The future of computers in financial institutions

An examination of the development of computer usage in financial institutions reveals two reasons for this use. First, the pressure of growth e.g. cheque clearing, where irrespective of cost justification, business volumes were growing at such a rate that it would have been impossible to exist without automation. Secondly, those uses which were cost justified, usually in saving labour but which were constrained in their implementation by the answers to the justification equation e.g. centralized accounting systems in banks and building societies. Only so much was implemented because the technology was relatively expensive. More recently, however, technology has advanced in power, complexity and price-performance terms to the point where the user is no longer constrained either by the capability of the system to carry out the task, or by the expense of the system in relation to the cost of the job as currently performed.     

The marriage of risk management and the processes of patient care

So, your organization is considering taking on a capitation contract. Or you have already done so. Sooner or later, most physician executives with whom I have worked have asked the question: "How the hell are we going to manage this thing so we don't go broke?" Good question. Here, in brief, is the answer: Accepting capitated contracts without having the resources to manage both insurance-like risk and the process of caring for capitated patients is roughly equivalent to flying through mountains shrouded by clouds: Sooner or later, a mountainside is likely to appear in your windshield, close up and closing rapidly, at a point where it is too late to do anything about it!     

The bureaucratic side of computers: Memory,evocation and management information

Management information systems fail to support management because they are not flexible enough to keep pace with the unstructured nature of decision making processes. Observations made in four welfare management information systems suggest that computerization improves evocation—the means by which decision makers pool data from the collective memory, only to the extent that choices and the relevancy of data are predetermined. Facing rigid procedures and irresponsiveness to irregular data needs, managers of all ranks duplicate the computerized memory with manual records and files so as to retain access to their memory under their terms.     

Marital breakdown and the future of marriage

The institution of marriage is in a process of transformation. There is evidence of changing patterns of premarital sexual behaviour and cohabitation. But the single most important indicator of change is an unprecedented rise in marital breakdown in the last 25 years. In England and Wales one in three marriages are heading for dissolution and in the U.S.A. the number is nearer one in two. The adverse consequences of divorce are extensive and involve ill-health and poor functioning at work. In order to match the new aspirations of marriage a whole series of corrective measures are needed in education and preventive work.     

The microprocessor and medicine

Technology continues to accelerate at an amazing pace. Where have we been, where are we going, and what do these technology enhancements mean to the health care industry? We are entering the era of the personal computer becoming the window to the multimedia digital world of cyberspace. Microprocessors will continue to improve from one generation to the next to make cyberspace as realistic as possible-and with their improving capabilities will come myriad applications for health care services, either not cost-effective, or not even contemplated, until now. As a leader of an organization, one who approves substantial budgets for information technology, you must ask yourself what new products and services these startling technological advances will create. How will they change health and medical care?     

Strategic thinking with computers

The author describes the development of a system of cognitive mapping as a strategic management tool. Strategic Options Development and Analysis (SODA) has been used extensively by project teams working on strategic issues. A typical programme is described and the procedure is based on attention to the ownership of data as the basic material, and on the design of strategy workshops using the owned data. This appendix describes the use of the system in practice and the benefits and drawback perceived in running the strategy workshop.     

CPOE is much more than computers

A prominent hospital in Pennsylvania turned to CPOE to help reduce medical errors and improve patient care. Learn what steps hospital officials took to establish a successful CPOE system.     

Manufacturing planning with computers at Honeywell

Honeywell devised and developed a computer-aided planning system to determine future resource requirements. The system is primarily used to generate labour and equipment projections for each revision of the various marketing forecasts, but it is also used as a tool for conducting routine standards audits. The paper describes the system, its applications and limitations, the problems encountered in its use. The second generation planning system has become an efficient and useful tool.     

Integrating computers and marketing management: A European overview

The authors look at the role of computers in marketing management, examining some current literature on computers and marketing decision support systems (MDSS). They then present the results of a survey to gauge the extent to which computers are being used by marketing management in Europe, and explore the potential for accelerating the process of integrating computer technology into the marketing manager's job. Specifically they examine the current personal computers (PCs) usage patterns of 50 marketing executives in a selection of high-performing industrial corporations in Europe.The article then briefly highlights areas of greatest PC applications by these executives and the benefits they have brought in practice. It also identifies the problems they have experienced and their views on how better and more effective utilization can be made of the technology in order to enhance their managerial capabilities.     

Complementary and alternative medicine. The daunting challenge.

There is no question that the past few years have seen a tremendous surge in interest in what has come to be known as complementary and alternative medicine (CAM). Health plans contemplating adding CAM benefits face a daunting challenge. How should a plan define CAM benefits? How should a plan define appropriate CAM providers? How can these benefits be managed? Will the addition of CAM benefits undermine coverage policies for conventional biomedicine? The answer to these questions lies largely in uncharted waters, as even CAM advocates will agree that many alternative therapies (even those like Oriental medicine which has been in practice for some 5,000 years) have not yet undergone the type of rigorous, evidence-based analysis that is required to validate conventional biomedicine. This article explores options for CAM benefit design by considering two basic approaches-creating an uninsured benefit or insured benefit.     

