Technology

ATM Healthcare? The Way of the Future?

By Peter Yellowlees  |  2010/07/05 20:58 Posted in Health Care  |  Comments (0)

Doctors are starting to redesign the way they work to link better with patients and to use the newly available multi-media technologies. This is an important process that will undoubtedly accelerate over the next 20 years. There is a need to substantially redesign many of the traditional processes used to practice medicine – and move to new ways of delivering health services, using what I call ATM Healthcare.

What, then, is ATM Healthcare?

When we think of the term ATM, most of us think of banks. The acronym ATM has entered our language so completely that many people don’t even know what the letters stand for – they just know that undertaking an ATM transaction allows money to be drawn direct from their bank account, not from a credit account, and that they can do this at a special ATM machine usually in the street, or at a store checkout. ATM stands for Automated Teller Machine and is simply a direct electronic entry to your bank and your accounts. And it is very simple, convenient and consumer friendly. ATM has made banks and bank accounts much more accessible to customers, wherever and whenever they want. At the same time they have made the work of banks more efficient while dramatically cutting the cost of bank transactions to a few cents from an average of $10-15 per face to face transaction with a teller. This has happened because ATM machines now manage most of the simple bank transactions that used to take up a lot of the time of tellers. This frees up bank staff to spend more time on complicated transactions where human expertise is required. Who can now imagine a bank without widespread ATM facilities? And all this has happened in just a few years.

Computer scientists think of ATM in a very different way. For them ATM is a technical term describing how data can be passed across an electronic network. Here ATM stands for a protocol called Asynchronous Transfer Mode. This protocol was designed as a way of merging old telephone networks with more modern packet-switched computer networks in order to deliver data, voice, and video over the same channel. In other words it allows all sorts of differing data, from varying data sources, to be delivered at the same time.

So what have these two types of ATM have to do with healthcare?

Think of the obvious parallels.

The doctor-patient consultation is in many ways similar to the traditional bank interaction with a teller. It is confidential, about 80% of consultations are relatively simple, and if complications arise, a second person can be called in to give specialist advice. There are also parallels with the computer scientist ATM, because this consultation nowadays involves typically several different types of data – voice, lab results, paper and electronic documents (health records), and increasingly video and digital images. The consultation itself can be described in both computer language and clinical terms as consisting of three information processes ? data capture (history and examination), data analysis (diagnosis), and business planning (treatment).

What we in healthcare need to do is start thinking like bankers, and focus on providing our services in a more consumer friendly way. As we do this, doctors need to follow two core principles. The first is the complementarity principle – computers do well, what humans do badly, and vice versa. Computers never forget, and are great at scheduling, remembering and reminding, but humans are much better at data analysis and decision making. So computers should be able to do many simple health transactions, remember and order prescriptions and lab tests, schedule appointments, and provide preventative health information. The second principle is the importance of redesigning business processes before introducing new technologies. There are a lot of similarities between banking and the practice of medicine. And doctors can learn from bankers in this area. There is no reason why we should not introduce ATM Healthcare, in just the same way as bankers have introduced ATM Banking.

What would ATM Healthcare look like?

Firstly, lets assume that, like banking, ATM Healthcare is going to be used for relatively straightforward consultations in many specialities, and will not replace the complicated face to face consultation or intervention that makes up about 20% of overall medical consultations, and will always remain the health “gold standard” consultation. We already have most of the tools of ATM Healthcare at our disposal. Electronic Medical Records, lab results and x-ray images are the health equivalent of bank statements. Telemedicine – video consulting either in real time (synchronous), or delayed time (asynchronous) – is now a proven technology, is already available in some supermarket clinics, and is the equivalent of the teller machine. Email and wireless telephony provide more mobile access to providers, and the whole internet is an amazing educational and clinical communication platform that is already delivering all sorts of ATM Healthcare. We have lots of systems to combine different types of data and present them simultaneously to doctors and patients, just as per the computer scientists version of ATM.

Patients need to encourage doctors to think of ways of redesigning their practice processes to make better use of available multimedia technologies so that they can continue to provide better and more available care. I am sure this will happen, especially as more of the younger generations start receiving care. They will demand that doctors use these technologies, and increasingly change their ways, and hopefully use the example of banking as we move increasingly to ATM Healthcare.

This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together,” by Peter Yellowlees MD. Available at http://www.InformationAgeHealth.com and most online bookstores. An e-Book called “4 simple steps to better health – an insiders look” is available at Smashwords at http://www.smashwords.com/books/view/1271

Author: Peter Yellowlees
Article Source: EzineArticles.com
Humorous photo captions

Healthcare Reform – What About Us?

By Linda Rosenberg  |  2010/07/02 20:30 Posted in Health Care  |  Comments (0)

In recent times, there have been extraordinary events that put a pause on routine and threw our country into animated conversation but they have mostly been about bad news – 9/11, the invasion of Iraq and most recently the Wall Street bailout. The election was neither bad news nor a distraction like a celebrity meltdown, it actually mattered. And as a result of this incredible election season, America’s children have a chance to grow up unaware that there’s anything unusual about an African-American President or a woman running for the White House.

2008 Legislative Success
Now, it’s over – the excitement, the soaring and in some cases snoring oration, the primaries and the debates – the Presidential campaigns are over. It was my great good fortune to attend the Democratic National Convention and to have affirmed in speeches and by actions that our community has indeed made progress. We had Senator Kennedy’s bittersweet appearance and his steadfast commitment that was so critical to the passage of parity; Michelle Obama’s unexpected reference to mental health when she talked about universal healthcare; Bill Clinton’s description of a mom struggling with her sons’ autism; the first ever “recovery room” at a convention; and a luncheon honoring the Campaign for Mental Health Reform that included A list celebrities as well as national and state political leaders all vocal in their support of accessible, affordable mental health and addiction treatments.

The rhetoric of the convention was matched by an extremely successful legislative year: the delay of damaging Medicaid rules on rehabilitative services and targeted case management and the introduction of the Medicaid Services Restoration Act; the passage of Medicare parity; veterans legislation that extends mental health and addictions services beyond the VA out to communities; improved collaboration between criminal justice and mental health; expansion of the disability definition in the ADA making it easier for people with disabilities to obtain protection against disability-based discrimination; and the passage of parity ending health insurance discrimination.

It is a hopeful time for people with disabilities. Our string of legislative and policy successes reflects tremendous progress. And substance use and mental health advocates – united by the Presidential campaign – can share a path forward into a new era.

The Economy and Service Capacity
But times are tough in communities across the country – and the world, people losing their jobs, their homes and their retirement savings. Many of us at the National Council have spent these last few months traveling from state to state and community to community. And we return from these trips filled with anxiety.

As states attempt to manage their budgets in a very fragile economy, increased demand for mental health services could be on a collision course with impending cuts to publicly funded services. Our already tattered mental health and addictions safety net is in grave danger of collapsing as unemployment rates soar, anxiety over the future grows and demand for services is at an all time high.

We urge states to resist cutting essential mental health and addictions services and we’re lobbying for federal stimulus packages that include Medicaid relief and financial supports so that communities can meet treatment demand in the difficult months and perhaps years ahead. At the same time, our industry -the behavioral healthcare industry – has to be ready to work with the greatest efficiencies and be accountable for every taxpayer dollar. And the National Council’s proud of the initiatives – our Access and Retention, Six Sigma and Process Benchmarking projects -that we’ve introduced to support member efforts to streamline access, creating more treatment capacity and more effectively engaging consumers and communities in the recovery process.

Our Role in a Progressive Era
Now the question being asked is what’s our role in a new administration, in a new era? One of President elect Obama’s challenges will be to harness the extraordinary idealism that he inspired in his campaign to a larger, national cause. We appear to be leaving behind the conservative agenda and entering a progressive era. A progressive era being shaped by the millenniums with their internet culture and by a new breed of the very rich that are using their wealth to support progressive causes and demanding accountability in return for philanthropy.

But even in a new era, the reality, pace or shape of healthcare reform – is uncertain. Washington is already abuzz with health care groups lobbying their points of view and potential candidates for healthcare posts in the new administration polishing their resumes. But economics, politics, and history suggest that any major overhaul of our healthcare delivery system will be a difficult process at best. Healthcare is now bigger than the “military-industrial complex” about which we were warned in 1950s, 1960s and 1970s; and there’s no sector of the economy with more politically powerful special interests.

