Case Study in Globalization of Hospitals

This chapter demonstrates the application of the GET process in the area of Tele-health, to a hospital. The reason for selecting the domain of Tele-health for this exercise is significant. In the modern communication age, there are still many situations where people who are in pain and/or have an acute need for help have to travel hundreds of miles just to be close to a physician or a healthcare specialist. This scenario is exacerbated by overworked physicians and surgeons, and ever shrinking funds for health care from governments and other funding bodies. Thus the need for, and the value of, being able to provide medical facilities and support by utilizing technology is at its highest leading us to believe in the extreme importance of Tele-health in today’s world. Tele-health is all about the use of technology to ease the ability to provide medical care beyond physical distances, especially in rural areas. Tele-health is also about alleviating the routine pressures on doctors beyond the needs of their own specialist or generalist skills. Tele-health goes further beyond patients and doctors, and also involves education, research and administration in the field of medicine. Given this tremendous importance of Tele-health, it is appropriate that the concepts of globalization discussed in this book, in all its previous chapters, are applied to a case study that deals with a hospital. In this chapter, we have appropriately considered the area of hospital management and patient access to care, in demonstrating the concepts of the GET process, as applied to a hospital. Needless to say, this remains a relatively small part of the overall effort required in globalizing a hospital. Nonetheless, we believe this is an excellent demonstration of most of the concepts discussed here. This chapter results from our attempts at verifying in practice the principles discussed in this book. Therefore, although the entire case study is hypothetical, it has its roots in a real life hospital, with real doctors, nurses, administrative staff, and of course, real patients. By considering the application of GET to Tele-health, we hope we will not only demonstrate the process to our readers, but also show how this process will come in handy in the health domain where globalization is going to become extremely important.

Enabling Technologies for Enterprise Globalizations

We have discussed, thus far, the vision of a global enterprise and the process of achieving that vision. However, it is the technologies available today that have made such globalization possible. In this chapter, we deepen our understanding of globalization by delving into the technologies that facilitate this globalization. In addition to the technically minded reader, this understanding will be helpful to the business reader in correlating the technologies that bring about these transitions. At the outset, it is crucial to understand that the fundamental basis of these technologies is their ability to facilitate communication electronically. Figure 5.1 shows these enabling technologies: Internet

Global Enterprises- Visions and Structures

Successful globalization requires good strategic vision and its implementation. Strategic vision refers to what an enterprise expects to be its ideal image in the long-term future. In the context of globalization, this ideal image is a primary driver for the enterprise’s planning and implementation of GET. The guidelinefor such an envisioning process will be the planning of a strategic vision for the enterprise’s future position. In this regard, it is worth noting what Tregoe and Tobia (1990) have to say: “In the companies we know that are successfully making the transition to a more collaborative organization, the key to success is developing and then living by a common strategic vision. When you agree on an overall direction, you can be flexible about the means to achieve it. …. Really powerful visions are simply told. The Ten Commandments, the Declaration of Independence, a Winston Churchill World War II speech — all present messages that are so simple and direct you can almost touch them. Our corporate strategies should be equally compelling.” It is vital for the success of GET that we develop a strategic vision of a global organization that is as palpable as some of the visions in day-to-day lives.

Enacting Global Enterprise Transitions

Enactment is the application of the theory of the Global Enterprise Transition (GET) process in practice. Thus, while the discussion up to the previous chapter in this book may be considered akin to a roadmap, the discussion here is more like actual driving on the road. Figure 4.1 explains the subtle differences between enactment and the earlier works an organization undertakes during the globalization process. In Figure 4.1, the “Consider GET” phase indicates that the organization is investigating and weighing various options, issues and factors in terms of globalization. These options and factors were considered in detail in Chapter I. As described earlier, this is the state when the organization realizes that irrespective of its current profitability and position in the market, globalization is becoming a serious part of its business strategy for survival and growth. Once the organization is satisfied and its stakeholders are convinced of the need to globalize, it then moves into the phase of “Planning and Documenting the GET process”as shown in Figure 4.1. During this phase, the organization is again applying the discussions undertaken so far in this book, particularly Chapters II and III, which encompass the vision, framework and technologies for global enterprise transitions. These visions and frameworks provide the backdrop for the planning and documentation activities that described the GETs. The organization may be considered in a strategic mode thus far. However, once the strategic aspect of the GET is consummated, the very practical phase of the process — the launching and management of the GET begins. These are the third and fourth states in which the organization finds itself, together called “Enactment,” as shown in Figure 4.1. With the commencement of this practical enactment phase of the GET, various additional and valuable activities like handling the “feedback” from the stakeholders in terms of the efficacy of the process of GET, mechanisms to manage the process in practice and approach to measuring the results of the GET, all come into play. It is this practical phase

Systems and Processes Framework in Global Business Transition

Having argued for and created a vision of the global entity, we now consider the system and process framework for GET. During global transition, organizations often face many explicit as well as implicit factors that could delay or, in the worst cases, even destroy the globalization process. In order to eliminate these unnecessary incidents, enterprises need to identify, document and follow the activities of the process of GET. In the past decade, researchers have made significant efforts to identify the global information systems management (GISM) activities. Most notable are Senn’s six key information technology issues (Senn, 1992), and the eight multinational categories of global information technology challenges by Palvia and Saraswat (1992). Based on the implication of activities on the process of globalization, six categories are identified to facilitate classification and collation of the GISM activities (Figure 3.1). The core concept of categorization intends to provide the organizations with an abstract overview of concerns in relation to the transition to globalization. These categories are labeled as:

Global Enterprise Transitions

Globalization, especially in the business world of the 21st century, is inevitable. Today, almost all businesses face intense competition all around the globe. The rapid changes in the global environment force enterprises to seek suitable business strategies to sustain them. This leads enterprises to change the way they conduct and operate businesses, and transform themselves in a way that will enable them to cope with the global challenges, compete globally and eventually grow. The winners in this phenomenon are the companies that implement their business operations in the most creative and innovative manner possible. Needless to say, this is done through the incorporation of information and communication technology (ICT) into business strategies and goals. In the past few years, IT has been recognized as an imperative factor that drives companies towards global operations (Palvia et al., 2002). Globalization is an all-pervasive phenomena in today’s world, with the business providing a significant context to the overall process. As former U.S. President Bill Clinton (2002) stated in his address at the University of California, Berkeley: