As world becomes
more dependent on technology to store and obtain
information quickly and effectively, there has
been increasing concern in the social work community
about protecting privacy and maintaining confidentiality,
especially in a managed care environment. The
concept of confidentiality is very different in
a technologically advanced environment.
A three-level topology of client problems and
behaviors is delineated and illustrated through
practice examples, which demonstrate the different
types of information that can be computer stored
and retrieved and electronically transmitted.
The article discusses levels of security, including
log-on procedures, firewalls, and encryption,
which can be used at each level to protect sensitive
information, and presents guidelines to help professionals
protect and promote confidentiality within the
constraints of technology and managed care. (Barney,
99-120) .
Managed information is also the focus of increasing
public attention. A recent search on the Internet
yielded more than 60, 000 entries on this topic.
Although many report abuses under managed information
related to denial or curtailment of benefits,
others focus on threats to privacy and confidentiality.
In the age of computers, the Internet, e-mail,
and the electronic record, it is necessary for
social workers and other human services, health,
and mental health professionals to rethink and
revise principles of confidentiality, especially
in the context of managed care.
The revisions may involve creating more stringent
standards for protecting the confidentiality of
the most sensitive data, which have the potential
for serious damage to clients; and having more
liberal policies for data that have the least
potential for damage. Although not widely acknowledged
by public services agencies or clients themselves,
health care and other client information belongs
to the client. Only the client controls the privilege
to confidential information, not the provider
or agency.
Clients' access to their records is established
by federal law as well as included in the NASW
Code of Ethics. Yet clients often are uninformed
about their rights to retain confidentiality over
information about themselves. Fears about maintaining
privacy may lead a client to pay for treatment
out of pocket rather than through a managed care
plan. It should be noted, however, that this option
is not available for poor clients who do not have
any additional financial resources. Is confidentiality
possible in a world of advanced technology and
information management? A recent conference presentation
entitled,
The Death of Confidentiality, addressed the end
of the confidentiality as we have known it. Information
management managers once advised employees not
to talk about clients in elevators or go to lunch
leaving case records opened on their desks. Now
they must instruct other employees to have clients
sign three-page forms about the limits of confidentiality
with managed care companies and to protect electronic
client records through passwords.(Bonanzas, R.)(40-57).
This article focuses on the new confidentiality
for the 21st century, especially in regard to
information management and communication.
(Cheng, Y.T., and Van de Ven, 593-614)
Information management companies eavesdrop on
treatment when they need to know why a person
is seeking treatment, the type of treatment provided,
as well as the content of treatment. It is standard
practice in contractual agreements between managed
care organizations and providers to have a "boiler
plate" clause requiring that the managed
information organization have access to all records
and details of treatment. The burden of obtaining
the required patient consent is usually placed
entirely on the provider of care. The knowledge
that this information is readily available may
prevent some people from pursuing treatment at
all and thus contribute to human suffering and
decreased productivity. Concerns about information
management companies has led many states to adopt
a "Client Bill of Rights," and currently
the federal government is considering a national
Bill of Rights for those covered under managed
information plans.
In the proposed bill there is a requirement that
managed care companies establish procedures to
safeguard the privacy of client information.(Conner
& Prahalad, 477-501) An earlier plan to issue
every American a health care ID number had been
dropped as too invasive of client privacy
Improved Communication Skills at Individual and
Organizational Level Based on the promised benefits
of Internet technologies, businesses have been
embracing the concept of Internet-based enterprise
computing at increasingly rapid rates. The success
of the World Wide Web as a medium for reaching
customers hinges on an easy migration path to
browser-based computing while maintaining the
core functionality and remote processing capabilities
of traditional client-server systems. The benefits
of Web technologies are many.
