that are of high demand in their locale. For example the plant in Illinois specializes in providing for the healthcare industry in northern Chicago while the Oregon plant serves the needs of Hewlett-Packard. The clientele base was also shrunk by focusing on corporate clients rather than individual clients . In reference to the internal organization of the plants, each plant had its own board of directors rather than a centralized form of leadership for all plants (Voorheis 1998).Advertising Looking for critical writing on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More The board of directors is selected from different plants, with every member of the board coming from different departments of different plants. In so doing, the board is composed of a variety of individuals with vast experiences ranging in all aspects that pertain to the interests of Nypro (Clayton, 1999). In product development, development teams are set up comprising of Nypro engineers and the client firm’s engineers; the responsibility of these teams is to conceptualize the product and recommend cost effective processes for production. Once through, the development teams are disbanded and Continuous Improvement teams set in place to analyze manufac turing, procurement of materials and marketing. Once the product is released to the market, a business review committee is set up to follow up on the success of the product. Knowledge management Nypro has shown exceptional information and knowledge management, a strong reason to the success of this company. Even though they encourage internal friendly competition, vital information on successful processes and failed processes has to be shared. The quarterly performance reports was not enough to ensure the consistent flow of information and therefore the Manufacturing Resource Planning (MRP2) software systems were integrated into Nypro to ensure there was proper knowledge management between all plants. The software provided a platform where all plants and their customers could communicate on the production planning of particular products and share data regarding different production models. Additionally, knowledge management can be demonstrated by the integration of different individ uals from diverse plants who are successful in various departments, to form a board of directors for each plant. It is therefore evident that a board of directors has a vast wealth of knowledge from a cross section of the company and they are responsible for propelling growth by incorporating their expertise (Voorheis 1998). Strategy development The de facto strategy at Nypro during its initial years was similar to other existing molding companies in that they focused on small scale customers such as individuals and small companies to supply them with custom injected plastics. However, with the introduction of the strategic planning process, Nypro took on large scale customers with demanding technologically progressive jobs. This approach saw the number of Nypro†s customers drop drastically but the remaining clients were large multi-national companies and as a consequence, the revenue per customer rose by more than 500%.Advertising We will write a custom critical writing sample on Managing Innovation at Nypro, Inc. specifically for you for only $16.05 $11/page Learn More With the high demand that came with the customers also came the need for a larger workforce and new manufacturing technology. The de facto strategy can be considered as redundant in that it did not produce significant results or apply a different approach to production. In comparison, the strategic planning process was highly efficient and progressive and it led to the expansion of Nypro and the increase in revenue. Recommendation At the end of the case, it is recommend that Lankton also considers the manufacturing of custom injection plastics for individuals and small scale companies; this means that Lankton can expand on the current workforce to include a department for small-scale production to carter for these small scale companies (Clayton, 1999). This department can receive two NovaPlast molders and function effectively both in production and sales, be aring in mind the prime locations and goodwill the company has. References Clayton, M.C. (1999).Innovation and the general manager. California: rwin/McGraw-Hill. Voorheis, R. (1998). Managing Innovation at Nypro, Inc. (A). Harvard Business School Journal 9:696-061. This critical writing on Managing Innovation at Nypro, Inc. was written and submitted by user Mohammed Stark to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Understanding Americas Digital Divide

