Use of the Electronic Health Record in Private Medical Practices

The purpose of this study is to examine the use of the electronic health record (EHR) by physicians in Allegheny and Westmoreland counties in Southwestern Pennsylvania. Five research questions were designed to inquire about the physician practice characteristics and its relationship to the EHR deployment, the importance of educational intervention in the EHR adoption, and the physician\u27s belief if the EHR contributes to improvements in the quality of patient care and practice productivity and profitability. A survey of The Use of Electronic Health Records by Medical Practices was used to collect 169 physician responses from the two counties. This survey was divided into six sections: practice characteristics, health information technology, computers and health care, financial considerations, the office practice environment and personal characteristics for a total of 27 questions. These were designed to inquire about the current status of the practice, availability of the electronic health record or its components, current use of information technology, practice and physician perspective about the EHR and information technology and personal demographical questions. This survey was adopted in a modified format from the original article, Correlates of Electronic Health Record Adoption in Office Practices: A Statewide Survey, written by Dr. Steven R. Simon, MD et al, and conducted in the Commonwealth of Massachusetts. The responses were statistically analyzed using the Statistical Package for Social Sciences (SPSS v. 16) Software. Results of the survey questions show that there is a correlation with having an EHR system and its effect on a practice, leading to improvements in the quality of patient care, and an increase in practice productivity and profitability. In spite of findings such as this, the adoption of EHR in Allegheny and Westmoreland counties is relatively low because of a lack of financial investment in the technology driven by the physician perception that EHR does not add to their personal income. These results show that an opportunity exists to educate physicians on the EHR to point out its contribution to improving the quality of patient care, as well as positively affecting their financial well being. It also indicated the necessity of developing industry-wide common EHR technology adoption initiatives and protocols in order to increase the implementation of EHR in physician offices

Consulting report - Euromotors S.A

Euromotors S.A. is the exclusive brand representative of the Volkswagen, Audi, Porsche, and SEAT brands among others within 11 strategic business units in Peru. Since its foundation, the firm has since grown exceptionally in size, scope and sophistication from their original operational function as an automobile importer to their current status engaged in the sale of vehicles, new and used cars, servicing and sale of original spare parts. As a multi-brand firm, it maintains 1,052 employees who function relatively autonomously within each business division for the separate brands. In order to propel the firm forward as a cohesive unit, synergies within need to be created to eliminate the replication of processes and procedures and to ultimately streamline overall organizational function. After a few years of declining profitability, Euromotors is looking at opportunities to improve its competitive position within the Peruvian automotive retail sector, which is rapidly changing and increasingly competitive market. In order to withhold a competitive advantage, a micro-pilot project has been designed within the consulting process, which has taken deep rooted analysis at both the internal and external environmental factors, to be implemented with Euroshop, Euromotors’ most profitable division. A cultural transformation will impact the sales force team of Euroshop; however, before it can be properly administered, overcoming organizational resistance to change must be dealt with. The proposed solution develops method for Euromotors to incrementally overcome the resistance to change in a multi-step system, to increase employee motivation and unity while increasing intrinsic responsibility to function as a team throughout the entire firm. This proposal considers the necessity of maintaining commitment to the strategic goals of the company. Through the development of a strategic map and a KPI based scorecard, the firm will have visibility on the key factors in garnering true change. Project timeframe is estimated in six months and total budget in USD 25,500Euromotors S.A. es la representante exclusiva de las marcas Volkswagen, Audi, Porsche y SEAT entre otras dentro de once unidades estratégicas de negocios en Perú. Desde su fundación, la empresa ha crecido excepcionalmente en tamaño, alcance y sofisticación desde su función original de importador de automóviles hasta su estado actual de venta de vehículos, automóviles nuevos y usados, servicio y venta de repuestos originales. Como empresa multimarca, mantiene 1,052 empleados que funcionan de forma relativamente autónoma dentro de cada división de negocios para las marcas separadas. Con el fin de impulsar la empresa hacia adelante como una unidad cohesiva, las sinergias dentro de la necesidad de ser creado para eliminar la replicación de los procesos y procedimientos y, en última instancia, racionalizar la función organizativa en general. Después de unos años de caída en la rentabilidad, Euromotors está buscando oportunidades para mejorar su posición competitiva en el sector de la venta automotriz peruana, que está cambiando rápidamente y cada vez más competitivo en el mercado. Con el fin de retener una ventaja competitiva, se ha diseñado un proyecto de micro proyecto dentro del proceso de consultoría, que ha tenido un análisis profundamente arraigado tanto en factores ambientales internos como externos, para ser implementado con Euroshop, la división más rentable de Euromotors. Una transformación cultural fortaecerá al equipo de la fuerza de ventas de Euroshop; sin embargo, antes de que pueda administrarse adecuadamente, debe superarse la resistencia al cambio. La solución propuesta desarrolla un método para que Euromotors pueda superar gradualmente esta resistencia para aumentar la motivación y la unidad de los empleados, al tiempo que aumenta la responsabilidad intrínseca de funcionar como un equipo en toda la empresa. El objetivo de la propuesta busca mantener el compromiso con los objetivos estratégicos de la empresa. Mediante el desarrollo de un mapa estratégico y un cuadro de mando, la firma tendrá visibilidad sobre los factores clave para lograr una verdadera transformación. Se estima que la implementación del proyecto se realice en seis meses y que el presupuesto ascienda a 25,500 dólares americanosTesi

