Table of Content

1.0 Introduction .......................................................................................................................... 2 2.0 Company overview ............................................................................................................... 3 3.0 Internal Analysis ................................................................................................................... 4 4.0 External analysis ................................................................................................................... 5 5.0 E-Learning ............................................................................................................................ 8 6.0 Problem statement ............................................................................................................... 10 7.0 Objectives ........................................................................................................................... 11 8.0 Product and methods ........................................................................................................... 12 9.0 Possible issues and Risks of the new e-learning system ....................................................... 18 10.0 Controls ............................................................................................................................ 20 11.0 Cost Benefit Analysis ........................................................................................................ 21 12.0 Feasibility analysis ............................................................................................................ 23 13.0 Summary........................................................................................................................... 23 14.0 Invoice .............................................................................................................................. 24 15.0 References ........................................................................................................................ 25 16.0Appendices ........................................................................................................................ 28 Appendix 1 ............................................................................................................................ 28 Appendix 2 ............................................................................................................................ 28 Appendix 3 ............................................................................................................................ 28

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1.0 Introduction
This report evaluates the overall importance of the newly introduced e- learning system and the impact it has on the employees at Nawaloka Hospitals PLC. The e- learning system is named as the Nawaloka Social Networking Site. The target audience of the proposed web based learning system will be the employees at Nawaloka hospital. The nurse staff will be the key target audience, which the learning system will be mainly focusing on. The Nawaloka Social Networking Site is a web based social network system which is used to educate, train and develop the employees of Nawaloka Hospitals. In order to support the training and educational needs, we have used YouTube, twitter and various other online medical libraries and partnering universities. All the video materials on training will be uploaded through YouTube, and all the educational materials will be available to the employees through the availability of access to various online libraries and other online service providers in which the system has received its memberships. Moreover all the latest updates will be communicated promptly to the employees through the usage of twitter. So the entire system will be a new and an exciting experience to the employees. Currently Nawaloka Hospital is engaging in training their staff in the traditional way, by operating two nursing schools outside Colombo and managing these two schools has been a costly process to the hospital. However these programs are also time consuming as they are designed for three years and on. In addition these programs do not focus on the latest developments in the health care industry, and as a result employees at Nawaloka are way behind international hospitals in terms of knowledge and expertise on the latest medical technologies and processes. This has also slowed the career progression of the employees. So this web based system will now open new doors to Nawaloka to provide up to date training and education and also to develop their staff to the international level while reducing costs and time. This e-learning system will ensure effective career progression if the system is accurately implemented and operated.

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2.0 Company overview

Image 1: Retrieved from http://www.google.lk/imgres?q=nawaloka+hospitals

Nawaloka hospitals PLC was established in the year 1985. Nawaloka Hospital is one of the leading hospitals in Sri Lanka at present. Today its main intention is to fulfill the need of a high technology to serve the public for an affordable cost. This hospital comprises with highly qualified consultants, Physicians, Surgeons, Anesthetists and well trained nursing staff. This is a staff that is capable in providing various medical and surgical facilities for its patients or customers. (Nawaloka hospitals plc, n.d.)

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3.0 Internal Analysis

Nawaloka hospital currently comprises of over 4500 employees within the country and also around 500 employees are involved in overseas organizations that are linked with Nawaloka group. These 4500 employees are involved in providing various services that Nawaloka group. (Please refer Appendix 1) Nawaloka Hospitals believe that the employees are the nerve centre of the hospital and they are the most valuable asset who would take them to their vision. Today Nawaloka has two training schools outside Colombo. (Refer Appendix 2) Basically at present what Nawaloka hospital does at training is to make employees have a strong desire in helping others, to have concern for the welfare of patients and clients and further to create the ability for them to work in challenging situations with various people who have diverse backgrounds. Nawaloka hospital provides training programs which includes classroom instruction for programs such as first aid training and further an internship in a basic support staff position. Further an introduction to the health care environment is given as it enables employees to have customer service skills, professional image development and medical terminology etc. (Professor Lal G. Chandrasena, Director/ General Manager- Nawaloka Hospitals PLC Personal communication, 15th January 2012). However these training programs have been really costly for the hospital and have also been a time consuming process. The kind of people or employees that Nawaloka hospitals look for are the people with the ability of working under any challenging circumstances. They should be able to take the stress and work for long hours and also to self learn at the same time. Basic requirements would be the education qualifications, language skills and learning skills where they should be able to work even at different countries (Personal communication, 15th January 2012). Today, Nawaloka hospitals have newly introduced several software systems. They are as follows. y y y E-Channeling New Laboratory information management system Pharmacy system in hospital information system (HIS) (Please refer Appendix 3 for further information)
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However, some of the basic software systems used in Nawaloka are; patient management, OPD management, discharge summary, security management and laboratory management (personal communication, January 15, 2012).