To date behavioral healthcare’s progress has received little mainstream attention. And our community has a good story to tell. While healthcare costs have skyrocketed, our services, historically underfunded, have seen little increases. Richard Frank, Harvard economist and co-author of Better But Not Well, uses data from the National Co-morbidity Survey to make the case that more money is being spent on mental health but mental healthcare’s share of GDP is constant and its share of health spending is declining while access, quality, and supports for people with mental illnesses have increased. We have data that tells a compelling story; and science that supports return on investment. So what about us?

It’s almost a sure bet that the next administration will include treatments for mental illnesses and addictions in any expansion of health coverage. We’ll be included in movement towards universal coverage, whether incrementally like the re-authorization of SCHIP or as part of more comprehensive reform like the plan offered by Ezekiel Emanuel (Dr. Emanuel, who is invited to speak at the National Council’s conference in San Antonio, is the brother of Obama’s new chief of staff Rahm Emanuel) in Health Care Guaranteed. But will inclusion in universal coverage strategies or general reform solve the fundamental problems we face? At best, reform will enable us to begin to solve our own problems.

Mental healthcare shares the problems of the larger healthcare system; and like health care suffers unintended policy consequences. We threw medicine out with the medical model, now we’re talking as if we’ve just discovered that mental health is fundamental to health and the result is people with serious mental illnesses are dying far too young. We brought Medicaid into every possible service, promoted decentralization and the marketplace, and now we’re faced with the same consequence – fragmentation.

Over the years, risk and responsibility have been downloaded from states to community organizations without the resources needed to keep pace with mental health, addiction and co-occurring treatment advances; without the resources to create organizational infrastructure that supports planned change; and without the resources needed to coordinate and ensure good general medical care for people with serious mental illnesses. Instead of investing in quality services, states have introduced intermediaries to manage what they still call their “system” – the result is a deskilled workforce and business as usual.

And in some cases, providers have lost the trust of their communities. As they’ve been increasingly relegated to and paid for only the treatment of people with the most serious mental illnesses, their communities have been left adrift. Mental health prevention and early intervention were very much part of the original concept of community based mental health care. We justified eliminating the funding for those services by labeling them as dollars wasted on the “worried well”.

Serving your community means running a receptive and responsive organization: flexible hours that fit the schedules of people who work; emergency availability; and a presence in all aspects of the community where help is needed – schools, jails, senior centers, foster homes, and on and on. It also means offering one stop shopping, sending people to multiple sites of service doesn’t work very well and doesn’t work at all when there is little to no coordination.

Can we transform ourselves into organizations that will be propelled by a progressive agenda and supported by new coalitions? I think the question is answered by another question. Can we offer a vision of communities increasingly free from addictions and mentally fit; a vision of communities where those with histories of addiction and mental disorders are included not excluded from mainstream life; and can we be accountable for the quality of services we provide – with national standards and practices? Can we do as education has done, combine vision with accountability? If the answer is yes, then perhaps the new entrepreneurial philanthropy will be by our side and perhaps one day President-elect Obama will write about the staff in behavioral health as he writes about teachers in The Audacity of Hope, “There’s no reason why an experienced, highly qualified, and effective teacher shouldn’t earn $100,000 … teachers in such critical fields as math and science – as well as those willing to teach in the toughest urban schools – should be paid even more.”

An Actionable Agenda
But even as we think big thoughts about health care reform, the National Council remains practical and ready to move an actionable agenda.

We need to be accountable for continuity of care for people with serious mental illnesses and addictions. The National Council’s Health care Collaborative Project successfully brings together behavioral health and primary care organizations offering a bi-directional approach for care, addressing the integration of primary care services in behavioral health settings as well as the need for behavioral health services in primary care. But far too often when the patient walks out the door, our responsibility ends – from hospital to community, from mental health to addiction treatment center to primary care, from the streets to the jails – we’ve created an array of disconnected even if well intentioned services. People with chronic illnesses and chronic problems need a home; and science has taught us that mental and addiction disorders are often chronic conditions. The patient-centered medical home – that provides care management; shifts the focus from episodic acute care to managing the health of those living with chronic health conditions; and emphasizes self-care that resonates with our recovery and resilience orientation – is a model we can embrace. And at the community level the idea of behavioral health care organizations providing a “health care home” for people with serious mental illnesses and addictions makes a lot of sense.

We need cost based plus financing that supports clinical excellence – skilled staff delivering nationally recognized practices within organizations that live by the rule, if you don’t measure it you can’t improve it. People want and deserve high quality services but services depend on the staff skill, and skilled staff must be adequately compensated. Low salaries have created-and are perpetuating-a recruitment and retention as well as a quality crisis for behavioral health care. We need organizations and staff that can provide state of the science behavioral health interventions, can treat and triage general health disorders and can lead site of service performance improvements. The public increasingly accepts that mental illnesses and addictions are treatable disorders and that recovery is possible. Now we must be sure that there are effective organizations and skilled practitioners.

We need a federal mental health funding stream dedicated to mental health and integrated treatment services for the uninsured. The uninsured have exceptionally high rates of untreated mental illnesses with co-occurring addiction disorders and there is no safety net. State general fund mental health dollars were reallocated to the Medicaid match. And now state plans to cover the uninsured are floundering. We have large numbers of individuals with treatable mental illnesses in our overburdened emergency rooms, in jails and on the streets …and without access to the services that can engage them, treat them and return them to work. We’re denying our economy productive taxpayers. We’re wasting human lives.

We need a pool of funds to support investments by behavioral health care organizations in information technology. We talk about information technology and service transparency yet organizations that move forward to automate their clinical systems find little available support, funding, or technical assistance. A September 2006 National Council poll of community behavioral health care providers across the country indicated that 8 percent had implemented an EHR system with clinical components fully functioning. Technology offers critical support to the service improvement process; promotes the application of protocols and guidelines; helps maintain contact with individuals who move through complex systems; and holds the promise to reduce the enormous financial burden of paperwork and reporting duplication-all efficiencies that improve service quality. The time has come to walk the technology talk.

We must have increased emphasis on and greater funding for research-based education and prevention practices. We have prevention and education programs that work. Research-based prevention programs that reduce the risk of childhood serious emotional disturbance by treating maternal depression; and the Nurse-Partnership Program that has an array of consistent positive effects across multiple trials. We have research-based education programs that increase mental health literacy like Mental Health First Aid. The National Academies Institute of Medicine report to be issued later in 2008 is expected to underscore the importance of greater emphasis on prevention and health-promotion practices that can impede the onset or reduce the severity of mental health and substance-use disorders in children, youth and young adults. This report presents an excellent opportunity to place prevention practices on the new Administration’s table.

The “Key Contact” Club
We can provide healthcare homes for people with serious mental and addictive disorders; we can ensure a skilled workforce, effective organizations and quality care; we can help those that are mentally ill and uninsured become productive members of their communities; we can employ the promise of technology; and we can bring research-based prevention and education to our communities. But we know from our ’08 successes that we cannot do any of these things without the leadership of our members – members that have real impact, tackling what can appear to be intractable problems. We have a vision, we have an agenda, and we have a “key contact” strategy.

Under the direction of Chuck Ingoglia, our VP, Public Policy, our strategy is to establish and track a key contact system – a network of members, their boards, consumers and families who have good, and soon to be better, relationships with members of Congress. Key contacts must be committed to meeting with the elected officials and to keeping us updated on these contacts. Our plan is to have a key contact in every congressional district. We’re taking what has been an ad hoc arrangement of our members reaching out to Congress and nurturing what we hope will be a formidable rolodex.

When change is being debated in Congress, we will be there. We’ll leave behind references to a system in shambles; we’ll lead with data; with our history as good managers of public dollars; and with an actionable agenda. But we need you at our side, as John F. Kennedy said so very long ago, “Political action is the highest responsibility of a citizen.”

I look forward to hearing from you and to your involvement in the “key contact” club.

Linda Rosenberg leads the National Council for Community Behavioral Healthcare in treating children, adults and families with mental illnesses and addiction disorders across the country. She holds faculty appointments at several schools of social work. http://www.thenationalcouncil.org/

Author: Linda Rosenberg
Article Source: EzineArticles.com
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Healthcare Information Technology – Business Valuation

By Dave Kauppi  |  2010/06/29 20:11 Posted in Health Care  |  Comments (0)

One of the most challenging aspects of selling a healthcare information technology company is coming up with a business valuation. Sometimes the valuations provided by the market (translation – a completed transaction) defy all logic. In other industry segments there are some pretty handy rules of thumb for valuation metrics. In one industry it may be 1 X Revenue, in another it could be 7.5 X EBITDA.