The adoption of web based marketing in the travel and tourism industry: an empirical investigation in Egypt

The main objective of this research is to increase academic understanding as well as provide managerial implications in relation to the determinants of the levels of web adoption for marketing purposes by small and medium sized enterprises (SMEs) in Egypt. Web adoption is specifically defined in this research as the ownership of a website to communicate and/or deliver travel services to a target market. Providing facilities for inquiry, reservation, communication and booking are examples of adoption of the web to provide travel services. This research is thus interested in how the web is being used to interact with customers. Additionally, the levels of adoption represent the different levels that SMEs go through in their adoption process starting with not owning a website to being a simple adopter to being a sophisticated adopter. Non-adopters do not own a web site. Simple adopters own web pages that have facilities for information provision and communication whereas sophisticated adopters own web pages that have facilities for online booking and completing a full transaction online. It is worth noting that the levels of adoption are interrelated and are not static but are part of a process of eEvolution. This research provides an empirical contribution by studying the tourism sector as an example of a service industry and investigating the relative importance of the factors that determine the different levels of web adoption by SMEs in the context of a developing country. In order to achieve this objective, the research integrates existing theories in order to develop a conceptual framework for the determinants of Web adoption in the tourism sector. Besides Roger’s model of innovation adoption, the Resource-based view of the firm, a theory that deals specifically with firm resources and capabilities, is used to provide valuable information about the firm-specific factors that are thought to have an influence on innovation adoption. The model developed in this research is based purely on existing research and it integrates different theoretical perspectives. In addition, the researcher empirically tests this framework using both qualitative and quantitative data from travel agents in Egypt. This research is divided into three main parts. The first part (chs. 2 &3) introduces the literature where the concept of Internet marketing is presented and the key themes of research on Internet marketing are discussed. A literature review on Internet adoption by firms is then presented and the gaps in literature highlighted. The key literature includes defining the web as an innovation and organizational adoption of innovation. The different ways in which innovation adoption has been studied are discussed and a classification of the different factors influencing innovation adoption is made. A review of the existing research on the factors influencing technological innovation adoption by organizations is then provided. Finally, Internet adoption including the web by SMEs is discussed. The main gaps identified are lack of research on SMEs adoption of the web from a level perspective (i.e. distinguishing between use for communication versus use for transactions), lack of research on innovation adoption in developing countries, too much focus on consumer adoption in comparison to organizational adoption of innovations, shortage of research on innovation adoption from a level perspective and a need to identify the critical factors that affect each level of adoption. A conceptual framework (ch.4) is then presented, based on integrating existing theories and literature, and a series of hypotheses derived. The second part starts by discussing the tourism sector in Egypt (ch.5) which is selected to be the research context and then outlines the methodology (ch.6). This research relies on triangulation with a mixed methods research approach which combines both qualitative and quantitative analysis. The qualitative work provides depth to the analysis. It is used to compare with the proposed model in an attempt to provide a more complete picture of the investigated phenomenon. The quantitative work tests the hypotheses and indicates generalizability of the results. It consists of descriptive analysis, factor analysis and regression analysis. Both logistic and multiple regression were conducted in this research. The third part of the research is concerned with the analysis of empirical results presented in four chapters. Chapter 7 deals with a small scale content analysis on travel agents’ websites to measure the evolution of services provided on these sites over a period of two years. Chapter 8 includes details of the qualitative work conducted in this research which consisted of 12 in-depth interviews with travel agents in Egypt and provided a basis for triangulating the findings from the quantitative analysis. Chapter 9 includes the descriptive analysis of the data as well as the reliability and validity tests on the measurement instrument. Chapter 10 presents the findings and the interpretations of the hypotheses testing. The contribution of this research is a synthesis of Roger’s innovation adoption model with the Resource-based View of the firm (RBV) to produce a revised conceptualisation for the adoption of innovations which is empirically tested for developing country SMEs in the context of tourism in Egypt. The key findings of this research are that management factors are important for the initial adoption decision by firms whereas marketing capabilities are important for more sophisticated adoption. As for perceived innovation attributes, relative advantage and complexity were found important for the initial adoption decision whereas perceived risk was found important for more sophisticated adoptions. This suggests that different factors affect the different levels of adoption. The main contributions of this research to theory are: first,-innovation attributes are not the whole story when studying firms’ adoption of the web, firm resources also affect firms’ adoption decision. Second,-different factors affect different levels of adoption thus when studying innovation adoption by firms, it is important to consider the adoption process as a continuous process that consists of different levels rather than a dichotomous process of adopt vs. non-adopt. The main contribution at the context level is that this is the first research to be conducted in Egypt which represents an important extension to the Web adoption studies that focused largely on developed countries. Additionally, the results of this research can be transferable to countries that share similarities with Egypt and may also be of relevance to SMEs in other sectors in Egypt as will be explained later

Physicians in Cyberspace: Finding Boundaries

10.1353/asb.2016.0023Asian Bioethics Review84272-28