Managing change in the British Airways

Managing change in the British Airways Contemporary business firms face unique opportunities and challenges in their search for survival and growth. British Airways, the UKs flag carrier airline, has constantly had to deal with numerous external and internal challenges, ever since its formation in 1974. BA has suffered harsh financial losses during 2009 and 2010; its cumulative net losses for the two years amount to around 800 million GBP. The organisational management recognises the need to bring in a significant strategic change in order to grow and improve its market share and competitive advantage. The companys change initiatives, however, face numerous obstacles. This report examines the need for strategic change at British Airways. This is followed by discussions on the requisites for successful organisational change, the barriers faced by the corporation in bringing about such change, and recommendations on the way forward. 1.1. Overview Modern day organisations face unprecedented opportunities and challenges in their quest for business success and competitive advantage. Environmental change of astonishing and global dimensions has changed the landscape of contemporary business (Hughes, 2006, p 14). Such environmental change, which commenced in earnest after the Second World War with the decolonisation of huge populations, accelerated in later years with the growth and subsequent collapse of the Soviet bloc, the reunification of Germany, the formation of the European Union, economic liberalisation across developing countries, the emergence of China and India as economic and political powers, astonishing developments in technology, and of course globalisation (Hughes, 2006, p 14). Whilst changes in global environmental conditions and advances in science and technology opened up numerous opportunities to business organisations, they also resulted in the creation of numerous challenges that threatened the operations and the very existence of established business firms (Hughes, 2006, p 14). Much of the modern day challenges to business organisations come from intensified competition, the emergence of numerous new products and substitutes, the development of equal quality but low-cost production and service centres in the emerging economies and from technological advances (Henry, 2008, p 44). The Japanese focus on fuel efficient small cars, pulled the rug from beneath the feet of huge automobile makers like General Motors and Ford, dethroning them from their positions of undisputed global leaders of the automobile sector (Henry, 2008, p 44). Low cost mining of Rare Earth Metals in China led to the closing of mines of such metals in the US and other countries and to concentration of 97% of global production of Rare Earth Metals in China (Areddy, 2010, p 11). Liberalisation of travel and free movement of people across the world for purposes of business and travel resulted in the emergence of low cost airlines like Ryan Air and Easy Jet in the UK and others in different par ts of the world, causing body blows to established airline giants like British Airways, Air France, and Swiss Air, some of which, (like Swiss Air), closed shop (Lynch, 2006, p 52). British Airways, the flag carrier airline of the UK has constantly faced external and internal challenges, ever since its inception in the early 1970s (British Airways, 2011, p 1). Formed by the coming together of BOAC, BEA, Cambrian Airways and North East Airlines in 1974, the organisation worked as a public sector corporation for 13 years until it was privatised by UKs Conservative government in 1987 (British Airways, 2011, History). British Airways (BA) has had to face numerous environmental challenges in its history, both as a public and as a private sector carrier. Such challenges have occurred on account of reasons like intense competition from other airlines in its domestic and global operations, erosion of market share on account of entry of low cost airlines, global terrorism, pandemics like SARS and Bird Flu, and natural calamities (British Airways, 2011, Annual Reports). The terrorist strikes of September 11, 2001, resulted in a huge downturn in local and international tra vel, resulting in the collapse of numerous airlines and in significant financial losses (approximately 200 million GBP in 2002) for British Airways, which lost (British Airways, 2011, Annual Report 2002). The volcanic explosion in Iceland, which resulted in ash filled skies and disruption of flights in early 2010, also resulted in significant revenue losses (Milmo, 2010, p 1). The last two years, 2009 (losses of 400 million GBP before taxes) and 2010 (losses of 530 million GBP before taxes) have been truly alarming for the organisation (Milmo, 2010, p 1). It also needs to be realised that whilst thousands of shareholders enthusiastically subscribed to the companys shares at the time of its privatisation, they have gained very little, by way of dividends or market value appreciation, in the last 24 years (Hosking, 2009, p 1). The management of British Airways recognises the need for the Airline to change significantly in response to various environmental challenges in order to grow and enhance market share and competitive advantage. A number of change initiatives have also been introduced by the company in various strategic and operational areas with varying degrees of success. 1.2. Objective This report examines the need for strategic change at British Airways. Such examination is followed by discussions on the requisites for successful organisational change and the barriers faced by the corporation in bringing about such change. The report closes with a section on recommendations and conclusions. 2. Strategic Change at British Airways Modern day organisations, as discussed in the preceding section, need to change on account of various internal and external environmental reasons, in order to achieve organisational growth, enhance productivity and profitability, and enhance competitive advantage (Cameron Green, 2004, p 31). Such strategic change could be needed to exploit new opportunities as well to obtain protection from threats. Such strategic change could also be necessary to break out from existing conditions of financial distress or operational or strategic deficiencies (Cameron Green, 2004, p 31). The importance of bringing about strategic change has been emphasised by numerous management academics and experts, who have repeatedly addressed its importance for modern day organisations (Cameron Green, 2004, p 31). Peter Drucker in fact drives the point home by stating that it is the responsibility of every responsible manager to constantly search for ways in which he or she can beneficially contribute to the process of strategic change (Stein, 2010, p 7). Whilst organisations clearly have to engage in strategic change, if not out of choice than out of necessity, their track record of success in its realisation is poor (Balogun, 2001, p 2). Many senior managements fail to understand that implementation of strategic change, i.e. the conversion of plans to reality, constitutes the most difficult part of the change process (Balogun, 2001, p 2). Such change can become possible only when individuals working in organisations change their behavioural ways and patterns and align them with new strategic objectives (Balogun, 2001, p 2). Strategic change is not new to BA. Numerous case studies detail BAs success in change management. The organisation engaged in strategic downsizing by practically 40% in 1981 and 1983 (Docshare, 2009, pp 27 to 30). Privatisation in 1987 called for the bringing about of significant cultural change. The adoption of the Putting People First programme in the 1980s aimed to align organisational working with new competitive realities and modify the behaviour of customers, who were deserting the airline in droves (Docshare, 2009, p 36). Recent years have also witnessed a number of change initiatives, primarily in response to intense competition by low cost carriers like Ryan Air and Easy Jet and altered customer expectations. The commissioning of Terminal 5 at Heathrow, which encountered significant negative publicity in account of opening day operational goof-ups, is one such example. The company is currently operating with a multi-pronged business strategy that includes (a) up gradation of customer experience, (b) modernisation of aircraft fleet, (c) offering new services, (d) managing its cost base and (e) increasing corporate social responsibility in areas of environment (British Airways, 2011, Annual Report 2008, Chairmans Speech).Whilst this report does not deal with an elaborate strategic analysis of the company, the most important factors about its internal and external environment, as well as its current performance are bulleted below. The organisation operates in an environment of intense regulation and heightened security because of terrorist threats. Its sales revenues and profitability