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Servicenow-CIS-ITSM
Certified Implementation Specialist IT Service Management
http://killexams.com/pass4sure/exam-detail/Servicenow-CIS-ITSM Question: 422
An administrator notices that there are two account records in the system with the same name. A contact record with the same name is associated with each account.
Which set of steps should be taken to merge these accounts using the Salesforce merge feature?
A. Merge the duplicate contacts and then merge the duplicate accounts.
B. Merge the duplicate accounts and the duplicate contacts will be merged automatically.
C. Merge the duplicate accounts and check the box that optionally merges the duplicate contacts.
D. Merge the duplicate accounts and then merge the duplicate contacts. Answer: D Question: 423
Which two values roll up the hierarchy to the manager for Collaborative forecasting? (Choose two.)
A. Product quantity
B. Quota amount
C. Opportunity amount
D. Expected revenue Answer: BC Question: 424
An administrator has been asked to grant read, create and edit access to the product object for users who currently have the standard marketing user profile.
Which two approaches could be used to meet this request? (Choose two.)
A. Create a new profile for the marketing users and change the access levels to read, create and edit for the product object.
B. Change the access levels in the marketing user standard profile to read, create and edit for the product object.
C. Create a permission set with read and write access for the product object and assign it to the marketing users.
D. Create a permission set with read, create and edit access for the product object and assign it to the marketing users. Answer: AD Question: 425
The sales team has requested that a new field called Current Customer be added to the Accounts object. The default value will be "No" and will change to "Yes" if any
related opportunity is successfully closed as won.
What can an administrator do to meet this requirement?
A. Configure Current Customer as a roll-up summary field that will recalculate whenever an opportunity is won.
B. Use an Apex trigger on the Account object that sets the Current Customer field when an opportunity is won.
C. Use a workflow rule on the Opportunity object that sets the Current Customer field when an opportunity is won.
D. Configure Current Customer as a text field and use an approval process to recalculate its value. Answer: C Question: 426
Sales management wants a small subset of users with different profiles and roles to be able to view all data for compliance purposes.
How can an administrator meet this requirement?
A. Create a new profile and role for the subset of users with the View All Data permission.
B. Create a permission set with the View All Data permission for the subset of users.
C. Enable the View All Data permission for the roles of the subset of users.
D. Assign delegated administration to the subset of users to View All Data. Answer: B Question: 427
How can an administrator ensure article managers use specified values for custom article fields?
A. Create a formula field on the article.
B. Require a field on the page layout.
C. Use field dependencies on article types.
D. Create different article types for different requirements. Answer: C Question: 428
A user has a profile with read-only permissions for the case object.
How can the user be granted edit permission for cases?
A. Create a permission set with edit permissions for the case object.
B. Create a sharing rule on the case object with read/write level of access.
C. Create a public group with edit permissions for the case object.
D. Add the user in a role hierarchy above users with edit permissions on the case object. Answer: A Question: 429
Which three actions can occur when an administrator clicks "Save" after making a number of modifications to Knowledge data categories in a category group and changing
their positions in the hierarchy? (Choose three.)
A. Users are temporarily locked out of their ability to access articles.
B. Users may temporarily experience performance issues when searching for articles.
C. The contents of the category drop-down menu change.
D. The articles and questions visible to users change.
E. The history of article usage is reset to zero utilization. Answer: ADE Question: 430
What are three capabilities of Collaborative forecasting? (Choose three.)
A. Rename categories
B. forecast using opportunity splits
C. Overlay quota
D. Add categories
E. Select a default forecast currency setting Answer: ABE Question: 431
Universal Containers wants customers who buy the freight Container product to be billed in monthly installments.
How should an administrator meet this requirement?
A. Create a default quantity schedule on the product.
B. Create a default revenue schedule on the product.
C. Create a workflow rule on the product.
D. Create custom fields on the product. Answer: B Question: 432
Which two deployment tools can be used to deploy metadata from a Developer Edition organization to another organization? (Choose two.)
A. Data Loader
B. Salesforce Extensions for Visual Studio Code
C. Change sets
D. Ant Migration Tool Answer: BC Question: 433
An administrator wants to allow users who are creating leads to have access to the find Duplicates button.
Which lead object-level permission will the administrator need to provide to these users?
A. Merge
B. Read and Edit
C. View All
D. Delete Answer: C Question: 434
An administrator has been asked to create a replica of the production organization. The requirement states that existing fields, page layouts, record types, objects, and data
contained in the fields and objects need to be available in the replica organization.
How can the administrator meet this requirement?
A. Create a developer sandbox.
B. Create a configuration-only sandbox.
C. Create a metadata sandbox.
D. Create a full sandbox. Answer: D
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https://killexams.com/exam_list/ServiceNowServiceNow Unusual Options Activity For June 05
Someone with a lot of money to spend has taken a bearish stance on ServiceNowNOW.