4.0 External analysis

Health Care industry in Sri Lanka The healthcare industry is one of the fastest growing sectors in Sri Lanka today. Sri Lankas private healthcare sector had a steady growth of 23% in 2009 and today therefore there is a massive potential to develop medial tourism in Sri Lanka (Hewage, 2010). However the growth in this sector is driven by several major factors such as change in patters of diseases, changes in the life styles, changes in the environment and shifting of demographics. Apart from that as a result of the rapid economic development more people will move towards private healthcare facilities from the state sector for better and high quality treatments (A caring hospital under state control, n.d.).

Challenges faced in the Health and Care industry y Today Sri Lanka is facing major challenges to provide heath services to noncommunicable diseases like cancers, diabetes, heart diseases and mental health problems due to the increased life expectancy and changing patterns of diseases ( Improving health services in rural Sri Lanka, 2011). y y Low returns on capital due to low margins earned on services provided Re-designing processes requires adopting international best practices to gain a competitive edge in the industry. y At present most of the real customer needs are not met by the private sector (A caring hospital under state control, n.d.)

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The human resource development and deployment has become a severe problem where it has adversely affected the peripheral health system. That is there is a shortage of nurses and other related personnel even though the doctors are increasing.

Stewardship in the health sector- this involves engaging and regulating the private sector, collaborating with education, stakeholders and other sectors.

Health financing- current government expenditure is unable to meet the financial requirement of health needs and the increasing development of technology will bring more burdens to the health financing.

Information technology- very few hospitals at present have computer networks and health information systems for documenting, information processing and for other purposes. To solve this drawback will need training on computer usage, using simple understandable software and proper maintenance of the computer networks.

Strengthening public-private sector partnerships- privates sector facilities are only concentrated today in the urban areas. Apart from that most private sector medical and health professional are also working in the public sector resulting in shortage and inefficient geographical distribution of health personnel. (WHO country cooperation strategy- Sri Lanka health development challenges, 2011.)

Employee needs When looking at the global arena in the context of the health care industry, it has been a sector which has grown dramatically along with the technological developments. Therefore the global health care industry is in the centre of high-tech processes. So in order to match the gap upto a certain extent, following needs are to be fulfilled at present.  Graduate programs and diplomas for nurses in English  Vocational training program for nurses and other staff  Course on improving the English knowledge and the IT skills for new high-tech processes of the nurses and other staff.  Overseas training programs for employees to update them with the latest practices and to give proper training on advanced programs and processes.

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But however the following are some of the employer considerations on recruiting employees for hospitals. These are mainly for the nursing and IT staff. Nurses y y A diploma is nursing and registration from the Sri Lankan medical council Or a 3yr diploma in General Nursing from a private hospital school of nursing, which is approved by the Ministry of Healthcare and Nutrition in Sri Lanka y y English knowledge and communication skills Work experience in a reputed hospital in similar capacity (Vacancies for nurses- The Lanka Hospitals Corporation, 2008) IT Assistants y y y Advance level passed in the field science Knowledge on MCP and CCNA Should posse two years of experience in the following areas o Thorough knowledge of Windows XP/7 and Microsoft Office o Network (LAN/WAN) concepts o PC, printers and other peripherals: installation, configurations, troubleshooting and repairing o Ability to solve network related issues o Fixing threats of virus and security issues in the information systems (Career opportunities, n.d.)