are under threat because of the global economic crisis, slow projected global economic growth, the weakening of the pound, and oil prices, which have started soaring again. With the population of its home market ageing steadily, the organisation will be under stress to achieve the same amount of revenues from existing customers. With passengers becoming increasingly aware and vocal about their rights and expected service levels, BA continues to be under pressure on account of underperformance in areas of cancelled flights and poor baggage handling. The management and the cabin crew union are in direct confrontation with each other. The organisation has suffered severe financial losses during the last two years; with cumulative net losses for 2009 and 2010 near 800 million GBP. The organisations biggest threat, now and in the coming years is in the area of revenues, sales, costs and profits. With competition likely to intensify and global economic growth forecasted to be low, the company urgently needs to engage in activities for improving its financial viability (Milmo, 2010, p 1). Cost management and reduction is a critical element of organisational strategy. Whilst all airlines are equally affected by fluctuations in fuel costs, large economic and passenger movement trends, terrorism and global political instability, BAs labour and workforce costs are significantly higher than its competitors (Carley, 2009, p 1). It is relevant to note in this context that BA employees earn more than 2 times the remuneration earned by Virgin Air workers (Robertson, 2009, p 1). BA has adopted a strategy of cost management and reduction to overcome these financial challenges. Whilst the organisation is still financially strong, further periods of poor performance could well strain its financial resources (Carley, 2009, p 1). The major area of cost reduction relates to remuneration and employment terms of its employees, especially its cabin crew. 3. Change Management Strategies Whilst BAs immediate and imperative change strategy focuses on the critical area of financial viability, the route is extremely challenging because of its need for considerable employee sacrifice. It needs to be appreciated that the organisation has initiated a number of other strategic changes to improve customer satisfaction and satisfaction, including the commissioning of terminal 5 at Heathrow, (McGinn, 2009, p 2), and the need to achieve financial viability has now assumed important dimensions. Change management theories focus on three important dimensions, namely (a) the planning and implementation of the change process, (b) the involvement of the organisation in the proposed strategic change, and (c) the role of leadership in the change process for bringing about of successful strategic change (Hayes, 2006, p 71). Both Lewin and Kotter stress upon the need to implement change in a planned process that takes the organisation from its current stage to its desired state through clearly demarcated phases. Lewin states that change management can be best achieved through the planned application of three phases, namely unfreezing, implementing of change and refreezing the organisation in its new state through institutionalisation of implemented changes (Lewin, 2005, p 9). Kotter, whilst basically following Lewins theory, feels that the process can be better achieved through the implementation of change in 7 stages (Kotter, 1996, p 7). Change management experts secondly call for the committed involvement of organisational staff for the successful implementation of strategic change proposals (Bovey Hede, 2001, p 373). Many proposed strategic changes can result in resistance from organisational employees on account of causes like (a) incomplete knowledge of the proposed change, (b) ignorance about change objectives and benefits, (c) lack of belief in change benefits, and (d) change associated threats to the individual and collective wellbeing of organisational employees (Bovey Hede, 2001, p 373). Whilst ignorance about the nature and objectives of change can be set right through appropriately designed and powerful communication, tackling change related threat perceptions of employees is totally another matter (Bovey Hede, 2001, p 373). Such threat perceptions could arise because of apprehensions about (a) change in working condition, (b) change in terms of employment, (c) change in location, (d) requirement to tak e up new functions, (e) need to learn new skills, (f) loss of remuneration, and (g) loss of employment (Bovey Hede, 2001, p 373). The third critical factor in bringing about successful strategic change concerns the role of organisational leaderships (Hayes, 2006, p 78). Organisational leaders must clearly outline the proposed strategic changes, communicate the change objectives and the reasons for such change to organisational members, and bring about intense involvement of organisational employees in the change process (Hayes, 2006, p 78). Such involvement is essentially done by leading from the front and through visible commitment to the change process. Effective leaders identify and encourage change champions throughout the organisation to support the change process, engage in constant and transparent communication about the benefits of change and obtain he support of the overwhelming majority of organisational employees to the change process (Hayes, 2006, p 78). 4. Barriers to Change at British Airways BA has asked individual employees to accept temporary earning reductions and has engaged in negotiations with unions for pay cuts, alterations in employment terms, and reduction in its workforce. The companys management asked employees in June 2009 to work without basic pay for a maximum period of 4 weeks over six months, take a year of unpaid leave, and change from fulltime to part time employment for a period that could stretch up to a year. It is proving to be difficult to bring about strategic changes for effecting reduction in employee costs at the airline because of intense opposition by well organised and united cabin crew members to proposed changes (Carley, 2009, p 1). Whilst BAs pilots have agreed to some reduction in remuneration, the cabin crew has strongly opposed the changes and has constantly threatened to take industrial action if such changes are implemented (Carley, 2009, p 1). Effective strategic change, it is accepted, is difficult to implement without employee involvement and participation. Organisational leaderships try to bring about such involvement through communication, creation of awareness and training. The involvement and agreement of even a significant proportion of employees in the change process, along with constructive empathy for employees likely to be adversely affected by the change process, helps organisations to implement change processes that include termination, salary reduction and downsizing. It is necessary to understand that BAs cabin crew, whose agreement and involvement is important for effecting strategic change, are strongly united in their opposition to organisational plans and strategies (Neilcaff, 2011, p 1). The strength of their unity has been evidenced in the past when their strikes have resulted in significant stoppages and financial losses (Neilcaff, 2011, p 1). The last two years have been marked by intense confrontation between the management and the cabin crew on this issue, with no constructive result. The first half of the current year has been spent in the shadow of a proposed strike during the Easter holidays (Neilcaff, 2011, p 1). Some part of this problem can also be attributed to the current organisational leadership at British Airways. The leadership style of Willie Walsh, the existing CEO could also be a barrier to the change process. Walshs autocratic and uncompromising style is not encouraging employee stakeholders to acknowledge and embrace the required change. Other leaders, like Schultz at Starbucks, have been more successful at driving change programmes. 5. Recommendations and Conclusions The course of urgently required strategic change at British Airways is being thwarted by constant stand-offs between the management and employee unions, even as the organisation continues to be buffeted by a difficult competitive environment, soaring fuel prices and intense competition. It is relevant to note that the principal owners of the organisation, i.e. the shareholders, have received little benefits over the years, even as two sets of agents, the management and the employees, have obtained significant financial benefits and continue to wrangle over their individual interests and egos. It would appear to be opportune for shareholder organisations and even the government to step in, appoint neutral experts, obtain suggestions for strategic change, and push such measures through, even at the risk of industrial action and financial losses. The failure to take firm action and drive change forward could well have catastrophic repercussions for the company.

