Regulatory hurdles risk slowing US telemedicine surge

Significance Utilisation has fallen as movement restrictions have eased, but it remains far above pre-pandemic levels, implying a secure foothold in mainstream healthcare provision. This could lay the groundwork for a redesign of the fractured and expensive US health system to improve access, quality and affordability. Health-tech firms are attracting record private equity funding. Impacts Virtual care could expand access to healthcare for underserved urban and rural communities. Digitalisation of healthcare will not bring transformative benefits without reengineering healthcare's workflows and financial incentives. With two in five US residents covered by federal government-funded health programmes, lawmakers can set industry norms for telehealth. App-based health-tech services will drive a convergence of wellbeing and healthcare platforms.

2018 ◽  
Vol 8 (3) ◽  
pp. 293-304 ◽  
Author(s):  
Chukwuka Christian Ohueri ◽  
Wallace Imoudu Enegbuma ◽  
Ngie Hing Wong ◽  
Kuok King Kuok ◽  
Russell Kenley

Purpose The purpose of this paper is to develop a motivation framework that will enhance labour productivity for Iskandar Malaysia (IM) construction projects. The vision of IM development corridor is to become Southern Peninsular Malaysia’s most developed region by the year 2025. IM cannot realise this foresight without effective labour productivity. Previous studies have reported that the labour productivity of IM construction projects was six times lower than the labour productivity of Singapore construction projects, due to lack of motivation among IM labourers, and a shortage of local skilled labour. Therefore, there is a need to study how to motivate IM construction labourers, so as to increase their productivity. Design/methodology/approach A quantitative research method was used to collect data from IM construction skilled labourers and construction professionals, using two sets of questionnaire. The respondents were selected using a purposive sampling technique. In total, 40 skilled labourers and 50 construction professionals responded to the questionnaire survey, and the data were analysed using Statistical Package for Social Science software (version 22). Findings The analysis revealed the major factors that motivate labourers participating in IM construction projects. The factors were ranked hierarchically using Relative Importance Index (RII) and the outcome of the ranking indicated that effective management, viable construction practices, financial incentives, continuous training and development, and safe working environment were the most significant motivation strategies that positively influence IM construction labourers. Originality/value The study developed and validated a framework that can be used to boost the morale of IM construction labourers, so that their productivity can be increased. Implementation of the established motivation framework will also lead to career progression of IM construction labourers, based on the training elements in the framework. This career prospect will attract local skilled labourers to participate in IM construction projects.


2016 ◽  
Vol 19 (2) ◽  
pp. 33-44 ◽  
Author(s):  
Martin Whiteford ◽  
Glenn Simpson

Purpose The purpose of this paper is to provide an exploratory account of the links between devolution, homelessness and health in the UK. Specifically, it focusses on the policy context and governance structures that shape the systems of healthcare for homeless people in London, Scotland, Wales and Northern Ireland. Design/methodology/approach Empirically the paper draws on semi-structured interviews with a small sample of policy and practice actors from the devolved territories. Qualitative interviews were supplemented by a comparative policy analysis of the homelessness and health agenda within the devolved regions. Theoretically, it takes inspiration from Chaney’s concept of the “issue salience of homelessness” and explores the comparative character of healthcare as pertains to homeless people across the devolved territories. Findings The paper provides clear evidence of areas of divergence and convergence in policy and practice between the devolved regions. These features are shown to be strongly mediated by the interplay of two factors: first, the scope and scale of national and local homelessness prevention strategies; and second, intra-national variation in public health responses to homelessness. Originality/value The paper offers considerable insight from a comparative policy perspective into the nature of healthcare provision for homeless people in the devolved regions.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Imranul Hoque