Since it is critical to our business to help our healthcare information technology clients maximize their business selling price, I have given this considerable thought. Why are some of these software company valuations so high? It is because of the profitability leverage of technology. A simple example is what is Microsoft’s incremental cost to produce the next copy of Office Professional? It is probably $1.20 for three CD’s and 80 cents for packaging. Let’s say the license cost is $400. The gross margin is north of 99%. That does not happen in manufacturing or services or retail or most other industries.

One problem in selling a small healthcare technology company is that they do not have any of the brand name, distribution, or standards leverage that the big companies possess. So, on their own, they cannot create this profitability leverage. The acquiring company, however, does not want to compensate the small seller for the post acquisition results that are directly attributable to the buyer’s market presence. This is what we refer to as the valuation gap.

What we attempt to do is to help the buyer justify paying a much higher price than a pre-acquisition financial valuation of the target company. In other words, we want to get strategic value for our seller. Below are the factors that we use in our analysis:

1. Cost for the buyer to write the code internally – Many years ago, Barry Boehm, in his book, Software Engineering Economics, developed a constructive cost model for projecting the programming costs for writing computer code. He called it the COCOMO model. It was quite detailed and complex, but I have boiled it down and simplified it for our purposes. We have the advantage of estimating the “projects” retrospectively because we already know the number of lines of code comprising our client’s products. In general terms he projected that it takes 3.6 person months to write one thousand SLOC (source lines of code). So if you looked at a senior software engineer at a $70,000 fully loaded compensation package writing a program with 15,000 SLOC, your calculation is as follows – 15 X 3.6 = 54 person months X $5,800 per month = $313,200 divided by 15,000 = $20.88/SLOC.

Before you guys with 1,000,000 million lines of code get too excited about your $20.88 million business value, there are several caveats. Unfortunately the market does not care and will not pay for what it cost you to develop your product. Secondly, this information is designed to help us understand what it might cost the buyer to develop it internally so that he starts his own build versus buy analysis. Thirdly, we have to apply discounts to this analysis if the software is three generations old legacy code, for example. In that case, it is discounted by 90%. You are no longer a technology sale with high profitability leverage. They are essentially acquiring your customer base and the valuation will not be that exciting.

If, however, your application is a brand new application that has legs, start sizing your yacht. Examples of this might be a click fraud application, Pay Pal, or Internet Telephony. The second high value platform would be where your software technology “leap frogs” a popular legacy application. An example of this is when we sold a company that had completely rewritten their legacy management platform in Microsoft.Net. They leap frogged the dominant player in that space that was supporting multiple second generation solutions. Our client became a compelling strategic acquisition. Fast forward one year and I hear the acquirer is selling one of these $100,000 systems per week. Now that’s leverage!

2. Most acquirers could write the code themselves, but we suggest they analyze the cost of their time to market delay. Believe me, with first mover advantage from a competitor or, worse, customer defections, there is a very real cost of not having your product today. We were able to convince one buyer that they would be able to justify our seller’s entire purchase price based on the number of client defections their acquisition would prevent. As it turned out, the buyer had a huge install base and through multiple prior acquisitions was maintaining six disparate software platforms to deliver essentially the same functionality.

This was very expensive to maintain and they passed those costs on to their disgruntled install base. The buyer had been promising upgrades for a few years, but nothing was delivered. Customers were beginning to sign on with their major competitor. Our pitch to the buyer was to make this acquisition, demonstrate to your client base that you are really providing an upgrade path and give notice of support withdrawal for 4 or 5 of the other platforms. The acquisition was completed and, even though their customers that were contemplating leaving did not immediately upgrade, they did not defect either. Apparently the devil that you know is better than the devil you don’t in the world of healthcare information technology.

3. Another arrow in our valuation driving quiver for our sellers is we restate historical financials using the pricing power of the brand name acquirer. We had one client that was a small healthcare IT company that had developed a fine piece of software that compared favorably with a large, publicly traded company’s solution. Our product had the same functionality, ease of use, and open systems platform, but there was one very important difference. The end-user customer’s perception of risk was far greater with the little IT company that could be “out of business tomorrow.” We were literally able to double the financial performance of our client on paper and present a compelling argument to the big company buyer that those economics would be immediately available to him post acquisition. It certainly was not GAP Accounting, but it was effective as a tool to drive transaction value.

4. Financials are important so we have to acknowledge this aspect of buyer valuation as well. We generally like to build in a baseline value (before we start adding the strategic value components) of 2 X contractually recurring revenue during the current year. So, for example, if the company has monthly maintenance contracts of $100,000 times 12 months = $1.2 million X 2 = $2.4 million as a baseline company value component. Another component we add is for any contracts that extend beyond one year. We take an estimate of the gross margin produced in the firm contract years beyond year one and assign a 5 X multiple to that and discount it to present value.

Let’s use an example where they had 4 years remaining on a services contract and the last 3 years were $200,000 per year in revenue with approximately 50% gross margin. We would take the final tree years of $100,000 annual gross margin and present value it at a 5% discount rate resulting in $265,616. This would be added to the earlier 2 X recurring year 1 revenue from above. Again, this financial analysis is to establish a baseline, before we pile on the strategic value components.

5. We try to assign values for miscellaneous assets that the seller is providing to the buyer. Don’t overlook the strategic value of Blue Chip Accounts. Those accounts become a platform for the buyer’s entire product suite being sold post acquisition into an “installed account.” It is far easier to sell add-on applications and products into an existing account than it is to open up that new account. These strategic accounts can have huge value to a buyer.

6. Finally, we use a customer acquisition cost model to drive value in the eyes of a potential buyer. Let’s say that your sales person at 100% of Quota earns total salary and commissions of $125,000 and sells 5 net new accounts. That would mean that your base customer acquisition cost per account was $25,000. Add a 20% company overhead for the 85 accounts, for example, and the company value, using this methodology would be $2,550,000.

7. Our final valuation component is what we call the defensive factor. This is very real in the healthcare information technology arena. What is the value to a large firm of preventing his competitor from acquiring your technology and improving their competitive position in the marketplace. One of our clients had an outcomes database and nurse staffing software algorithm. The owner was the recognized expert in this area and had industry credibility. This was a small add on application to two large industry players’ integrated hospital applications suite. This module was viewed as providing a slight features advantage to the company that could integrate it with their main systems. The selling price for one of these major software systems to a hospital chain was often more than $50 million. The value paid for our client was determined, not by the financial performance of our client, but by the competitive edge they could provide post acquisition. Our client did very well on her company sale.

After reading this you may be saying to yourself, come on, this is a little far fetched. These components do have real value, but that value is open to a broad interpretation by the marketplace. We are attempting to assign metrics to a very subjective set of components. The buyers are smart, and experienced in the M&A process and quite frankly, they try to deflect these artistic approaches to driving up their financial outlay. The best leverage point we have is that those buyers know that we are presenting the same analysis to their competitors and they don’t know which component or components of value that we have presented will resonate with their competition. In the final analysis, we are just trying to provide the buyers some reasonable explanation for their board of directors to justify paying 8 X revenues for an acquisition.

Dave Kauppi is the editor of The Exit Strategist Newsletter, a Merger and Acquisition Advisor and President of MidMarket Capital, representing owners in the sale healthcare and technology based businesses. We provide Wall Street style investment banking services to lower mid market companies at a size appropriate fee structure.

Author: Dave Kauppi
Article Source: EzineArticles.com
Digital economy, mobile technology

How to Manage Your Sales With CRM Software

By Flaminio Ranzato  |  2010/06/28 19:58 Posted in Open Source  |  Comments (0)

Using a CRM software, CRM is the acronym of Custom Relationship Management, is a must for all those enterprises that want to retain their customers and want to grow their business. There are many software solutions and some are also free, the most important are: Vtiger CRM, CRMadar, Anteil open-source CRM and the Open Source by Sugar CRM; VTiger and the Open Source by Sugar CRM offer multilingual support while the other have only the english version.

Vtiger CRM, based on Sugar CRM’s engine, allows you to manage customers, documents, lists, marketing and sales; gives also a statistical report about sales and marketing results. Working on web platform needs a server, linux is recommended, along with PHP and a MySQL database.