An Overview Of Immigrants In Malaysia

An Overview Of Immigrants In Malaysia Throughout human history, migration of human beings is a pre-requisite of human progress and development. Without migration, human being would be doomed to an existence worse than that of the animals. Even animals migrate to seek a better life. The first humans migrated out of Southern Africa thousands of years ago and spread throughout the world and people have been moving about since then. People also migrate because of factors like wars, poverty, discrimination, and for political or even religious reasons. In modern times, people often migrate for security, work and even for education opportunities. Organised immigrant labour migration and free immigration in Malaysia took place under the British colonial administration in the 19th century. During this period, the British required immigrant labour from China, India and Indonesia to help them in the exploitation of natural resources of the colonised countries establishing plantations and building infrastructure. It is mainly because of immigrant labour provide a steady, adequate and cheap supply of workers at a time when the locals labour was either deemed unsuitable or was not interested in working under the same harsh conditions as migrant labour. This period of free movement into Malaya saw large numbers arriving to work as well as returning home. However, because of free immigration and economic difficulties in the countries of origin, many immigrant workers decide to settle down in Malaya permanently. Malaysias rapid economic development since independence has relied on Malaysian workers moving from rural-to-rural and rural-to-urban areas and immigrant workers, especially from Association of South East Asian Nations (ASEAN) and other Asian countries. In the case of movement from rural-to-rural areas, rapid migration was swift mainly by government intervention in rural development and agriculture. Rural-to-urban migration accelerated after government intervention in urban and industrial development was stepped up, especially after the second Malaysia Plan. The push and pull factors at the international level in the region also caused workers to migrate to Malaysia for employment. The accelerated economic development programmes and the sustained high economic growth rates in Malaysia over approximately three decades caused the influx of immigrant workers to meet the increasing demand in the Malaysian labour market. 2.2 WHY PEOPLE MIGRATE There are many theories that attempt to explain why people migrate. Among others is the need and stress theory  [30]  . This theory holds that every individual has got his own needs to be fulfilled. These needs take various forms including economic, social, psychological and cultural. The higher the chances that an individuals needs will not able to be fulfilled, the higher the stress he suffers from. If this stress grows beyond tolerable limits, the individual will force himself to move to a different area, which seems to promise possible fulfilment of his needs. The migration of people from one country to another country is not a new phenomena. Since early days of colonialism, the colonial powers travelled around the world in search for raw material and new territory. Some of them moved to seek for freedom of worship and some even moved because of the instability of the government. The migration of Muslims from British India to form an Islamic state of Pakistan is one of the biggest voluntary migrations in history  [31]  . Wars and conflicts are another reason for mass movements of people and this kind of movement is categorized as refuges. Because of the situation are so serious, the international consciences were moved and many voluntary organisations were formed to assist these refugees. The Vietnamese Boat People is a good example of the mass movement of people of this nature. Today, we still can see refugees fleeing their country because of war and a good example is the latest situation in Liberia and Sudan. These people who enter another country through unofficial channels are known as illegal immigrants who later, may create problem to the host country. In modern days, seeking for a better life and a stable economy become the main factors that influences migration. Sociologist have long analysed migration in terms of the push-pull model  [32]  . This model differentiates between push factors that drive people to leave home from pull factors that attract migrants to a new location. Push factors occurs within sending states, that is, those that send migrants abroad, while the pull factors occur within receiving states, that is states that received migrants from abroad. Push factors are negative aspects of the sending country, while pull factors are positive aspects of the receiving country  [33]  . In fact, these differentiating factors are really two sides of the same coin. In moving migrants must not only see a lack of benefits at home but also a surplus of benefits abroad. There are also more ambiguous factors, called network factors that can either facilitate or deter migration. Generally, the network factors are the networks of friends and relatives already settled in destination countries that serve as sources of information and anchor communities for newcomers  [34]  . The network factors also include, cost of travel, the ease of communication and international business trend. These factors are not related to a specific country, but still have a profound effect on international migration. The Pull Factor Generally, there are two factors attracting migrants to receiving countries. First, the higher standards of living and higher wages; economic provide the both biggest push and pull factors for potential migrants  [35]  . Second, Labour Demand; almost all developed countries have found that they need immigrant labour. Rich economies create millions of jobs that domestic workers refuse to fill but immigrant workers will cross borders to take  [36]  . In the case of Malaysia, a wave of labour migration began in the early 70s where shortage of labour became critical especially in the plantation sectors. In mid 80s, the labour shortage becomes acute and this has attracted more immigrant workers into the country. The Push Factor Generally, there are several reasons driving people to emigrate from their home country. First, lack of jobs/poverty; economic provides the main reason behind migration  [37]  . In some countries jobs simply do not exist for a great deal of the population. In others, the gap between the rewards of labour in the sending and receiving country are great enough so as to warrant a move. Second, civil strife, war, political and religious persecution; some migrants are impelled to cross national borders by war or persecution at home  [38]  . Some of these migrants end up in receiving countries as refugees or asylum seekers. Third, environmental problems  [39]  ; environmental problems and natural disasters often cause the loss of money, homes and jobs. The Networking The demand-pull of jobs is linked to the supply push of low wages and joblessness by migration networks. Migration network encompasses everything that enables people to learn about opportunities abroad and take advantage of them. Others are motivated to go abroad by family members who are working or settled down in the host country, contractors, labour brokers and other often-shadowy middlemen or tekong who promise the migrants better deals. 2.3 WHY MALAYSIA BECOME MIGRANT DESTINATION The theory of migration occurs because of the sending and receiving factors mainly due to the push-pull and supply-demand forces. The influx of immigrant workers to Malaysia is not a recent phenomena. Malaysia replicates the complexity of international migration that exercises both of imports and exports of labour. Better economic growth and Malaysias geographical location that shares common borders with it neighbouring countries has become a pull-factor for migration to Malaysia. In contrast, the economic disparity, inequality and poverty in the country of origin serve as the push-factor for them to migrate, looking for jobs and better living. Generally, there are many other reasons why these immigrant workers choose Malaysia as their destination. First, Malaysia geographical location, second, the stable and sound government, third, labours shortage, fourth, higher wages and finally, the employer attitudes. Geographical Location Malaysia geographical location, which is in the centre of South East Asia is easily accessible either by land or sea. In addition, the easy access and the shortage of enforcing agencies along the extended shores and entry points into Malaysia have caused the entry of many illegal immigrants undetected. Stable and Sound Government Since independence, Malaysia has been governed by a stable government and with sound economic growth. This political and economical stability has become the main attraction for migration. Comparatively, Malaysia has been seen as the most stable nation in this region in comparison to her neighbours. As such, others have regarded this country as an oasis in the region. Labour Shortage Malaysia has been experiencing a very high level of industrial development and it has developed further to be classified as a newly industrialized country. Therefore, from the human assets perspective the country has generated a huge demand of the work force especially unskilled workers for immediate employment in the industrial and manufacturing sectors. The labour shortage in Malaysia has become an important issues and employing immigrant workers is considered to be the most viable short-term solution. Higher Wages Generally, the immigrant workers in Malaysia can be regarded as an economic migrant. Comparatively, Malaysian employers pay higher wages to the immigrant workers for a similar job back home. This situation is made even worse, where the wages offered is considered low for the local workers. Thus, it opens the job opportunities to the immigrant workers. The Employer Attitude The Malaysian employers attitude is also another pulling factors that attracted foreign workers. Beside that, it is suspected that there has been a simultaneous entry of huge number of illegal workers as well. Similar to the legal workers, the illegal workers were also employed in the construction, manufacturing and service sectors at a very low wage rate. It is a known fact that employers prefer this arrangement for various reasons such as a lower overhead cost and preventing them from registering to the Employees Provident Fund (EPF), Social Security Organization (SOCSO), medical and social benefits. For the illegal immigrants, because of their unlawful status, they become less demanding in terms of salary and other privileges. As for the employers, in order to boost their production, the illegal immigrant workers can be easily employed to work extra hours with minimum wages. 