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5.0 E-Learning
E-Learning is the use of technology to enable people to learn anytime and anywhere. E-Learning can include training, the delivery of just-in-time information and guidance from experts. (ELearning consulting, 2011). For a hospital they can deliver patient-centred, accessible e-learning to all levels of staff within health and social care. (Epic,2012)And also the healthcare sector is a fast changing environment and it is clear that its performance also depends on the ability of their staff to take up knowledge fast and acquire the competencies which are necessary for the adaptation to that constant changing environment. (Sarantos .,n.d). Thereby as Nawaloka hospital they can use this Elearning methods in order to give better learning experience to their staff. However Nawaloka Hospital can be considered different types of e-learning methods as follows. 1. Asynchronous e-Learning this method can be used by the learners or else staff of Nawaloka hospital at anytime and this has two methods such as self-paced courses and discussion groups. 1.1 Self-paced CoursesNawaloka Hospital can be delivered this method for their staff in different waystypically, Internet, Intranet or Local Area Networks and CD-ROM or DVD. 1.2 Discussion GroupsDiscussion groups can be used to support a group of people taking the same class or can be used to support people performing similar tasks. Therefore this method can be implemented among doctors, nurses and among all the other staff as well.(Asynchronous E-Learning, 2011) 2 Synchronous e-Learning

2.1 Virtual Classroom- A virtual classroom duplicates the capabilities found in a real classroom.

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2.2 Audio and Video Conferencing 2.3 Chat- Chat allows several staff members to communicate with each other regarding anything. Shared Whiteboard- A shared whiteboard is a common feature within virtual classroom software packages. 2.3 Application Sharing- It demonstrates how to use software applications.So Nawaloka Hospital can use this method for their remote learners with application sharing. 2.4 Instant Messaging- Instant messaging is similar to chat. One person communicates to another through typing. Instant messaging also provides some additional features. (Synchronous e-Learning, 2011) Benefits y y y y y y y y Nawaloka Hospital can produce this inexpensively for their staff. It's self-paced so it can be used as a convinent method for Nawaloka Hospital staff. It moves fasterso staff of Nawaloka Hospital will be learnt faster. It provides consistent messages to staff. Staff of the Nawaloka Hospital can work from any location and any time. Staff members can get updates easily and quickly It can lead to increased retention and a stronger grasp among staff members. It can be easily managed for large group staff members of Nawaloka Hospital. (Lee A., 2012) Drawbacks
y y y y y

Unmotivated staff members or those with poor study habits may fall behind Lack of familiar structure and routine may take getting used to Instructor may not always be available on demand Slow or unreliable Internet connections can be frustrating Managing learning software can involve a learning curve
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6.0 Problem statement

Presently Nawaloka hospital is spending huge amounts on training purposes which are done physically. The training colleges are located outside Colombo and one in Galle. Therefore this has been a time consuming process as coordination of activities takes a considerable time. This has also been a highly expensive program for the hospital since maintaining and operating two training colleges in two different locations needs considerable financial and training costs. Therefore this has caused the hospital to waste time and money. In the same time there are no online training programs compared to the competing firm in the health care industry. Today in all the developing countries training programs are conducted online where the staff gets access to wider area of training materials throughout the universal cyber space. This has helped the hospitals to cut their costs in training physically. Therefore when comparing with the developed nations, Nawaloka is way behind engaging in the traditional methods of training their employees. As a result the extra knowledge about the latest medical services and processes of the employees at Nawaloka are at a lower level. This in the same turn has hindered their career progression as the physical training programs takes longer periods to train the latest services to the employees.

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7.0 Objectives
The primary objective of this project is to develop a web based social network which will introduce a new form of online learning and training programs for the employees at Nawaloka and also to encourage and motivate the employees to learn more on the latest medical processes and gain extra knowledge and expertise. In order to achieve our primary aim the following objectives will be accomplished. y To provide vast access to online medical and healthcare libraries and other online learning materials to improve the knowledge base of the employees. y To provide cost effective training by uploading video and audio files and through various other youtube videos available online. y To inform all the employees about the latest updates on the social network promptly through the usage of twitter. y y To provide a new and an exciting learning experience through online training. To provide a comprehensive, continuous and a flexible learning process through the availability of all the learning materials 24/7. y To reduce the hierarchy within the hospital system and help all the employees within the hospital to interact with each other and discuss their needs and issues. y To update, train and develop the employees with the latest medical transformations and new medical processes and help them with their career progression to be quicker.

