EMR feasability Article Example | Topics and Well Written Essays - 250 words

EMR feasability - Article Example It is feasible to implement Electronic Medical Records (EMR) in hospitals that plan strategically to accomplish the inaugural state requirements of a meaningful use. EMR is an essential and exciting step towards the right direction. Currently in this rural area, there are no certified products of EMR in the market; however, the bodies responsible for certification are already planning to do so. This certification process and technological interoperability within the healthcare facilities have been awarded significant thought and attention by government officials and healthcare leaders. The feasibility of implementing EMR is limited with time; however, the process of implementation is very realistic and feasible. This will bring major changes in the healthcare industry; therefore the implementation process should be given top priority due to its feasibility. The paper has ascertained that creation of inter-related health systems, rather than stay alone silos of rural health care syste ms is a realistic opportunity to implement an EMR medical offices (Jones, 2008). The implementation of EMR is beneficial in the following ways; EMR improves greatly the quality of care through keeping up to date patient records and enhancing their accessibility; EMR allows easy tracking of patients by clinic staff who need follow up care; EMR allows physicians to find comprehensive patient medical records from the past; EMR improves the ability of clinicians to help the patients in managing the treatment of most complex diseases; and it also allows researchers and clinicians to analyze long term trends and patient data. On the other hand, implementation of the EMR has a lot of challenges some of which are: need for training data clerks in data entry and management which can be expensive to the implementer; setting up a system of information technology can be much expensive on the part of the implementer;

The History of Colonial Rule of Puerto Rico by United States :: Historical Colonization spanish Essays

The History of Colonial Rule of Puerto Rico by United States On July 25, 1898 the United States arrived in Puerto Rico. The U.S. defeated the Spanish and gained possession of the island. Despite the intimidation the Americans inflicted on the Puerto Ricans, the Puerto Ricans remained hopeful. The Americans were the representatives of the free world. They had written the Constitution and provided a Bill of Rights for their inhabitants. The Americans were the advocates of democracy, and the Puerto Ricans hoped the Americans would show the pathway to freedom. Unfortunately, the wishes of the Puerto Ricans were never fulfilled. The United States established a military government. The Americans arrived with racist, arrogant attitudes. They deemed the the Puerto Ricans ill equipped for self government, as as the descendants, or pupils of the inferior Spanish. The Americans believed only they could establish Puerto Rico as a respectable nation, because the United States possessed an arrogance rarely seen. As a result, they claimed Puerto Rico as their possession, to do with what they seemed appropriate. What resulted was an adverse effect on Puerto Rico brought upon by Americans, from an economical, political and social standpoint. The rule of the United States over Puerto Rico also further obscured the definition of Puerto Rican identity. The impact of early U.S. Colonial rule had an adverse economic effect on Puerto Rico. Before the arrival of the U.S. in 1898, coffee was the premier enterprise in Puerto Rico. Puerto Rican coffee was highly regarded in Europe for the quality of its flavor and had a price in the markets of Cuba, France, Spain and Germany. After U.S. possession, Spain considered Puerto Rico a foreign country, and raised its import tax on Puerto Rican coffee, while Cuba quadrupled its tariff on the Puerto Rican product.