2.4 THE MIGRANT COUNTRY OF ORIGIN Most of the immigrant workers in Malaysia came from her neighbouring countries; Indonesia, the Philippines and Thailand  [40]  . However, in early 90s, immigrant workers from Bangladesh, Myanmar, Nepal and few other countries started to dominate the Malaysias labour workforce. Therefore, it is only realistic to identify the country of origin of the immigrant workers and examine the push factors that make them migrate to this country. Indonesia Being the largest country in this region with 1.9 million sq km, Indonesia is facing administrative problems in trying to govern the nations vast regions equally. To develop the whole country, it requires massive effort and resources and this have created a gap between the provinces. Some parts of the country enjoy multi multi-fold development while others are still left far behind  [41]  . The problems of socio-economy seem to have centred on its big population, since Indonesia is the fourth most populous country with approximately 225 million. The Indonesian economy is dependence on oil and gas, plywood, textiles, rubber and palm oil. However, the limited resources and infrastructure available were not adequate to accommodate the demands of growing population  [42]  . This among other factors has caused poverty, which is estimated 24% of its population. Beside that, unprecedented turmoil in recent years, first the Asian financial crisis, followed by the fall of President Suharto, the first free election since 1960, the loss of East Timor, independence demands from restive provinces, bloody inter-ethnic and religious conflict and devastating tsunami had worsen the economic situation, increased the inflation and unemployment rates. Thailand Like Indonesia, Thailand is also facing the problem of poverty, where 80% of the population lives in the rural areas and most of them are poor farmers. The reason is simple; the Thai government is concentrating more on defence rather than the socio-economy development of the country. Philippines The Philippines, which consist of 3,666 islands, is facing almost similar problem like Indonesia in terms of administration and developments of the provinces. Beside that, religious conflict between Islam and Christian has imposed serious threat to the country. This is coupled with the uneven development between the provinces, which has created a disparity situation amongst the citizen while the armed revolution by the militant groups in Southern Philippines post a major threat to its internal security. Bangladesh This small country with a large population is facing many problems. The high rates of poverty and political instability of the country has influenced the citizen to look for better opportunities in other countries. The country also constantly experiences natural disaster such as floods and drought, which made the situation worst. Myanmar The close policy of Myanmar to the outside world is one of the reasons for the backwardness of the country. The poverty rates is very high amongst the population of 85% Buddhist. Being a poor country, Myanmar faces the same socio-economy problem and political instability, which hinder the development of the country. Nepal With its ancient culture and the Himalaya as a backdrop, the landlocked Kingdom of Nepal has for many years been the destination of choice for foreign travellers in search of adventure. The country with an area of 147,181 sq km and 26.3 million people is one of the poorest countries in the world where more than 40% of its population is estimated to live in poverty. Being a landlocked country with limited agriculture and other industries, Nepal economy relies mainly on tourist industries. However, the current political turmoil and the growing Maoist guerrilla insurgency movement that keeps the tourist away are now undermining the Nepal economies. Maoist rebels have been waging a campaign against the constitutional monarchy in a conflict that has left more than 11,000 people dead since it started in 1996. Based on the UN reports, it is indicated that, the rebellion has displaced more than 100,000 people  [43]  . Nepal also has been at odds with neighbouring Bhutan over the repatriation of thousands of refugees living in camps in Nepal. The refugees, Bhutanese of Nepalese descent fled violence in their homeland in early 1990s. With these ongoing problems, worsen economy and political situation has drive away the people to look for a better living in other countries. Other Countries Other than the countries mentioned, there are also immigrant workers from India, Pakistan, China, Middle East and even African countries. These countries are also facing the same socio-economy problem and political instability. However, the numbers is not as high as the other immigrants from the Malaysias neighbouring countries. Some enter the country legally but had extended their stay although their visa had expired. Their main reason in doing so is to earn a better living in this country. 2.5 SUMMARY In summary, Malaysia needs the immigrant workers for the development, but their presence should not dominate the labour work force because they will definitely pose some positive and negative impact as well as threat to the national security. The positive and negative impact of their presence varies. From the economic perspective, their employment helped the continuous development and economic growth of the country by filling the gap of the acute labour shortages. On contrary, their presence and employment depress wages and this has reduced the competitiveness of local workers and frustrates attempt made by the trade unions to improve their working terms and conditions. A productive and competitive workforce is crucial for Malaysia in order to develop a knowledge-based economy and to achieve its aspiration of becoming a fully developed nation. However, most of the immigrant workers are unskilled or semi skilled labours with lower academic background. Therefore, the government has to formulate a comprehensive policy governing this requirement, which will definitely incur extra cost and procedures to the employer. As a result of this bureaucracy, the employer often blamed the process of importing workers as being lengthy and tedious process. Therefore, they recruited illegal workers who are readily available for employment. Socially, being less educated, poor and lower social class, these immigrants workers seem to be un-stabled economically, physically and mentally. As a result, negative competitions for a better living can emerged from these situations. For example; their incursion into non-designated jobs like petty trading imposes unnecessary competition to the local traders. They also compete with the locals for cheaper housing especially in the urban areas, which resulted the rise in rental and short supply of houses. Some of them are even move into developing new illegal squatters and this has impose strain on the basic amenities in the areas. Any slightest conflicts resulted from this competition might turn into social clashes between the immigrants and the locals. Immigrant workers have also been seen as a threat to security and political stability. This stems from their ignorance of the countrys law. This can be seen from various activities such as, illegal entry, involve in criminal activities, over staying, opening government land illegally, and many others. These activities will definitely have serious implication on security. Illegal entry for examples, implies that Malaysias has porous borders and was unable protect the borders, allowing not only economic migrants to come through but also any subversive elements. Illegal entry will also enables those with contagious diseases to filter through and spread it to the population.

Computer Crime :: essays research papers

Computer Crime Computer crimes need to be prevented and halted thought increased computer network security measures as well as tougher laws and enforcement of those laws in cyberspace: Computer crime is generally defined as any crime accomplished through special knowledge of computer technology. All that is required is a personal computer, a modem, and a phone line. Increasing instances of white-collar crime involve computers as more businesses automate and information becomes an important asset. Computers are objects of crime when they or their contents are damaged, as when terrorists attack computer centers with explosives or gasoline, or when a "computer virus"--a program capable of altering or erasing computer memory--is introduced into a computer system. As subjects of crime, computers represent the electronic environment in which frauds are programmed and executed; an example is the transfer of money balances in accounts to perpetrators' accounts for withdrawal. Computers are instruments of crime when used to plan or control such criminal acts as complex embezzlements that might occur over long periods of time, or when a computer operator uses a computer to steal valuable information from an employer. Computers have been used for most kinds of crime, including fraud, theft, larceny, embezzlement, burglary, sabotage, espionage, murder, and forgery, since the first cases were reported in 1958. One study of 1,500 computer crimes established that most of them were committed by trusted computer users within businesses; persons with the requisite skills, knowledge, access, and resources. Much of known computer crime has consisted of entering false data into computers, which is simpler and safer than the complex process of writing a program to change data already in the computer. With the advent of personal computers to manipulate information and access computers by telephone, increasing numbers of crimes--mostly simple but costly electronic trespassing, copyrighted-information piracy, and vandalism--have been perpetrated by computer hobbyists, known as "hackers," who display a high level of technical expertise. For many years, the term hacker defined someone who was a wizard with computers and programing. It was an honor to be considered a hacker. But when a few hackers began to use their skills to break into private computer systems and steal money, or interfere with the system's operations, the word acquired its current negative meaning. Organized professional criminals have been attacking and using computer systems as they find their old activities and environments being automated. There are not a large number of valid statistics about the extent and results of computer crime. Victims often resist reporting suspected cases, because they can lose more from embarrassment, lost reputation, litigation, and other consequential losses than from the acts themselves.