And retail traders should know.
We noticed this today when the big position showed up on publicly available options history that we track here at Benzinga.
Whether this is an institution or just a wealthy individual, we don't know. But when something this big happens with NOW, it often means somebody knows something is about to happen.
The overall sentiment of these big-money traders is split between 23% bullish and 76%, bearish.
Out of all of the special options we uncovered, 13 are puts, for a total amount of $551,294, and 8 are calls, for a total amount of $417,952.
What's The Price Target?
Taking into account the Volume and Open Interest on these contracts, it appears that whales have been targeting a price range from $460.0 to $600.0 for ServiceNow over the last 3 months.
Volume & Open Interest Development
Looking at the volume and open interest is an insightful way to conduct due diligence on a stock.
This data can help you track the liquidity and interest for ServiceNow's options for a given strike price.
Below, we can observe the evolution of the volume and open interest of calls and puts, respectively, for all of ServiceNow's whale activity within a strike price range from $460.0 to $600.0 in the last 30 days.
ServiceNow Option Volume And Open Interest Over Last 30 Days
Biggest Options Spotted:
Symbol
PUT/CALL
Trade Type
Sentiment
Exp. Date
Strike Price
Total Trade Price
Open Interest
Volume
NOW
CALL
SWEEP
BEARISH
01/19/24
$480.00
$92.8K
189
15
NOW
CALL
SWEEP
BEARISH
06/09/23
$555.00
$90.1K
70
147
NOW
PUT
SWEEP
BULLISH
06/09/23
$600.00
$84.5K
2
1
NOW
PUT
SWEEP
BEARISH
06/09/23
$600.00
$82.5K
2
16
NOW
CALL
TRADE
BULLISH
11/17/23
$550.00
$65.5K
125
16
Where Is ServiceNow Standing Right Now?
With a volume of 1,311,328, the price of NOW is up 1.56% at $556.71.
RSI indicators hint that the underlying stock may be overbought.
Next earnings are expected to be released in 51 days.
What The Experts Say On ServiceNow:
Oppenheimer downgraded its action to Outperform with a price target of $500
Bernstein has decided to maintain their Outperform rating on ServiceNow, which currently sits at a price target of $665.
Wolfe Research downgraded its action to Outperform with a price target of $575
Barclays has decided to maintain their Overweight rating on ServiceNow, which currently sits at a price target of $559.
JMP Securities downgraded its action to Market Outperform with a price target of $553
Options are a riskier asset compared to just trading the stock, but they have higher profit potential. Serious options traders manage this risk by educating themselves daily, scaling in and out of trades, following more than one indicator, and following the markets closely.
If you want to stay updated on the latest options trades for ServiceNow, Benzinga Pro gives you real-time options trades alerts.
Š 2023 Benzinga.com. Benzinga does not provide investment advice. All rights reserved.
Mon, 05 Jun 2023 08:54:00 -0500text/htmlhttps://www.benzinga.com/markets/options/23/06/32726270/servicenow-unusual-options-activity-for-june-05Setting Up Cloud Transformations for Success in Healthcare
In healthcare, getting the most out of the cloud can mean using a complex mix of legacy and new technologies. But as more health organizations rely on cloud workloads, theyâll need to ensure their modernized infrastructure has reliable storage and backup capabilities.
By 2024, healthcare users expect to up their reliance on multicloud strategies from 27 percent to 51 percent, according to the 4th Annual Nutanix Enterprise Cloud Index. The top challenges in healthcare for multicloud adoption include integrating data across clouds, performance issues with network overlays and managing costs.
Cloud integration requires radical change within health systems, but leaders need not fear it, says Jeffrey T. Thomas, vice president and CTO at Norfolk, Va.-based Sentara Healthcare.
âFundamentally, it changes the way we architect from the beginning and automate deployment. It changes the support models, and it also changes the skill sets needed,â says Thomas.
How Sentara Healthcare Approaches Cloud-First Strategies
Sentara Healthcare has nearly 30,000 employees and serves communities in Virginia and North Carolina. The large system recently launched a joint venture focused on cloud-first solutions to help healthcare organizations modernize their environments.
âThe first bottom line is that many CIOs in healthcare do not have the skill sets in their own organizations to move the cloud,â Thomas says. âBecause of what weâve learned, weâre at the forefront of large-scale movements of systems to cloud.â
Thomas joined Sentara Healthcare in 2018 with the goal of driving the organization to cloud-supported solutions, starting with the largest on-premises data set.
