Forms of Communication in a Fast Paced Environment

As world becomes more dependent on technology to store and obtain information quickly and effectively, there has been increasing concern in the social work community about protecting privacy and maintaining confidentiality, especially in a managed care environment. The concept of confidentiality is very different in a technologically advanced environment.

Introduction

A three-level topology of client problems and behaviors is delineated and illustrated through practice examples, which demonstrate the different types of information that can be computer stored and retrieved and electronically transmitted. The article discusses levels of security, including log-on procedures, firewalls, and encryption, which can be used at each level to protect sensitive information, and presents guidelines to help professionals protect and promote confidentiality within the constraints of technology and managed care. (Barney, 2002, p.99-120)

Managed information is also the focus of increasing public attention. A recent search on the Internet yielded more than 60, 000 entries on this topic. Although many report abuses under managed information related to denial or curtailment of benefits, others focus on threats to privacy and confidentiality. In the age of computers, the Internet, e-mail, and the electronic record, it is necessary for social workers and other human services, health, and mental health professionals to rethink and revise principles of confidentiality, especially in the context of managed care.

The revisions may involve creating more stringent standards for protecting the confidentiality of the most sensitive data, which have the potential for serious damage to clients; and having more liberal policies for data that have the least potential for damage. Although not widely acknowledged by public services agencies or clients themselves, health care and other client information belongs to the client. Only the client controls the privilege to confidential information, not the provider or agency. (Barney, 2002, p.125-141)

Clients' access to their records is established by federal law as well as included in the NASW Code of Ethics. Yet clients often are uninformed about their rights to retain confidentiality over information about themselves. Fears about maintaining privacy may lead a client to pay for treatment out of pocket rather than through a managed care plan. It should be noted, however, that this option is not available for poor clients who do not have any additional financial resources. Is confidentiality possible in a world of advanced technology and information management? A recent conference presentation entitled, The Death of Confidentiality, addressed the end of the confidentiality as we have known it. Information management managers once advised employees not to talk about clients in elevators or go to lunch leaving case records opened on their desks. Now they must instruct other employees to have clients sign three-page forms about the limits of confidentiality with managed care companies and to protect electronic client records through passwords. (Bonanzas, R., 2003, p.40-57)

Information management companies eavesdrop on treatment when they need to know why a person is seeking treatment, the type of treatment provided, as well as the content of treatment. It is standard practice in contractual agreements between managed care organizations and providers to have a "boiler plate" clause requiring that the managed information organization have access to all records and details of treatment. The burden of obtaining the required patient consent is usually placed entirely on the provider of care. The knowledge that this information is readily available may prevent some people from pursuing treatment at all and thus contribute to human suffering and decreased productivity. Concerns about information management companies has led many states to adopt a "Client Bill of Rights," and currently the federal government is considering a national Bill of Rights for those covered under managed information plans. In the proposed bill there is a requirement that managed care companies establish procedures to safeguard the privacy of client information. An earlier plan to issue every American a health care ID number had been dropped as too invasive of client privacy. (Conner & Prahalad, 2001, p.477-501)

Improved Communication Skills at Individual and Organizational Level Based on the promised benefits of Internet technologies, businesses have been embracing the concept of Internet-based enterprise computing at increasingly rapid rates. The success of the World Wide Web as a medium for reaching customers hinges on an easy migration path to browser-based computing while maintaining the core functionality and remote processing capabilities of traditional client-server systems. The benefits of Web technologies are many.

For example, any browser-equipped device can function as a Web client, allowing a heterogeneous mix of client platforms (such as PCs, Macs and network computers) to coexist without the usual client administration costs. The browser provides a single, intuitive interface to multiple applications, simplifying the learning process. Other benefits include low-cost infrastructure, with less code at the desktop; streamlined information distribution, allowing organizations to publish and revise information broadly without the constraints of paper-based processes; and component commoditization, meaning parties with traditionally proprietary environments can communicate easily. (Dalton, 2003, p.46-49)

The key is an integrated architecture offering both client-server and browser modes in a single version. Different users can implement the mode to best serve their needs while maintaining consistent data and functionality both within the enterprise and when extending data and capabilities to partners and customers. In any enterprise, only a fraction of employees have access to the enterprise-wide application suite. While organizations like to maximize return on technology investments and keep communication lines open, they don't want to equip every user with a fully-loaded desktop machine. Corporate intranets alleviate some of these problems, yet most of the information is relatively static - unlike enterprise-wide information, changing with each new transaction. In this case, an integrated solution allows a business to leverage the corporate intranet for increased access to enterprise applications. Any browser-equipped device can provide a real-time window into the enterprise's information resources. Because of the low overhead, businesses can include more users in the information flow; they disseminate information more quickly to a broader audience and knit together disparate business operations and distributed sites. Goals, priorities and strategies are communicated effectively, in turn leading to improved decision-making at every organizational level. (DeFillippi & Arthur, 2002, p.307-324)