For example, any browser-equipped device can function
as a Web client, allowing a heterogeneous mix
of client platforms (such as PCs, Macs and network
computers) to coexist without the usual client
administration costs. The browser provides a single,
intuitive interface to multiple applications,
simplifying the learning process. Other benefits
include low-cost infrastructure, with less code
at the desktop; streamlined information distribution,
allowing organizations to publish and revise information
broadly without the constraints of paper-based
processes; and component commoditization, meaning
parties with traditionally proprietary environments
can communicate easily. (Dalton, 46-49) .
The key is an integrated architecture offering
both client-server and browser modes in a single
version. Different users can implement the mode
to best serve their needs while maintaining consistent
data and functionality both within the enterprise
and when extending data and capabilities to partners
and customers. In any enterprise, only a fraction
of employees have access to the enterprise-wide
application suite. While organizations like to
maximize return on technology investments and
keep communication lines open, they don't want
to equip every user with a fully-loaded desktop
machine. Corporate intranets alleviate some of
these problems, yet most of the information is
relatively static -- unlike enterprise-wide information,
changing with each new transaction. In this case,
an integrated solution allows a business to leverage
the corporate intranet for increased access to
enterprise applications. Any browser-equipped
device can provide a real-time window into the
enterprise's information resources. Because of
the low overhead, businesses can include more
users in the information flow; they disseminate
information more quickly to a broader audience
and knit together disparate business operations
and distributed sites. Goals, priorities and strategies
are communicated effectively, in turn leading
to improved decision-making at every organizational
level. (DeFillippi & Arthur, 307-324) .
Extending the concept to the supply chain, an
integrated solution allows businesses to offer
partners access to information such as order status
and inventory levels via technology that is likely
already in place at the partner's site, i.e. any
browser-equipped device. Partners access only
approved applications through applets downloaded
to the client at run-time. The partner assumes
no maintenance responsibilities while the shared
applications provide standardized, real-time communication.
Like users, enterprise applications tend to fit
better with either a client-server environment
(a flexible architecture allowing object-based
data and logic to be seamlessly communicated on
a heterogeneous network) or through a browser,
depending on the role the application plays in
the information flow. Applications providing tools
for analyzing and manipulating information from
a variety of sources are well served by client-server
implementations. On the other hand, applications
intended to communicate and distribute shared
information and support standard transaction entries
work well in browser mode. Application logic in
the form of applets resides on a Web server added
to an integrated environment. The applets are
then downloaded to the browser when requested
by the user. Browser-based solutions don't pose
the same maintenance issues as client-server solutions
because of the streamlined client environment.
But because of their platform-independence, browser-based
applications characteristically don't yet offer
the same integration with personal productivity
applications compared to their OLE-compliant client-server
counterparts. (Eisenhardt & Martin, 1105-1121)
An integrated solution is therefore ideal because
both modes are inherent in the architecture, to
be deployed when needed. The enterprise can deploy
a mix of both modes, maintaining consistency in
business data and processes. A business can embrace
new Internet technologies without rethinking or
re-engineering its existing information flow.
The IT team need only learn one toolset and maintain
and upgrade only one software version.
Increase Collaboration between Teams and Departments
Effective collaborations involving organizations
is to identify most commonly voiced reasons for
collaboration and factors perceived as being most
important to collaboration. Partnerships are often
founded as means for a an organization is to better
fulfill its own mission through working with other
departments .
Those involved with effective collaboration report
that willingness to listen, mutual respect, long-term
commitment, frequent communication, flexibility,
and careful selection of partners were key factors
in the success of their collaboratives. This theme
issue is intended to expand on the idea and practice
of collaboration involving different departments
of a business. This article in particular serves
to provide commentary and reflection on the previous
case descriptions of collaborative efforts. The
issues of why to collaborate and factors contributing
to effective collaboration are highlighted. For
the purposes of this discussion, an effective
collaboration is one that Is sustainable (i.e.,
partners wish to continue working together, sufficient
resources can be generated to continue operations).
Is viewed positively by all partners, which may
be due to a variety of reasons, but would generally
include the perception that the collaboration
was useful and productive.