Left Wing Extremism Essay

Six years back, when on November 4, 2004, the Prime Minister proclaimed Left Wing Extremism as the biggest threat confronting the nation that had to be dealt at ‘war footing’, it had a ring of resolve of a freshly elected government to take the bull by its horns. However, when he repeats the same now, it carries an air of helpless lamentation. The efforts at war footing notwithstanding, during the last six years, the area under Naxal influence has nearly doubled extending to nearly 203 districts in fourteen states. The strength of armed guerrillas has swelled from less than 7,000 then to somewhere around 13,500 now. Left extremists, today, have many more and much sophisticated weapons; (estimated to be nearly 14000 as against 5500 in 2004) and have upgraded their tactics, field craft and skills in handling weapons and explosives manifold. They raise funds nearly to the tune of Rs. 1,200 Crore a year, which in an impoverished area of their dominance is a huge amount to create instability and enables them to pay regular monthly salaries to their armed cadres. Economic conditions of the people have by and large remained unchanged despite sizeable developmental outlays – most of the funds either misused or siphoned off by the corrupt. It would be erroneous to infer that the government took no initiatives both at security and developmental fronts to deal with the situation. However, in terms of results achieved, the efforts made have failed to achieve the expected results. It makes it a case less of error of intention, and more of lack of capability, which in a national security paradigm is a cause of much greater concern. The matter that needs to be pondered over is why a country of India’s Comprehensive National Power is unable to cope with an existentialist threat from an ideology that has been defeated and discredited world over, is unable to counter an offensive by under-resourced and ill trained tribals and despite being world’s biggest democracy is unable to mobilize its civil society in its fight against the extremists, whose agenda is patently anti-national. The first requirement for designing an effective response is to accept the realities as they are and to make a hard assessment of the enemy – his mindset, doctrines, capabilities and goals. One can not win unless one fights and one can not fight till one is able to define the enemy – boldly and bluntly. One major reason why we, as a state, have often gone wrong in our responses and not derived full value out of our efforts and sacrifices is our fear to face the hard realities as they exist, notwithstanding the compelling evidence. What needs to be accepted by all those in power and those who aspire for it is that Left Wing extremism is pure and simple terrorism that fully meets the conventional definition of the term i. e. Use of violence to terrorise people for achieving political objectives’. Their armed struggle is for acquiring and then retaining political power through barrel of the gun and both in theory and practice they have not deviated from this goal. While often advanced causative factors –developmental, social, political etc. – may have ample justifications on their own merit, for Maoists they are only instrumentalities to seize political control. In pursuance of this end, they are prepared to make a common cause with all those who are inclined to give expression to their dissent through violence. They support everything that negates Indian nationhood – may it be the secessionists in J&K, insurgents in North East, radical Islamic groups or armed ethnic groups. In an interview in 2007 Ganapathy, the Secretary General of CPI-Maoists asserted â€Å"We see the Islamic upsurge as a progressive anti-imperialist force in the contemporary world. It is wrong to describe the struggle that is going on in Iraq, Afghanistan, Palestine, Kashmir, Chechnya as Islamic fundamentalism. Our Party supports the Islamic upsurge†. Commenting on 26/11 massacre of Mumbai, Bimal, Polit Bureau Member was quoted in Hindustan Times that â€Å"We do not support the way they attacked the Victoria station, where most of the victims were Muslims. At the same time, we feel the Islamic upsurge should not be opposed as it is basically anti-US and anti-imperialist in nature. We therefore want it to grow. † Varavara Rao referring to North East insurgencies stated on May 13, 2007 that â€Å"This is a time for all revolutionary, democratic and nationality movements, like the ones in Kashmir and the Northeast to unite, and something will come out of this unity†. They stand against India’s sovereignty, unity, democratic polity and civilisational values and hence will have to be fought and defeated at all planes – ideological, political, and physical. Any dilution in accepting this basic character of the threat will only compound the problem and prolong the national agony. Having settled the goal, the next stage is working out the strategy to achieve it. It is obvious that the policy of ‘blow hot blow cold’ does not work and only betrays the confusion indecisiveness of those in power. It also demoralizes the security personnel. Indecisiveness is a consequence of fear and needs to be shunned. The security apparatus of the country, given the right resources, empowerments and leadership is quite strong and resilient to take on the Left Extremists. They need to be provided best of weapons, vehicles, communication equipment, armoured personnel carriers, night vision devices, portable gen-sets, direction finders etc. There is also an urgent need to improve their living conditions, making safe their work places and keeping their morale high. Most importantly, tactical plans should be well deliberated upon by senior and experienced officers and wherever possible duly rehearsed. It is particularly necessary where central forces have to work along side the local police forces. Maoists are great political analysts who carefully work-out their long term strategy and tactical plans. Maoists in their political estimates assess, and probably with some justification, that the political class in the country, irrespective of the brand names that they carry, are fast losing their legitimacy and credibility. The elected representatives hold their positions more by virtue of legality of the process that catapultes them to power than the moral authority, trust and respect of the people that they claim to represent. The credibility of the governmental apparatus to provide a sense of security and justice to the