âWhen we started deploying our first workloads into Azure, we designed backup as a core part of it,â Thomas says. âWe set all the policies up before we deployed our first solution set into Azure. That was two months, so it was a very quick evolution.â
This year, Thomas says, close to 80 percent of the organization is supported by cloud solutions. Within the next 18 months, Sentara Healthcare will leave its last on-premises backup solutions and move it all to the cloud.
In southern Oregon, health system Asante adopted HPEâs GreenLake, a hybrid edge-to-cloud platform for its critical on-premises data services. The process of discovery, setup and handoff took about 18 months, says Asante ITS Operations Manager Tim OâRourke.
âOur internal cloud has been a very valuable resource, spanning redundant systems across data centers in different buildings and on different sites. We have been able to deliver most of the benefits of the public cloud to our internal customers for years. Now, under GreenLake, Asante can also realize the financial benefits,â OâRourke says.
Asanteâs rural location doesnât offer wide availability of high-capacity internet access, nor is it nearby public cloud data centers, so the health system uses cloud services only for data backup and under a Software as a Service model for some applications.
âOur first GreenLake initiative was for HPE Primera storage arrays,â OâRourke says. Though Primera is a hardware solution, it has the performance and agility of the cloud. âThe program allowed us to spec equipment at a level that we could not have capitalized in a single fiscal year.â
OâRourke says his team first studied how the GreenLake program would work, assessing the benefits, risks, costs, support needs and lifecycle management. He discussed the implications of the shift from capitalized to operationalized server/storage infrastructure with Asanteâs finance department and senior leadership.
âWe had internal discussions about how on-premises cloud resources would be managed, usage reported, budgets established and project chargebacks processed under the GreenLake model,â OâRourke says.
Fundamentally, it changes the way we architect from the beginning and automate deployment.â
Jeffrey T. Thomas Vice President and CTO, Sentara Healthcare
Deciding Cloud Deployments Based on Organizational Needs
Thomas says that Sentara Healthcare uses a variety of solutions to address particular business needs, including Microsoft Azure for native backup, Rubrik as an instance for Unix and Dell Avamar to back up virtual machines, images and snapshot servers.
âThe percentage changes because we are bringing in new solutions and retiring solutions,â Thomas says. âWe are heavy users of cloud backup, and we've transitioned a lot of our on-premises to cloud backup solutions.â
Itâs important that cloud support is chosen based on application and system need, Thomas adds. Considering the processes along with their risks is key, even over staff needs.
âItâs usually never an individual making recommendations, because they would be driven by the processes they create, and then we manage the risk for them,â Thomas says. âIt's very easy for somebody to say, âI want it backed up every night,â because they think it's free, but itâs not. We need to manage that risk, the frequency of backup and how long we maintain the backups based on the data classification and record retention policies.â
Vibrant Emotional Health began working with Hitachi in 2016 to move to public cloud and build a data warehouse and call center failover solution using Amazon Web Services (AWS). Formerly known as the Mental Health Association of New York City, Vibrant operates a 24-hour crisis center with more than 500 employees.
The organization chose to work with Hitachi due to its ongoing customer service offerings, says Vibrant Marketing and Communications Specialist Dante Worth. âOne major benefit of working with Hitachi is their reliable 24/7 monitoring of our environment. Hitachi also offers an ideal cost along with cost and security reviews,â Worth says.
The data warehouse allows for Vibrant to offer continuous behavioral health services in New York City. The process of AWS implementation with Hitachi took about 45 days.
âBefore getting started with Hitachi, we started by outlining requirements. We then moved into the initial architecture and design phase. Finally, we followed up by initiating the infrastructure build,â says Worth.
52%
The percentage of healthcare cloud users who said cost savings was a popular adoption driver
Source: Presidio, â2022 Cloud Transformation Benchmark Report,â August 2022
Supporting and Maintaining Cloud Capabilities in Healthcare
Ensuring that connectivity is resilient and has bandwidth to manage large data sets is an important step to reduce possible workflow interruptions, Thomas says.
âIn the cloud, itâs really about the timing of when you back it up, because youâre not constrained by the throughput. Youâre more constrained by the impact to performance, the method you use for backing up,â Thomas says. His team performs regular checkups to measure cloud health.