Understanding America's Digital Divide While America’s once vast digital divide is narrowing, the gap between groups of people who have those who lack access to computers and the internet persists, according to data from the U.S. Census Bureau. What is the Digital Divide? The term â€Å"digital divide† refers to the gap between those who have easy access to computers and the internet and those who do not due to various demographic factors. Once referring mainly to the gap between those with and without access to information shared via telephones, radios, or televisions, the term is now used mainly to describe the gap between those with and without internet access, particularly high-speed broadband. Despite having some level of access to digital information and communication technologies, various groups continue to suffer the limitations of the digital divide in the form of lower-performance computers and slower, unreliable internet connections such as dial-up. Making quantifying the information gap even more complex, the list of devices used to connect to the internet has grown from basic desktop computers to include devices such as laptops, tablets, smartphones, MP3 music players, video gaming consoles, and electronic readers. No longer simply a question of having access or not, the digital divide is now best described as â€Å"who connects to what and how?† Or as Federal Communications Commission (FCC) Chairman Ajit Pai described it, the gap between â€Å"those who can use cutting-edge communications services and those who cannot.† Drawbacks of Being in the Divide Persons without access to computers and the internet are less able to fully take part in America’s modern economic, political and social life. Perhaps most significantly, children who fall into the communication gap lack access to modern educational technology such as internet-based distance learning. Access to broadband internet has become increasingly important in carrying out simple day-to-day chores like accessing health information, online banking, choosing a place to live, applying for jobs, looking up government services, and taking classes. Just as when the problem was first recognized and addressed by the U.S. federal government in 1998, the digital divide remains concentrated among older, less educated, and less affluent populations, as well as those living in rural areas of the country that tend to have fewer connectivity choices and slower internet connections. Progress in Closing the Divide For historical perspective, the Apple-I personal computer went on sale in 1976. The first IBM PC hit the stores in 1981, and in 1992, the term â€Å"surfing the internet† was coined. In 1984, only 8% of all American households had a computer, according to the Census Bureau’s Current Population Survey (CPS). By 2000, about half of all households (51%) had a computer. In 2015, this percentage grew to nearly 80%. Adding in smartphones, tablets and other internet-enabled devices, the percentage rose to 87% in 2015. However, just owning computers and connecting them to the internet are two different things. When the Census Bureau began collecting data on internet use as well as computer ownership in 1997, only 18% of households used the internet. A decade later, in 2007, this percentage had more than tripled to 62% and increased to 73% in 2015. Of the 73% of households using the internet, 77% had a high-speed, broadband connection. So who are the Americans still in the digital divide? According to the latest Census Bureau report on Computer and Internet Use in the United States compiled in 2015, both computer and internet use continue to vary based on a variety of factors, most notably, age, income, and geographic location. The Age Gap Households headed by persons 65 years and older continue to lag behind households headed by younger persons in both computer ownership and internet use. While up to 85% of households headed by a person under age 44 owned desktop or laptop computers, only 65% of households headed by a person age 65 and older owned or used a desktop or laptop in 2015. Ownership and use of handheld computers showed an even greater variation by age. While up to 90% of households headed by a person less than 44 years of age had a handheld computer, only 47% of households headed by a person 65 years and older used some type of handheld device. Similarly, while up to 84% of households headed by a person less than 44 years of age had a broadband internet connection, the same was true in only 62% of households headed by a person aged 65 and older. Interestingly, 8% of households without a desktop or laptop computer depended on smartphones alone for internet connectivity. This group included 8% of householders ages 15 to 34, versus 2% of households with householders age 65 and older. Of course, the age gap is expected narrow naturally as younger current computer and internet users grow older. The Income Gap Not surprisingly, the Census Bureau found that using a computer, whether a desktop or laptop or handheld computer, increased with household income. The same pattern was observed for a broadband internet subscription. For example, 73% of households with annual incomes of $25,000 to $49,999 owned or used a desktop or laptop, compared with only 52% of households earning less than $25,000. â€Å"Low-income households had the lowest overall connectivity, but the highest proportion of ‘handheld only’ households,† said Census Bureau demographer Camille Ryan. â€Å"Similarly, black and Hispanic households had relatively low connectivity overall but high proportions of handheld only households. As mobile devices continue to evolve and increase in popularity, it will be interesting to see what happens with this group.† The Urban vs. Rural Gap The longstanding gap in computer and internet use between urban and rural Americans not only persists but is growing wider with the increased adoption of new technologies such as the smartphone and social media. In 2015, all persons living in rural areas were less likely to use the internet than their urban counterparts. However, the National Telecommunications and Information Administration (NITA) found that certain groups of rural residents face a particularly wide digital divide. For example, 78% of Whites, 68% of African Americans, and 66% of Latinos nationwide use the internet. In rural areas, however, only 70% of White Americans had adopted the Internet, compared to 59% of African Americans and 61% of Latinos. Even as internet use has increased dramatically overall, the rural vs. urban gap remains. In 1998, 28% of Americans living in rural areas used the Internet, compared to 34% of those in urban areas. In 2015, over 75% of urban Americans used the internet, compared to 69% of those in rural areas. As NITA points out, the data shows a consistent 6% to 9% gap between rural and urban communities internet use over time. This trend, says NITA, shows that in spite of advances in technology and government policy, the barriers to internet use in rural America are complex and persistent. People who are less likely to use the internet no matter where they live- such as those with lower income or education level- face even greater disadvantages in rural areas. In the words of the FCC chairman, â€Å"If you live in rural America, there’s a better than a 1-in-4 chance that you lack access to fixed high-speed broadband at home, compared to a 1-in-50 probability in our cities.† In an effort to address the problem, the FCC in February 2017, created the Connect America Fund allocating up to $4.53 billion over a period of 10 years to advance high-speed 4G LTE wireless internet service primarily in rural areas. Guidelines regulating the fund will make it easier for rural communities to get federal subsidies for advancing internet availability.

