Example Business Essay:The Impact of Environmental Changes and Paradigm Shifts on Organisational Strategy

Example Business Essay:The Impact of Environmental Changes and Paradigm Shifts on Organisational Strategy
This report has been prepared on the request of the CEO of Crossover Technologies Limited (Crossover), a UK headquartered supplier of a range of services to health care professionals. The company has four major service groups, namely, (a) medical transcription, (b) scheduling, (c) billing and coding, and (d) customised software solutions. With delivery centres in the United States, the UK, India and Africa, Crossover has been growing steadily since its founding in 2000.
The US government’s recent decision on widening the health care net in the country in order to include millions of additional people, presently uncovered by health insurance, in its ambit has been accompanied with the framing of policies and regulations for health care professionals; calling upon them to introduce and maintain Electronic Medical Records (EMR) for all their patients (Adams, 2009, p1). This decision has created an enormous new market for suppliers of such services and has radically altered existing perceptions and paradigms in the sector (McCullagh, 2009, p1). Observers expect an enormous shaking up of the sector to occur because of changes in workforce requirements, adoption of HR strategies and policies, new entrants, and introduction of game changing software (McCullagh, 2009, p1).

Whilst Crossover and other industry participants have been anticipating such a development in the US, its actual occurrence has proved to be unsettling and most companies are reviewing their strategic options in this radically changed environment. Crossover has on its own been developing proprietary web based software, which, it feels, will help in improvement of its competitive advantage and in the growth of its market share. Overall projected scenarios of the industry are however unclear, because of the possibility of entry into the sector by big players with deep pockets, ramping up of operations by existing sector participants, and development of alternate products by different companies.

This report deals with evaluation of the causes for the development of a paradigm shift and the identification of the different external factors that are expected to impact the organisation. The report analyses the existing strategy of the company and evaluates the possible outcomes of the existing strategic programme of Crossover. The concluding section deals with the actual impact of environmental changes and paradigm shifts on the various organisational strategies of market participants.

2. Organisational Overview

Crossover was founded in 2000 by two UK based entrepreneurs as a private limited company with equity from personal sources, as well as from family and friends (Crossoverint.com, 2008, p1). The company aimed to provide services to small and medium medical practices, comprising of one to twenty doctors, in the US and in the UK, for the maintenance of clear and easily accessible records of the medical histories of their patients (Crossoverint.com, 2008, p1). Such records were at that time prepared by the secretarial staff of such practices, either from personal dictations from doctors or from notations on the physical records of individual patients (Crossoverint.com, 2008, p1). Crossover entered the medical transcription business by establishing two small medical transcription centres in South Africa and India (Crossoverint.com, 2008, p1). Health care professionals in the US and the UK would dictate the medical history of patients into recording machines, the contents of which would be transmitted across continents over leased lines (Crossoverint.com, 2008, p1). The voice recordings would be converted into data processed word formats by accent trained workers, edited carefully, and sent back to the clients before the commencement of the next working day (Crossoverint.com, 2008, p1).

Whilst the initial years were difficult for the company because of numerous production associated problems, Crossover was able to grow steadily in the US market, especially in the affluent Boston Philadelphia corridor (Crossoverint.com, 2008, p1). The company has, over the years, added staff to its Indian and South African delivery centres and introduced services in areas of scheduling, billing and coding, and customised software solutions for the health care sector (Crossoverint.com, 2008, p1). Crossover has gained a reputation for quality that has helped it in retaining clients despite the entry of new competitors and rampant occurrence of price cutting between companies to wrest away business (Crossoverint.com, 2008, p1).

