case study in management information system

The success of a management information system in health care - a case study from Finland

Affiliation.

• 1 Central Finland Health Care District, Keskussairaalantie 19, FI-40620 Jyväskylä, Finland. [email protected]
• PMID: 22705086
• DOI: 10.1016/j.ijmedinf.2012.05.007

Purpose: The purpose of this article is to describe perspectives on information availability and information use among users of a management information system in one specialized health care organization. The management information system (MIS) is defined as the information system that provides management with information about financial and operational aspects of hospital management.

Methods: The material for this qualitative case study was gathered by semi-structured interviews. The interviewees were purposefully selected from one specialized health care organization. The organization has developed its management information system in recent years. Altogether 13 front-line, middle and top-level managers were interviewed. The two themes discussed were information availability and information use. The data were analyzed using inductive content analysis using ATLAS.ti computer program.

Results: The main category "usage of management information system" consisted of four sub-categories: (1) system quality, (2) information quality, (3) use and user satisfaction and (4) development of information culture.

Conclusions: There were many organizational and cultural aspects which influence the use of MIS in addition to factors concerning system usability and users. The connection between information culture and information use was recognized and the managers proposed numerous ways to increase the use of information in management work. The implementation and use of management information system did not seem to be planned as an essential tool in strategic information management in the health care organization studied.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Publication types

• Research Support, Non-U.S. Gov't
• Delivery of Health Care / organization & administration*
• Health Information Management / organization & administration*
• Management Information Systems*
• Models, Organizational*
• Organizational Culture*

Management Information Systems: In Business, in Academia, and in The Future

By Andy Marker | October 26, 2017 (updated December 14, 2021)

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Management information systems (MIS) is a changing and challenging field. Modern businesses can’t survive for long without using some sort of MIS to manage massive amounts of data, and there are plenty of opportunities to study or work in the discipline. In this article, we’ll cover what is happening with MIS in both business and academia. You’ll learn about what constitutes an MIS, their origin and evolution, their capabilities, and also gain insights from experts in the field.

What Is a Management Information System?

In business, management information systems (or information management systems) are tools used to support processes, operations, intelligence, and IT. MIS tools move data and manage information. They are the core of the information management discipline and are often considered the first systems of the information age.

MIS produce data-driven reports that help businesses make the right decisions at the right time. While MIS overlaps with other business disciplines, there are some differences:

• Enterprise Resource Planning (ERP) : This discipline ensures that all departmental systems are integrated. MIS uses those connected systems to access data to create reports. 
• IT Management : This department oversees the installation and maintenance of hardware and software that are parts of the MIS. The distinction between the two has always been fuzzy.
• E-commerce: E-commerce activity provides data that the MIS uses. In turn, the MIS reports based on this data affect e-commerce processes. 

Maeve Cummings , Co-author of Management Information Systems for the Information Age and Professor of Accounting & Computer Information Systems at Pittsburg State University in Pittsburg, Kansas, explains how MIS functions in academia. “[Management information systems is] the study of computers and computing in a business environment. Computer science focuses on the machine while information systems, or management information systems, focuses on how IT can support the strategy and operation of organizations,” she explains.

The concept includes what computers can do in this field, how people process information, and how best to make it accessible and up-to-date. Cummings adds, “The ‘right information in the right place at the right time’ is what we are striving for. This discipline is much more eclectic than straight computer science.” 

Besides computer science, there are fields of study that overlap with MIS, both at the theoretical and practical levels:

• Information Systems (IS): In IS, there is a greater emphasis on tools, while MIS places more emphasis on business processes and operations.
• Information Technology (IT): IT is similar to IS, but it focuses solely on computers.
• Informatics: A discipline that combines software engineering, information systems development, and networking. 
• Electrical Engineering and Computer Engineering: These fields focus on the development and improvement of hardware and software, respectively. MIS helps determine the practical and theoretical implications of these changes. 

History of Management Information Systems

The technology and tools used in MIS have evolved over time. Kenneth and Aldrich Estel, who are widely cited on the topic, have identified six eras in the field. 