CRMadar manages customers, documents, marketing and gives a statistical report on marketing results. Works on a Windows computer.

Anteil Open-Source CRM allows to administrate customers, internal communications, marketing and sales; also has an event’s recording but doesn’t give statistical services. Needs a computer with Linux.

Last the Open Source by Sugar CRM allows to manage calls, customers, documents, marketing, offers and also gives statistical reports about sales and marketing. Has the same technical requirements of vTiger since they are based on the same technology.

We have seen that all listed software allows to manage marketing and by this is meant the management of marketing campaigns while for marketing statistics is meant a statistical report about such campaigns and their results and this feature is not included in every software.

These free softwares are anyway fully working though if they have their limitations compared to the paid versions, they can be good for the little enterprises that don’t have a huge amount of datas to analyze. It’s also true that when the business grows it will be requires to have more powerful tools that are offered by the CRM paid versions.

If you have a certain experience in computer programming and since these software, with the exception of CMadar, are released as open-source then you can modify them to meet your specific needs. Surely CRM software is a tool that allows to analyze productivity and shows where it needs to be improved: topics as customer’s retaining, the creation of sales pages that turn vistors into customers and the generation of sales motivation have a great importance. PubblicitAdvertising is a website that teaches you how to grow your web traffic and your online and offline productivity.

PubblicitAdvertising is a website that teaches you how to grow your web traffic and your online and offline productivity: PubblicitAdvertising [http://www.pubblicitadvertising.com/english]

Author: Flaminio Ranzato
Article Source: EzineArticles.com
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California Job Outlook – Healthcare Workers in Huge Demand

By Dotty Zukoff  |  2010/06/26 19:51 Posted in Health Care  |  Comments (0)

Temperature is right for Healthcare Opportunities

A healthcare career might be just the cure for your occupational woes. Whether it’s working with patients, being a key contributor in a medical office team, or opening up your own business, healthcare is a satisfying, challenging and exciting career choice. And there’s never been a better time to train for a healthcare position. With the aging of the baby boomers (those born between 1946 and 1964), a shift from inpatient to outpatient care, and the expansion of healthcare centers, the demand for healthcare workers is expected to increase in the years to come, especially in California.

Below are the fastest growing Healthcare Careers in California:

*Dental Assisting*

Average Annual Wage: $31,985

2002-2012 Job Growth: 57%

Future Career Paths: Dental Hygienist, Licensed Vocational Nurse

*Health Claims Examiner/Medical Biller*

Average Annual Wage: $31,772

2002-2012 Job Growth: 41%

Future Career Paths: Medical Coder, Insurance Adjuster

*Massage Therapy*

Average Annual Wage: $36,340

2002-2012 Job Growth: 21%

Future Career Paths: Physical Therapist, Day Spa Manager

*Medical Assistant*

Average Annual Wage: $28,890

2002-2012 Job Growth: 46%

Future Career Paths: Licensed Vocational Nurse, Medical Coder

*Optical Dispensing*

Average Annual Wage: $32,441

2002-2012 Job Growth: 23%

Future Career Paths: Store Owner, Manufacturers Sales Rep

*Pharmacy Technician*

Average Annual Wage: $33,632

2002-2012 Job Growth: 31%

Future Career Paths: Occupational Therapy Assistant, Dietetic Technician

*Surgical Technology*

Average Annual Wage: $40,178

2002-2012 Job Growth: 36%

Future Career Paths: Central Supply Mgr, Asst. Operating Room Admin.

*Diagnostic Medical Sonagraphy*

Average Annual Wage: $60,908

2002-2012 Job Growth: 21%

Future Career Paths: Physician’s Assistant, Medical Technologist

** Salaries listed above are average annual wages reported by the Employment Development Department of the State of California and do not reflect entry level salaries for the healthcare positions listed.

Key Success Factors

Do you have a genuine desire to help people? Then chances are you’ll be successful as a healthcare professional. The four other critical skills you’ll need to succeed in health care are:

o Team player. Healthcare is a group activity, so people skills and teamwork are essential.

o Compassionate and caring. Helping take care of people requires patience and a service-orientated attitude.

o Comfortable in any setting. You might be part of a huge organization or a small staff, working at the local, state, regional or national level. The possibilities are endless.

o Desire for lifelong learning. You’ll need to keep studying and learning throughout your career to keep up with the latest developments in the field.

Healthcare provides a helping hand

Healthcare professionals are essential when it comes to caring for the physical, mental, social and emotional wellbeing of individuals. Whether you’re a health information specialist or a dental receptionist, all support staff play a vital role in patient care. As an important contributor to the healthcare system, you’ll need to be able to establish trust and credibility with fellow workers and patients. Good communication skills, ability to follow directions, and strong listening ability are important, especially if you’re working in a clinical environment.

Technical abilities are a must

Technology has altered the practice of healthcare. No matter what the healthcare field, an ability to work with computers and high-tech equipment is a powerful asset. As a medical biller, you will probably be asked to help process some claims electronically. Medical clinical assistants may need to deal with an Electronic Medical Record. Pharmacy technicians often operate automated pill dispensers. But if you’re unfamiliar with such tools, don’t worry–your all-important career college will help introduce you to these concepts.

Exciting environments

Is it any wonder that shows like NBC’s “ER” and “Scrubs,” and CBS’ “Rescue 911,” have been so popular? They show the drama of medicine and the reality of life-and-death situations. Healthcare is filled with stimulating and interesting interactions. Of course, big-city hospitals bustle with activity, but even a quiet suburban assisted living facility, chiropractic office, retail pharmacy, HMO, or medical clinic have everyday drama and fascinating daily interactions. If you like a variety of tasks, work well under stress, and take pride in doing a job well done, then you have what it takes to be a valuable member of the healthcare team.

Lifelong learning

Medical-related workplaces have always been settings that support and encourage professional growth and development. Opportunities for on-the-job training and continuing education abound, and often employers will subsidize your schooling. You’ll also have lots of opportunities for advancement, so your ambition will serve you well in a healthcare profession. If you’re interested in a career like massage therapy, be assured that complementary and alternative medicines are being integrated into conventional healthcare systems, offering you even greater opportunities. No matter what your area of interest, be sure you start out at a school that provides a positive learning environment and is prepared to help you launch your career in this exciting arena.

Reality check

Although not every healthcare professional works with patients, those who do will find that people are sicker, older, and living longer, often with chronic diseases. Keeping a positive attitude is key for maintaining a cheerful office or clinic. Are you up to the challenge? Being a paid caregiver requires confidence, commitment and compassion.
Summary

The clock never stops ticking in the healthcare profession. Perhaps it’s time for you to join this financially rewarding, stable and gratifying occupation. One recent study showed that California led other states in the number of advertised healthcare job vacancies, with other regions also showing a strong demand across the nation.

One healthcare worker said it best: “Touching someone’s life in a positive way is the most rewarding work that there is.”

To request free information about the healthcare career training programs offered in southern California, visit http://www.americancareer.com.

To request free information about the healthcare career training programs offered in northern California’s San Joaquin Valley, visit http://www.acicareercollege.com.

About American Career College

For over 25 years, American Career College (ACC) has been helping thousands of students get their start in the healthcare industry. ACC offers nine healthcare training programs at campuses in Los Angeles, Orange County and Norco, California:

Dental Assisting

Health Claims Examiner/Medical Biller

Massage Therapy

Optical Dispensing

Vocational Nursing

Pharmacy Technician

Surgical Technology

Diagnostic & Medical Sonography (Ultrasound)

Medical Assistant

About A.C.I. Career College

At its McHenry Avenue campus in Modesto, CA, the College offers six accredited healthcare training programs:

Health Information Specialist

Medical Clinical Assistant

Medical-Dental Administrative Assistant

Pharmacy Technician

Massage Therapist

Medical Dental Receptionist

Dotty Zukoff is a freelance writer who specializes in writing articles on career education opportunities. She contributes regularly to e-zines and works with strategic marketing companies that specialize in lead generation marketing for career schools, including Smart Prospector (www.smartprospector.com) and Effective Student Marketing (www.effectivestudentmarketing.com).