The Negative Impacts of the Harlem Renaissance Essay -- essays researc

The 1920’s were a period or rapid growth and change in America. After World War I American’s were introduced to a lifestyle of lavishness they had never encountered before. It was a period of radical thought and ideas. It was in this time period that the idea of the Harlem Renaissance was born. The ideology behind the Harlem Renaissance was to create the image of the â€Å"New Negro†. The image of African-American’s changed from rural, uneducated â€Å"peasants† to urban, sophisticated, cosmopolites. Literature and poetry abounded. Jazz music and the clubs where it was performed at became social â€Å"hotspots†. Harlem was the epitome of the â€Å"New Negro†. However, things weren’t as sunny as they appeared. Many felt that the Harlem Renaissance itself wasn’t so much a celebration of Black culture, but rather a regurgitation of White ideals. To these African-Americans, the Harlem Renaissance represented conformity and s ubmission to the White culture. Yet there were also those who were not even given the opportunity to be a part of the Harlem Renaissance. The poor Blacks in the South never received any of the racial tolerance up north. They lived in a world of racism and the Ku Klux Klan. The Harlem Renaissance did not redefine African-American expression. This can be seen through the funding dependence on White Americans, the continued spread of racism and the failure to acknowledge the rights of poor Southern African-Americans.   Ã‚  Ã‚  Ã‚  Ã‚  Harlem provided a source of entertainment for many people. With its Jazz Clubs and poetry readings it was the â€Å"hip† place to be. This was a shock to many African-American’s, who had never before had the opportunity to perform in such affluent surroundings. Oftentimes funding for these clubs or programs was provided by White Americans. This in itself was not a problem. However, the Harlem Renaissance became so dependant on the funding that when it stopped coming, there was no means by which to keep any of the clubs or literary cafes open. Some clubs in Harlem even discriminated against Black audience members. The popular Cotton Club, which featured solely Black performers, even went so far as to ban African-Americans’ from its audience entirely. Even in the Mecca of supposed racial equality, these sorts of discrimination were still prevalent. Advertisements for products produced by African-Americans were also skewed. Para... ...  Ã‚  Ã‚  Ã‚  Ã‚  The Harlem Renaissance was a time of growth and development in for African-Americans. They wrote novels, performed in clubs, and created the genre of Jazz. However, the Renaissance was imprisoned by its flaws. Rather then celebrating the unique culture of African-American’s, it oftentimes catered to what the White Americans would want to see and hear. Although racism seemed to be lower in Harlem and the Northern states, for many Blacks racism was at all time high. The Ku Klux Klan reached membership of astronomical proportions. They marched on Washington DC and handed out membership cards bashing minorities. Less educated Blacks, or those who couldn’t make it to Harlem, were often deemed ignorant. There was a barrier built between those Blacks with an education, and those without. And when the Great Depression hit, African Americans lost their jobs at a rate almost triple that of White Americans. Where was the equality Harlem had fought so hard f or? The Harlem Renaissance, although it did achieve some remarkable things, did not redefine African American expression. That ideal, would take many more years of strife, struggle, and segregation to achieve.

Shoot The Teacher :: essays research papers

Shoot The Teacher During the couple of days that pass in this book, lots of things happen. A boy in his mid teens becomes to heavy a burden for his mother to carry. She kicks him out. Her divorced husband gets to take care of Adam. Adam and his father, who Adam calles Simon, move to a new place with a new school where Simon is a teacher. The very first day they're involved in a shooting. But there is more to come! Three people are shot and killed in only a few days. There are many theories of hwo comitted the killings. Simon is the main suspect, however he's found innocent. Instead the find that the murderer is Adam's only friend Naomi, who was the stepdaughter of the first victim. Adam is in the beginning of the book a rebellious young man. The typical teenager in revolt. He's growing his hair long, refusing to go to school and talking back to his mother. He seemes to calm down quite a bit though in just a few days. As a matter of fact, as soon they arrive at the new school, Adam seemes to be more mature and calm. Maybe that's because he doesn't have any friends in the new school, maybe because he feels inferior being the new kid and outsider that he is. Adam's relationship to his father seemes to vary a lot. At first Adam looks at his father as if he was a perfect stranger.And he has all rights to do that since they practicly hadn't seen each other att all since Adam was born. Then some kind of a father-son friendship evolves, but I get the feeling that it's only because they feel they have to. When Simon is accused of murder, Adam starts to hate him. Perhaps stop caring about it, is a better way of describing Adam's feelings towards his dad. The author used a technique with many enviromental descriptions. He didn't use a lot of fancy words, probably because it is a youth book.

Edgar Allan Poe’s The Masque of the Red Death Essay

Edgar Allan Poe’s short horror story entitled ‘The Masque of the Red Death: A Fantasy’ was published in Graham’s Magazine in 1838, and talks about a plague that the main character, Prince Prospero, attempts to evade (Laurent 2003). He holds a masquerade ball, each in different color, inside seven rooms in his abbey. On the other hand, Irvin Layton’s horror (or suspense) poem entitled ‘Rhine Boat Trip’ was written in 1977 and talks about murdered rabbis and the ghosts of children in the events in Nazi Germany, especially those that occurred during the Holocaust (Rhine Boat Trip, n. d. ). These two texts are both horrific, but aside from being different in terms of the format and the length, both display contrasting perspectives in their artistic, textual frames. Poe’s short story and Layton’s short poem display a suspense story; yet, as a whole, they display different styles and time frames. While Poe’s style displays something that is currently happening and distinctively described, Layton displays one that had already happened in the past and is directly described. Main Body The Masque of the Red Death by Edgar Allan Poe This short story attempts to describe how a plague called the Red Death enters Prince Prospero’s dominion, a prince who is being described as â€Å"happy and dauntless and sagacious† (Poe par. 2). The plague that has swept over the land is horrifying. As described, Blood was its Avatar and its seal –the redness and the horrors of blood. There were sharp pains, and sudden dizziness, and then profuse bleeding at the pores, with dissolution. The scarlet stains upon the body and especially upon the face of the victim, were the pest ban which shut him out from the aid and from the sympathy of his fellow-men. And the whole seizure, progress and termination of the disease, were the incidents of half an hour. (Poe par. 1) From this paragraph, Poe specifies how horrifying the plague is. The victim loses most of the blood within the body, which is the cause of sudden dizziness and dissolution. Poe’s use of blood is enough to make the story appalling to the reader. Using pictures that signify awfulness and terror, Poe makes the story one that makes the reader horror-struck. However, the plague is said to have stricken only his dominions and not Prince Prospero and his â€Å"hale and light-hearted friends from among the knights and dames of his court† (Poe par. 2). Poe makes it appear that the plague only