âWe also have automated the alerting and the reporting of backups, and if a backup fails, it goes into ServiceNow as an incident and gets processed just like any other incident. Next, the team checks why the backups had issues and works through those processes to resolve them,â Thomas says. âFrom an operational workflow, weâve just rolled the cloud support into our standard model. I think the big difference is that weâre not moving tapes. Weâre not worried about offsiding tapes the same way.â
Thu, 01 Jun 2023 03:56:00 -0500Donna Marburyentext/htmlhttps://healthtechmagazine.net/article/2023/06/setting-cloud-transformations-success-healthcareRemote, Hybrid Work Drives ServiceNow Momentum in BrazilNo result found, try new keyword!ServiceNow Implementation and Integration Services, and ServiceNow Managed Service Providers. The report names Accenture, Alpar, Aoop, Capgemini, Deloitte and Extreme Group as Leaders in all three ...Wed, 19 Apr 2023 01:04:00 -0500https://www.businesswire.com/news/home/20230419005331/en/Remote-Hybrid-Work-Drives-ServiceNow-Momentum-in-BrazilCurrent Research and Implementation Projects
Suicide Prevention in Schools and Colleges
The Suicide Prevention in Schools and Colleges initiative will implement suicide prevention and early intervention strategies for youth ages 10-25 across Pennsylvania. The grant will provide gatekeeper training, suicide risk management training, standardized screening, and training in empirically supported treatments. The project will raise awareness, increase identification of at risk youth, facilitate referrals to treatment and Strengthen treatment outcomes. The problem addressed by our proposal is that suicide risk is being under identified in Pennsylvaniaâs schools, community colleges and universities. There is no systematic training for professionals or standardized screening procedures to identify youth at risk. Therefore, too many young people are not identified and too many of those who are high risk are not being adequately screened, and not receiving treatment and support.
There are 500 school districts and 181 community colleges and universities in Pennsylvania. In the general state population, there are 2,570,000 individuals age 10-15 representing a wide range of cultures and demographic diversity. The majority is white, but there are also Black, Hispanic, Asian and American Indian students. We will focus on racial and ethnic, rural and urban cultural differences as well as the needs of the Veteran and the lesbian, gay, bisexual, and transgender populations. Building on the Student Assistance Program in Pennsylvania schools, we will provide gatekeeper training and state of the art screening tools to appropriate school personnel and the behavioral health systems that serve these schools.
Building on the work of past Campus Grants, we will organize a coalition of community college and university representatives to develop model suicide prevention plans and processes for higher education throughout the Commonwealth. Project goals and measurable objectives include: a) increasing the number of persons in schools, colleges, and universities, trained to identify and refer youth at risk for suicide, b) increasing the number of clinical service providers (including those working in schools, mental health, and substance abuse) trained to assess, manage and treat youth at risk for suicide, c) increasing awareness about youth suicide prevention, specifically including the promotion and utilization of the National Suicide Prevention Lifeline, d) comprehensively implementing applicable sections of the 2012 National Strategy for Suicide Prevention to reduce rates of suicidal ideation, suicide attempts and suicide deaths in their communities, and e) promoting state systems-level change to advance suicide prevention efforts in our public schools.
With gatekeeper training and awareness campaigns, we plan to reach 186,000 youth over five years. With screening in schools, colleges and primary care practices, we plan to reach approximately 26,000 indicated youth over five years. Thus, our total impact will be felt by nearly 212,000 youth across Pennsylvania.
Screening and Referral of Suicidal Youth in Primary Care
A major challenge in suicide prevention work is locating adolescents before they attempt suicide. Fortunately, over 70 percent of adolescents see a physician at least once a year making primary care a potentially important gatekeeper for adolescent health. We proposed to build a comprehensive identification, screening and triage system within primary care systems to identify adolescents at high risk for suicide. In Year 1, we organized a statewide suicide prevention task force consisting of a wide range of stakeholders from public and private sectors through a participatory action research framework. Bi-monthly meetings were held to identify policy barriers and solutions to better integrating suicide prevention and behavioral health services (mental health and substance abuse treatment systems) into primary care offices. Representatives from 11 diverse counties participated. In Year 1 our goals focused on creating educational resources, technical assistance, policy changes and funding support to help several of these counties implement the new system. Year 2 focused on this implementation.
The proposed program consisted of four components. First, pediatricians, family physicians and nurse practitioners (referred to as medical practitioners) received gatekeeper training in identifying adolescents at risk for suicide. Second, computer-based screening measures were introduced into the medical offices. Third, a system to provide family based, clinical assessment of the adolescent was geographically and administratively integrated into the primary care offices, as needed. Fourth, clinical training for treatment systems (medical and behavioral health) in how to engage and work with suicidal youth and their families was provided. Systemic change at the state and local levels enabled other counties to implement a similar system over the next five years. This project was a state effort (supported by the Departments of Public Welfare, Health and Education) in collaboration with suicide experts at the Children's Hospital of Philadelphia (CHOP), the University of Pennsylvania, Western Psychiatric Institute at the University of Pittsburgh and the Pennsylvania Academy of Pediatrics.
Behavioral Health Screen (BHS) in Emergency Departments
The BHS has been used for many years in several emergency departments. The longest operation is at Childrenâs Hospital of Philadelphia. Here, BHS is used for all adolescent presenting at the emergency department (ED). CHOP treats 27,000 teens a year and screening about 500 adolescent a month. BHS also operates at the Childrenâs Crisis Center, the Medicaid Managed Care psychiatric emergency room in the City. This facility treated about 2000 psychiatric pediatric emergency case each year.
