CareGroup

CareGroup was a team of health-care professionals dedicated to providing the best quality care to patients in a highly personalised manner. 

• world renowned academic health centers 
• outstanding community hospitals
• physician offices
• community health centres

October 1, 1996

• CareGroup was formed (merger of The Beth Israel Hospital, the Deconess Hospital and the Mount Auburn Hospital)
• produced $1.6 billion in revenue after merger
• reasons to merge was due to the intense compeititive environment in the Healthcare industry in the mid-1990s
• The hospitals felt that they need to bulk-up negotiating power to push back against the HMO(individual patients and employees and hospitals and patients)*
• HMO is also under great financial pressure from various Banks
• aim to drive down medical costs

The factors that brought CareGroup together

• contacting power needed by the hospitals against the HMOs(increase in size, increase in negotiation and contacting power)
• the possibility of developing integrated services across the hospitals(the hospitals exchanges knowledge with each other and can conclude the most effective methods of healthcare in terms of quality and costs. Thus improves quality of services and drives down costs.)
• The need for a strong balanced sheet in a complex price war(maintain competitveness)

Quick note on the parade state: 

CareGroup has currently 13,000 employees and 2000 medical staff

::Food for thought:: With such a wide scope in their business, how are they going to cope with all the data required? 

My opinions: There is a need for a good IT System to manage the Human Resource side at least. There is a large number of employees in this CareGroup and there is a need to monitor their statuses, and payrolls etc. It is an uphill task if all these are to be done manually, because of the large number of employees. 


Dealing with Issues:
There were alot of financial pressure faced by the CareGroup under two CEOs. 

1. Mount Auburn Hospital - the most profitable hospital for the past 15 years suddenly produced a $10 million loss,and had to reengineer its operations
2. While salvaging MAH, Beth Israe Deaconess began to lose significant amounts of money. 
3. Mid 2002, a change of CEO, he did recover abit, however, Baptist Hospital suddenly incurred a $20 million loss, thus there was a change of new management

However as time passes, each hospital was managed by a different CEO, and financial stability issues went negligent. 

1. Operational coordination across hospitals were difficult (due to history of independence)
2. However, the joint contracting with the HMOs had been very successful(Good)
3. There is an unexpected success in the development of an integrated technology system that linked the entire group together.

Food for thought: It was great that they actually developed an integrated technology system which helps the organisation to work more efficiently. The unexpected success will probably lead to more revenues for this company. 

One of the business processes : IT support by CareGroup

It is able to deliver ample IT support to the hospitals associated with them. This helps to deliver a greater efficiency to the Healthcare hospitals in general and also generate more revenue. Instead of focusing on it's primary job scope, Healthcare, CareGroup actually expanded its scope on IT side. 

November 1, 1998 

CareGroup was given a $41 million project to deal with the Y2K problem. 

Halamka became CIO of CareGroup. Halamka is a talent. 

• Developed a software company at an age of 18
• well educated
• headed a group of 50 data analysts and Wed soecialists developing Web applications for CareGroup

Therefore, with Halamka taking over as CIO, it actually serves as an asset to the company. It can greater enhance the company's already good IT System. 

CareGroup IT

Before Halamka took over: 

• IT organisation was decentralised, nonstandardised operation
• each hospital ran its own system that predated the merger
• complicated computer systems
• antiquated lab system with hand typed results
• 10 yr old homegrown system with non integrated lab and radiology systems
• problematic lab system
• self developed payroll system
• failed operating room system installation
• limited network incapable of remote access

After Halamka take over:

• Common system with Meditech software at the centre
• all had state-of-the-art email, networking, PCs, and clinical/financial informations at costs similar or reduced.
• drop in IT budget(there isnt a need for this budget)
• believed to have the most advanced network in healthcare
• all applications Web enabled - able to access patient's personal health records, X-rays, and records of office visits for the past decade
• three backup generation, tried and tested with lightsout - did not suffer and data outage

Pros:

It made the whole network more organised

Consolidating of data is much easier

Obtaining information of individual patients were much faster and easier

Increased productivity

Increased efficiency

Drop in cost

Cater for larger needs

Cons:

Should there be any crop ups, there are no ready instant information at hand for backups. 