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8.0 Product and methods

Social Network Site Our consultancy has decided to propose a social network site to Nawaloka Hospital, which would be the product in this case. In order to develop our software we have benchmarked a famous social networking site called Facebook. The research we did indicated that presently many hospitals in western countries have implemented this idea successfully to be beneficial. (Lexology, 2010) Nawaloka is a well known hospital is Sri Lanka which is not conservative in term of operation systems and technology. Our consultancy has come up with an innovative and advanced idea of introducing a customized social network site for Nawaloka which could be exclusively used by individuals who are related to the hospital.

Features of the product y y y y y y y y y y Connecting people Video share Image share Status share Individualized Profiles Messaging facility Calling facility Privacy controls Groups Communities

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Benefits of the Software y y y y y y y y y Comprehensive strategies and sound policies could be developed A new culture could be implemented Better employee- employer relationships Reduction of training costs Media for marketing purposes Connecting the stake holders with the firm Feedback from the patients could be received Can educate the employees Employee empowerment (Lexology, 2010) Blended learning Blended learning is approaches in which face to face methods and computer based learning are combined together in order provide instruction or basic knowledge about concepts. The software we are going to introduce is a look alike of an existing social network site; it requires the basic skills and knowledge from the employees and customers to use it. (PennState, 2009)

Methods and Tools In order to educate their employees successfully Nawaloka could use two well known approaches of E-Learning which are; synchronous and asynchronous methods. We highly recommend synchronous E-Learning for Nawaloka hospital because it is more practical and easy approach. This approach will enable them to overcome the identified problem. The major problem faced by Nawaloka is occurrence of high cost due to training. Synchronous learning uses media such as videoconferencing and chat. It educates and develops employees by

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categorizing them into communities. Through this E learning process Nawaloka could cut down its costs immensely. (Stefan Hrastinski, 2009)

Tools This section includes brief explanations about the tools which are to be used throughout the process. In order to make the learning more effective audio conferencing, video conferencing, application sharing, application, shared whiteboard and instant messaging will be used.

Chat, Audio & Video conferencing This tool will enable both employers and employees to engage in face to face communication. Senior staff could educate the new recruits regarding their work, doubts and procedures. This tool will be implemented by connecting network such as you tube and audio referencing to Navaloka social networking site. The main reason for including this tool is to create more interaction between staff members.

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Shared White board This tool is been included to assist employees to brain storm at a common place without any barriers. Employees could share their ideas and opinions through this. If one employee shares something other employees could post their comments and learn things. Ultimately everyone will get a chance to generate ideas and receive feedback from peers.

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Application Sharing This tool is similar to Shared white board; this tool will facilitate the learning process by making it quicker and easier. Employees will be updated with everything and the control they have on application will allow them to perform their tasks effectively. (E-Learning Consulting, 2011)

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Implementation

Audio Web Designing software Visuals Domain Web Host Intigration with facebook, twitter and youtube

The above graph shows the steps of how a social networking site could be created according to the hospital needs. Not only for social networking site but for any website a domain is essential. Domain gives the identity to a site by differentiating it. Further web designing software and web host will be needed to modify and create application according to the hospitals needs. Web host is basically a company which is connected to the internet all the time. It has many computers and called as servers and they are designed with different IP numbers so it could be found by other computers which are connected to the internet at the same time. Files will be stored and received by programs such as HTML, graphic, CSS and Java scripts. (NTC Hosting, 2010) This product could be launched easily without any hassles by Nawaloka hospital management. Social network would not be a new concept for employees and employers since everyone is connected with many different people through social networking sites such face book and twitter. The knowledge they already have about social networking site will be sufficient to operate the Nawaloka E-Learning social networking site. Management could organize few tutorials in order to introduce and enlighten everyone on the applications the site has.