Author: Dotty Zukoff
Article Source: EzineArticles.com
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Healthcare Industry of India

By Kamal Poria  |  2010/06/23 19:36 Posted in Health Care  |  Comments (0)

The Indian healthcare industry is a US$ 35 billion industry and is anticipated to reach US$ 75 billion by 2012. This sector thus provides a lot of potential as Indians are becoming more health conscious and vying for better amenities. To address the increasing demands of this sector, India needs about US$ 50 billion annually.

The healthcare system is practically non-existent in rural India. With a rise in India’s economy and rural infrastructure, the healthcare industry is stated to grow exponentially in this area. Thus, there is a need for investment in infrastructure, equipment, and technological areas.

The public healthcare system is overburdened and also lacks technological support. The entry of private equity has enhanced the healthcare industry of India further. In addition, healthcare majors have released IPOs (initial public offerings) trying to tap the potential of this field further.

With growing consciousness about the health hazards and illnesses that can befall them, Indians are recognizing the benefits of health insurance. Thus, this sector shows lots of promise. The health insurance industry is going to reach US$ 5.75 billion by 2010 according to a study by the Chamber of Commerce, PhD department.

Also, with the stress- and lifestyle-related illnesses on the rise, this sector is gaining more popularity. International giants, such as AIG, have partnered with the Tata group. Other such collaborations are Bajaj Allianz and Aviva. More people are going for insurance to help secure their healthcare needs. Thus, this industry is a major investment area.

The pharmaceutical industry is also gaining in prominence. With skilled labor available and low research costs this is a nice investment option. The production costs and technologically sound infrastructure make it a viable option.

Indian healthcare systems like ayurveda and homeopathy are increasingly gaining prominence overseas. More patrons abroad are going for these alternate therapies as they are completely natural and have no side effects. As they are derived from plant extracts and have been in existence for a long time, more people are recognizing the potential of this field. Thus, this offers good scope.

Another area for investment in India is the research industry. With a huge talent pool and the rise of biotechnology and bioinformatics in India, this offers tremendous growth prospects.

Yet another area is the export of medical equipment to India. There is a demand for more technologically sound instruments in India. With the rise of high-end hospitals, this offers immense prospects. And with patients vying for quality healthcare facilities and hospitals this is an expanding field.

India is also a rising destination for medical tourism. With affordable medical expenses and a sound technology in place, this is a growing sector. This bodes well for the healthcare industry in India.

There are no inhibiting factors for foreign investment in this industry unlike other industries. The absence of regulatory laws is an encouragement. The government recognizing the need for technological advances in this sector has granted many relaxations.

Thus, overall the healthcare industry is going to grow exponentially and offers good investment potential for foreign investors in India.

The government of India has taken several initiatives to attract foreign investments in India. Not only foreign establishments but also entrepreneurs from India can reap the benefits of the growing Indian Market.

Author: Kamal Poria
Article Source: EzineArticles.com
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New Financial Services in US Healthcare

By Niamh J Byrne  |  2010/06/20 19:26 Posted in Health Care  |  Comments (0)

SSON speaks to Susir Kumar (MD & CEO, Intelenet) and Suresh Ramani (President – North America Sales & Operations, Intelenet) about outsourcing trends for the next year, acquisition of captive centers by BPO and how changes in the U.S. healthcare represent opportunities for Intelenet.

SSON: Let’s start with a look at BPO generally. We’re just seeing the back end of a global recession – how has this affected Intelenet over the past few months?

Susir Kumar: OK. A BPO is basically the back end of a company’s operations, so we handle their customers’ transactions. Through the recession period we have seen, for example, banks issuing a lesser number of credit cards; banks giving fewer mortgages; the new accounts that are being opened up have reduced. We are the back-end supporter of these clients of ours: the volumes coming in from these clients of ours have actually gone down, so if we were issuing 60,000 cards a month for a particular client it perhaps went down to as little as about 5,000. We became extremely concerned about issuing any further loans [while] people were just not willing to spend money or buy things, and all of that had a significant impact on the number of transactions and the number of calls coming in.

What we first saw in this initial phase of this whole recession was volume reduction, and a whole lot of companies being extremely concerned about whether they would survive through this phase of recession or not. So everyone started strategizing around how to survive. We had a set of companies which thought by taking certain actions they would survive, and then we had a set of companies which were pretty concerned about their survival. So in some companies we actually saw some drastic measures being taken, and now people were not expecting the traditional outsourcing deals. They were asking us “Tell us how you can accelerate the cost savings process? I know you can give us 50% reduction of costs after 18 months: is there a way that you can give us 30% right now?” So it was a completely new expectation that came in, and I think after the first six months of recession we saw a lot of companies coming out with the question, [so] we had to change our value proposition or our offers to clients and prospects… Then we started observing, over the next six months to about nine months, that these companies were making faster decisions: in the past it would take anything between six to 18 months to take a decision on outsourcing or offshoring, but during this phase we were seeing companies taking decisions as quick as maybe two or three months.

We noticed that clients who had outsourced just about 15% or 20%, were all talking to us about how they could increase the outsourcing/offshoring percentage, and get their costs down; so we also went after every company that had outsourced just a small component, and we told them that “yes, in this case you are saving $5 million a year, or $10 million a year; here is another opportunity where you can accelerate and increase the scope of offshoring and outsourcing, and you could save potentially double or triple the amount that you are currently saving.” The third thing that we saw was, [before the recession] people would not make an offshoring or outsourcing decision if the saving was, say, less than 40%. In the new environment we saw that even if we gave a value proposition of savings of 15%, people would make a decision. Three years back we would never go to a company if the value proposition was just a 15% saving.

I think right now we are in this phase – where from the bottom our clients have actually been growing about 5 to 10%, so we have already seen more cards being issued, more mortgages being given, more people traveling; in the travel segment that we handle, we are seeing a lot of demand coming up. And in the last six months most of the companies that have downsized their own labor force, are all believing that there is going to be some growth in the next six to 12 months. Albeit, these companies are not convinced that this growth is going to be sustainable; people are generally believe that 2012, is where they will see a growth equal to what they saw in 2007-2008. So the value proposition that we are offering to our clients is: ‘you guys have come out with a plan for next year that talks about 10% growth versus the bottom; rather than you building your own capacity and people why don’t you look at working with us, because you can turn on the tap or turn off the tap with us, whereas it’s more difficult for you guys to do it in your environment where it’s expensive and more regulated.’

SSON: Looking forward then, Susir, what now do you see as the biggest challenges facing outsourcing providers? And how are you positioning Intelenet to overcome these?

SK: Just to give you a summary: over the last, say, 18 months to 20 months, we’ve actually seen a reduction or a contraction of our existing business of around 10% to 15%. But there is new demand which is offsetting this shrinkage, and net-net we are still seeing a 10% growth. The good news is that people are making faster decisions and looking at outsourcing more. Because of these multiple reasons and the fact that we are giving them capacity as a value rather than just cost, there has been a growth in our existing-to-new business, to the extent of almost 25%, which after offsetting the 10%-15% shrinkage still accounts for 10% net growth. So that’s the bottom line of the whole thing.

People are also negotiating more. And people have actually tested the market in the last 18 to 24 months and trying to squeeze a little more out of service providers like us. When they came in through this phase of recession and asked us for a 5% or 10% discount, we gave it to them because these are long-term relationships, and we have to reciprocate in some form in their time of difficulty. Now this is becoming a new norm for pricing.

We have also learned in the last 18 months or 24 months to run the operations more efficiently. So what we have been telling the clients in the last 18 months is, “ok, you guys want a 10% discount, we’ll give you a 10% discount. But don’t dictate to me in terms of where the operations should be run from, what should be the span of control, what should be the kind of technology – you tell me what is the end result you want, in terms of efficiencies, in terms of turnaround times, in terms of accuracy, and let me decide how and from where to run the operations, and I’ll give you the 10% discount.” So what has happened in the last 18-24 months is we have been given the freedom to decide how to run and from where to run the operation.

Net-net, though we have reduced the price, we have been able to get the same margin as what we were getting in the past..

Another big challenge is that people are asking for more and more financially structured deals, rather than the regular outsourcing which is a per-FT price or a per-transaction price; it’s becoming a little more complex. They are asking us to fund the redundancy, they are asking us to fund the set-up costs; there are a few clients that are asking us to take an outcome-based pricing, and we’re taking more and more of that. I think from a risk perspective, we are now required to factor in if at all we have funded the redundancy – and if the contract is say over a period of 5 years, if it actually gets terminated before that, then we will not have to cover the entire funding of redundancy that we have done.