strikes those that are not hale and light-hearted or only those that are wicked, depraved, or poor. When his dominions were cut in half and the depraved dominions were already cast out, Prince Prospero is said to summon his friends, and using a masquerade ball inside seven rooms, each in different color, of his castellated abbey, he entertains his friends amid the plague. Poe describes the abbey: This was an extensive and magnificent structure, the creation of the prince’s own eccentric yet august taste. A strong and lofty wall girdled it in. This wall had gates of iron. The courtiers, having entered, brought furnaces and massy hammers and welded the bolts. (Poe par. 2) The exact description of the castellated abbeys indicates that Prince Prospero and the one thousand light-hearted friends are being protected from the killing plague that has stricken over the land. Then Poe begins to describe extensively the seven colored rooms: It was a voluptuous scene, that masquerade†¦ There was a sharp turn at every twenty or thirty yards, and at each turn a novel effect. To the right and left, in the middle of each wall, a tall and narrow Gothic window looked out upon a closed corridor which pursued the windings of the suite. These windows were of stained glass whose color varied in accordance with the prevailing hue of the decorations of the chamber into which it opened. (Poe par. 4) Poe mentions that, having to describe the decorations of the castellated abbey, Prince Prospero is actually eccentric, august, voluptuous, and bizarre. Poe also mentions that â€Å"[t]he tastes of the duke were peculiar. He had a fine eye for colors and effects. He disregarded the decora of mere fashion. His plans were bold and fiery†¦Ã¢â‚¬  (par. 6). A mystifying figure suddenly appears, one that is described as â€Å"a masked figure which had arrested the attention of no single individual before† (par. 9). When Prince confronts the mystifying image, he suddenly falls dead, as specified in these lines: â€Å"There was a sharp cry – and the dagger dropped gleaming upon the sable carpet, upon which, instantly afterwards, fell prostate in death the Prince Prospero† (par. 12). The Red Death has entered the ball, and as the prince falls dead in the carpet, the people surges to the figure to remove the mask, only to find it empty. Each one falls to the ground, as the plague enters each of the one thousand guests in the ball. The Red Death surges upon all of the dominion. The Masque of the Red Death is one horror story in which Poe exemplifies great and immense description in every detail and part of the story. Poe uses symbols, such as colors and lines, in order to describe each detail magnificently and make the reader see distinctively. Rhine Boat Trip by Irvin Layton This 16-lined poem attempts to describe how the castles of the Rhine are haunted by ghosts of Jewish mothers and children in the lines: â€Å"The castles on the Rhine / are all haunted / by ghosts of Jewish mothers / looking for their ghostly children† (Rhine Boat Trip, L1-4). In contrast to Poe’s distinctive description, Layton’s style is simple and easy to read and understand. It does not describe each detail individually but rather, puts the picture and leaves the reader free to describe each picture. It allows the reader to put in detail what the castle looked like at Rhine. Having to put the exact name of the castle in the line is enough to picture the detail distinctively. Unlike Poe’s style, which provides the exact picture by describing immensely the detail in the story, Layton’s style is one that uses words in order to describe immensely what the picture or detail appears to be. However, instead of describing the castle as something that is enormous, fantastic, or incredible as Poe has done, Layton pictures the castle in a horrifying manner: â€Å"[A]nd the clusters of grapes / in the sloping vineyards / are myriads of blinded eyes / staring at the blind sun† (Rhine Boat Trip, L5-8). Layton instantly pictures the castle as horrifying, which is different from Poe’s style, wherein the latter pictures the castle as magnificently decorated before interpreting it as horrifying in the latter portion of the story. Each word that Layton uses carries a specific meaning. This is different from the manner in which Poe writes, wherein he describes in detail only to prove that the place is magnificent and is owned by a splendid duke living in the castle. In lines 5-8 of Layton’s poem, for example, the clusters of grapes of line 5 does not just depict the Jewish families but may depict families or communities that include everyone, including the reader. However, because Layton uses ‘sloping’ when he describes the vineyards, it may conclude to something that is negative, since it goes downhill, which is symbolic. Something negative, such as negative customs or culture that are found in the family or community, might have been included in the clusters of people. The use of grapes also depicts meaning, since grapes are used by the Jewish during the Passover and Holocaust. Having depicted too, that the clusters of grapes are actually â€Å"myriads of blinded eyes† (Rhine L7), it appears that the Jewish families (or German families) are blinded to what is about to happen to them and the surrounding community. They are staring at the blind sun because there is no hope for them in the end, since God is about to punish them, it is like God is nowhere in sight. In lines 9-10, wherein it says that â€Å"the tireless Lorelei / can never comb from their hair† (Layton L9-10), it appears that Lorelei is praying and doing sacrifices to God; and because she can â€Å"never comb from their hair† (Rhine L10), it symbolizes that important people in the community, such as Lorelei, pray and do sacrifices to God, so that the latter may show mercy to them and then remember His covenant with them. Lastly, lines 11-16 depict the rabbis that have been murdered and are wailing: â€Å"[T]he crimson beards / of murdered rabbis / however sweetly they sing / one hears only / the low wail of the cattle cars / moving invisibly across the land† (Rhine L11-16). Crimson is used to signify blood or death. The word ‘one’ is being used to mean both the person that hears only the wailing rabbis, as well as, the One God that appears to have turned His back on the Jewish people despite their prayers and offerings. Cattle cars are wailing in line 15, meaning that these cattle cars that are â€Å"moving invisibly across the land† (Rhine L16) are not with cattle but with people, which signifies a state that is inhumane and atrocious. The cattle cars are invisible because, first, no one had paid attention to them during their crisis; and, second, what the author has been describing is something that had already happened in the past. This poem also depicts strong emotional response because of distinctive images that were used by the writer. Like Poe’s story, this poem uses images, such as castles, grapes, vineyards, sun, rabbis, and cattle cars. However, unlike Poe’s story, Layton’s style is one that is simple yet direct; one that is more symbolic than that of Poe’s. Conclusion Poe’s short story entitled The Masque of the Red Death, as well as, Layton’s short poem entitled Rhine Boat Trip are both horrific, symbolic, and descriptive. However, Poe’s story is distinctively descriptive in detail, with an enormous, fantastic castle. Layton’s poem on the other hand, is simpler and direct, easier to read and understand, more distinctive in word, more symbolic in style, with a horrifying castle. Layton and Poe are alike; yet diverse. Works Cited Laurent, Sabrina. Metaphor and Symbolism in The Masque of the Red Death. July 2003. United Nuke. 14 March 2009 . Poe, Edgar Allan. The Masque of the Red Death. 2009. Jalic Incorporated. 14 March 2009 . Rhine Boat Trip (1977). N. d. Gonzaga University. 14 March 2009 . Other Sources Roberts, Edgar. Writing About Literature – Brief (11the ed. ). White Plains, NY: Pearson Longman, 2005.