After an era ends, the previous era’s hardware are still in use. In fact, mainframes (albeit much faster, cheaper, and easier to access than their predecessors) are still used today.

From Ledgers to Flash Memory

In the days where businesses recorded all transactions in a bound ledger, tallying and tracking what was going on took a lot of time and work. In the late 1800s, process automation began to appear in the the form of punch cards. Associated machines tabulated the punch card data and printed results, which made it easier to capture transactions. The company that came to eventually be known as IBM was founded in the early 1900s and became the leader in business machines and punch cards. These cards evolved from a solution to automate pattern creation in weaving machines. The company adapted the idea to store and input data for applications from as simple as time for payroll to very complicated uses like recording census data. When general-purpose computers became available after WWII (originally developed for codebreaking, calculating shell trajectories, and other war-related needs), the punch card became an input method as well as a way to store outputs (though it required readers to decode and print the data so people could read it). 

Later, magnetic media (such as tapes and floppy disks) took over the storage of input and output, and computers could read and write directly to their own memory. This eliminated the need for the specialized machines. Next, optical media (like CDs and DVDs) that could store much more data on a single disc came along. Today, we are transitioning to flash memory (which also goes by solid state, as in a solid state drive or SSD). Flash memory has a higher capacity, is less volatile, and you can reuse it thousands of times with little degradation in quality.

Each of these periods has brought an increase in storage capacity at a lower cost. In tandem with the constant increase in computing power, more and more powerful software, almost-ubiquitous connectivity via wifi and mobile devices, and ever-expanding networking that evolved into the internet, work that previously took many hours - like tabulating a company's shipping costs over a year or population increases in a state over a century - now takes little time or human effort.

On the software side, the functions that paper ledgers performed moved to spreadsheet programs (the term spreadsheet came from the large sheets of paper spread out on tables). Microsoft Excel is the best-known example, but it wasn’t the first to become popular. VisiCalc, which was created for the Apple II in the late 1970s by Dan Bricklin and Bob Frankston, was the first to gain popularity. There were spreadsheet programs available for mainframes and minicomputers before VisiCalc, but they didn’t offer the ability to see results in real time. 

Spreadsheets became more powerful in the 70s and 80s. When connected with databases, they gave users the ability to easily and quickly access and manipulate data. As users’ needs and desires changed, specialized programs were developed for different user groups, allowing innovative ways to use data. 

Information technology and MIS used to be synonymous. Task automation (such as report creation) led to an expansion of the work that fell under MIS. Simultaneously, the definition of IT expanded even more, and it now encompases areas beyond MIS, such as cyber security and network administration.

Categories of Management Information Systems

Management information system is a broad term that incorporates many specialized systems. The major types of systems include the following:

• Executive Information System (EIS): Senior management use an EIS to make decisions that affect the entire organization. Executives need high-level data with the ability to drill down as necessary. 
• Marketing Information System (MkIS): Marketing teams use MkIS to report on the effectiveness of past and current campaigns and use the lessons learned to plan future campaigns.
• Business Intelligence System (BIS): Operations use a BIS to make business decisions based on the collection, integration, and analysis of the collected data and information. This system is similar to EIS, but both lower level managers and executives use it. 
• Customer Relationship Management System (CRM): A CRM system stores key information about customers, including previous sales, contact information, and sales opportunities. Marketing, customer service, sales, and business development teams often use CRM .
• Sales Force Automation System (SFA): A specialized component of a CRM system that automates many tasks that a sales team performs. It can include contact management, lead tracking and generation, and order management.
• Transaction Processing System (TPS): An MIS that completes a sale and manages related details. On a basic level, a TPS could be a point of sale (POS) system, or a system that allows a traveller to search for a hotel and include room options, such as price range, the type and number of beds, or a swimming pool, and then select and book it. Employees can use the data created to report on usage trends and track sales over time.
• Knowledge Management System (KMS): Customer service can use a KM system to answer questions and troubleshoot problems. 
• Financial Accounting System (FAS): This MIS is specific to departments dealing with finances and accounting, such as accounts payable (AP) and accounts receivable (AR).
• Human Resource Management System ( HRMS ): This system tracks employee performance records and payroll data.
• Supply Chain Management System (SCM): Manufacturing companies use SCM to track the flow of resources, materials, and services from purchase until final products are shipped.  