people, redress their basic grievances, assure development and assure dignity is at a low ebb. Most of the extremist actions analysed in strategic terms are aimed at exploiting this in firmity and indulging in acts will further erode the legitimacy and credibility of the system. Their attacks on police and para-military forces are aimed at demonstrating that the coercive power of the government is a myth as it is even unable to protect itself. Their holding Jan Adalats, imposing fines and dictating terms for talks are calculated to undermine the government’s ability to enforce its writ and authority and gave credibility to their propaganda that government is only a ‘paper tiger’. On the contrary, the state has been able to do little to demolish the contrived self image of the Left Extremists as saviors of the people. The discordant voices within the government and display of confusion and indecisiveness immensely boost their moral. While the far flung tribal areas are in the news because of incidents of violence what is lesser known is their fast spreading influence in urban suburbs, among the trade unions, unemployed youth etc. much beyond the tribal areas. To meet this grave challenge the political class first needs to do a serious introspection and subordinate their party interests if not for the larger national interests than at least for their own self interest. All political parties need to realize that they face an existentialist threat as the political power, the booty of the war, has to be seized from them. This is a classical model of Fourth Generation Warfare-(4GW) – a warfare where the enemy is invisible and the battle is for the control of civil society – through coercion, controlling the hearts and minds of the people or delivering results by redressing grievances of the people. The modern day guru of Fourth Generation Warfare, William Lind aptly observes that, â€Å"If nation states are going to survive, people in power must earn and keep the trust of the governed. Addressing the American Council of Foreign Relations he said â€Å"The heart of Fourth Generation Warfare is a crisis of legitimacy of the state†. How true to the Indian model when he added that, â€Å"The establishment is no longer made up of ‘policy types’- most of its important functionaries are placemen. Their expertise is in becom ing and then remaining members of the establishment. Their reality is covert politics and not the competence or expertise†. When the 4GW will visit them their response would be to â€Å"close the shutters on the windows of Versailles†. Majority of the people in Maoist affected areas and even their supporters and cadres have little to do with Maoism at ideological level. They are only alienated and angered people with real of perceived sense of injustice, oppression and indignity. Maoists are cleverly exploiting this sentiment to their advantage – caste conflicts in Bihar, resentment against landlords in Andhra, discontent against forest laws in tribal areas, unemployment amongst youth and radicalism among Muslims are all given prescription of capture of power through gun as the ultimate solution of all their problems. While the local grievances need to be effectively addressed through improved governance and ruthless accountability, there is also a need for creating mass awareness of the ultimate designs and consequences of what the extremists stand for. Maoist propaganda must also be effectively countered, particularly at the political level. Democratic political parties have plenty of political arguments and facts in their favour to demolish the subversive propaganda of the Left extremists. They also have reach and access upto village levels with intimate social networking that needs to be arnessed. This task cannot be undertaken by the government agencies or the police. Additionally, through a concerted, credible and sustained psy-war offensive contradiction in their ideologies and practices, tales of their brutalities, collaborations with the rich to collect funds, incidents of moral turpitude etc. should be highlighted. The local and national media, think tanks and NGOs operating in the region could be leveraged for the purpose. Some of their front organizations, masquerading as think tanks and NGOs engaged in subversive propaganda also need to be tackled effectively. At tactical level the most important advantage of 4GW warriors is the advantage of invisibility. Only quality operational intelligence can make them visible for counter tactical operations aimed at pre-empting, preventing and punishing the depredators. It is also the only instrumentality through which they can be tactically surprised and their advantage of speed and surprise neutralized. The tendency to raise additional battalions without corresponding accretion in operational intelligence capability creates little pressure on the extremists and only provides them more targets to hit at. State Police forces, with their intimate knowledge of the terrain, language and local people are best equipped to develop ground intelligence. They need to be resourced and trained for intelligence work. Diversion of at least 30% of central modernization grants to state police for intelligence up-gradation should be made mandatory. Money is one of the most important factors helping extremists to acquire weapons and explosives, raise their cadre strength by recruiting youth on regular salaries and carrying out mass mobilization programmes. They are reportedly collecting Rs. 1,600 crore a year, which is a big money for carrying out armed insurrection in an impoverished area. With a determined effort and much lower risk, the governments can take stern actions against business houses paying protection money, transporters paying levies, contractors giving taxes and corrupt government officials sharing the loot from the developmental funds. Most would be willing to cooperate if provided sense of security and protection which can be achieved at a much lesser cost. There is no doubt that this menace ultimately will be contained and countered. A finely chiseled strategic response is required only to minimize its cost to the nation in terms of valuable lives lost, growth and development stalled and innocent people falling prey to malicious propaganda of the extremists. The civil society and opinion builders have a vital role to play in this. They should create right pressures on the politicians and create broad spectrum awareness among the people to help bring about a convergence in national response.