Companies are also coming and telling us, “guys, just take our operation lock stock and barrel, and you guys decide the onshore/offshore mix, etc: this is what we want as outcomes.” And what that means to us is investment; taking over the risk of pensions of these employees and costs associated with just aligning that new business that we buy out with our business, and so on and so forth. In the last six months we have done about five acquisitions of just the back-end operations of a company. And that always has the challenge of integration – and the risks.

SSON: That’s an interesting point: at the moment we’re seeing a lot of BPOs buying into shared services captives, for example Cognizant and UBS: is that something on your agenda for 2010?

SK: Yes they are, and actually, one of the advantages we have is we’re not a listed company, and being a part of Blackstone, we do have access to capital. When you acquire a back office of an existing company, what you need is capital, and an ability to take the impact on your P&Ls for the first six months or a year of buying out the company.

For example, if I were to buy the back office of an existing company, the company would expect a reduction of costs of, say, 20%. In the moment that you buy it and you start billing 20% less the next day, you’re actually incurring a loss in your books, because the cost structure and the way the operations are designed needs you to spend, for example, 100 and you’re only actually billing the client about 90. There’s a hole in your P&L. Only after about six months to one year you will start reducing your costs, you will start building efficiencies in the processes and so on and so forth, and you will be able to bring down your costs from 100 to, say, 80 or so – and because the client is paying 90, you start making a profit of 10. What this means to us is it will impact on our P&L accounts for a period of one year. But because we are not listed it really doesn’t matter to us; and the good thing is, normally when you do a transaction like this we ask them for a lock-in – to provide us a commitment of business for a period of time. And as I told you we did about five transactions in the last six months: all of those five transactions have come with a revenue commitment for a period of time. You will see us do more and more of these kinds of deals both onshore as well as offshore.

SSON: Who have you done transactions with over the last five months?

SK: We have done one transaction with one of the large banks, we are about to finish off a transaction in the UK. We bought two captives from travel companies, we bought one captive from a very large bank, we about to buy one very large captive from a transport company in the UK and we have also bought another company in the retail space, reasonably big: about 200-300 seats.

SSON: Moving on, Susir – let’s take a look at healthcare? We are running this a US healthcare series with Intelenet, can you give us some insight into the work you are doing directly in this space?

SK: There are two things. Firstly, Blackstone has about ten companies in the healthcare space in the US, either on the provider side and the payer side. Secondly, we are looking towards the regulatory changes that are taking place in the US: The new regulations will mean if a person in the US goes and applies for insurance, that person has to be given an insurance policy. Today they may just go and tell a customer that they will not give insurance coverage at all. The Obama administration is opening up insurance in that, earlier, insurance companies could only provide insurance for people in a particular jurisdiction – which could be a particular state, for example the state of Arizona. Now they have allowed these insurance players to give insurance policies across the United States.

So taking Arizona again for example – say there were four large insurance companies giving health insurance; all of a sudden now there are companies from New York that are issuing polices in Arizona, there are companies in Texas issuing policies in Arizona. The number of companies actually providing insurance cover has gone up by virtue of this new regulation. So in suammary, they cannot deny people coverage and the competition has actually gone up. By virtue of this we believe that both the insurance payers and insurance providers will have an implication on their cost and profitability.

A new code is also being prescribed. If you look at any medical diagnosis or procedure in the US or across the globe, it needs to be codified. For example if someone is diagnosed with four ailments, each of those needs to be coded; or if some surgery has been performed on a particular person then this again needs to be coded. This coding helps to keep medical records, and also helps to pay the insurance company and the hospitals – so insurance companies use this code to work out how much to pay for hospitals based on whatever ailments they have. Now this code is undergoing a change from what is called an ICD9 to an ICD10 which increases and changes the way things are codified.

So what does all of this mean to companies? Firstly, they will need to retrain their people in coding, they need to change the systems that they use for coding and, because the number of codes has gone up, they need to get more people into coding. The government will monitor payers and providers to make sure the coding is done properly. All of this will cause a huge impact on the healthcare companies in terms of costs and profitability so our value proposition at this point in time is that we can come in and help with codification. You don’t need to train people at your end, because we can either get these people onshore in the US or we can help you with an offshore solution. When you provide an offshore solution, the cost comes down – or it helps with the new issue we have in terms of competition and the universal access. As we have access to the ten companies in the Blackstone portfolio, we are already doing work for a few of them, we can just leverage this expertise and get across the whole market. So the reason we are focusing on the US is, one, to take advantage of the new situation, and two, to leverage the expertise we are already building by virtue of doing work for a few of these Blackstone portfolio companies, both on the payer and the provider side.

Suresh Ramani: I think if you were to draw a context of where US healthcare has been traditionally and where it is moving, I think there is cause for worry. If you look at the spend in 2008, they spent about $2.4 trillion on healthcare – which is about 17% of GDP – and of that $2.4 trillion, 80% of that went to 20% of the population of the US of the insured. That number today is going to double, within the next eight years the spend on healthcare will be about $4.5 trillion. So you can see the exponential growth and with all the reforms which Susir has talked about, such as universal access and going outside the state to insure, the risk appetite of all the providers is going to go up.

The other big piece is the unfunded mandates which are the conversions of ICD9 to ICD10 which as a program, I think, whether other countries have adopted, the US has to adopt, and that will be a regulation which has to come into effect by 2012. So, these are again costs that the providers and payers need to absorb.

Another big component to this is in terms of the reimbursements which will come down, because the Obama administration wants about $400 billion out of the spend to pay off the deficit. So if all this is going to happen, the payers have to focus on their operating costs if at all they are to survive – or there will have to be a story of consolidation or elimination out of the 1,800 payers in the American market.

There is also the issue of regulatory compliance. With all these changes, it is difficult to keep processes up to date; as a result healthcare insurance carriers are not meeting obligations to the state, to the federal government – and they are paying huge penalties. So Intelenet can step in here and fix these problems. The most important piece to that is not only do we consult but we actually implement process improvements. The other piece to this is that we get solutions which are both BPO and technology related so there is process optimization that we focus on and an enabler to that is outsourcing or offshoring. So clearly three things: regulatory compliance, driving down operational costs and improving quality, I think are our three pillars, if you will, of our service delivery.

SSON: Susir, you talked about the services that are being outsourced: processes and compliance etc, and you mentioned coding. What other services do you expect the healthcare industry in the US to outsource to you?

SK: There are two sets of people in this space: providers – basically hospitals and payers who are the insurance companies. On the providers’ side, there are also companies which provide medical equipment – so again another huge market. For example, the services we provide for hospitals are coding, billing services, contact center support, claiming monies from insurance companies – if somebody goes through a procedure then we need to ensure that the doctor writes it on a form and the form is scanned and it comes to us – we need the machine, we need to do the right coding, we need to send it to the insurance company to check that it is covered. If it is not covered by the insurance and it’s a deductible amount, we need to go after the insured. Then we need to raise a bill and say the payers challenge what we have invoiced, we negotiate and close those issues. Then there are complaints, and complaints management. On the payers side we receive invoices, we pay invoices, and we reconcile accounts.

SSON: Are you providing these services from onshore or are you providing from locations in India?

SK: There are clients who are asking us to do some piece of work onshore in our location, or in near-shore locations, or offshore. So, we are working with all of the models. We are offering clients both India and the Philippines. The Philippines has a lot of nurses who are either looking at going to the U.S. or who have returned back from the U.S. So that is a big pool that we are tapping into to say that “if you work with us in the healthcare space, it may be an added experience for you guys when you seek a job in the U.S”. Or for people who have come back from the US, when they already know the nuances and systems there, they can be readily employed in an environment such as the Philippines. We also have a site in Poland, again a good site from where we provide services in healthcare.

SSON: You are obviously looking very closely at the US healthcare space; do you foresee Intelenet possibly expanding into other countries?

SK: We have had a client from the UK for the past 8 years. But as there is a huge demand now from the US, we are all focused on the US. [But] we will be going beyond the US to other geographies. India itself is a huge market. The amount of people who are getting covered under insurance in India is huge; everybody now wants cover and there are a lot of healthcare companies, both on the provider and payer sides, coming into India. This is a completely new market for us.

SSON: So why do you think new customers – within the US or India further down the line – should sign with you as opposed to any of your competitors?