(to add on)

Boxes

HP/Compaq were initial suppliers

Chaned to IBM because they offered better deals

more efficient IT

Outsourcing

CareGroup outsourced their Logistics to PeopleSoft.

- Handle HR, payroll, accountspayable and other logistics 

2002, Halamka suggests modernising the network

wrong decision as there was a significant impact and thus lead to his departure.

CareGroup 

had managed to cut capital budget expenditures by 90%, within 3 years from 2003.

• recognised to provide the best knowledge management service in the United States BUT

13 November, 2002

NETWORK COLLAPSED

why?

• something happened to the monopolised switch
• important part of the network
• algorithms for computing alternative data paths could not operate correctly

Areas affected

• physicians who are accustomed to using technology to prescribe and identify drugs had to do it manually
• doctors, nurses, employees are too dependent on network, had quite abit of problems using paper and write

Despite many recoveries, there network stability remains, failures continued to occur

Outsourced to CISCO

to help solve the problems.

Why CISCO?

They had adequate equpiments ad team to build an entire core network to get CareGroup systems up and running again. 

• CAP Process
• there were flaws

Decision to remain on Backup Procedures

Guns and Dolls, Parenting

Guns and Dolls, Parenting
Renkl, M

Toys may be said to be part and parcel of one's childhood. When it comes to children's choice of toys, does parents really have a say? Or children will go for their choice of toys no matter what hinders them? Does gender really matter? These questions have been in a debate tussle for a long while and no one can actually conclude which side was more correct.


Renkl mentioned that children are actually the source of gender division of toys themselves. She thinks that from young when they were not mature enough, they tend to observe whats happening and finally when they can have some reasoning skills on themselves, they can actually conclude that boys are meant to get dirty,aggressive toys and girls will need to have long hair and look pretty.She also mentioned that when children starts to get older, peer pressure picks up a role in their choices too. Through observation they may have observed certain things like guys dont wear skirts, dont play barbie dolls etc, that might not have caused them to make a different choice, but looking at their peers toys, and their preferences, it may really have caused them to change their choice preferences. I agree with the author about children observe their surroundings from young and depended on it in their choice of toys, and it was made worse with peer pressure. It will tend to be weird if you are a boy and you dont play cars and superheros figurines. Also, it will also reduce to a state of being outcasted if you do not play these kind of toys when all your friends of the same gender are. This contributes to a valid point. However, I would like to question if only through observations and pressure that affects children's choice of toys? It seems like there is an increasing trend of girls picking up aggressive toys like guns, and guys picking up domestic products, however in general, boys still go for their stereotyped toys and girls too. Perhaps the author could have mentioned that kids are also influenced by the presence of media which kind of brainwashed them into choosing the types of toys they want. 


In the middle part of the article,the author suggests that a toy is just a toy for children to past time, and it has no relations to the child's development. This claim was supported by Harvard psychologist Dan Kindlon, stating that there was no link established that toys determine the kind of adult they become. Well, I disagree to this claim as I thought that this sentence is rather based  on an assumption rather than with supported evidence. With the emergence of aggressive and violent toys like transformers,spidermen etc, it is only natural that the character traits in these characters are instilled into the child. These fantasy toys are produced with the common theme of victory or destroy, there is sure a significant influence on how the child would behave, being exposed to such toys. Perhaps, this is not the author's viewpoints, as she merely picked the source from somewhere and put into the essay for us to think through. Maybe it's better for her to critique on this claim too. 


The author also suggests that banning a toy could actually backfire. Parents tend to concern in how the child's character is developed, and thus it is only natural that they only allow certain toys to be given to the child. I agree to her point. Somehow, gender stereotype is something cultivated since young, as it is natural for guys and girls to go for different toys. It's in their genes. Even if a parent gives her boy barbie dolls, the boy might not even like it or play with it. However, when we talk about backfire, we may also be saying that child will go do things otherwise behind their parents, which actually might result in a worse consequences. 


So, can child be nurtured from young? Or is just a natural behaviour and it is impossible to change? I would pick nature. No matter how much you try to nurture your child not to fall into the gender divided loop, there will always be a distinct difference in the choice of toys for boys and girls. The author is also good to suggest that in the nurture aspect, unless the father and mother are willing to cross dress to bring up the child, it is not possible. The child picks up through observations, and they can observe the most from their parents. Thus I think nature should be the reason.