PurposeThis study aims to investigate how buyer-assisted lean intervention in garment supplier factories affects garment suppliers' productivity and production capability development.Design/methodology/approachEmploying a qualitative research approach and a lean intervention design, a multiple case study method was adopted for this study. Quantitative data on productivity performance and qualitative data on production capability development were collected from a Danish buyer and their four corresponding garment suppliers. Collected data were analysed using standard lean measurement tools and qualitative data analysis techniques.FindingsThis study demonstrates that buyer-assisted lean intervention is a useful strategy for garment suppliers to enhance their productivity and production capability. However, suppliers need to select the right lean tools, ensure seriousness and commitment to lean initiatives, substantial involvement of top management and workers, arrange formal and informal training, provide performance-based financial/non-financial incentives and nurture a learning culture to facilitate suppliers' production capability development.Research limitations/implicationsThis study implemented few lean tools in a single sewing line in four supplier factories for a short intervention duration. Thus, there is a scope for future studies to investigate the impact of the lean intervention on a large scale.Practical implicationsThe findings of this study might bring new insights to the management of buyer and supplier firms concerning how buyers could involve in suppliers' lean intervention initiatives and what suppliers need to ensure to develop production capability.Originality/valueFor the first time, this study engaged a buyer in suppliers' lean intervention initiatives to improve productivity and production capability in the garment industry of a developing country.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Bertrand Géradin

Purpose Luxembourg is the jurisdiction of choice for many private equity and venture capital investors/funds. Though the optimum balance of financing instruments in relation to any structure varies according to its particular circumstances, one factor that all Luxembourg domiciled FDI structures have in common is the requirement for an appropriate level of equity investment. This article intends to summarize some of the topics frequently encountered in relation to equity structuring choices. Design/methodology/approach Author details the different steps and choices available to investors and funds. The article offers answers to questions to provide a broad, yet detailed, overview of the process and journey; from selecting the vehicle right through to distributing to investors, governance, and compliance. Findings To avoid an expensive mistake, it is paramount that the private equity or venture capital investors and management team receive detailed advice to ensure: (i) the deal is structured in the most tax efficient manner possible and the commercial deal is suitable for all parties, and (ii) the deal is structured in a manner which is effective under Luxembourg law, for both tax and legal purposes. Practical implications It is important that non-Luxembourg lawyers are able to identify key issues when negotiating the terms of the investment documents, in particular, the articles of association and shareholders' agreement. Originality/value Practical guidance from Luxembourg lawyer specializing in corporate law, mergers and acquisitions, venture capital and private equity transactions.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Harry Barton Essel ◽  
Dimitrios Vlachopoulos ◽  
Dickson Adom ◽  
Akosua Tachie-Menson

Purpose The purpose of this study is to explore the characteristics and potential effects of teaching and learning through audio teleconferencing (dial-in) with a cell phone. In addition, the study aims to identify the associations between the audio teleconferencing and video teleconferencing in a 12-week postgraduate course. Design/methodology/approach The study is a cross-sectional survey conducted at the Department of Educational Innovations at the Kwame Nkrumah University of Science and Technology from March to June 2020. The purposive sampling technique was used to sample 100 postgraduate students who registered for a course in the department. The data for the study were collected using the System Usability Scale (SUS) and 17-item self-administered eQuestionnaire. Multiple Linear Regression analysis, ANOVA, Independent sample T-test and Mann–Whitney U-test were used to estimate the differences in course achievements of students who experienced education through audio teleconferencing and those who experienced education through video teleconferencing. Findings In total, 59% of the participating postgraduate students chose to attend the synchronous online lectures via audio teleconferencing (dial-in). The participants gave a high SUS score (SUS > 80.3; Grade A; Excellent) for audio conferencing service. Among the students in the audio teleconferencing cohort, the results evidenced a strong positive linear correlation, (r (57) = 0.79, p < 0.05), between the individual adjective ratings and the SUS scores. There was marginal significance among demography of students in the audio teleconference (AT) cohort with regards to their perception about the dial-in lecture. There was no statistically significant difference, (t (98) = 1.88, p = 0.063), in the achievement test for AT students and video teleconference (VT) students. The instructors and the students were satisfied with the AT. Practical implications Based on the students’ preference, AT offers equal benefit as VT with regards to system satisfaction and perceived quality of online teaching. AT, as teaching modality, should be an option for students who reside in communities with high latency internet connectivity. It is recommended that instructors are trained on how to engage and motivate students via AT. Originality/value Higher education institutions in Ghana are facing decisions about how to continue learning and teaching through flexible pedagogy, while keeping their faculty members and students protected from the COVID-19 pandemic. Many of these institutions have canceled the brick-and-mortar education and other conventional learning practices and have instructed faculty to adopt online teaching through synchronous video teleconferencing platforms. However, the learning experience is not the same for students who reside in remote or rural communities with low bandwidth. There is very little research in this topic, especially in developing countries like Ghana, and the present study aims to bridge the gap in the literature by exploring the characteristics and potential effects of teaching and learning through audio teleconferencing (dial-in) with a cell phone, in the context of a 12-week postgraduate course.


