The electronic medical record system: health care marvel or morass?

The author considers the potential advantages and disadvantages, as well as possible unintended consequences, of introducing electronic medical record systems in health care organizations. Special consideration is given to the issues such information systems raise concerning privacy, confidentiality, and quality of care from both patient and provider perspectives. The potential gains from computerizing medical records include the benefit of instantaneous availability of patients' medical history, treatment regimes, and current health status in routine and emergency clinical situations. Ease of access to this information should reduce adverse outcomes. The added value of a complete and up-to-date medical record immediately available to medical caregivers seems undeniable. The potential disadvantages include issues around patient confidentiality and unauthorized access to records, the enormous capital investment for computer hardware, and system maintenance.     

Medicare private contracting: increasing patient choice and access?

Congress modified the Medicare program through the Balanced Budget Act of 1997 to expand patient choices for payment to physicians and certain other practitioners by allowing private contracting. This represents a shift in policy that has broad consequences for health care financing and program integrity. The effect of private contracting on quality and access to care remains unknown. Quality and access should be the most important measures of its success or failure. Out of pocket costs to seniors and vulnerable patients must also be watched closely.     

Strategic vision or strategic con?: Rhetoric or reality?

Major companies devote considerable effort to communicating corporate visions and missions. Yet three recent surveys suggest that much of this effort has been counter-productive. A gap has emerged between rhetoric and reality. Arenas of confrontation have arisen between directors and managers, head offices and business units, holding companies and their subsidiaries, and between specialists and generalists. A widespread desire for corporate transformation is not matched by understanding of how to bring it about. The lack of top management commitment and of communication skills are major barriers to change. More competent directors and more effective boards are needed. The article suggests key roles for the chairman and the chief executive. It examines how best to share a compelling vision, and identifies a requirement for new attitudes and approaches to communication.     

Distance Learning: Education or Economics?

Sir John Daniel, Vice Chancellor of the Open University in England, pronounced that American universities are in a crisis of access, flexibility and cost. His solution is that American Universities and Colleges should employ educational technologies that allow students to earn college degrees without visiting the college campus (distance learning). The argument is that distance learning is a cost-effective way of providing more students with access to higher education. Sir John's argument illustrates a crisis in neither access, flexibility, nor cost. On further inspection, distance learning degree programs appear to be a strategy for reducing the cost of higher education by replacing professors with computers and part-time teachers. This strategy offers limited educational benefits for the student and may present a financial danger to smaller colleges and universities, if they succumb to the pressure to develop distance, learning degree programs. This revised version was published online in July 2006 with corrections to the Cover Date.     

Physician-led: good idea or not?

Whether physicians or not, leaders must possess certain skills and qualities to achieve success. Take a look at what's required to be an effective leader.     

Network Stability: Opportunity or Obstacles?

Scholars of public management have begun to focus on networking as a key component of managerial activity ((Agranoff and McGuire, 2001); (Milward and Provan, 2001); (O'Toole and Meier, 1999)). Although the study of networks has garnered considerable academic attention, few studies have worked to bridge previous knowledge about hierarchical organizations with the research on the network. This study introduces the concept of stability into the network, arguing that stability should be a core value in networks, as the function of the network largely depends on repeat interactions. Texas school districts serve as the units of analysis, with the superintendent as the manager of interest. Findings suggest that stability may not always provide the benefits expected in traditional, hierarchical organizations.     

专利联盟:馅饼or陷阱?

专利联盟作为一种重要的专利管理模式,对企业在国际产业竞争中赢得竞争制高点发挥着越来越重要的作用。本文回顾了有关专利联盟竞争效应各角度的研究,并对我国专利联盟发展现状进行介绍,最后从政府和企业两个层面对我国企业组建有利于竞争和增进社会福利水平的专利联盟提出相应的对策建议,使专利联盟成为人见人爱的"馅饼"而非人人躲避的"陷阱",增强我国在国际专利联盟中的话语权。     

The Founder's Legacy: Hangover or Inheritance?

