Investigation of the adoption of telemedicine technology in the Kuwaiti health system: Strategy and policy of implementation for overseas referral patients

This thesis was submitted for the degree of Doctor of Philosophy and was awarded by Brunel UniversityThe cost of health care services is rising and the number of patients requesting overseas treatment from the Kuwait Government continues to increase; this is becoming an unsustainable financial burden. A telemedicine system has the potential to support the Kuwaiti health system to provide medical consultations from global medical centres, and thereby reduce the number of Kuwaiti patients being sent abroad for treatment, and so reduce costs. This research investigates the readiness of the key stakeholders in regard to adoption of telemedicine systems in the Kuwaiti healthcare system. This is achieved by assessing the readiness of individuals (physicians and patients), the organisation (policy makers) and the technical infrastructure (IT managers). Moreover, the lack of research on this topic, particularly in the Arabian Gulf Region, was the reason behind carrying out this study. An in-depth study was conducted by using a quantitative and qualitative approach. A questionnaire was used to explore the attitudes of specialised physicians and patients by obtaining their opinions based on specific criteria. Next, semi-structured interviews were conducted: (1) with IT managers to assess the technical infrastructure of the health system; and (2) with policy makers to assess the organisation in regard to its readiness towards telemedicine adoption. The study shows that the overseas referral patients are ready to use telemedicine systems, as a consequence of their need to receive medical consultations from global experts. However, they expressed some concerns, such as privacy and confidentiality of their data. The specialised physicians also showed readiness towards adoption of telemedicine in the Kuwaiti health system, and their responses indicated that they are willing to use such systems. However, the findings of the interviews reveal that the current technical infrastructure for ICT in the Kuwaiti healthcare system is not ready for telemedicine adoption and there are needs to be change in the way management is organized in order to improve and enhance trust among departments. The qualitative approach identified factors that would inhibit and hinder the adoption of telemedicine in Kuwait, as well as the supportive factors in the organisation. Using the results, a strategy was developed to demonstrate how the Kuwaiti health system could be made ready to receive a telemedicine system, together with policies for the use of telemedicine systems by overseas referral patients. A comparison with Jordan and Syria shows that the Kuwaiti healthcare system is more ready to adopt a telemedicine system with respect to the individuals, technical infrastructure and governmental support. Finally, an economic analysis was performed in order to investigate the cost effectiveness of the proposed system

The impact of sovereign wealth funds on global financial markets

This paper analyses the impact of sovereign wealth funds (SWFs) on global financial markets. It presents back-of-the-envelope calculations which simulate the potential impact of a transfer of traditional foreign exchange reserves to SWFs on global capital flows. If SWFs behave as CAPM-type investors and thus allocate foreign assets according to market capitalisation rather than liquidity considerations, official portfolios reduce their “bias” towards the major reserve currencies. As a result, more capital flows “downhill” from rich to less wealthy economies, in line with standard neoclassical predictions. More specifically, it is found that under the assumption of SWFs investing according to market capitalisation weights, the euro area and the United States could be subject to net capital outflows while Japan and the emerging markets would attract net capital inflows. It is also shown that these findings are sensitive to alternative assumptions for the portfolio objectives of SWFs. Finally, the paper discusses whether a change in net capital flows triggered by SWFs could have an impact on stock prices and bond yields. Based on an event study approach, no evidence can be found for a stock price impact of non-commercially motivated stock sales by Norway’s Government Pension Fund. JEL Classification: F30, F40, G15.Sovereign wealth funds, capital flows, foreign exchange reserves, financial markets.