Extension of BHS development into the emergency department setting occurred in 2006 with a Health Resources and Services Administration (HRSA) grant (R49CCR 321711-01). After the qualitative studies on acceptability and feasibility of standardized screening in the ED mentioned above, full implementation of the screening began in March 2007 and evaluation of the screen lasted for nine months. All non-critical patients between the ages of 14 and 18 years who presented for something other than a primary psychiatric concern were asked to complete the Behavioral Health Screening-Emergency Department (BHS-ED). In the end, 857 adolescent patients completed the screening tool. Of those screened, 4.3 percent self-reported moderate or severe depressed mood and 3.6 percent reported suicidal ideation in the past week. Results showed that screening increased the identification of youth with behavioral health problems (Ď2 = 154.86, p < .001), increased the rate of behavioral health assessment (Ď2 = 141.86, p < .001), and increased behavioral health referrals (Ď2 = 76.86, p < .001). This screening process was fully incorporated into clinical care for adolescents, and when initiated by the nursing staff achieved a 40 percent penetration rate for eligible patients. Findings from this study can be found at Fein et al, 2010 in our reference list.
The great digitization breakthrough that has swept through much of the world has been slower to materialize in Germany, ISG Provider Lens⢠report says
FRANKFURT, Germanyâ(BUSINESS WIRE)â$III#ISGProviderLensâGerman enterprises have been slow to embrace ServiceNow, yet stricter government regulations and the growing complexity of the overall IT landscape may provide the workflow automation platform with new momentum in the German market, according to a new research report published today by Information Services Group (ISG) (Nasdaq: III), a leading global technology research and advisory firm.
The 2023 ISG Provider Lens⢠ServiceNow Ecosystem Partners report for Germany finds the crisis in Ukraine and a reluctance to part with legacy systems have contributed to Germanyâs comparatively slow adoption of ServiceNow, despite the platformâs rapidly expanding functionalities. Given ServiceNowâs high licensing costs, clients who fear vendor lock-in are clinging to the preferred open-source model, the ISG report says.
âServiceNow and its partners are gaining traction in the German market,â said Dr. Matthias Paletta, director, technology modernization, for ISG in Germany. âYet their growth is not as steep as it is in other markets, notably the U.S.â
Although ServiceNow can be potentially more flexible than legacy systems, that increased flexibility also hinges on a companyâs willingness to adopt a prefabricated solution, rather than going through the process of customizing it to match precise business requirements. Companies that continue to pursue âperfectâ solutions do so at the expense of increased deployment speed, the ISG report says.
The Ukraine crisis, which led to higher energy costs and inflation, has proven that upheavals can occur rapidly and that periods of relative planning certainty are becoming shorter than ever, the ISG report says. ServiceNowâs Tokyo platform, which was released in the fourth quarter of 2022, strongly focuses on process efficiency and opportunities for rapid value creation. The speed at which it can react to changing circumstances is seen as a boon for many companies.
In addition, the growing prevalence of multicloud environments has significantly increased the overall complexity of the IT landscape and reinforced the need for tools that can help address it, as have Germanyâs Supply Chain Act and the introduction of new ESG regulations, the ISG report says.
âEnterprises in Germany are looking for reliable, accredited professional services to take full advantage of ServiceNowâs broad functionalities,â said Jan Erik Aase, partner and global leader, ISG Provider Lens Research. âServiceNow implementations can act as a catalyst for a new type of company management.â
The report also examines the improved analytics and RPA capabilities introduced in ServiceNowâs exact release of its Utah platform.
The 2023 ISG Provider Lens⢠ServiceNow Ecosystem Partners report for Germany evaluates the capabilities of 29 providers across three quadrants: ServiceNow Consulting Services, ServiceNow Implementation and Integration Services, and ServiceNow Managed Service Providers.
The report names Accenture, agineo, Atos, Capgemini, Infosys and T-Systems/OS as Leaders in all three quadrants, while Deloitte, DXC Technology, HCLTech and nuvolax are named Leaders in two quadrants each. Cognizant, Fujitsu, KPMG, Kyndryl, NTT DATA, TCS and Tech Mahindra are named as Leaders in one quadrant each.
In addition, Computacenter and Fujitsu are named as Rising Stars â companies with a âpromising portfolioâ and âhigh future potentialâ by ISGâs definition â in one quadrant each.
A customized version of the report is available from T-Systems/OS.
The 2023 ISG Provider Lens⢠ServiceNow Ecosystem Partners report for Germany is available to subscribers or for one-time purchase on this webpage.