What are the pros and cons of company's IPO Should company be floated Essay

What are the pros and cons of company's IPO Should company be floated at all - Essay Example Although the aim of growth is to bring benefits to the company, there exist both pros and cons that can arise from this process of going public (Helwege 2004, p.541). Pros and cons of Initial Public Offer (IPO) There are several advantages that accrue to a company by going public. As mentioned above, the principal advantage is the financial benefit through raising capital. An IPO adds a value on the company's stock. In addition, those insiders retaining stock are able to sell their shares or even use them as collateral (Datta 2000, p.715). Going public also creates a currency type in the form of its stock, which can be used in making acquisitions. In addition, there is a possibility that the company can access the capital markets for its future financing needs. Overall, a company's debt-to-equity ratio improves considerably after an initial public offering, which indicates that the business is likely to earn more favorable loan terms from its lenders (Datta 2000, p. 716). Another adv antage is the increase of public awareness of the company. IPOs normally produce more publicity by increasing the awareness of their products to a new group of potential customers. Subsequently this is expected to increase the company’s market share. The founders can also use the IPO as an exit strategy. Many venture capitalists have tried this in an attempt to open up successful companies (Hao 2007, p.112). For others, the prestige associated with the public companies or a post of a director or officer of any public company has a certain allure. Furthermore, going public puts the company ahead for promotion. The publicly traded companies are mostly better known than non-publicly traded ones. The company can gain publicity and a stable image by trading publicly. This makes the public companies offer a wide variety of stock, which has a considerable potential of significant appreciation in value. Those companies will trade publicly and portray a positive image hence attracting highly qualified personnel at all levels of management. It is possible to view such companies as growth-oriented hence their duty is to answer to a board of directors and shareholders who in turn demand increased profitability as frequent as possible, and also act quickly to solve managerial problems and also replace those senior executives who are performing poorly (Benninga 2005, p.117). Although the benefits of an IPO are many, there are certain challenges. One outstanding challenge is the disclosure of information to investors. There is a high cost of complying with the regulatory requirements. Other costs that will also arise include the generation of financial reporting documents and audit fees (Hao 2007, p.112). This will subject the public companies to added pressure of the market. This may force them to focus mainly on short-term results rather than their long-term growth. Since the investor is keen on profits, management will be under scrutiny. This may trigger the manage ment to engage in questionable practices in order to increase earnings. Another setback of going public is that these public companies operate under precise scrutiny. There is disclosure of confidential information touching on the company including those transactions with management; the prospectus divulges prior violation of security law and executive compensation. This may be confidential information belonging to the company that it may be reluctant to reveal. Furthermore, formalisation of the decision-making process follows and with less flexibility when the shareholders are also there. This may bring complexities to these companies. Previously, decision making was quite flexible due to the presence of few people. The company is also subject to