Evaluating Sociotechnical Factors Associated With Telecom Service Provisioning: A Case Study

Provisioning Internet services remains an area of concern for Internet service providers. Despite investments to improve resources and technology, the understanding of sociotechnical factors that influence the service-provisioning life cycle remains limited. The purpose of this case study was to evaluate the influence of sociotechnical factors associated with telecom service provisioning and to explore the critical success and failure factors, specifically in the telecommunication industry of Kuwait. Guided by sociotechnical systems theory, this qualitative exploratory case study approach examined a purposeful sample of 19 participants comprising of managers, engineers, and technicians who had the knowledge and experience of the service-provisioning life cycle. Semistructured interviews, project logs, and a self-created follow-up questionnaire were the primary sources of data. Thematic analysis techniques assisted in coding the data and developing themes, which resulted in a set of critical success and failure factors that influence the service-provisioning life cycle. Cross-functional communication, risk management practices, infrastructure availability, and employee skill development were among the emergent factors that influenced the service implementation. Internet service providers may use the results from this study to improve the service-provisioning life cycle. Successful implementations will promote an environment of positive social change that will increase employee motivation, productivity, and employee morale

Police-Community Relationship in Kuwait: Public Relations Perspective

This thesis explores the current police-community relationships in Kuwait where no previous research on this particular topic is known. Therefore, the overall goal of this thesis is to both describe the current relationship between the Kuwaiti police and the community and, based on the results, provide suitable recommendations to help forge and maintain positive relations. In order to accurately illustrate the current relationship, this thesis utilises three major theoretical concepts: the co-creational approach (relational approach and community theory), systems theory, and social exchange theory. Habermas’s Theory of Communicative Action (TCA) was also discussed to shed light on the power dynamic of the police-community relationship. Although these theories differ in their approach, they present the public relations approach through a shared focal point – relationships, which is the primary focus of this research. In a qualitative approach, twenty-two participants were interviewed and their answers coded and transcribed. Particular attention was paid to the sampling of interview participants through the use of the qualitative sampling techniques of quota and purposive sampling. In the analysis of data, three themes, Faith, Communitarianism, and Optimism represent an important and special context for the public relations theorist. They contribute to our understanding of public relations in the context of Kuwaiti police-community relations. Furthermore, the relational elements of trust, satisfaction, control mutuality and commitment are integrated with the three aforementioned themes. This analytical framework strengthened the analysis by adding a comparative and universal perspective. The main findings of this research are the key attributes affecting the police- community relationship in Kuwait, such as trust, satisfaction, commitment, control, mutuality, and the worldviews through which the participants regard the police: Faith, Communitarianism, and Optimism. Furthermore, the implication of this thesis goes beyond that of the police-community relationship in that country. It also provides a thorough discussion regarding 1) public relations theory and practice, and 2) a thematic analysis of the Kuwaiti police. This thesis adds to public relations theories as it extends the body of knowledge of public relations to a specific context of police public relations in Kuwait. This will help to round-out existing police PR data, especially by adding a Middle Eastern and Arabic perspective to otherwise Western theories (e.g. relational, community, systems and social exchange). Furthermore, this thesis demonstrates how environmental factors (Kuwaiti history, culture and economics) influence organisation-public relations. This thesis explores an essential area for Kuwaiti police that has not been explored before. Through the investigation of interview data, this thesis provides a snapshot of the current police-community relationship, highlighting important issues that are obstacles to a better police-community relationship. The most salient two are (1) police force behaviour, and (2) the organization's communication style. It is recommended that Kuwaiti police should adapt the community policing approach. This thesis proposes that adapting the community policing approach will help to improve behaviour and communication styles by addressing root issues. This adjustment will require the police organisation to adjust its goals and mission so as to become aligned with that of the community's goals and mission

Management and work environment in Kuwait society: the implication of gender for management style