Managing Operational Risk In Financial Institution Finance Essay - Free Essay Example

Sample details Pages: 7 Words: 2063 Downloads: 2 Date added: 2017/06/26 Category Finance Essay Type Research paper Did you like this example? Q1. Explain the internal control failures that allowed this fraud to occur and recommend what steps you would take to improve the risk framework at Caforilus to prevent similar loss events occurring? The fraud that occurred at caforilus was not due to one single factor but there were multiple factors which encouraged the fraud to occur. All three lines of defence failed to overcome the fraud the first line of defence, the business line failed to establish and maintain stronger risk controls, risk culture, risk appetite, on day to day responsibilities of business line second line of defence the oversight, which failed to monitor the risk guidance in the firm this involve compliance, legal and finance, IT security, HR functions and risk management functions, the third line of defence is the risk assurance where the internal Audit committee failed to provide independent assurance. Don’t waste time! Our writers will create an original "Managing Operational Risk In Financial Institution Finance Essay" essay for you Create order All three levels reports through to the board and are all responsible to it, so the fourth line of defence in a sense is the board but in caforilus it is the Board the Director of marketing and sales was corrupt and made a fraud so knowingly or unknowingly all three lines of defence failed to report the fraud. Firstly we will look at the Cause, Event and Effect. The Cause to the fraud was poor process, system, people, Technology. Event was internal fraud and Effect was scam of  £8 million, Jail to the sales and marketing Director, loss of reputation, effect on staff moral, possible fine by FSA, loss of shareholder wealth. There were plenty of indicators to the fraud at caforilus but everyone turned a blind eye. There were plenty of internal control failures which allowed the fraud to occur. People:- The internal fraud was created by the director of the sales and marketing mark Hughes, who created a miscellaneous account and solely authorised all the transactions. Helen Northcroft realised the fraud but due to the lack of training or knowledge wasnt sure of what action to take or who she should report to. HR department as the report doesnt say if there were any checks made on Mark Hughes before employing. Chief Internal Auditor Keith Garret, didnt took any action and just ignored to Helens suspicions. Kelly Feingold who worked in operational risk department wasnt sure about what action to take and thought Steve (Operational Risk Director) is a good friend of Mark so wouldnt take action so she did not reported but got James Bellamy from the fraud Department to look into. Finally James Bellamy got control of the situation and exposed Marks fraud. Process:- There were no internal audit checks carried out, even if there was audit then the audit team failed to pick up the fraud which was occurring. There was no oversight of invoices, all invoices were approved by the director of the sales and marketing, and were not back checked by the finance department. Top management had concentration of power, so for decision making no other department managers were consulted. Few invoice were raised for same amount under different company names for same date but yet not been noticed by the finance department. Daily transaction reports were not been produced in organisation, so no past records could be checked. Authorisation of payment was only by one person i.e. the marketing and sales director. Technology Caforilus did not had proper technology to prevent fraud, eg. Same amounts, same date, same services, invoices were paid, if caforilus had proper technology then the fraud would have detected at the very first. Environment Poor risk control culture as no one, apart from Helen or James took initiative to investigate the fraud. The culture was developed that everyone turned on blind eye, it could be said that directly or indirectly many other people were involved but all turned on blind eye to marks seniority. A culture was developed that director was a problem solver, a good guy, giving out freebies, get things done, so no one was ready to believe that such a person could create fraud. Staff member felt pressure and felt threatened to be fired if challenged somebody. There are plenty of loopholes into the system of caforilus which led fraud to occur, some recommendation that could be given to prevent the fraud to occur in future are. Training and Development:- It is very important in a firm that relevant training is given to each member to do their work efficiently. In caforilus we could say company lacked of training and development as the head of marketing and sales wasnt sure of who to report to about the fraud, when she came to know about the fraud she would have taken the step and could have had directly contacted the external company to check the invoice and the fraud could have had caught so more training is required to senior managers to detect fraud and how to solve it. Head of finance department to check the accounts at least once a month so if any fraud occurring could be noticed immediately. No authorisation/signage of cheque by one person two signatures required on any payment and that too both authorised person need to be from different department. So in case of caforius one sign from director of sales marketing then other sign from the head of finance department. Regular Internal Audit to be taken. Audit staff to take independent audit and not to make any judgements on person nature. Audit committee to be independent and any relationships that unduly influence the professional judgement should be avoided. Create a climate of discipline and control which would help to reduce the opportunity of fraud. Oversight of any payment no matter even if authorised by director. Stronger corporate governance structure. No one person decision but should be group involvement. Director to conduct meeting with the head of the department before any contracts been given out, and to update to staff of any decisions taken solely, Director to report to NED. Q2. Discuss why financial institutions are vulnerable to people risks and recommend how Caforilus could reduce its exposure to these risks? Managing people risk plays a very important role in any company. (Blunden T, and Thirwell