About ISG Provider Lens⢠Research
The ISG Provider Lens⢠Quadrant research series is the only service provider evaluation of its kind to combine empirical, data-driven research and market analysis with the real-world experience and observations of ISGâs global advisory team. Enterprises will find a wealth of detailed data and market analysis to help guide their selection of appropriate sourcing partners, while ISG advisors use the reports to validate their own market knowledge and make recommendations to ISGâs enterprise clients. The research currently covers providers offering their services globally, across Europe, as well as in the U.S., Canada, Brazil, the U.K., France, Benelux, Germany, Switzerland, the Nordics, Australia and Singapore/Malaysia, with additional markets to be added in the future. For more information about ISG Provider Lens research, please visit this webpage.
A companion research series, the ISG Provider Lens Archetype reports, offer a first-of-its-kind evaluation of providers from the perspective of specific buyer types.
About ISG
ISG (Information Services Group) (Nasdaq: III) is a leading global technology research and advisory firm. A trusted business partner to more than 900 clients, including more than 75 of the worldâs top 100 enterprises, ISG is committed to helping corporations, public sector organizations, and service and technology providers achieve operational excellence and faster growth. The firm specializes in digital transformation services, including automation, cloud and data analytics; sourcing advisory; managed governance and risk services; network carrier services; strategy and operations design; change management; market intelligence and technology research and analysis. Founded in 2006, and based in Stamford, Conn., ISG employs more than 1,600 digital-ready professionals operating in more than 20 countriesâa global team known for its innovative thinking, market influence, deep industry and technology expertise, and world-class research and analytical capabilities based on the industryâs most comprehensive marketplace data. For more information, visit www.isg-one.com.
Sun, 23 Apr 2023 22:24:00 -0500it-ITtext/htmlhttps://www.01net.it/germany-cautiously-expanding-servicenow-adoption/The implementation of national health insurance
OPINION
By Dr Ian Clarke
I was channel hopping the other morning and landed on a South African TV station in which they were discussing the proposed national health insurance scheme (NHIS) for South Africa.
South Africa currently has a dual healthcare system, with expensive private facilities and a public system that is underfunded. The cost of care in private hospitals is high, so the premiums for medical insurance are also high (around 4-5 times what we pay in Uganda).
Despite the high premiums, the coverage of health insurance is much higher than in Uganda, with about 20% of the population covered (compared to under 2% here).
Although only 20% of the population use the private system, 80% of total health resources go to the private system. The principle of national health insurance (NHI) is that health expenditure should be spread across the whole population, making it equitable for everyone, but getting everyone to agree on the way forward is a challenge.
Like Uganda, the debate on NHI has been going on for several years, but they do not seem to be making much progress, despite a proposed 2026 launch date.
The debate on television was critical of government, with a professor from Wits University claiming that the problem was blatant corruption and that the political establishment were making promises but doing nothing to tackle the underlying issues. He claimed that even now the money in the public system was not reaching the intended beneficiaries.
It seems that in all African countries, we have aspirations and then we have reality and the two are rarely the same.
Many of our government ministries, such as health, are not working well, but when spoken of at a high political level, apparently, everything is fine. There is a gap between what we say and what we do, and the aspiration is taken as the reality. We do the same thing in everyday life: if a person is asked whether he is coming for an appointment he may say kanzije (let me come), but what he has stated is an intention and he may not arrive because of obstacles which prevent him from fulfilling his intention to attend the meeting. We should not confuse aspiration (or intention) with implementation. When politicians or news outlets announce a government programme, we should ask ourselves the question â is it being funded and implemented or it is an aspirational promise?
The professor was pointing out that promises of the benefits of the new NHI meant nothing until they first dealt with the underlying obstacles in the existing public system. It is the same scenario in Uganda â we will not make any progress with a more idealistic system until we fix what we have. People talk about NHI as if it is a magic bullet, but no one has even carried out a detailed actuarial analysis on the promises being made. I am not against NHI, but if we simply form another statutory body with draconian powers to make unrealistic rules and regulations for health providers, it could make the situation worse.
Although there is no simple fix for our health services, we can Strengthen them using our current resources.
NSSF has shown willingness to offer a scheme to its members, but this has not been explored. Prof. Francis Omaswa has demonstrated a community mobilisation approach in four districts, which has yielded better health outcomes.
One of his key findings was that the quality of the district leadership has a profound effect, but we are not mobilising or educating the district leaders.
There are other initiatives in the health sector which could Strengthen the system. A Ugandan tech company called CTI has developed a system that can track health indicators in the individual, in the community and for patients in hospital.
A tech start-up, Clinic Pessa, has developed a system for saving small amounts on a mobile money clinic account for payments to clinics, which can be topped up through loans, should the need arise.