In conclusion, since gender stereotype is ongoing for ages, and there is not much alternatives one can change such a trend, other than educations from school, parents. However, it all depends on how the child is reacting to toys and this behaviour comes from the genes which one cannot really fathom and change accordingly. The author has made the essay such that we can actually think through, and these points are not necessary her point of view but sources taken from different places. It's good that we get to evaluate and analyse each point and we can come to a conclusion. This never ending debate will still go on, it's more important that we know our views. 

What toys make of little boys

What toys make of little boys
Pat Caplan

In the modern world today, when we talk about toys, it would still be a common thing that people will  refer certain toys to boys and others to girls. It has been a trend, or rather, a stereotype that has been generated since ages ago. In the past, where the technology were not so advanced, and there were not many variety of toys, we see children coming out and play things like 'Paper Aeroplanes', and ball games together, regardless of gender, there were not many topics of gender stereotyping to talk about in that context. However, with the generation of toys, there is an increasing trend of gender stereotyping of toys, which makes one wonder why such a trend actually occurs.


The author states that the gender stereotype is actually blown out of proportion due to the effects of the media,marketing and advertising strategies. There have been many toys generated in the past ten to twenty years, from simple toys like cars and dolls to fantasy toys like Power Rangers, Transformers. Looking at how the producers actually market and advertise the toys, where we often see males taking up the dominant roles such as car racer, superheros, and girls are often protected, and likes to doll up in several television series and advertisements, I will conclude that it has thus influenced the way on how children actually feel about certain toys. I agree to a large extend that gender stereotype is contributed by media and advertising strategies,  as with the effect of media, the thoughts of a normal children will actually be altered, and it may just feel rather strange if boys go for barbie dolls and girls take up guns. However, I thought that the writer could have mentioned more about why are toys actually marketed in this manner, as I personally feel that there is this nature aspect in every boy and girl where boys will want to go for more aggressive toys and girls will tend to want to look pretty and doll themselves up.  With this aspect, the claim that gender stereotypes has been blown out of proportion due to media would have been more valid.  The author should not just contribute everything to the media without crediting the nature aspect which kicks off the children's choice of toys in the first place. 


The author mentioned that the effect of gender stereotyping of toys actually could have detrimental effects on a child's behaviour. With the high profile development of the fantasy world, where superheros, monsters, robots come into place, where violence and destruction were the only two keywords they knew about themselves in their world, could have influenced the children to think in this way. I agree to the writer that such influence is caused by the great development of the fantasy world, and the intensity of such idea being fed to the society today, it actually gives rise to violence and aggression among boys, since such genre of toys are catered mainly for boys. This is evident from things that are happening in the world recently, where there is an increase of violence in the U.S., where children at the age of 15 can actually carry guns and carry out a major shooting in schools of the U.S., and also in our home ground, we see a sharp rise in the gang violence which had proved to be fatal. The author also mentioned that such behaviour is rather encouraged and there were no programs to actually discourage such behaviour and educate the young on how such things are to be coped with. I would like to refute his claim on this as this is not true, because there has been quite alot of educational programs in the media that actually mentions about the consequences of their actions, shows like "crime watch", and documentary channels actually catered to this kind of education. I would say this kind of education programs are largely overshadowed by the high profile media on the aspects of the other world, and not none at all. So what the society could do now is to actually place emphasis on educational programmes by including the focus on such programmes in school, media. 


In conclusion, the gender stereotyping is actually expanded in the recent years, which is largely contributed by the influence of media and marketing strategies. The impact of such stereotype is also detrimental. The writer actually gives very good points for us to think through but he failed to provide alternatives and solutions to what is happening now. When we talk about education, I believe parents have also a large part to play. A child will take an example from their parents as they have a direct contact, and things would have been different if the father weren't that manly and the mother weren't that feminine. Education starts from young and the direct source of education is actually from the parents, and not the schools. Thus, the writer could have mentioned more about his. Well, there is a benefit of doubt here as the title suggests what toys made of little boys, strictly speaking, there is not a need to suggest solutions, because the writer just wants to talk about the why and impact of the trend, and not how the society could manage such an impact.