Telecommunications technology in rural health care

Areas of low population density present special problems with respect to the delivery of health services. In this article, an overview is given of some technological approaches to solving these problems. The author's remarks are based on several years of experience of managing a research programme in health care telecommunications, and, more recently, a review of selected Rural Health Initiative and Health underserved Rural Areas projects that utilize a combination of innovations involving telecommunications and computer technologies.     

Valuing and value in diversity: the policy‐implementation gap in an IT firm

The focus of UK‐based research on diversity theory and diversity managers has led to a relative dearth of studies focusing on the critical issue of line managers' agency in policy implementation. This article provides a context‐sensitive organisational case study of the policy‐implementation gap in the UK base of one multinational IT company. The article explores male and female managers' perspectives on valuing diversity at a level of general abstraction, and the extent to which they see value in diversity for the effectiveness of their project teams. In the context of a White, male‐dominated industry, the case study shows how the gap is sustained rather than bridged despite the implementation of numerous diversity initiatives.     

The patient trajectory: A modelling tool for planning rural telemedicine systems

The authors present an analytical tool developed and applied to plan for the use of telecommunications technology to link a non-physician health care provider in a rural satellite clinic to a central source of medical expertise. The principal result obtained is that narrowband technologies appear nearly two- thirds as effective as broadband technologies in averting patient travel.     

‘Control – What Control?’ Culture and Ambiguity Within a Knowledge Intensive Firm*

ABSTRACT This paper explores the distinctive culture that existed within a knowledge‐intensive firm (KIF) and also attempts to explain the emergence and effects of this culture. The findings are based on a detailed case study that was conducted over two years within a consultancy firm that created and applied scientific knowledge and expertise to the invention of solutions for clients. The firm employed highly educated scientists, considered ‘leading’ in their respective disciplines and project work was inherently fluid, complex, and uncertain. These kinds of ‘knowledge workers’, and this kind of work, are expected to demand high levels of autonomy. This creates complex managerial dilemmas around how to balance autonomy with control and uncertainty and flexibility with efficiency. The analysis shows how a strong culture based on an acceptance of ambiguity (e.g. in roles, power relations, organizational routines and practices) promoted the development of a loyal, committed, effective workforce and sustained a fluid and flexible form of project working over time. Critically, ambiguity allowed individuals to sustain multiple identities as both ‘expert’ and ‘consultant’. This, coupled with a corporate identity premised on ‘élitism’, helped to maximize commitment to the work and minimize tensions between control and autonomy. Thus the culture that embraced ambiguity (a consensus that there would be no consensus) engendered a form of normative control whereby consultants operated freely and at the same time willingly participated in the regulation of their own autonomy.     

From imitation to invention: creating commodities in eighteenth‐century Britain

This article presents the history of new goods in the eighteenth century as a part of the broader history of invention and industrialization. It focuses on product innovation in manufactured commodities as this engages with economic, technological and cultural theories. Recent theories of consumer demand are applied to the invention of commodities in the eighteenth century; special attention is given to the process of imitation in product innovation. The theoretical framework for imitation can be found in evolutionary theories of memetic transmission, in archaeological theories of skeuomorphous, and in eighteenth‐century theories of taste and aesthetics. Inventors, projectors, economic policy makers, and commercial and economic writers of the period dwelt upon the invention of new British products. The emulative, imitative context for their invention made British consumer goods the distinctive modern alternatives to earlier Asian and European luxuries.     

The Role of Networks In the Diffusion of Technological Innovation*

This research considers the diffusion of computer-aided production management (CAPM) technology in the UK manufacturing sector during the mid to late 1980s, focusing on the role of inter-organizational networks in the diffusion process. Research on innovation diffusion has tended to adopt a ‘pro-innovation bias’ such that adoption of prescribed best practice technologies is always considered to be the best policy. In the UK, one particular form of CAPM (MRP/MRPII) has been heavily promoted by technology suppliers as best practice. However, the notion of ‘best practice’ de-emphasizes the importance of decisions about technology design when users attempt to develop firm-specific solutions. Crucial to these decisions are the inter-organizational networks through which potential adopters learn about relevant technologies. Using three case companies, where the introduction of CAPM occurred at approximately the same time, decisions regarding adoption, design and subsequent implementation, are explored in order to establish the influence of inter-organizational networks on the diffusion and subsequent appropriation of CAPM technologies. These cases revealed that potential adopters engaged in a range of inter-organizational networks through which they learned about new technologies. However, the knowledge diffused through many of these networks was shaped by technology suppliers who were promoting similar ideas about best practice. Thus, while involvement in inter-organizational networks gave potential adopters access to information about new technology, this information tended to reinforce supplier images of best practice and did not always lead these firms to develop appropriate technological solutions. Problematic relationships between the suppliers of the technology and the users was seen here to limit the redesign and further diffusion of CAPM.     

The role of wasta in repatriates’ perceptions of a breach to the psychological contract: a Saudi Arabian case study

This study examines the influence of a national cultural dimension, specifically a strong orientation towards collectivism/reliance on network relationships, referred to as ‘wasta’, on the way in which psychological contracts form and change in a Saudi organisation. Specifically, it focuses upon how the psychological contract is perceived to have been breached by repatriates because of the role that wasta plays in shaping formal and informal HR practices pre- and post-assignment. The analysis demonstrates that prior to international assignment, wasta was taken for granted and only implicitly acknowledged as influencing selection criteria for assignments and individuals’ expectations and obligations associated with their psychological contract. Once repatriated, wasta was foregrounded and perceived as highly problematic in terms of career advancement. This shaped repatriates’ perceptions that their psychological contract had been breached, influencing their intentions to leave. These findings suggest that the psychological contract can be viewed as highly context-specific, as well as a person-centred phenomenon. We consider the implications of our research in terms of the influence of national cultural characteristics on individual’s perceptions of breaches to the psychological contract and highlight the possible implications generally for Saudi Arabia, which is aiming to be less reliant on foreign labour.