Types of MIS Reports

At their core, management information systems exist to store data and create reports that business pros can use to analyze and make decisions. There are three basic kinds of reports: 

• Scheduled: Created on a regular basis, these reports use rules the requestor has provided to pull and organize the data. Scheduled reports allow businesses to analyze data over time (e.g. an airline can see the percentage of lost luggage by month), location (e.g. a retail chain can compare sales figures from different stores), or other parameters.
• Ad-hoc: These are one-off reports that a user creates to answer a question. If the reports are useful, you can turn ad-hoc reports into scheduled reports. 
• Real-time: This type of MIS report allows someone to monitor changes as they occur. For example, a call center manager may see an unexpected spike in call volume, and find a way to increase productivity or send some of the calls elsewhere.

Benefits of Using Management Information Systems

Using an MIS system can improve the performance of a company in many ways. R. Kelly Rainer, Jr. , George Phillips Privett Professor at Auburn University and Co-author of Management Information Systems, Moving Business Forward , says, “Any organization that does not use MIS simply will not exist for long. This statement would not have been true a couple of decades ago, but computer-based information systems are now essential to the survival of any organization.” 

Beyond the need to stay competitive, there are some key advantages of effective use of management information systems:

• Management can get an overview of their entire operation.
• Managers have the ability to get feedback about their performance.
• Organizations can maximize benefits from their investments by seeing what is working and what isn’t.
• Managers can compare results to planned performance by identifying strengths and weakness in both the plan and the performance.
• Companies can drive workflow improvements that result in better alignment of business processes to customer needs.
• Many business decisions are moved out of upper management to levels of the organization that is closer to where the knowledge and experience lie.

Management Information Systems in Healthcare Organizations

As healthcare companies continue to evolve with the changing technology landscape, and more information, like treatment data, patient information, and operations processes are stored within these systems, healthcare organizations face a need to gain visibility into this critical information anytime, anywhere.

MIS in healthcare enables data and information management related to clinical trials, financial and legal information, pharmaceutical details, physician credentials, and more, to be handled within one comprehensive system. However, because much of this information is confidential and must abide by HIPAA regulatory requirements, these organizations must also be confident that their MIS is safeguarded.

To enable healthcare teams to organize, manage, and store critical information within one holistic system, while also ensuring that their data is safe and all protected health information (PHI) is secure, they need a tool that provides transparency into critical processes, while remaining protected.

Smartsheet is a work execution platform that enables healthcare companies to improve work efficiency, scale business processes, and manage patient data and information, all while securely storing and sharing PHI. Streamline reporting, track and manage assets and resources, and organize all business-critical information in one centralized location to ensure your business runs efficiently, knowing that your data is protected and compliant under HIPAA guidelines.

Interested in learning more about how Smartsheet can help you maximize your efforts? Discover Smartsheet for Healthcare .

MIS Degrees and Careers

The U.S. Bureau of Labor Statistics Occupational Outlook Handbook (OOH) projection for employment in computer and information occupations are projected to grow by 22 percent from 2010 to 2020, adding about 758,000 new jobs.