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9.0 Possible issues and Risks of the new e-learning system

Issues
There are several issues that can occur while the e-learning program is conducted. Some key issues as following. y Technophobia- the computer literacy rate of most of the employees is at a low level at present. Therefore employees may hesitate to learn under IT background as they have a phobia over it. This can cause low confidence and low interests towards the e-learning process. y Internet failures- Proposed e-learning system for Nawaloka Hospital is conducted through internet. However many internet failures and interruptions can occur while employees are engaged with their learning. Therefore this can hinder the efficiency of the learning system. y Hardware failures- hardware failures as a result of poor maintenance can once again hinder the efficiency of the learning system.

Risks
However, apart from the above mentioned issues, there are other several risks that Nawaloka will have to face when conducting this program. They are as follows, y Security and privacy problems-

This is a major risk of publishing e-mail addresses and other sensitive information on internet. When the staffs share their e-mail addresses with others via websites or in chat rooms, those addresses can be easily taken up by hackers and SPAM Companies to send junk e-mails. Moreover since this is a social network most of the information is published and privacy is very low and anyone can post things to the Nawaloka page also. So, unwanted posts can adversely affect the company image as well.

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Moreover any person can copy the things that are confidential of the e-learning process of Nawaloka Hospital. (Top 10 Technology Risks, n.d.)

Cyber harassment-

Cyber harassment usually occurs with threatening or harassing with email messages, instant messages, or to blog entries or websites dedicated merely trouble to organizations. Some states approach cyber harassment by including language addressing electronic communications in general harassment statutes, while others have created stand alone cyber harassment statutes. (NCSL,2012) y Entertainment rather than learning

Since this is a social network employees can use this system for personal usage and misuse the system by focusing on personal entertainment rather than learning. This is where employees could chat with other friends, post irrelevant things, play games, watch unwanted videos and listen to music and etc. So this is a risk for the system and managers should control it in order to gain the maximum out of benefits through this e-learning process.

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10.0 Controls
In order to measure the success of the new e-learning program and the developed knowledge of the Nawaloka employees (after having participated in the e-learning process), the following tools can be used as measurement tools. y Online exams- Nawaloka Hospital can conduct various online exams such as MCQs and Case studies for their employees in order to test the employees knowledge that they have gathered throughout the e-learning process. Once the exams are conducted, Nawaloka can award various certificates and medals reflecting the employees performance and achievement. These certificates will be a valuable for their lives and will also help in their career progression. This will also motivate the employees to learn more and develop themselves. y Practical test- However measuring the knowledge through learning alone is not sufficient enough. What is more important is applying the knowledge what has been gathered throughout the e-learning process. So for this purpose Nawaloka can conduct various practical tests to measure how well the employees can apply their knowledge gathered from e-learning system. Finally as mentioned earlier certificates, medals and badges can be given for high performers as a reward of recognition. So this will ultimately help the hospital to create a performance driven culture within the organization.

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11.0 Cost Benefit Analysis

The financial cost benefit analysis for the new web based social network system is given below. Cost- Web based social network system y y y y Domain charges per month- Rs. 2000 Web hosting- Rs. 1500 Professional web designing cost- Rs. 75, 000 Paying for online libraries and other training materials- Rs. 500,000 Total cost for social network system= Benefits However the fee for the web designing will be a pay for once and for all. Apart from that the fee for online libraries will be to a fixed time period. Therefore the monthly costs are very low just amounting to Rs. 3,500. However if the training and learning were conduct physically for the employees the cost would be much greater than Rs. 500,000. Therefore there is a huge benefit of using a social network as an E-learning system. Cost- New computer equipment: y y y y y Two large rooms to be used as computer lab rooms Rs. 600, 000 100 network-ready PCs with supporting software Rs. 30, 000 each 1 server at Rs. 150, 000 10 printers at 15,000 each Cabling & Installation at Rs. 50000 Total costs for computer equipment= Benefits The costs which are for new computer equipment will be a once and for all pay. Therefore in the future there is no need of spending money frequently for the above mentioned costs. Also when the new training and learning system is located within the hospital premises the costs on maintain and operating two training schools outside Colombo could be dramatically cut down letting the hospital to save some millions of money. Rs. 845, 000 Rs. 578, 500