SK: I did mention to you that we have about ten companies in the Blackstone portfolio, all of whom we’re working with pretty closely – and the work that they give us covers almost the entire range of work that healthcare insurance companies look at outsourcing. Now these companies have not been used to offshoring and outsourcing as much as the financial services sector, and one big thing they will look for is, “are you guys really doing this, why I am looking at outsourcing?” And we are able to demonstrate an actual live case of the work they’re expecting to outsource. Also what we have done is significantly enhanced our management of healthcare, so we have of late recruited about half a dozen people who are some of the best-known people in the healthcare industry in the US; these are the guys who actually build applications for healthcare companies. We’re also leveraging, through the Blackstone portfolio, networking with people who are actually working in the companies, to see how they can work along with us, to build solutions for some of the companies in the U.S. We have a program where we can actually import people who are working with healthcare companies as part of the Intelenet team.

SSON: What other sectors do you think will provide you with the greatest scope for expansion over the next few years?

Suresh Ramani: I think there are some key areas that are going to grow in the US market. One is utilities and the second is government spends, but healthcare makes the biggest growth pie. Clearly speaking for us as an organization the US contributes about one third of our revenues. We’re equally distributed in the Indian market as well as the UK market. On an overall basis we see the banking industry again moving, not at an aggressive pace, but at a reasonable pace over the next 18-24 months; we can see some good traction in the marketplace. And we are very strong in the banking and financial services space. We have today close to about 8,000 people working in this market, and doing all the types of processing that you can think of doing for a bank. In short, if we had the money, we would be a bank ourselves!

Another area of growth for us is travel and hospitality. Susir started off pointing out that people are not travelling so much, but it’s a matter of time: when the economy starts looking up, there will be demand for travel as well as hotels. So that’s an area where we already have invested, both onshore and offshore and we have close to about 3,000 people in that space, so that’s again a focus area for us.

Telecoms is a focus for us especially in the Indian market; that’s a sunrise industry, with every month about 1 million customers being added in the Indian market space. Telecoms account for close to about 10% of our revenues today. And of course we are getting into new markets: Australia, we have a presence there, and we also do work for utility companies from Australia. The Middle East is again a good opportunity that we see for banking. And Europe of course with Poland coming in. We also have a center in Mauritius which caters for French opportunities. And all this will give us an identity of being a global player located in these markets who also can do work for these markets from low-cost destinations. So clearly we are moving away from a brand identity of an Indian-based BPO provider to a global BPO provider.

SSON: And is acquiring businesses in those locations a key priority for you?

Suresh Ramani: Absolutely. Like, in the US we already have two centers up and running with close to a thousand people; we have a partner signed in Australia. Susir talked about having a site in the UK now. So big markets, yes, certainly I think that’s a growth engine for us. We want to be present with a reasonable population in each of these countries.

SSON: Where would you like to see Intelenet in five years’ time?

SK: What we’re really trying to be is a one-stop shop for all the things associated with outsourcing and offshoring. There are companies who want multilingual solutions; there are companies who want multi-geography solutions; there are companies who want consultancy solutions; there are companies who want technology solutions; there are companies who want actual business process solutions, which might be either in terms of costs or in terms of efficiency; there are companies who want analytics. So everything which is a pain around the business process side, is what we want to really provide. That’s our focus; in the next five years that’s what we want to be: a company that can design, a company that can put in the relevant technology for implementing the design, and a company that can execute the business process. So we are looking at a one-stop shop for all the things associated with the business process.

SSON: Comparing yourself with other Indian BPOs such as Wipro or Tata – there’s plenty that have emerged out of India – how would you put yourself at the forefront, as an organization?

SK: If you look at Wipro and TCS – all the IT companies, all the large Indian IT companies, they are predominantly focused on IT and BPO is a sub-segment of it. If you look at the percentage of revenue that comes from BPO versus IT, BPO is a very small component. Compared with the IT companies, we are a focused BPO company – and I think that people who are seeking a large impact, like telecom companies or retail companies or banking companies, who have a lot of dependency on good operations to get in new business in new markets, they in the long term would rather work with a focused BPO company than an IT company that has got a subset of BPO, number one.

What we do is basically bolt on technologies which can build efficiencies into the processes that are outsourced or offshored – so we have scanning solutions, workflow solutions, ERM solutions, etc. Whereas the approach that an IT company takes is to build a solution. So that’s a difference between the two of us. There are instances where we lose deals to some of these IT companies; there are instances where we win deals against them. It depends how the buyer is looking at it: if they want more IT and less BPO they’ll go to companies like TCS or Wipro. If they’re looking at specialized BPO services, they come to us.

There’s also going to be competition from the Accentures and the IBMs of this world; but I think there are also issues with them in terms of cost, in terms of flexibility, in terms of speed, and that they’ve become too big, and we think very clearly we have an advantageous position against these guys because of the size and nimbleness and speed and the flexibility with which we can clear transactions. That’s where we have seen we have been able to win deals against these guys.

SSON: And do you consider yourselves competitive on price?

Suresh Ramani: Absolutely. We are best in class.

SSON: Of course you’re going to say that! Finally, I’d like to ask you: what is your definition of the perfect outsourcing relationship? And the perfect client?

SK: I think in terms of the services that we provide, everybody provides more or less a similar service. In the long term what really matters is the element of trust. And my definition of a true relationship between the company that is outsourcing and the company that is providing a service is that you can really live like a partner. So for example if you see the recession that we’ve had in the last 24 months, people have come and asked us for things which aren’t written in the contract. They’ve said, “we’ve actually given you a commitment of a minimum, a minimum commitment of so much: I can’t live up to the minimum for the following reasons.” Have we gone and sued them? Or have we really recognized that there has been a difficulty? I have not gone by the pure letter of the contract, but really responded like a true partner, and helped people through difficult times. And they have responded back, most of the companies to whom I gave discounts and to whom I let off a lot of conditions in the contract, have in the last three to six months come back and said “look, Susir, we’re looking at something new, and we really want to work with you; we don’t want to call for an RFP, we just want to stick with you guys because we trust you.”

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The Shared Services & Outsourcing Network (SSON) is the largest and most established community of shared services and outsourcing professionals.

We provide the roof under which key industry experts and organizations share their experience, knowledge and tools, and your practitioner peers connect with other all over the world, face to face and online.

SSON focuses on developing its members through providing training, tools, and networking opportunities. Our staff works from international offices in New York, London, Singapore, Sydney, Johannesburg, Berlin and Dubai to research current trends and developments in shared services.

Author: Niamh J Byrne
Article Source: EzineArticles.com
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Turning Healthcare Over to Computers – The Risks of Rapid Adoption of EMR and Speech REC Technology

By Christopher L. Dunn  |  2010/06/17 19:15 Posted in Health Care  |  Comments (0)

Healthcare documentation has come a long way. A continuous stream of technological advancement and automation has generated significant gains in efficiency while increasing the quality of care through improved access to vital patient information. The future looks bright indeed, as incremental improvements in technology promise to confer additional benefits. Many health care providers are embracing new versions of technology as quickly as they are rolled out in the hope of delivering heightened levels of patient care at a lower cost.

Nowhere are the advances in technology felt more keenly than in the healthcare documentation arena. For many years, medical records departments have been viewed as cost centers and subordinated to other seemingly more important areas of the healthcare organization. As a consequence, healthcare documentation has historically received neither the glamour nor the funding that other front office and patient care activities have enjoyed. Over the past few decades, however, the balance of power has begun to shift. Healthcare documentation is now rightly seen as one of the keys to profitability and a catalyst for industry growth.

New talent and resources are beginning to flow into this area breathing new life and vitality into what was once an afterthought in most healthcare organizations. Leading the charge is a new breed of profit minded executives set on transforming the healthcare model. As the industry ushers in a new era of efficiency and profitability, decision making executives would do well to remain aware of some of the significant risks of an overly ambitious technology adoption timeline. For instance:

Underdocumentation

The risk of underdocumentation has the potential of increasing dramatically with new electronic medical record (EMR) protocols. That EMR technology promises to exponentially increase efficiency in some aspects of care – primarily by decreasing administrative workload and increasing the speed of information flow – is not in dispute.

However, it should be recognized that the rapid adoption of this technology in its current form has the potential to create down- stream issues with patient care as a result of improper or inadequate documentation. EMR threatens to increase costs as inadequately documented assessments and activities are reworked. Patient care may also be compromised as diagnoses are delayed due to lack of complete information flow.