There’s a common misconception that MIS is just coding. Though that task is a part of it, there are many skills and attributes required for MIS-related careers, including the following:

• Problem solving
• Liking to work with people
• Strategic thinking, especially about technology. In a 1998 paper titled The Balanced Scorecard: A Foundation For the Strategic Management of Information Systems , authors Maris Martinsons, Robert Davison, and Dennis Tse state: In addition to managing current performance, there is also a need to measure and evaluate the readiness of the IS department or function for the future. The future readiness perspective is concerned with: 1. continually improving the skillset of IS specialists in order to prepare them for potential changes and challenges in the future; 2. regularly updating the applications portfolio; and 3. putting effort into researching emerging technologies and their potential value to the organization.
• Developing and implementing new ideas
• Understanding both technology and business
• The ability to look at both details and the big picture
• Communication skills, both written and oral. R. Kelly Rainer, Jr. explains, “The ability of MIS employees to communicate effectively with users in order to understand their business problems. After gaining that understanding, MIS employees must present computer-based solution(s) to those problem(s) without using MIS jargon. The trickiest problem here occurs when a business problem does not have a computer-based solution. In some cases, users are looking for a ‘silver, computer-based bullet’ for a problem that does not have such a solution. For example, a problem with corporate culture might not have a technological solution.”
• Time and resource management
• Comfortable with technological change. R. Kelly Rainer, Jr. says, “One function of MIS employees is to keep abreast of emerging technologies and the potential impacts that these technologies will have on their organization. In fact, MIS employees must be conversant with SWOT (strengths, weaknesses, opportunities, and threats) analyses for each of these technologies. MIS employees must use original thinking when they present these analyses to organizational management.”

There are many employment paths for someone who wants to pursue a career in MIS. These are some MIS-related job titles/fields:

• Business analyst
• Business application developer
• Business intelligence analyst
• Computer and information systems manager
• Computer systems analyst
• Data communications analyst
• Data integration
• Database administrator
• Database analyst
• Information exchange
• Information integration
• Information resources management
• Information security
• Information systems manager
• IT consultant
• IT development project leader
• IT user liaison
• Knowledge management
• Network administrator
• Network systems analyst
• Systems analyst
• Systems developer
• Technical support specialist
• Web developer

While every modern business needs MIS, some industries devote more of their resources to the practice than others do; these include health care, financial services, and telecommunications. Therefore, job seekers might find more opportunity in those verticals.

If someone wants to pursue a degree in an MIS-related field, Collegefactual.com has compiled a list of the top BA programs in the U.S., based on related overall education quality, degrees offered, earnings potential, and other factors:

• University of Notre Dame
• University of Washington
• Georgetown University
• Villanova University
• Santa Clara University
• Worcester Polytechnic Institute
• University of Texas at Austin
• Rochester Institute of Technology

Recent Developments and The Future of Management Information Systems

Management information systems, like any discipline that involves computers and software, is constantly changing. Some recent developments in the field include the following:

• PCs Can Now Host MISs: A small business can have access to the powerful software that previously was only available to large enterprises.
• Application and Management Service Providers: Similar to renting cloud storage, companies can rent software packages and systems management services and expand as their needs change.
• Security: As proved by recent data breaches, data security has moved from a minor concern to a major one. Detailed information about security practices can be found here . 

In the future, many of the same forces that will change the larger world will affect MIS, but some will have a greater impact than others. MIS experts weigh-in on the topic and what we can expect going forward:

Maeve Cummings believes:

One big area of development in information technology is artificial intelligence (AI), which goes far beyond robots that control production (for example, in the automobile industry). Machines are becoming smarter in that they can learn how to solve problems. One such system is a neural network, which is used to alert you that your credit card may have been used unlawfully. These neural networks form a pattern of your spending and based on that, they flag purchases that are out of character, which is when you're notified or your credit card is frozen, depending on the situation. Such developments undoubtedly affect MIS, but they also affect the culture, the law, medicine, military defense, etc.

With so much big data being collected and analyzed nowadays, there will be a great need for legal minds to help sort through the various issues of what should and should not be legal from a privacy point of view. Also, with the budding field of computer-aided mind reading, still very much in its infancy, the issue of what society is allowed to do with that information will be crucial. For example, if you can read a person’s mind to determine whether that person is lying or not, would that be considered evidence or testimony? The law protects people from incriminating themselves (i.e. testimony). However, evidence, such as blood and hair samples may be taken without the consent of the accused. So which is mind-reading? The most interesting part of this business is that it is constantly changing and becoming more powerful. That is also the most alarming part of it.