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Training costs:
y y y

Computer introduction 8 people at Rs. 20,000 each Keyboard skills 8 people at Rs. 20,000 each Social network Support System 12 people Rs. 25,000 each Total costs for training= Rs. 620, 000

Benefits These costs will be short term to the organization. This is because once the employees have learnt their basic skills they can be self dependent. As a result once again the Nawaloka can save huge amounts of money without physically conducting training and educational programs outside the hospital, but inside the hospital at a very convenient and financially in a cheap manner. Total cost= Rs. 2, 043, 500

Some of the other Benefits:

y

Improved efficiency and reliability of follow-up within the Hospital : estimate: Rs 5,000,000 / year

y y

Improved patient service and retention of the employees: estimate: Rs. 8,000,000 /year Improved accuracy of patient and medical information: estimate: Rs.2,000,000 / year

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12.0 Feasibility analysis

The proposed e-learning system is designed after analyzing the issues faced by Nawaloka Hospital and to provide a better solution. Therefore this social network system will provide comprehensive trainings through the provision of immense online learning materials to their employees. As the computer labs are based within the hospital premises, employees can learn at anytime when they are free. This will also reduce both the costs and time on maintaining two training schools in two different locations. As employees will now be connected with the entire staff and the management, there will be better coordination among the hospital as well. So finally this proposed system will ensure to create an exciting and a new learning culture which will help the employees to develop themselves and fasten their career progression.

13.0 Summary
Today we are living in the Knowledge era. Due to the massive technological advancements and developments, every moment a new thing is created. This is evident in the health care industry as it is in the centre of high tech processes. Therefore growing along with the latest knowledge is important to be effective and successful. The current training programs at Nawaloka have been costly and time consuming. More over it has failed to cope up with the latest developments in the healthcare industry. Therefore in order to overcome these problems we introduced a new system of training and development for the employees at Nawaloka to be kept in par with the international level. This e-learning system has promised many benefits to the organization if its implemented accurately.

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14.0 Invoice

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15.0 References
About e-learning. (2012). RetrievedJanuary 14, 2012, from:http://www.about-elearning.com/elearning-advantages-and-disadvantages.html A caring hospital under state control. (n.d.). Retrieved January 13, 2012 from

http://www.lankahospitals.org/data/media_centre/news_2.html Asynchronous E-Learning. (2011). RetrievedJanuary 14, 2012, from: http://www.elearningconsulting.com/consulting/what/asynchronous.html Career opportunities. (n.d.). Retrieved January 25, 2012 from http://www.durdans.com/careers/career_opportunities.php E-Learning consulting. (2011). RetrievedJanuary 14, 2012, from: http://www.elearningconsulting.com/consulting/what/e-learning.html E-Learning Consulting, (2011) Virtual classroom retrieved on 20th January, 2012 from:http://www.e-learningconsulting.com/consulting/what/synchronous.html Epic. (2012).RetrievedJanuary 14, 2012, from: http://www.epic.co.uk/casestudies/sector/health.html Hewage, I. (2010, June 3). Lanka hospitals to target medical tourism. Retrieved January 25, 2012 from http://www.dailynews.lk/2010/06/03/bus02.asp Improving health services in rural Sri Lanka. (2011). Retrived January 13, 2012 from http://www.worldbank.lk/WBSITE/EXTERNAL/COUNTRIES/SOUTHASIAEXT/SRILANKA EXTN/0,,contentMDK:22221867~menuPK:232812~pagePK:2865066~piPK:2865079~theSiteP K:233047,00.html Lee Ann Obringer. (2012). RetrievedJanuary 14, 2012, from: http://people.howstuffworks.com/elearning4.htm

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Lexology, (2010) Hospital social networking retrieved on 2nd January, 2012 from:http://www.lexology.com/library/detail.aspx?g=e2fa2dd3-9ed0-4c03-8be0-a49e3d122033 Malawaraarachchi, B. (2004). Nawaloka hospital to go ahead with major expansion program. Retrieved January 25, 2012 from http://www.dailynews.lk/2004/08/27/bus03.html