Generates positive outcomes in accordance with
the goals and purposes of the collaborative entity.
Creates a means of open and equal communication
and decision making.
Provides an improved mechanism to achieve common
purposes more readily (e.g., more efficiently,
at reduced cost, with better quality) through
partnership than alone
Communication and Ability to Innovate and Creativity
at Organizational Level.( Grant, 105-121)
Firm specializes in finding executive-level marketing
talent. Their hypothesis were that such changes
as the faster pace of business, the influence
of technology and the consolidation of both manufacturers
and channels would have to have some impact on
the key skills demanded of a chief marketing officer..
Here are the skills required for creativity and
innovation.
Strategic vision and strategic process. For companies
to succeed, someone needs to be able to gather
the key data, sift it and not only set a long
term direction but also lay out the steps to get
there. Vision is not enough. You have to be able
to rally the troops and get action. Importantly,
the executives generally agreed strategic vision
is not something that can be taught or trained.
It can be developed and nurtured, but only if
the skill is recognized early and encouraged Intuition
and the ability to react.
The world is too complex and moving too fast for
classic analytical tools to cope. You can't wait
to gather all the data, and even if you could,
the data would change before you could react.
Executives must be able to set reasonable hypotheses
and then react to the market. Can intuition be
taught? Not in the opinion of our panel. But it
can be killed early in a young manager's career.
Intuition demands that people trust their judgment,
take risks. If companies hammer a young manager
for a market failure, will he or she ever take
a risk again? What you can teach these young people
is how to mitigate risks, how to cover their bets.
That would be valuable.( Hamel & Prahalad,
109-122)
Change agent. It's perhaps one of the most overused
terms, but the need is very real. Companies have
always needed people who would tilt at windmills
and challenge the status quo. But this skill is
no longer limited to dreamers thinking about the
long term. Today, mainstream management needs
people who can find their way through the maze
and break through policies and procedures to react
to the marketplace. Just how would you teach this
skill? How do you train someone to balance the
brashness of a new idea with the sensitivity to
get things done without breaking too much glass?
Creative development and innovation. Innovations
in products, services, advertising, promotion,
compensation, etc., are the lifeblood of a business.
Top executives either need to be innovators themselves
or need to be able to recognize creativity in
others and be able to nurture it. With fewer and
fewer resources available, companies can no longer
just try a dozen ideas to see which one works.
Creativity is more critical than ever.
Innovation cannot be taught. Creativity cannot
be taught. Tolerance of creative people can be
taught and must be taught if companies are to
develop the resources that they do have. Creative
people are different. What they produce, whether
it is a piece of art or a product design or a
marketing plan, is a part of them. Reject it and
you reject them. Too much rejection and the creative
person will just shut down. Companies not only
need creative, innovative thinkers. They also
need the environments where these people can thrive.(
Hamel & Prahalad, 63-76)
Desire for accountability. True leaders want responsibility.
Let's be clear. This is not the willingness to
accept responsibility. This is the desire to take
responsibility. Risk is a challenge to be taken
up. And these people are rare. Can you train it?
Or do you just see it in their eyes?
Communication. It has been pointed out that communication
is about more than the ability to write a clear,
concise memorandum. Communication at the top levels
of a company is about being able to formulate
an argument and a recommendation in a way that
gets not only acceptance but support and enthusiasm.
In a world of cross-functional, worldwide, multidivisional
businesses, the risk of miscommunication has increased
exponentially.
This is a skill that can be taught, although it's
amazing how many major corporations are still
doing business using chart decks with bullet points.
These decks get sent around to people not at the
meeting, who did not hear what the speaker had
to say or the discussion that ensued, but who
are expected to learn something from the bullet
points. Amazing.( Hamlin & Stewart 27-32)
Action orientation. There was a time when senior-most
executives would set goals and review plans, leaving
the execution to the managers. Those days are
over in many, many firms. Organizations are flatter.