An investigation of the role of SIS in The (Especially, In A Rural Part Of Our Planet)expand Health Servicing

Introduction Strategic information systems are concerned with aligning information systems with a firm’s business strategy to achieve competitive advantage (Arvidsson, Holmstrom & Lyytinen, 2014). Strategic alignment between information systems and the business involves a timely and appropriate fit between the business strategy, processes, and infrastructure and the IT infrastructure, strategy, and processes to achieve harmony in the management of information systems and the business (Gerow, Thatcher & Grover, 2014). Through such alignment, the performance of a business is positively affected (Yayla & Hu, 2012). The overarching argument for this is that firms perform well when IT resources including knowledge assets, managerial and technical IT skills and physical IT infrastructure elements are aligned with the business strategy, and when suitable structures are employed in effectively managing the IT resources and supervising their deployment (Coltman et al., 2015). This alignment is ever important in the current environment where new information technologies continue to fundamentally alter conventional business strategies by allowing firms to function across the boundaries of function, time, and distance by leveraging these technologies (Bharadwaj et al., 2013). This report discusses the role of strategic information systems in expanding the health service in rural areas. Specifically, it focuses on the implementation of a telemedicine program for managing diabetes for patients in rural areas by a hospital in an urban centre. The investigation focuses on the planning and the implementation of this technological solution by considering the perspectives of different stakeholders. The report starts by discussing literature on telemedicine in diabetes management. Telemedicine and Diabetes Management The management of diabetes and its associated complications is quite costly. Targeted glycaemic control is necessary for minimising the complications of this chronic condition. Conversely, less than 70% of individuals with diabetes are attaining targeted glycaemic control, showing that effective management of the disease continues to be a challenge (Fatehi et al., 2014a). Patients in rural areas are unable to attain targeted glycaemic control partly because of poor access to specialised healthcare providers. Because of the increasing need for quality healthcare and the declining availability of clinicians, information and communications technologies have demonstrated the potential for improving access to healthcare services and reducing the costs of delivering healthcare (Fatehi et al., 2014a). Telemedicine involves providing health and medical services remotely using ICT. Telemedicine facilitates the expansion of healthcare by bridging the physical gap between consumers and healthcare providers thus reducing costs. Synchronous telemedicine entails consumers and healthcare providers interacting in real time by relying on communication technologies. For instance, video conferencing, where there is exchange of image and voice in real time, is increasingly becoming popular in telemedicine in the delivery of various healthcare and clinical services at a distance (Fatehi et al., 2014b). Verhoeven et al. (2010) systematically reviewed asynchronous and synchronous teleconsultations in diabetes and reported that these offer a reliable, cost-effective, and feasible solution for the delivery of diabetes care. Video conferencing is used in collaborative goal setting, nutrition counselling, self-management training, and diabetes education for patients (Siriwardena et al., 2012). According to Faruque et al. (2016), telemedicine is helpful in the provision of care t o individuals with diabetes especially those in rural areas who are unable to travel to healthcare facilities due to large distances. Therefore, telemedicine, especially teleconference, is a technological solution for managing diabetes for individuals in rural areas who are underserved by specialists. The next section explains the methodology used to obtain stakeholders’ views on the adoption and use of teleconferencing for diabetes management. Methodology This report collected data using interviews to understand the implementation of telemedicine for expanding access to healthcare services for people with diabetes in rural areas. The report included the views of various perspectives including patients, healthcare providers at the hospital, and in the rural areas to understand the adoption and implementation of this information system. Semi-structured interviews were conducted with these stakeholders in locations and time that were convenient for the stakeholders. The interview was based on the interview schedule found in Appendix 1. These interviews were digitally recorded followed by verbatim transcription. After transcription, the interviews were analysed using coding (Vaismoradi et al., 2016). The coding led to the identification of various thematic categories including the strategic intent of adoption of telemedicine, benefits of telemedicine, and challenges during implementation as explained in the section below. Findings and discussion Strategic intent of implementation of telemedicine The telemedicine intervention was adopted by the hospital after it was discovered that some of the patients from the rural areas were not coming for the follow- up appointments to get information on ongoing management of their diabetes. An endocrinologist at the hospital stated that: I noticed that some of my patients were not coming for their appointments†¦ I looked at their records and realised that they were unable to do so because they came from rural areas. Therefore, we had to find a way of ensuring they got the much-needed information and support to manage diabetes at home The hospital identified the need for providing cost-effective care for their diabetes patients in rural areas who were unable to access specialised care in their communities. The hospital considered the adoption of telemedicine as a way of providing quality care while minimising unnecessary patient admissions due to diabetes complications. Thus, this was a critical component of the hospital’s strategic intent. According to Coltman et al. (2015), having a strategic intent involves the allocation of resources and engaging in activities to assist in achieving their objectives. In line with this, the stakeholders at the hospital had to consider how the telemedicine program will improve access to healthcare for patients with diabetes in a cost-effective manner. The CEO of the hospital said that: We recognised that the telemedicine would provide us with an opportunity for providing the required care to our patients†¦ However, we had to consider the overhead costs to set-up the telemedicine infrastructure both on our side and the rural side. Additional funding was required for this initiative. The implication of this is that the hospital had to set aside funds for the telemedicine infrastructure and this entailed working with managers from the finance and IT departments. The manager from the IT department determined the costs of using telemedicine intervention in terms of initial costs and ongoing upgrades to achieve a sustainable system. The IT manager identified a cost-effective technological solution provider for the information systems that was required for the provision of diabetes care and support to patients from rural areas. The manager from the finance department and the CEO worked together in determining how to get the funding for this initiative. The initiative was funded using funds from the hospital’s contingency budget. Furthermore, the CEO of the hospital had to talk with administrators and nurses, and pharmacists in the rural areas to participate in the project as they critical to its success. This is captured in this statement â€Å"we realised th at we needed professionals on the ground to provide some aspects of the care. We approached healthcare providers to get their buy-in into this initiative’’ (hospital’s CEO). Therefore, the strategic intent of the hospital in the implementation and use of video-conferencing in reaching individuals with diabetes in rural areas and providing them with the necessary care reflects a strategic alignment between IT and business, particularly, strategy execution. Specifically, the hospital adopted a strategy execution alignment where the business strategy influenced the IT infrastructure, but this was constrained by the business infrastructure (Gerow et al., 2014). In other words, the hospital’s business strategy was to provide quality care in a cost-effective way to individuals with diabetes in rural areas. In turn, this strategy influenced the IT infrastructure in terms of the kind of technological solution required to meet the business strategy. Therefore, the hospital ended up selecting videoconferencing as the appropriate IT infrastructure. However, this was constrained by the hospital’s business infrastructure in terms of skills and processe s in the provision of diabetes care and support to individuals in rural areas. The telemedicine initiative involved using interactive video-conferencing between a multidisciplinary diabetes care team from the hospital and the patients in the rural homes. The multidisciplinary team consisted of diabetes specialists including diabetes education experts, nurses, endocrinologist, and ophthalmologist who provided personalised care to diabetes patients based on their clinical status. The patients were provided with tablets that allowed them to engage in video conferences with the multidisciplinary team on a daily basis. The patients shared with the specialists about their psychological, emotional, and physical health during the interactive video conferences. Furthermore, the patients’ health data including glucose levels, blood pressure, and weight were automatically captured by the tablets and transmitted on a daily basis to the clinicians. The outcomes of the consultation between the specialists and the patient were then communicated to the physician in the rural area to facilitate care coordination. According to a local physician, â€Å"the implementation of this initiative required a change in how care was delivered to individuals with diabetes†¦the hospital’s care team got in touch with me and communicated their daily consultations with patients to ensure that I was prepared to provide the necessary care at the local level†. This approach to the implementation of video-conferencing reflects strategic information systems planning to achieve alignment