Personal computers in business education: An experimental assessment

The growing importance of personal computers in business and the difficulties that business schools have had in effectively employing PCs in business education motivated an experimental study of the use of PCs in an educational context. The study confirms the merits of the strategy of off-loading basic computer instruction from mainframes to PCs. The results of the study also illustrated some important methodological points regarding the assessment of the effectiveness of computer systems.     

Approximation algorithms for hard variants of the stable marriage and hospitals/residents problems

When ties and incomplete preference lists are permitted in the Stable Marriage and Hospitals/Residents problems, stable matchings can have different sizes. The problem of finding a maximum cardinality stable matching in this context is known to be NP-hard, even under very severe restrictions on the number, size and position of ties. In this paper, we describe polynomial-time 5/3-approximation algorithms for variants of these problems in which ties are on one side only and at the end of the preference lists. The particular variant is motivated by important applications in large scale centralised matching schemes. A preliminary version of this paper appeared in the Proceedings of COCOON 2007, LNCS, vol. 4598, pp. 548–558. This work was supported by EPSRC grant EP/E011993/1.     

The emerging medical/industrial complex. The industrialization of medicine

Until recently, the traditional practice of medicine has been thought of as a cottage industry practiced by individuals or small partnership groups. The transition of practice settings to large groups, multi-specialty groups, and corporations has paved the way to industrialization, with even larger health care organizations primarily managed by non-physicians. The similarities of these events to the industrial revolution and its impact on crafts guilds are striking. In order to understand this point of view, this article explores the function and influence of crafts guilds during stages of industrial development and the dynamics of the changes of employment needs and employability in an industrial environment as a comparison to what is happening in the health care field.     

The physician condition: the age of economic medicine

A university professor believes the combination of Generation X physicians, who assert different expectations about work and home-life compared to Baby Boomer physicians, and the influx of female physicians over the past three decades, has profound implications on the structure of the health care industry.     

Complementary and alternative medicine. Integrative medicine: business risks and opportunities.

Much of the buzz over integrative medicine is well deserved. The opportunities seem to outweigh the risks, but superior management skills are needed to guide these programs through adolescence into clinical and business maturity. By carefully considering the staffing, team building, compensation methods, marketing, and program evaluation and development issues explored in this article, health care and physician executives should be able to steer between the rocks on their way to integrative medicine decisions that are right for their organizations. Many claim that integrative medicine has the potential to reshape health care delivery in a more patient-centered direction. While this may be true, such programs must prove themselves from financial and clinical operational perspectives in order to achieve this potential. Luminary clinical skills are not enough to guarantee the survival of such programs--a strong clinical base of expertise in alternative therapies is a key success factor. As with any health care venture, there are no substitutes for clinical excellence or sound management.     

Shiftwork effects in nuclear power workers: A field study using portable computers

This field study of nuclear power shiftworkers reports the use of hand-held computers to record alertness levels, cognitive task performance and workload ratings. Subjective ratings and performance tasks (Search and Memory-5 (SAM-5); Choice Reaction Time (CRT) were completed on the computers at 2-h intervals during selected shifts in the work schedule by maintenance crews and reactor operators. Sleep duration and quality data were also obtained during the 35-day shift cycle. Workload remained relatively stable across shifts. The night-shift was associated with shorter sleep durations and poorer sleep quality. Significantly lower levels of alertness and poorer perforniance for components of the performance tasks were also observed on the night-shift. Tinic-on-shift effects on alertness were evident, where by for the night-shift, especially, alertness dropped dramatically during the early hours. Components of SAM-5 performance showed differential time-on-shift patterning relative to each shift whereas CRT was unresponsive to time-on-shift effects. Significant variations were observed in alertness and performance components during the 12-h night-shift. Perhaps paradoxically, performance on the 12-h night-shift appeared to improve rather than deteriorate during the early-hour period that was associated with the greatest drop in alertness. This was suggestive of extra effort expenditure during this critical period.     

Shiftwork effects in nuclear power workers: A field study using portable computers

Abstract

This field study of nuclear power shiftworkers reports the use of hand-held computers to record alertness levels, cognitive task performance and workload ratings. Subjective ratings and performance tasks (Search and Memory-5 (SAM-5); Choice Reaction Time (CRT) were completed on the computers at 2-h intervals during selected shifts in the work schedule by maintenance crews and reactor operators. Sleep duration and quality data were also obtained during the 35-day shift cycle. Workload remained relatively stable across shifts. The night-shift was associated with shorter sleep durations and poorer sleep quality. Significantly lower levels of alertness and poorer perforniance for components of the performance tasks were also observed on the night-shift. Tinic-on-shift effects on alertness were evident, where by for the night-shift, especially, alertness dropped dramatically during the early hours. Components of SAM-5 performance showed differential time-on-shift patterning relative to each shift whereas CRT was unresponsive to time-on-shift effects. Significant variations were observed in alertness and performance components during the 12-h night-shift. Perhaps paradoxically, performance on the 12-h night-shift appeared to improve rather than deteriorate during the early-hour period that was associated with the greatest drop in alertness. This was suggestive of extra effort expenditure during this critical period.