The company has grown at an annualised growth rate of approximately 13% during the last five years. Its current turnover is approximately 40 million USD (Crossoverint.com, 2008, p1). Crossover employs 450 persons, 375 of whom are based in the delivery centres at Cape Town and Bangalore (Crossoverint.com, 2008, p1). The majority of the marketing staff is located in the US (Crossoverint.com, 2008, p1). The corporate headquarters of the business continues to be in the UK, primarily because of its midway location between the delivery centres and the main market of the company (Crossoverint.com, 2008, p1). Medical practitioners in the UK are however beginning to look at EMR seriously and Crossover hopes to achieve some growth in UK revenues in the coming years (Crossoverint.com, 2008, p1).

Crossover has invested the major portion of its profits during the last 3 years into the development of a web based technology that can be bought and installed by individual practices (Crossoverint.com, 2008, p1). The new system has numerous features that simplify and add flexibility to the existing EMR process (Crossoverint.com, 2008, p1). Doctors can manage their complete medical records efficiently with the system, and use voice recording options, if they wish to dispense with transcontinental transcription processes (Crossoverint.com, 2008, p1). Installation of such systems is expected to result in substantial savings of recurrent costs for health care practices (Crossoverint.com, 2008, p1).

Crossover derives practically 80% of its revenues from the medical transcription division. The other service divisions came about primarily because of demand from existing clients and the company has made little effort to grow them, both in terms of internal competencies and in terms of sales.

3. Environmental Changes and Development of Paradigm Shift

The US government passed a path breaking health care reform bill in March 2010 (Lotich, 2010, p1). The bill aims to make health care more affordable to Americans through (a) the introduction of substantial tax cuts that will benefit middle class families investing in health care, and (b) by reducing premium costs for the families who are unable to afford coverage today (Lotich, 2010, p1). The legislation is expected to help approximately 32 million Americans, (who are at present uncovered), to invest in health care coverage (Lotich, 2010, p1). Approximately 95% of the population of the country is now expected to be covered under health care (Lotich, 2010, p1). The bill will also bring about far greater accountability in the health care sector through the introduction of appropriate rules and regulations for insurance companies and medical practitioners (Lotich, 2010, p1).

The health care bill places significant emphasis on implementation of electronic medical records and systems, considering them to be instrumental to the ultimate success of health care reform policies (McCullagh, 2009, p1). A recent report from Accenture predicts that approximately 60% of US doctors in small and medium practices, which do not presently use EMRs, intend to purchase and install EMR systems in the coming two years (McCullagh, 2009, p1). Considering that only 6% of such practices use EMRs at present, the expansion in demand is expected to be exponential in nature (McCullagh, 2009, p1). Such increase in adoption of EMR is expected to come about because of two specific causes, financial incentives for implementation of EMR systems and federal financial penalties for their non-adoption (McCullagh, 2009, p1).

The intention of hundreds of thousands of doctors in the US to buy and implement EMR systems is expected to radically change a number of premises about the EMR industry and associated businesses like medical transcription. The medical transcription industry will be impacted in several ways by the passing of the health care bill. The market for services to health care practitioners is expected to explode in the coming years and generate work of magnitudes that can be compared to the Y2K period. The requirement for implementation of EMRs in the US will lead to the creation of an enormous new market in EMR services. This will in turn spur the formation of thousands of companies across the world that aim to provide such services and lead to the creation of millions of jobs. Market expansion will lead to a surge of new entrants from across the world, especially from countries like India, Brazil and South Africa, and lead to the fresh demand for thousands of jobs in developing countries. With it being difficult to meet such sharp demand in services in such a short period, the increased needs of the US health care sector will inevitably lead to (a) the entry of companies with lesser competencies, (B) quality issues, (c) HR and training challenges, and (d) the inevitable demise of many start-ups.

The exponential increase in demand will also lead to intense work in development of software and applications by resource rich organisations and to the possible generation of breakthroughs and game changing software. The coming years are thus expected to be uncertain in areas of market size, product development, service formulation, entry of new entrants, development of substitute technology, creation of jobs, cross continental transfer of wealth and services, and intensification of competition. A paradigm shift of such dimensions will very obviously have numerous strategic implications for industry participants, including companies like Crossover.

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