Underexamination

EMR’s may steer physicians to point and click their way through a few standard procedures, potentially ignoring less obvious, non-charted options.

Undervaluing the traditional role of the physician

As technology asserts itself with fits and starts into the patient care process, there is a real risk that the transition from physician directed outcomes to technology driven outcomes will be too abrupt, again compromising patient care.

Chronic under reporting

Pushing physicians in a direction of drastically less documentation when the trend has been toward greater documentation of patient care for the past several decades is at best imprudent and at worst reckless. While some efficiency in healthcare documentation may be good and necessary, it is simply unrealistic to expect a physician to render what has historically been a multi-page detailed medical record document with a few clicks of a mouse.

Undervaluing the role of the medical transcriptionist and medical record technician in the records process

Speech recognition has made some significant strides in recent years and now plays in increasingly prominent role in the healthcare documentation process. However, it has still not proven to be as effective as a seasoned transcriptionist in rendering a dependable output – particularly when it comes to some of the more complex documentation tasks. There are simply too many variables that require human intervention to achieve consistently accurate and completely automated documentation with today’s technology. While it seems clear that the role of the traditional medical transcriptionist will be forever transformed by new advances in technology, there will likely always be a role, and I trust, an increasingly important role, for the professional medical records technician.

Conclusion

As technology continues its steady march, there is no doubt that it will continue to encroach on traditional methodologies and bring a new and important measure of efficiency and profitability to the healthcare industry – benefiting patients and practitioners alike. Those organizations that are careful and thoughtful in their implementation strategies will tend to have smoother transitions and will likely manage their risk more successfully than their more zealous counterparts.

Christopher L. Dunn has been active in operating and training aspects of the medical transcription and medical coding industry for the past 17 years. For more information please visit more of the authors websites:
http://www.mtworld.com
http://www.cixx.com.

Author: Christopher L. Dunn
Article Source: EzineArticles.com
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How Your Employees Can Make Or Break Your New Software

By Charles Bovaird  |  2010/06/14 19:55 Posted in Open Source  |  Comments (0)

When implementing a custom software solution, a company wants to achieve the highest return on investment possible. A crucial aspect of obtaining an adequate ROI is a smooth implementation. There are multiple hindrances that can undermine effective implementation, one of them being worker resistance to change. The source of this resistance is easily uncovered. Employees develop or incorporate standard operating procedures in order to increase the ease of the workday and also to either increase or maintain productivity. When new business processes must be adopted, the task requires more effort than was previously exerted and there is a certain level of discomfort as a result of altering one’s work habits. Switching to a new process is frequently perceived as a chore, and is sometimes accompanied with stress or even fear. Fortunately, many different actions can be taken in order to alleviate this negative perception.

Facilitating user buy in is the key to the success of any workflow project. For many, change from the status quo can be met with stress, frustration, and fear. In the workplace this can be manifested in many ways, but usually in negative behavior towards the source or agent of change. These negative behaviors can: lower morale, slow the training process, reduce the effectiveness of your new program, and lower the quality of data. Everyone responds differently to change, so it is important to recognize the personal aspect of making workflow changes. Avoiding some of the easy pitfalls when implementing workflow changes will lead to happier employees and a more successful launch.

The easiest way to turn fear and stress into excitement and relief in a workflow project is to listen carefully to your employees input. Input should be encouraged, and received before, during, and after the creation of your workflow software. Not only will your employees feel more in control of their jobs, you will likely get a better product in the end! It is their tasks you are automating, so naturally, they are the most important person to talk to while doing it. The most common pitfall in the software creation process is making too many assumptions about how employees actually get their jobs done, and not asking the right questions because of it.

Another great way to reduce the resistance to change is to encourage an open discussion about existing shadow systems. Shadow systems are tools that are developed by employees to make their jobs easier. They are usually made privately, without help or even knowledge from management or IT. Give the lack of resources they are most likely only partially effective. Many of these systems make work easier, but are kept secret for fear of being asked to discontinue their use for any number of legitimate reasons. Discussing these systems openly and without risk can shine a light on which areas of a job need automating. Not only do you gain insight into which tasks need automating, but also an idea about how they should be automated. Not only does that information help with the design of new software, it puts the user at ease knowing that their ideas are being considered and their job may soon get easier. After all, no one complains when you make their life easier.

Although employee resistance to change is a real roadblock for decision makers, and the consultants responsible for implementation, it can be either contained or reduced through the proactive measures described in this article. Additional obstacles preventing a smooth implementation and their respective solutions are certainly worthy of the consideration of everyone involved.

Author: Charles Bovaird
Article Source: EzineArticles.com
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Disruptive Technologies, Part 2: Music Editors and Steam Engines are Still Related

By TechWizard  |  2010/06/14 19:12 Posted in Technology  |  Comments (0)

I have illustrated on how music editors are related to steam engines in Part 1. Why so loose a connection? Because I want to stress the universal timeline from the early days of steam engines to the modernity of music editors, during which technology has evolved in waves of disruption.

Now somebody might break that already loose relationship.

John C. Dvorak, a very reputed columnist, fervently argues that there is no Clay Christensen disruptive technology in its very own coined definition: disruptive technologies are low performers, “less expensive technologies that enter a heated scene where the established technology is outpacing people’s ability to adapt to it”.

Is my music editors – steam engines connection invalid then, as there is no disruptive, let alone sustaining, technology? I thought so. Yes, I thought so, as in his paper, Dvorak rebukes so persuasively all purported disruptive technologies: the microcomputers are not cheaper than the minicomputers, and neither do internet sales supplant bookstores. His points are convincing, covering even the titans among the believed disruptive technologies of digital photography and Linux.

But I think again, “independently”. And let me re-affirm with you that despite the distant connection, music editors and steam engines are indeed parts of the twin aspects of technology, disruptive and sustaining.

Microcomputers were not cheaper, because the smaller-sized disks were more expensive. However, microcomputers were not the disruptive technology. It is the smaller-sized disk drives. When the sustaining technology of cost-saving capacity improvement came, the disruptive technology of smaller-sized drives truly took over as they achieved the same price points as larger-sized drives. The smaller-sized drives are thus cheaper in utility terms. Isn’t it now a disruptor?

Internet sales, on the other hand, might not outperform bookstores yet. But even that fits into the definition of a disruptive technology: it is an initial low performer. That internet sales would exceed bookstore revenues, especially when there are more credit card holders than ever nowadays, seems a good bet.

Thus, in similar arguments, it is fair to state that perhaps the conclusion that Linux and digital photography not being disruptive technologies is somewhat untimely. And who knows if digital photography is not cheaper because it can’t be cheaper or because it is so in demand its economic price can’t be lower?

If you are not yet convinced, Napster and VoIP technologies will make you. They fit into every aspect of Clay Christensen’s definition of disruptive technologies.

Napster was inferior, it was sued for copyrights violation and eventually shut down. But this first peer-to-peer music sharing program was not only cheaper (in fact, users only needed to pay for their internet access and the music editors if they wish to morph the songs before sharing) than what conventional music producers offer, but also quickly revolutionized the way people listen to music (so quickly that it had to be shut down as the then legal framework had yet to accommodate its form). Napster is non-existent now. But its variants are growing strong. And the sustaining industry of music editor softwares has carved out a niche market for its own. This is typical of a disruptive technology, one that not only changes the way things are, but also brings on other flows of goods and services.

In addition, Voice over Internet Protocol (VoIP) is another epitome of disruptive technologies. Telephony is getting cheaper, but VoIP is free (except for the internet access). And VoIP boasts efficient pioneers the like of Skype and Vonage that threaten to outdate traditional telephony practices. In fact, telecommunication services have become so complex consumers could not fully utilize their functions, thus turning to simpler services and paying only for what is relevant to their needs. That is how Sweden’s Comviq has seized 39% of the market from the incumbent Telia by offering half as many handset features and simpler pricing plans. But telecommunications will soon be free; VoIP will soon disrupt even the like of Comviq. And the sustainers that will keep VoIP evolving will be the class of voice changer softwares and cheaper and faster internet connection.

Ala, my music editors and steam engines are still related.

Josh Nowell is a Media Morpher writer who specializes in technology research. This article is the second in the 4-part series on Disruptive Technologies of his.

He could be contacted at media@audio4fun.com.

Author: Josh Nowell
Article Source: EzineArticles.com
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