2017 ◽  
Vol 6 (3) ◽  
pp. 86-100 ◽  
Author(s):  
Sana Azeem ◽  
Malik Asghar Naeem ◽  
Abdul Waheed ◽  
Muhammad Jamaluddin Thaheem

Purpose The purpose of this paper is to investigate the barriers inhibiting the adoption of green building and measures to promote this approach in Pakistan. Design/methodology/approach Barriers and measures were identified and examined by using a combination of research methods, including literature review, questionnaire survey, and in-depth interviews with the construction industry-related practitioners working in Pakistan. Ranking technique and factor analysis were used to identify the significant issues associated with the adoption of green building practices. Findings As per the survey results, the most critical barrier is “lack of awareness among people about the importance and advantages of adopting green building practices,” followed by “lack of incentives from government” and “lack of green building codes and regulations,” respectively. The results also indicate that most important measure to promote the adoption of green buildings is “creation of public awareness toward green initiatives through seminars, workshops, and discussions,” followed by “availability of green building codes and regulations (mandatory to apply)” and “financial incentives and penalties by the government (e.g. soft loan, tax) for promoting green building practices,” respectively. Research limitations/implications Research limitation is that its findings, other than Pakistan, cannot be generalized to other developing countries. Practical implications Findings of the research will be helpful in sensitizing the regulatory agencies, the policy makers, and the building construction practitioners about the barriers to adoption of green building practices. The suggested measures will help in devising policies and economic measures to promote the construction of green and environment-friendly buildings. Social implications This research will help the common people to know about the importance of green buildings that may lead to a deviation from the practice of traditional buildings to a widespread trend of building green buildings. This will lead to drastic reduction in demand for energy and considerable monetary savings for the common people. Originality/value The findings of this study are expected to contribute valuable information to decision makers for the better understanding of key issues that call for more attention in the promotion of efforts of green building practices in Pakistan. The results are based on the perception of local stakeholders, but might also be helpful for policy makers in other countries.


2016 ◽  
Vol 17 (2) ◽  
pp. 35-38
Author(s):  
Samuel Lieberman ◽  
John T. Araneo

Purpose To discuss the US Securities and Exchange Commission’s (“SEC’s”) increasing focus on disclosure and conflict-of-interest problems arising from how private equity fund (“PE Fund”) managers allocate expenses between management and fund investors. Design/methodology/approach This article summarizes the background of this focus on expense allocations and, drawing from the recent SEC enforcement actions focused on this issue, and identifies the types of both expenses and disclosures that have caught SEC attention. Findings After spending the first two or three years post Dodd-Frank raising awareness of these issues, the SEC has begun to impose large fines over expense-allocation conflicts and disclosure issues. Practical implications It is imperative for PE Fund managers to retain counsel to review their fund offering documents, expense allocation practices, and compliance programs to ensure consistency with the SEC’s recent decisions on these issues. Originality/value Practical guidance from experienced financial services lawyers.


2021 ◽  
Author(s):  
Liam Rose ◽  
Linda Diem Tran ◽  
Steven M Asch ◽  
Anita Vashi