J, 2010) says, Most operational risks are ultimately the result of people failure whether at strategic, managerial, or operational level. Financial institutions specifically are very vulnerable to people risk we could see this form the events that have occurred in past and which have led many financial institution to collapse for eg. Incident at Barings due to one person Nick Leeson a rouge trader who concealed unauthorised trading activities and made a fraud of $1 billion and led Barings to Bankrupt. (www.erisk.com) Similar fraud have occurred with Daiwa Bank, Natwest, Allied Irish Banks, which have faced huge losses due to people, so for any event and losses or failure ultimately people are going to be the cause unless its any natural cause of god, (Martin. P, 2009) says, there are two causes to operational risk event, one is an act of God and other is the people. People design and maintain processes and system and cause operational risk events by either doing something they should not be doing or not doing something they should be doing. T. Blunden, (2010) says People are essentially honest they do not come to work to defraud or to cause disruption. It is often true but the system which has some loopholes or process that are ineffective, motivate people to do fraud, or even due to lack of training, competence, experience, stress, bereavement, unemployment, health problems etc, many lead to errors and losses. So to overcome from these people risks there are some key controls such as, Training and development, Appraisal and rewards, effective management, openness and transparency, selection, rewards, staff retention, system update, etc, are some controls which could help and reduced people risks. In Caforlius the loss of  £8 million was encountered of people risk. There was one person who created the fraud but there was involvement of many other, who either turned a blind eye or just didnt bother to challenge the director for his fraud. Some recommendations could be given to reduce such a risk in future. There was no culture of openness and transparency in Cafarilus, many knew about the fraud but didnt report due to Marks seniority. So a culture needs to be developed to challenge the fraud and report it either a system to be developed where losses/events could be reported anonymously. Need of effective management structure, an effective system where communication could run freely from up and down, clearity of the roles and responsibilities to individually. Getting friendly with the staff, knowing them, rewarding them, are good sign of motivation but when it obstructs individual from taking professional duties then it could be a risk for the company, so from Caforilus the chief internal auditor director, operation manager, missed to take their professional duties and so such a pattern of bribe should be avoided. Financial companies are vulnerable to risk so training and development plays a key role to avoid risks. In Caforilus we see lack of training and development, head of department to be made aware of what fraud could occur and what action to take to overcome them. Staff appraisal to be conducted quarterly, which would help to know the employees better, openly taking suggestions from the staff, help to know what training could be required to developed and perform the duty better. Q3. Explain the importance of risk culture, critically analyse the risk culture at Caforilus and recommend how this could be improved? Risk culture plays a very important role in any organisation. A favourable culture is essential for the effective management of operational risk. The institute of operational risk, (2010) says a firms organisational culture it values and valued behaviours will under pin the risk culture, the openness, trust, honesty and integrity from a strong risk culture of an organisation. The openness and transparency encourage people to risk reporting, encourage challenging debate at all levels, increases the risk awareness helps to understand the duties motivates people to better do their job. But this culture must come from CEO, senior manager who must motivate and form a relevant culture in organisation, it could be said that culture is strongly influenced by its leadership. Developing and maintaining the right risk culture is highly influential in the effectiveness of the risk management. A favourable culture is essential for the effective management of operational risk. The favourable cul ture develops. High degree of personal responsibility and empowerment to take appropriate risk. It motivates employees to better do their jobs and enhances the organisation performance. It helps to built up staff morale. It develops high level of staff integrity. It develops positive environment where no staff are intimidated on their mistakes. It makes a continuous improvement of organisation where people take challenge and responsibility for being more effective and efficient. It makes aware about the risk. It brings stronger communication throughout the organisation. It brings expertise into organisation. However for a culture to be effective it is important a strong risk culture is embodied by the Boards and senior managers. In caforilus we see a poor culture through the organisation. There was loss of staff morale, weak communication between the departments; duties were not fulfilled by Audit committee or the operational risk department, finance de partment not overseeing the pay outs. Which all lead to a scam of  £8million so its very important that the Boards and senior managers play a positive role and develop a strong risk culture. Some recommendations that could be given are: Making people aware about the risk, educating them about the risk and risk controls. Making people understand about the importance of their duties and how it relates to risk if not fulfilled. Developing stronger controls throughout the organisation and letting people know of what is expected of them. Creating openness and transparency to the organisation which will develops a stronger culture. Provide better understanding of the organisation risk appetite. Segregation of duties and periodically rotation of senior staff so that would give a better understanding throughout the organisational functions to seniors, and even as in case of caforilus it would avoid developing internal contacts for personal benefits. So could be conclu ded that the risk culture at cafotilus wasnt strong so it increased the vulnevability of organisation.