Extending the concept to the supply chain, an integrated solution allows businesses to offer partners access to information such as order status and inventory levels via technology that is likely already in place at the partner's site, i.e. any browser-equipped device. Partners access only approved applications through applets downloaded to the client at run-time. The partner assumes no maintenance responsibilities while the shared applications provide standardized, real-time communication. Like users, enterprise applications tend to fit better with either a client-server environment (a flexible architecture allowing object-based data and logic to be seamlessly communicated on a heterogeneous network) or through a browser, depending on the role the application plays in the information flow. Applications providing tools for analyzing and manipulating information from a variety of sources are well served by client-server implementations. On the other hand, applications intended to communicate and distribute shared information and support standard transaction entries work well in browser mode. Application logic in the form of applets resides on a Web server added to an integrated environment. The applets are then downloaded to the browser when requested by the user. Browser-based solutions don't pose the same maintenance issues as client-server solutions because of the streamlined client environment. But because of their platform-independence, browser-based applications characteristically don't yet offer the same integration with personal productivity applications compared to their OLE-compliant client-server counterparts. (Eisenhardt & Martin, 2000, p.1105-1121)

An integrated solution is therefore ideal because both modes are inherent in the architecture, to be deployed when needed. The enterprise can deploy a mix of both modes, maintaining consistency in business data and processes. A business can embrace new Internet technologies without rethinking or re-engineering its existing information flow. The IT team need only learn one toolset and maintain and upgrade only one software version.

Increase Collaboration between Teams and Departments

Effective collaborations involving organizations is to identify most commonly voiced reasons for collaboration and factors perceived as being most important to collaboration. Partnerships are often founded as means for a an organization is to better fulfill its own mission through working with other departments .

Those involved with effective collaboration report that willingness to listen, mutual respect, long-term commitment, frequent communication, flexibility, and careful selection of partners were key factors in the success of their collaboratives. This theme issue is intended to expand on the idea and practice of collaboration involving different departments of a business. This article in particular serves to provide commentary and reflection on the previous case descriptions of collaborative efforts. The issues of why to collaborate and factors contributing to effective collaboration are highlighted. For the purposes of this discussion, an effective collaboration is one that Is sustainable (i.e., partners wish to continue working together, sufficient resources can be generated to continue operations). (Grant, 2002, p.95-108)

The world is too complex and moving too fast for classic analytical tools to cope. You can't wait to gather all the data, and even if you could, the data would change before you could react. Executives must be able to set reasonable hypotheses and then react to the market. Can intuition be taught? Not in the opinion of our panel. But it can be killed early in a young manager's career. Intuition demands that people trust their judgment, take risks. If companies hammer a young manager for a market failure, will he or she ever take a risk again? What you can teach these young people is how to mitigate risks, how to cover their bets. That would be valuable. (Hamel & Prahalad, 2001, p.109-122)

Change agent. It's perhaps one of the most overused terms, but the need is very real. Companies have always needed people who would tilt at windmills and challenge the status quo. But this skill is no longer limited to dreamers thinking about the long term. Today, mainstream management needs people who can find their way through the maze and break through policies and procedures to react to the marketplace. Just how would you teach this skill? How do you train someone to balance the brashness of a new idea with the sensitivity to get things done without breaking too much glass? (Grant, 2002, p.105-121)

Creative development and innovation. Innovations in products, services, advertising, promotion, compensation, etc., are the lifeblood of a business. Top executives either need to be innovators themselves or need to be able to recognize creativity in others and be able to nurture it. With fewer and fewer resources available, companies can no longer just try a dozen ideas to see which one works. Creativity is more critical than ever.

Innovation cannot be taught. Creativity cannot be taught. Tolerance of creative people can be taught and must be taught if companies are to develop the resources that they do have. Creative people are different. What they produce, whether it is a piece of art or a product design or a marketing plan, is a part of them. Reject it and you reject them. Too much rejection and the creative person will just shut down. Companies not only need creative, innovative thinkers. They also need the environments where these people can thrive. (Hamel & Prahalad, 2001, p.63-76)

Communication. It has been pointed out that communication is about more than the ability to write a clear, concise memorandum. Communication at the top levels of a company is about being able to formulate an argument and a recommendation in a way that gets not only acceptance but support and enthusiasm. In a world of cross-functional, worldwide, multidivisional businesses, the risk of miscommunication has increased exponentially.