Decisions need to be made more quickly and without
the luxury of multiple layers cogitating on each
step of the plan. Executive teams need players
whose instinct is toward action. Can you teach
this? Is it a skill really or an approach to life?
Communication Enhance Leadership and Manager Effectiveness
Businesses are designed with a built-in directional
gyroscope--the senior team. These individuals
oversee the parts of the organization that need
to work together to implement business strategy.
Yet consistent finding in many companies is that
these built-in gyroscopes are broken. The senior
management teams are not doing the fundamental
work that their organizations expect of them--setting
direction, resolving conflicting views about priorities,
and creating the context and culture that will
enable the firm to deliver results. In an extraordinary
number of companies, unclear strategy and conflicting
priorities obstruct performance. The cause, as
perceived by people at lower levels as well as
by members of the senior team, is an ineffective
senior team. When these teams meet they tend to
review results, focus on specific problems, or
discuss administrative matters. They do not dig
into or resolve fundamental strategic issues.
During senior team meetings people tended to interrupt
one another, ignore one another's comments, and
engage in a lot of side conversations. As a result,
the group had difficulty achieving consensus and
making timely decisions, particularly about the
politically charged issues of strategy and organization
design (Holman & Hall, 191-202).
The responsibility for building an aligned organization
cannot be delegated. The senior managers must
work together to define the business strategy
as well as the capabilities and values essential
for long-term success. Should start the strategic
fitness process with a one-day meeting. The senior
management team develops the strategy and drafts
a statement about organizational direction that
will later be used as the basis of the inquiry
into the organization's strategic alignment. To
promote an honest dialogue that uncovers differences
among members of the senior management team, they
should ask each member to prepare individual answers
to six simple but profoundly important questions:
What are the company's objectives and aspirations?
What are the market threats and opportunities?
What is the value proposition you are delivering?
What are the most critical things the business
must do to deliver on the value proposition and
create or sustain competitive advantage?
Which organizational capabilities are needed to
implement the strategy?
Which values should guide the organization?
The senior team's answers to these questions and
their efforts to create a direction statement
revealed to them that they were trying to straddle
two very different strategies. The first was a
reactive strategy--grow sales quickly by responding
to immediate customer needs using existing technology.
The second was a proactive, R&D driven strategy
of building distinctive, technology-based solutions
platforms that competitors could not easily replicate.
In creating the statement of direction, the senior
team for the first time clearly committed itself
to a technology-based platform strategy.( Hubler,
55-89)
The conversation between task force members and
the people they interview is kept focused but
open-ended. Interviewees are asked simply, what
are the strengths to build on and the barriers
to address in implementing this strategy? Task
force members find that respondents are eager
to discuss strategic issues because this is, in
many cases, their first chance to talk to management
honestly about the overall health and direction
of the company. Task force members report long,
emotional interviews. Employees who are not scheduled
to be interviewed sometimes line up outside conference
room doors, hoping for the chance to speak.
The task force's job is to extract from its hundreds
of hours of rich and emotionally charged discussions
the critical issues that matter most. This is
done through a series of screens. At the end of
each interview, the subject is asked to summarize
the two or three most business critical issues
to be shared with senior management. Each task
force member then reviews all of his or her interview
notes and selects the three or four most commonly
mentioned barriers to implementing business strategy,
as well as the major organizational strengths
that need to be preserved. When the task force
members come together, they collate these themes.
The most important ones form the basis for the
presentation to the senior management team. The
task force is careful to illustrate the themes
with descriptions of specific events or projects;
these rich stories provide the top team with an
in-depth view of how the organization really functions.
The stories resemble well-researched case studies.
People have found that these descriptions are
vital to convincing senior management that the
data are real and valid. Senior managers also
respond powerfully to quotes from (unnamed) interviewees,
which tend to bring home the employees' deep commitment
as well as their frustration. (Kim, 37-50)
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