Nawaloka hospitals plc.(n.d.). Retrieved January 21, 2012 from http://www.nawaloka.com/info/about-us Nawaloka Hospital first with ISO 9001:2008 certification. (2008). Retrieved January 26, 2012 from http://www.ft.lk/2010/10/28/nawaloka-hospital-first-with-iso-90012008-certification/ NCSL. (2012). Retrieved 20.01.2012, From: http://www.ncsl.org/issuesresearch/telecommunications-information-technology/cyberstalking-cyberharassment-andcyberbullying-l.aspx NTC Hosting,(2010) What is a domain? retrieved on 20th January, 2012 from:http://www.ntchosting.com/domains/what-is-domain.html PennState, (2009) What is blended learning retrieved on 2nd January, 2012 from:http://weblearning.psu.edu/blended-learning-initiative/what_is_blended_learning Sarantos P.(n.d). Retrieved January 14, 2012, from: http://www.eurodl.org/materials/contrib/2005/Sarantos_Psycharis.htm Stefan Hrastinski, (2009) Asynchronous and Synchronous E-Learning .Retrieved on 2nd January, 2012 from: http://www.educause.edu/EDUCAUSE+Quarterly/EDUCAUSEQuarterlyMagazineVolum/Asyn chronousandSynchronousELea/163445 Synchronous e-Learning. (2011). RetrievedJanuary 14, 2012, from: http://www.elearningconsulting.com/consulting/what/synchronous.html

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Top 10 Technology Risks. (n.d). Retrieved 20.01.2012, From: http://www.nortech.com/solutions/dox/Top_10_Technology_Risks.pdf Vacancies for nurses- The Lanka Hospitals Corporation. (2008). Retrieved January 25, 2012 from http://www.lankatopjobs.com/job-details/job-details.php?id=6918 WHO country cooperation strategy- Sri Lanka health development challenges. (2011). Retrieved January 25, 2012 from http://www.searo.who.int/LinkFiles/WHO_Country_Cooperation_Strategy__Sri_Lanka_Health_Development_Challenges.pdf

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16.0 Appendices
Appendix 1
Various services provided by the Nawaloka Hospitals PLC This comprises of such as mainly the intensive care unit, O.P.D. Services, Operation theaters, Ultra sound and M.R.I. scanning and dental unit would be some of the services and also they offer medical facilities such as Cardiac screening, Diabetic Screening, E.N.T. Tymponoplasty and Gynecology- Normal Delivery and also Health packages for over 50 years etc. also Nawaloka hospitals Plc has become the first in the industry to obtain the ISO 9001 : 2008 quality management system certification and also ISO 9001:2000 certification in years 2000, 2004 and 2007 (Nawaloka Hospital first with ISO 9001:2008 certification, 2008).

Appendix 2
Training schools of Nawaloka Nawaloka Hospitals PLC has implemented a training school for professionals called the Nawaloka Professional Training Academy (Pvt) Ltd and also a nursing training school in Galle district for the Post graduates to get the necessary training (Professor Lal G. Chandrasena, Director/ General Manager- Nawaloka Hospitals PLC, Personal communication, 15th January 2012). These training programs are being carried out at the Nawaloka training school for over hundred medical nurses at a time. Also Nawaloka Hospital has also set up a training institute in collaboration with the Manipal Institute of Higher Education (Malawaraarachchi, 2004) in order to give the employees the necessary overseas training which they need to perform.

Appendix 3
Newly introduced software systems at Nawaloka Hospitals PLC Nawaloka hospitals have introduced several software systems via using a quality assurance manager from John keells computer services in order to conduct QA process from manually to billing and to have nurse station portals in the hospital system. The process called E-Channeling is also done by this system. Further nawaloka hospitals have entered in to a joint venture with Metropolis health services, India (Pvt) Ltd. By this venture, it is expected to set up the first
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diagnostic service reference laboratory in Sri Lanka. Further metropolis was the first laboratory in India to develop a comprehensive laboratory information management system and further this system is to be introduced in Sri Lanka as well. Additionally theres a developed pharmacy system in hospital information system (HIS) in Nawaloka hospital which is used to train the staff for efficient performance.

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