The legacy of organizational founders is a comparatively under‐studied topic. Through two in‐depth case studies, this article explores the factors which influence whether founding strategic visions, objectives or decisions influence present‐day strategic choice. Furthermore, the study identifies and explores a number of factors which influence whether a strategic legacy is categorized as either an inheritance or a hangover. The article begins with an overview of existing research into the role of the founder, commitment and strategic inertia, which suggests that additional research is required to clarify the legacy of company founders. After a review of the research design and methodology adopted for the study, the findings of two case studies are presented. The findings suggest that the initial establishment of a strong organizational culture, continuing perceptions of success as well as successive family control all contribute to an adherence to the founding strategy, mission or objectives. In addition, the study indicates that the flexibility of the original strategy and environmental issues impact on the extent to which the strategic legacy is classified as an inheritance or a hangover. The article culminates in a series of conclusions and implications.     

The physician-patient privilege: friend or foe?

The physician-patient privilege that has been enacted in most states has usually been seen as having the benign, even salutary, effect of protecting confidences that patients have entrusted to their physicians in the course of obtaining medical care and treatment. However, case decisions in one state have turned the privilege into a sword that plaintiffs can use to interfere with physicians' and hospitals' defense of cases against them by denying their counsel access to key defense witnesses. This development could occur in many other states that have taken a similar general approach in analyzing the privilege.     

Voluntary agreements between competitors: trick or truth?

Voluntary agreements in which competitors commit to common goals are important tools for corporate social responsibility. After entering into a commitment, however, competitors often have incentives to behave opportunistically. This is possible because voluntary agreements are not enforced by external sanctions. We present the results of an exploratory laboratory experiment that investigates the behavior of competitors engaging in commitments and consequently the effectiveness of such measures. We find that introducing a publicly visible commitment device that is implemented with a low probability mitigated conflict between competitors substantially. Our results show that subjects’ inclination to defect one another after competition was mainly driven by the opponents’ refusal to enter into a commitment. In our experiment, a commitment was not used to trick the competitor into a false sense of security but rather to convey the truth about subjects’ moral behavior. We conclude that the efforts of (non-)governmental institutions to reinforce trust between competitors may be of substantial value.     

Managing Organizational Culture: Compliance or Genuine Change?

The issue of managing culture is of key importance within management theory and practice. A number of extant studies have found that attempts to 'manage' culture frequently degenerate into the enforcement of espoused behaviours. The objective of this paper is to provide empirical evidence and discussion of the consequences of management attempts to change culture. The paper reviews existing theory pertaining to organizational culture change and presents the desire to control as the rationale for management attempts to modify culture. After a brief discussion of the research design and methodology employed, the findings of a single case study are presented. The findings suggest that within the case study organization, a recent change initiative had resulted in changes to material manifestations, behaviours and in some cases values. However, it is noted that modifications to values could be the result of 'instrumental value compliance'. The paper culminates with conclusions, implications and suggestions for further research.     

Business Education: Real Time or Semester Time?

Both the context and content of management education are changing as new providers compete for market share. As education goes increasingly online and offcampus, many traditional universities will feel the effects of consolidation within their own ranks. Business schools will face additional pressure as corporate universities and Internet universities offer an economical and effective means of professional education. Unless MBA programs seize opportunities for creative collaboration, today’s potential partners will become tomorrow’s predators. This revised version was published online in July 2006 with corrections to the Cover Date.     

Doing or being?

The founder of Aikido, Morihei Ueshiba, would occasionally distill the essence of the art into three simple shapes--a circle, a square, and a triangle. These are three basic ways of dealing with what's coming at you. The square is the simplest. It is about, essentially, doing nothing. The saying here is from the old spiritual: "I shall not be moved." You meet the challenge head on. The triangle is about forward motion--attack, cutting right to the heart of what is coming at you, or cutting right past it to the space beyond. The circle is often the most interesting space. The circle is not about standing ground or cutting through. The circle is about dancing with whatever is headed your way. The real danger lies in being stuck in any one mode--perpetually intransigent, always flailing away in attack mode, or forever slip-sliding through one dance step after another. It is only when our response is embodied in who we are that we will have the power truly to lead other people.