This is a skill that can be taught, although it's amazing how many major corporations are still doing business using chart decks with bullet points. These decks get sent around to people not at the meeting, who did not hear what the speaker had to say or the discussion that ensued, but who are expected to learn something from the bullet points. Amazing. (Hamlin & Stewart, 2000, p.27-32)

Action orientation. There was a time when senior-most executives would set goals and review plans, leaving the execution to the managers. Those days are over in many, many firms. Organizations are flatter. Decisions need to be made more quickly and without the luxury of multiple layers cogitating on each step of the plan. Executive teams need players whose instinct is toward action. Can you teach this? Is it a skill really or an approach to life?

Communication Enhance Leadership and Manager Effectiveness

Businesses are designed with a built-in directional gyroscope - the senior team. These individuals oversee the parts of the organization that need to work together to implement business strategy. Yet consistent finding in many companies is that these built-in gyroscopes are broken. The senior management teams are not doing the fundamental work that their organizations expect of them - setting direction, resolving conflicting views about priorities, and creating the context and culture that will enable the firm to deliver results. In an extraordinary number of companies, unclear strategy and conflicting priorities obstruct performance. The cause, as perceived by people at lower levels as well as by members of the senior team, is an ineffective senior team. When these teams meet they tend to review results, focus on specific problems, or discuss administrative matters. They do not dig into or resolve fundamental strategic issues. During senior team meetings people tended to interrupt one another, ignore one another's comments, and engage in a lot of side conversations. As a result, the group had difficulty achieving consensus and making timely decisions, particularly about the politically charged issues of strategy and organization design (Holman & Hall, 2002, p.191-202).

The responsibility for building an aligned organization cannot be delegated. The senior managers must work together to define the business strategy as well as the capabilities and values essential for long-term success. Should start the strategic fitness process with a one-day meeting. The senior management team develops the strategy and drafts a statement about organizational direction that will later be used as the basis of the inquiry into the organization's strategic alignment. To promote an honest dialogue that uncovers differences among members of the senior management team, they should ask each member to prepare individual answers to six simple but profoundly important questions:

What are the company's objectives and aspirations?

What are the market threats and opportunities?

What is the value proposition you are delivering?

What are the most critical things the business must do to deliver on the value proposition and create or sustain competitive advantage?

Which organizational capabilities are needed to implement the strategy?

Which values should guide the organization? (Dalton, 2003, p.63-78)

The senior team's answers to these questions and their efforts to create a direction statement revealed to them that they were trying to straddle two very different strategies. The first was a reactive strategy - grow sales quickly by responding to immediate customer needs using existing technology. The second was a proactive, R&D driven strategy of building distinctive, technology-based solutions platforms that competitors could not easily replicate. In creating the statement of direction, the senior team for the first time clearly committed itself to a technology-based platform strategy. (Hubler, 2001, p.55-89)

The conversation between task force members and the people they interview is kept focused but open-ended. Interviewees are asked simply, what are the strengths to build on and the barriers to address in implementing this strategy? Task force members find that respondents are eager to discuss strategic issues because this is, in many cases, their first chance to talk to management honestly about the overall health and direction of the company. Task force members report long, emotional interviews. Employees who are not scheduled to be interviewed sometimes line up outside conference room doors, hoping for the chance to speak. (Hubler, 2001, p.65-89)

The task force's job is to extract from its hundreds of hours of rich and emotionally charged discussions the critical issues that matter most. This is done through a series of screens. At the end of each interview, the subject is asked to summarize the two or three most business critical issues to be shared with senior management. Each task force member then reviews all of his or her interview notes and selects the three or four most commonly mentioned barriers to implementing business strategy, as well as the major organizational strengths that need to be preserved. When the task force members come together, they collate these themes. The most important ones form the basis for the presentation to the senior management team. The task force is careful to illustrate the themes with descriptions of specific events or projects; these rich stories provide the top team with an in-depth view of how the organization really functions. The stories resemble well-researched case studies. People have found that these descriptions are vital to convincing senior management that the data are real and valid. Senior managers also respond powerfully to quotes from (unnamed) interviewees, which tend to bring home the employees' deep commitment as well as their frustration. (Kim, 2001, p.37-50)