Effect of Television on language development Essay

Effect of Television on language development - Essay Example Modern life is a haven of myriad issues that subject humanity to series of arguments and researches that seek to demystify and define these complex occurrences. Television, though relatively old, is a device that totally revolutionized the social lives of humanity. It brought into focus several issues of concern and continues to elicit heated debates regarding its effects on various aspects of human development and social life. Indeed, it must be emphasized that any technological invention must have its special repercussions on a particular sector of human life. Children today make up much of the population that spends much time in front of the television sets. Perhaps this occurs due to the ample time that children will usually have contrary to their parents and other adults. In that manner, several researches have been conducted with an aim of establishing the influences of television on children and establishing whether these effects are positive or detrimental. One particular iss ue regards the influence of television on children’s language development and the ascertainment of the myriad hypothesis that abound regarding this heated topic. It must be remembered that this concern actually arose out of the noticeable differences that were established after several years of observation that necessitated the commencement of this search of facts. Television programs are very many today with particular programs specifically meant for children through adults. For children, such programs mostly include comedies and other comical scenes that are meant for a child’s enjoyment. In most cases, these programs inhibit language development since the language used is never proper. In several cases, children organizations have raised concerns on the type of language used in some of these situations. The ability of a child to internalize basic concepts like language is normally very high in the early stages of development. As such, a television program that uses improper English may impart a lifelong discrepancy in a child. It is therefore appropriate that the concerned parties be very vigilant in their effort to ensure effective language use in television programs meant for children. In adults, this is never an issue, since most adults watch mostly news and documentaries, which are normally addressed in good languages. In most developed countries, it is established that by the time most children join high school, they shall have spent 15000 hours watching television. Well, that demands serious attention. The effect of such addiction emerges considering that in most of these countries; family planning has reduced most families to have two children. It then implies that a child will spent almost half of their pre-high school waking hours completely alone or with a brother or sister watching television. Indeed, the actual speaking of the language mostly enhances the development of proper language in children. The failure to frequently practic e the language will mean that a child will limit their ability of learning a language and will therefore be impaired in a way. Without doubt, television influences the mental occurrences of children as they simply sit and watch without stimulating their minds and subjecting themselves to reasoning that enhances their aptitude. The several arguments regarding the effects of television on language development majorly revolve around the lack of social interaction in children because of being too much glued to the sets. However, the role of parents in children development is an important aspect that needs much analysis. Several cases abound where parents also become addicted to watching television and thereby spent several hours alongside their children glued to their sets. In such a case,

The Network Management Systems Research Paper Example | Topics and Well Written Essays - 2750 words

The Network Management Systems - Research Paper Example The network management systems are designed on higher level structures called network management frameworks. There are several network management frameworks like the Information Technology Infrastructure Library (ITIL) and fault-management, configuration, accounting, performance, and security (FCAPS) framework. This report will follow the five staged FCAPS framework to analyze eight NMSs. Selection of a correct NMS relies heavily on an objective requirement analysis. These requirements include hardware, software, and connectivity requirements. Keeping these requirements in mind the report will draw comparisons between various NMSs on the basis of cost, network management standards, future support, relative advantages and security features required at IT LAB. However, the focus of the report will remain on the FCAPS framework for an efficient evaluation of Network Management Systems being gauged. Each of these solutions will be checked for its dynamic response in network fault-managem ent, configuration, and issues related to network security. The assistance provided the by the NMS for remote configuration and fault resolution is another important area which can help in its evaluation of competitive advantage. The selected solution is supposed to be proactive in order to ensure high availability and maximum uptime. Although, provisions like automated setup and configuration are not presently required the availability of such facilities will certainly make a difference in the final selection of a network management solution. No matter how stringent a network security may be, the selected network management system is required to provide a prompt disasters management and recovery mechanisms. All of the NMSs will be assessed for the self-healing and regulated recovery provisions. Another important feature is the ease of use and user-friendliness of the NMS.