Another area which can be improved is the collaboration between the public and private sectors, including increased support for the faith-based hospitals.
The Minister of Health thinks that NHIS will open another stream of cash from the private sector to fund improvements in the health sector, but the private sector is being so squeezed by the Uganda Revenue Authority that there is no more cash to be wrung out. Instead, what is likely to happen is that companies with existing private medical insurance will stop covering their employees and push the responsibility on to NHIS. Since no one has done the actuarial calculations of this shift, NHIS may not see a net inflow, but net outflows, making the system collapse.
Wed, 31 May 2023 00:17:00 -0500entext/htmlhttps://www.newvision.co.ug/category/sports/the-implementation-of-national-health-insuran-161670Exploring the Use and Application of Implementation Science in Health Professions Education: A WorkshopNo result found, try new keyword!A planning committee of the National Academies of Sciences, Engineering, and Medicine will organize and conduct a public workshop to explore the use and application of implementation science (IS) in ...Tue, 19 Apr 2022 07:10:00 -0500text/htmlhttps://www.nationalacademies.org/our-work/exploring-the-use-and-application-of-implementation-science-in-health-professions-education-a-workshopHealth Workers Protest Non-implementation of New Salary Scale
Onyebuchi Ezigbo in Abuja
The Joint Health Sector Unions and Assembly of Healthcare Professional Associations (JOHESU/AHPA) yesterday  held a protest in Abuja, urging the federal government to pay its members the adjustment of Consolidated Health Salary Structure(CONHESS).
The workers, who staged an early morning protest at the Unity Fountain,  called on President Muhammadu Buhari to immediately approve and implement the Technical Committee Report on the adjustment of  CONHESS.
The unions also tasked the incoming government, National Assembly especially, Senators-elect and House of Representatives members-elect to ensure the appointment of seasoned administrators with cognate experience as ministers in charge of the health sector.
The National Vice Chairman of Joint Health Sector Unions (JOHESU), Dr. Obinna Ogbonna, while reading a letter addressed to the Senate President, Senator Ahmed Lawal, said the unions were compelled to embark on the protest rally to draw  the attention of the National Assembly to the unending vicious cycle of tyranny visited on  the respective affiliate of JOHESU in the health sector by the physicians- dominated Federal Ministry of Health.
Ogbonna further explained that the collective Bargaining Agreement between the federal government and the JOHESU established strongly that once there is an adjustment in any of the salary structure, the other structure should be adjusted commensurately.
He said the last three successive physician health ministers in the last 12 years had done nothing to address their grievances in this regard.
According  to Ogbonna, the ministers have deliberately truncated the adjustment of CONHESS on four occasions since January 2, 2014.
He said this alleged social injustice and discriminatory adjustment championed by the Federal Ministry of Health in favour of the physicians and to the great disadvantage of other health workers led to a trade dispute declared by JOHESUÂ Â in September, 2021.
âThis dispute was, however, apprehended by the Chief Conciliator of the Federation and Minister of Labour, Senator Dr. Chris Ngige, at a conciliatory meeting held on 7 September, 2021 at the Conference Room of the Federal Ministry of Labour and Employmentâ.
âDuring the conciliatory meeting attended by the Minster of Health, Dr. Ehanire Osagie, and the then Minister of State for Health, Senator Olorunnibe Mamora, with other top federal government officials from ministries and inter-ministerial departments and agencies with the national leadership of  JOHESU, the meeting resolved that, all matters in dispute be referred back for negotiation at the Federal Ministry of Health.â
âUpon resumption of negotiation at the Federal Ministry of Health at a meeting held on 19â September, 2021, the FG and JOHESU team agreed to the setting up of a High Level Inter-Ministerial Committee to determine the justification for the adjustment of CONHESS, work out a detailed financial implication and make appropriate recommendations.
âThe committee was chaired by the Chairman, National Salaries, Incomes and Wages Commission (NSIWC), and membership drawn  from Office of the Head of Service of the Federation, Federal Ministry of Health, Federal Ministry of Labour and Employment, Budget Office, National Salaries, Incomes and Wages Commission, Office of the Accountant General of the Federation, and JOHESU.
âThe Technical Committee report had since been submitted to the Federal Ministry of Health for onward transmission to the Federal Executive Council. That the Ministry has refused to do since over a year.â
Speaking further, Ogbonna said the  bane in the spread of benefit packages is domineering as influence of Physicians in the Ministry Departments and Agencies (MDAs); from the Federal Ministry of Health to agencies like National Health Insurance Authority (NHIA), National Agency for the Control of Aids (NACA), National Primary Healthcare Development Agency (NPHCDA) and others where the Physician-CEOs have skewed privileges as well as other benefit packages in the direction of their Physician brethren.