between the business and IT. In particular, this planning was characterised by the identification of the required IT applications together with the necessary change management, resources, and infrastructure for implementing the technological solution (Maharaj & Brown, 2015).Benefits of telemedicineThe diabetes specialists were positive on the potentiality of video-conferencing in enhancing and expanding access to diabetes services to individuals in rural areas to prom ote self-management of the disease. A diabetes education expert said that: This technology increased my ability to provide education on exercise and diet modifications to my patients by talking to them via the video-conference, and this has empowered our patients to manage their diabetes in their homes. Patients were enthusiastic that the telemedicine would support the clinical needs even though they had no or limited experiencing in using video-conferencing. Some of the patients stated that: I didn’t have experience when it comes to telemedicine. But, I knew that it would be benefit me by providingwith ongoing support and information for diabetes management at home (patient 1) I had never used video conference before, but it provided me a way to talk with the physician and get timely advice and guidance on managing my diabetes (patient 2) In recognition of the limited experience that patients had in video-conferencing, the hospital’s IT department together with the external technological solution provider offered the required training. According to the IT manager at the technological solution provider: We collaborated with the hospital’s IT department in sending out individuals to provide training to the patients. The patients were taught on how to use the video conference system and provided with the necessary equipment. The stakeholders highlighted the benefits of video-conferencing for diabetes management for the patients in the rural areas. The statements below capture some of the stakeholders’ perspectives. During the video-conferences, we used the daily clinical status reports of the patient, and we were able to discuss appropriate interventions to implement with the patient. This benefitted the patients because they got personalised interventions, information, and support (Hospital endocrinologist). I got e-prescriptions from the healthcare team, and when the patients picked their medications, I talked to them about complying with their medications. By collaboratively working with the healthcare team, the quality of care of patients improved in terms of medication compliance (Rural Pharmacist) The use of video conference has contributed to preventing unavoidable admissions for diabetes for these patients. The daily support and education they got from us has improved care coordination and connections between the patients and us to minimise the use of emergency departments (Hospital ophthalmologist) A few months after the implementation of this project, we had seen a reduction in the admission of patients with diabetes in our area (Rural physician) I had problems before in controlling my diabetes because I did not have access to the kind of doctors who provide the necessary care†¦ but this changed with the daily video conferences (Patient 3) I am satisfied with information and guidance I get from the consultations with the doctors each day in managing my diabetes. I no longer need to travel to the hospital to get the care I need (Patient 4) The stakeholders’ perspectives highlight the impact of teleconferencing on the delivery of healthcare services to diabetes patients in rural areas. These perspectives have received support in literature. For instance, patient satisfaction is highlighted in the study by Fatehi et al. (2015) in an assessment of patient satisfaction levels with remote consultations for diabetes via video conference in a virtual outreach clinic using a cross-sectional survey. The results revealed that the patients were generally satisfied with remote consultation as they had no problem with building rapport with the clinical specialists over video conferences (Fatehi et al., 2015). Furthermore, the positive impact of telemedicine on the management of diabetes has been shown in the literature. Specifically, Huang and colleagues (2015) carried out a systematic review and meta-analysis of randomised controlled trials on the impacts of telecare intervention on glycaemic control in type 2 diabetes. I t was demonstrated that patient monitoring by telecare demonstrated significant improvement in glycaemic control in comparison with patients monitored by routine follow-up (Huang et al., 2015). Weinstock et al. (2011) also found that improvement in glycaemic control related to telemedicine was sustained over a period of five years among medically underserved patients with diabetes. In their randomized controlled trial, Steventon et al. (2014) discovered that telemedicine led to modest improvements in glycemic control among patients with type 2 diabetes over 12 months. Self-management as a critical aspect of diabetes management in telemedicine has been investigated by Young et al.(2014) who focused on the effect of person-centred health behaviour coaching model delivered through telehealth with patients with diabetes living in underserved, rural communities was assessed. The results showed that the interventions led to significantly higher scores in self-efficacy, which supported self-management of the disease (Young et al., 2014). According to Steventon et al. (2014), the greater self-care and oversight related to telemedicine might lead to fewer unplanned hospital admissions.Challenges during implementationImplementation of the technological solution was accompanied by some challenges. One of the major challenge identified by the stakeholders was unanticipated technical issues. This is explained by the IT manager at the hospital: Sometimes the video conferences failed because of a drop in the internet connection. This meant that the encounter could not take place. When this occurred, communication occurred via cell phones to address important issues. The technical issues had a negative impact on the interactions between the patients and diabetes care team. According to the endocrinologist, Sometimes in the middle of the video-conference, the connection dropped. I could wait till past the time I had allocated for that specific consultation. Mostly, by the time the connection was up again, I would be consulting with a different patient at the hospital, and I missed my encounter with the patient in the rural area. In those cases, I worked with the rural nurses via a cell phone to communicate important information about the patient. Technical difficulties in teleconference are due to problems with accessing broadband in rural areas, which is still lagging behind urban areas. Patients’ homes might lack high-speed cable internet that has more bandwidth capabilities and a highly reliable signal, and this causes connection problems during video conferencing (Batsis, Pletcher & Stahl, 2017). Schulz et al. (2014) reported in their study that 25% of all video conferences consultations experienced a drop in internet connection. Consequently, it is suggested that unanticipated technical issues with implementing teleconferencing should be anticipated and this highlights the importance of providing strong IT support with ongoing updates in protocols for patients in rural areas (Slusser et al., 2016). Another challenge reported was issues with reimbursements. This was identified by the finance manager at the urban hospital. She said that: I had problems with suitable billing of encounters between the patients and the doctors and capturing this. Sometimes, I billed an encounter, but the insurer failed to pay or took longer to do so. I had to go through convincing them [insurers] that the consultation actually occurred by talking with the patient and pharmacists or nurses in the rural areas for confirmation. One of the patients also talked about this issue by stating that, â€Å"after talking with the doctors on the video conference they tell you to pick up the drugs at your pharmacy and when you get there, you are told there are problems with your insurer in terms of payment. I had to call my insurer to follow up and address this issue’’ (patient 5). According to Batsis et al. (2017), low reimbursement is a problem for the lasting sustainability of telemedicine systems in a fee-for-service model. This problem is due to limitations that are placed on the type of telemedicine covered by health insurers. Conclusion In conclusion, this report has focused on the strategic information systems in expanding the health service in rural areas. This has been achieved by examining the implementation of video-conferencing between individuals with diabetes and diabetes specialists in the provision of diabetes care to patients in rural areas. This report has highlighted how the hospital ensured alignment between its business strategy of providing cost-effective diabetes care to individuals with diabetes in rural areas and the use of the video-conferencing as its IT infrastructure. The hospital had to plan for its strategic information systems by identifying the appropriate IT infrastructure, processes, and changes to how care was delivered to the targeted population in rural areas. The analysis revealed how the implementation of video-conferencing addressed the interests of the different stakeholders including the hospital, diabetes specialist care team from the hospital, the patients, and healthcare pro viders at the local level. Thus, the implementation of this technological solution was beneficial to all the stakeholders. Overall, this report highlights how strategic information systems are vital in the expansion of health service in rural areas. References Arvidsson, V., Holmstrom, J., & Lyytinen, K. (2014). 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Appendix 1: Interview Schedule Please explain why the hospital decided to implement videoconferencing in providing diabetes care to individuals in rural areas What was involved in the planning for the implementation of the technological solution Did the hospital work with external stakeholders in the implementation process How did the implementation of the technological solution affect the aims of the hospital and its specialist clinicians How has the use of videoconference affected your (patient) access to diabetes care Were there any challenges that were experienced during this processIf so, which ones To obtain answers to these questions and/or get a Custom Essay for you research, feel free to reach out to us and place an order today.