The research focused on three main themes in the Kuwait society. The first study is developed to measure the differences in the characteristics of the work environment between the public and the private sectors within Kuwait labor force. The study had been conducted on 80 managers of both sexes and 266 employees of both sexes from the public sector, and 80 managers of both sexes and 274 employees of both sexes from the private sector. The results had indicated that according to the combined group (employees and managers, both sexes), the private sector exceeded the public sector regarding: involvement, peer-cohesion, task orientation, work-pressure, clarity, control, innovation and physical-comfort. Only the employees sample showed similar results. By comparing the male employees and the female employees in both sectors, it was clear that males had higher mean scores than females regarding involvement, task orientation, work-pressure, clarity, and control. Also, the results of the manager group is consistent with the combined group (both employees and managers, both sexes). However, the comparison between the male managers and female managers in both sectors indicated that, involvement, staff-support, clarity, control, innovation, and physical-comfort were higher in males than their females counterparts. The second study is designed to clarify any differences in personality traits between male and female Kuwaiti managers. The study has been conducted on 150 male and 150 female managers from Kuwait society. The results showed few differences between male and female managers. It was clear that males were more lively or enthusiastic and more imaginative than females. While, females were more depressive (as a personality characteristic) or apprehensive than male managers. The third study is concerned with the status profile of Kuwaiti women during the oil era (1946-1960) and developing period (1960-1985) regarding her social, educational, and vocational status. So, regarding work environment, work in the private sector was more likely to be seen as high in the involvement factor, more concerned with the work's regulations, conscientious, and more likely to remain and conform to the organization's disciplinary systems, more committed to new styles and modern systems in their jobs to achieve their targets, and they were more interested with their work place, than their public staff counterparts. Also, the private sector is often seen as an efficient and productive work sector in comparison with the public sector. Regarding the personality traits, Kuwaiti male managers appear to be more enthusiastic and lively with strong and imaginative personality traits. However, the Kuwaiti female managers appear to have strong apprehensive personality traits

A systematic review of the adoption and acceptance of eHealth in Saudi Arabia: views of multiple stakeholders.

Background: eHealth is defined as “the use of information and communication technology for health”. Adoption and acceptance are key concepts to measure the level of eHealth impact. The aim of this systematic review was to critically appraise, synthesise and present evidence of the status of eHealth adoption and acceptance in Saudi Arabia from the perspectives of multiple stakeholders. Methods: Based on a Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guided protocol published with the international prospective register of systematic reviews (Prospero), five databases were searched for articles published between 1993 and 2017. Inclusion and exclusion criteria of studies were applied in which only peer-reviewed, full-text primary research articles in English language were included. One reviewer performed the searches; two reviewers independently screened the titles then abstracts followed by full articles. Studies excluded were recorded with reasons. Critical appraisal tools appropriate to study design were applied. Eleven items from every study were extracted for further synthesis. Results: After duplicates were removed, 110 papers were screened, and 15 studies met the inclusion criteria. Studies were generally of good quality. Thirty-nine factors were identified as influences affecting the adoption and acceptance of eHealth in Saudi Arabia. Lack of eHealth studies from the perspective of health managers and the limitation of studies to few geographical areas were identified as knowledge gaps. Conclusion: eHealth field in Saudi Arabia showed evidence of continual growth in both publications and awareness of significance. Therefore, findings from this review may help key professionals to address the current challenges and barriers and prioritise the main areas for improvement

BLOCKCHAIN IN THE MIDDLE EAST: CHALLENGES AND OPPORTUNITIES

The Blockchain technology has attracted a huge attention from both industry and academia. Despite the fact that there are great potentials of the blockchain, it is facing a number of technical challenges and social challenges. There is a substantial body of literature on the technical challenges and a limited number of researches that addressed the social challenges and opportunities of blockchain. Drawing on a multiple case study of twenty-one firms from six different Middle Eastern countries we synthesize the blockchain technology and IT in the Middle East literature to understand the challenges and opportunities of that technology in the Middle East. Our study identifies a classification of challenges and opportunities: Fine-tune challenges, estrangement challenges, sprint opportunities and act on opportunities and four associated factors: regulation, education, collaboration and culture. In doing this, our research extends and complements existing blockchain research and contributes to the IT literature in the Middle Eas