âIn one of the most bizarre development in contemporary times, the Physician dominated Federal Ministry of Health negated the Consultant Cadre status of Pharmacists which has met all components of due process as far back as 2011when the National Council on Establishment (NCE) approved the status. In 2020 and 2021, both the Office of the Head of Civil Service of the Federation and Federal Ministry of Health conclusively issued circulars to back up the NCE approval.â
Wed, 24 May 2023 13:17:00 -0500entext/htmlhttps://www.thisdaylive.com/index.php/2023/05/25/health-workers-protest-non-implementation-of-new-salary-scaleSuccessful Implementation of the National Institutes of Health Stroke Scale on a Stroke/Neurovascular Unit
Literature Review
Thorough neurological assessment of patients experiencing acute stroke is critical for accurate diagnosis, treatment, and care throughout hospitalization. Published guidelines for the early management of patients with ischemic stroke (Adams et al., 2003) detail the goals associated with early care, including observation for changes in patient condition that might prompt initiation of medical or surgical interventions and facilitation of measures aimed at improving outcome after stroke. Consistent use of a standardized assessment tool designed for stroke patients assists in the achievement of these goals.
The National Institutes of Health Stroke Scale (NIHSS) is a well-validated, reliable scoring system for use specifically with stroke patients (Goldstein, Bertels, & Davis, 1989; Lyden et al., 1999). It was designed by a group of stroke research neurologists to document the severity of neurologic deficits in acute stroke patients (Brott et al., 1989). It consists of 11 elements that reflect the wakefulness, vision, and motor, sensory, and language function of stroke patients (Figure 1).
Figure 1.
The National Institutes of Health Stroke Scale form used by Providence Health System.
The initial neurological examination of the acute stroke patient establishes the baseline stroke severity and can help identify individuals at greatest risk for hemorrhagic complications after thrombolytic therapy. Scores âĽ20 have been associated with symptomatic intracerebral hemorrhage (NINDS t-PA Stroke Study Group, 1997). NIHSS scores have been shown to strongly predict outcome after stroke and therefore can help guide decisions related to aggressiveness of care and disposition (Adams et al., 1999; Schlegel et al., 2003; Weimar, Konig, Kraywinkel, Ziegler, & Diener, 2004).
After the initial assessment and determination of acute treatment, the focus of assessment shifts to monitoring for neurological change or deterioration. The condition of approximately 25% of patients worsens during the first 24-48 hours after stroke (Adams et al., 2003), although neurological decompensation can occur later as well. Stroke-related neurological changes can occur rapidly, and often they result in irreversible brain damage. It is therefore important to have a comprehensive neurological assessment tool that objectively tracks changes and provides a standardized means for clear communication among caregivers. The NIHSS provides a numerical value for comparison from one time period to the next (Lyden et al., 1999).
During a stroke patient's hospitalization, the NIHSS can also be used to help identify clinical findings that might put the patient at risk for complications. For instance, dysarthria and facial weakness can indicate that the patient may have difficulty swallowing. Identification of motor weakness and ataxia can alert the staff to fall risk (Spilker et al., 1997).
Despite evidence that the NIHSS is valid and reliable, there has been reluctance to adopt it within clinical settings. Some users believe that scale completion is too time consuming when compared to standard neurological assessments (Lai, Duncan, & Keighley, 1998). Other detractors perceive a lack of interrater reliability in scoring on certain questions, particularly the questions for ataxia and dysarthria assessment (Lyden, Lu, Levine, Brott, & Broderick, 2001). Others cite a "hemispheric bias" within the NIHSS, because 7 of the points are directly related to measurement of language (a left hemisphere function) and only 2 points are related to neglect (a right-hemisphere phenomenon). Hence, the NIHSS may underestimate stroke severity in the right hemisphere (Woo et al., 1999). In addition, although many components of the NIHSS are part of a standard neurological assessment, training is required for reliable use of the tool (Andre, 2002).
Although there are some limitations to use of the NIHSS, studies have demonstrated that it can reliably measure stroke severity. The interrater variability of users decreases with the use of videotaped training and certification (Criddle et al., 2003; Meyer, Hemmen, Jackson, & Lyden, 2002). The NIHSS becomes easier and less time consuming to administer as it is made a standard part of nursing practice and provides a language healthcare providers can use to communicate stroke severity (Criddle et al., 2003). When compared with other stroke scales (e.g., the Scandinavian, Mathew, and Orgogozo scales), the NIHSS was the most sensitive in detecting changes in stroke signs (Bessenyei, Fekete, Csiba, & Bereczki, 2001).
Sat, 03 Jun 2023 11:59:00 -0500entext/htmlhttps://www.medscape.com/viewarticle/550818_2