Objective: To examine how VA shifted care delivery methods one year into the pandemic. Study Setting: All encounters paid or provided by VA between January 1, 2019 and February 27, 2021. Study Design: We aggregated all VA paid or provided encounters and classified them into community (non-VA) acute and non-acute visits, VA acute and non-acute visits, and VA virtual visits. We then compared the number of encounters by week over time to pre-pandemic levels. Data Extraction Methods: Aggregation of administrative VA claims and health records. Principal Findings: VA has experienced a dramatic and persistent shift to providing virtual care and purchasing care from non-VA providers. Before the pandemic, a majority (63%) of VA care was provided in-person at a VA facility. One year into the pandemic, in-person care at VA's constituted just 33% of all visits. Most of the difference made up by large expansions of virtual care; total VA provided visits (in person and virtual) declined (4.9 million to 4.2 million) while total visits of all types declined only 3.5%. Community provided visits exceeded prepandemic levels (2.3 million to 2.9 million, +26%). Conclusion: Unlike private health care, VA has resumed in-person care slowly at its own facilities, and more rapidly in purchased care with different financial incentives a likely driver. The very large expansion of virtual care nearly made up the difference. With a widespread physical presence across the U.S., this has important implications for access to care and future allocation of medical personnel, facilities, and resources.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Frances Barraclough ◽  
Sabrina Pit

PurposeThe COVID-19 pandemic has led to “forced innovation” in the health education industry. High-quality training of the future rural health workforce is crucial to ensure a pipeline of rural health practitioners to meet the needs of rural communities. This paper describes the implementation of an online multidisciplinary teaching program focusing on integrated care and the needs of rural communities.Design/methodology/approachA multidisciplinary teaching program was adapted to allow students from various disciplines and universities to learn together during the COVID-19 pandemic. Contemporary issues such as the National Aged Care Advocacy Program for Residential Aged Care COVID-19 Project were explored during the program.FindingsThis case study describes how the program was adopted, how learning needs were met, practical examples (e.g. the Hand Hygiene Advocacy within a Rural School Setting Project), the challenges faced and solutions developed to address these challenges. Guidelines are proposed for remote multidisciplinary learning among health professional students, including those in medical, nursing, pharmacy, dentistry, and allied health disciplines.Originality/valueThe originality of this program centers around students from multiple universities and disciplines and various year levels learning together in a rural area over an extended period of time. Collaboration among universities assists educators in rural areas to achieve critical mass to teach students. In addition it provides experiences and guidance for the work integrated learning sector, rural health workforce practitioners, rural clinical schools, universities, policy makers, and educators who wish to expand rural online multidisciplinary learning.


2014 ◽  
Vol 2 (2) ◽  
pp. 192-208
Author(s):  
André de Waal ◽  
Maarten Roobol

Purpose – In the home furnishing industry outside contract installers produce higher quality work than in-house installers which is reflected in less revisits to customers to repair mistakes. Many home furnishing retailers are therefore contemplating introducing so that the quality of the work of in-house installers will be linked to financial incentives, thus resembling the situation of contract installers. However, a necessary condition for a successful introduction of bonuses is that in-house installers are motivated by it to deliver better quality work, i.e. cause less revisits. The purpose of this paper is to look into the question whether the introduction of bonuses could be used to increase the quality of work of in-house. Design/methodology/approach – For the research the four steps of the evidence-based HRM framework, as developed by Rousseau and Barends (2011), were used. In steps 1, literature review, the research question was formulated based on work motivation theories (in particular on intrinsic and extrinsic motivation, bonuses, and the differences between contract workers and organizational employees). In step 2, systematic gathering of facts, two existing questionnaires were combined to measure the motivation of the two types of installers. Findings – In step 3, evaluation, the differences between the motivational factors and attitude towards bonuses was analysed for both groups of installers. The research results show that although in-house installers are potentially motivated by bonuses, they differ so much from contract installers in their general work motivation that introducing bonuses by no means will be a success. In step 4, ethical considerations, the consequences of the research findings were discussed. Research limitations/implications – The main limitations are the use of a self-constructed questionnaire and the fact that the research was conducted at only one case company, thus rendering the generalization of findings problematic. Practical implications – The practical implication of the study is that management of the case company can now better prepare itself for the issues to be expected when introducing bonuses for the in-house installers. Originality/value – This research adds to the literature on the effects of bonuses on motivation. It also addresses a gap in the literature as there is currently hardly any academic literature on the conditions necessary to introduce bonuses for craftsmen successfully, and on whether this introduction is advantageous for organizations in the first place. In addition, the case company offered the opportunity to research the issue in a comparative way, by looking at the motivational factors influencing in-house installers and contract installers who work in the same conditions, something which to the knowledge of the authors has not been done before. Finally, the sue of an evidence-based HRM framework is quite unique for the human resource management field.


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