R. Kelly Rainer Jr shares his thoughts on emerging technologies:

• Artificial Intelligence: Narrow AI (AI for specific tasks) is now pervasive in many organizations. Advances in machine learning and deep learning are making narrow AI much more valuable to all of us. Think instantaneous translation, autonomous vehicles, robots, digital manufacturing (3D printing), etc. MIS departments must try to keep up with these advances and decide how narrow AI can be used in their organizations. 
• The Internet of Things (IoT): The rapid increase of placing sensors on all objects (animate and inanimate) is leading to a sense-and-respond environment. MIS employees should perform the SWOT analysis on IoT for their organizations. A well-publicized example of IoT is General Electric and its Predix operating system.
• Blockchain: Distributed-ledger technology is now being used in a large number of areas. Again, MIS employees must keep up with this technology and see how it impacts their organizations. 
• Financial Technology (FinTech): If your organization is in the financial sector, your MIS employees had better be closely watching start-up FinTech companies. These companies are planning on disrupting the traditional financial sector.
• Quantum Computing: As Moore’s Law begins to slow as we reach the physical limits on how many integrated circuits we can place on a chip, a new paradigm is emerging called quantum computing. Classical computing uses bits, which are either a “0” or a “1.” Quantum computing uses quantum bits (qubits). Unlike classical bits, qubits can store much more information than just 1 or 0 because they can exist in any superposition of these values. Quantum computing is in its very early days, but its potential can provide a dramatic increase in computing speeds. For example, scientists are hoping to be able to accurately model the climate. Another application lies in the field of information security.

Revue of Top Management Information Systems Textbooks

The future of MISs and new technologies will provide new ways to use data to improve business processes, acquire and work with customers, educate employees, and more. If you’re interested in learning more about management information systems, these books can help flush out your understanding of the field and its opportunities. 

Management Information Systems for the Information Age by Steven Haag and Maeve Cummings. Learn the basics of the field and study examples of how organizations have implemented the concepts presented. 

Management Information Systems: Managing the Digital Firm by Kenneth C. Laudon and Jane P. Laudon. This is geared toward business students and provides insight into how businesses leverage IT systems to meet their corporate objectives.

Management Information Systems, Moving Business Forward by by R. Kelly Rainer, Jr. and Hugh J. Watson. This book ties MIS concepts to practice activities, and the activities give students experience with software used in the business world.

Business Information Management: Improving Performance Using Information Systems by Dave Chaffey and Gareth White. In this book, you’ll learn how to apply problem-solving skills to MIS-related problems while looking at them from the perspective of different roles inside a company.

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Home » Management Case Studies » Case Study on MIS: Information System in Restaurant

Case Study on MIS: Information System in Restaurant

Case Summary:

A waiter takes an order at a table, and then enters it online via one of the six terminals located in the restaurant dining room. The order is routed to a printer in the appropriate preparation area: the cold item printer if it is a salad , the hot-item printer if it is a hot sandwich or the bar printer if it is a drink . A customer’s meal check-listing (bill) the items ordered and the respective prices are automatically generated. This ordering system eliminates the old three-carbon-copy guest check system as well as any problems caused by a waiter’s handwriting. When the kitchen runs out of a food item, the cooks send out an ‘out of stock’ message, which will be displayed on the dining room terminals when waiters try to order that item. This gives the waiters faster feedback, enabling them to give better service to the customers. Other system features aid management in the planning and control of their restaurant business. The system provides up-to-the-minute information on the food items ordered and breaks out percentages showing sales of each item versus total sales. This helps management plan menus according to customers’ tastes. The system also compares the weekly sales totals versus food costs, allowing planning for tighter cost controls. In addition, whenever an order is voided, the reasons for the void are keyed in. This may help later in management decisions, especially if the voids consistently related to food or service. Acceptance of the system by the users is exceptionally high since the waiters and waitresses were involved in the selection and design process. All potential users were asked to give their impressions and ideas about the various systems available before one was chosen.

• In the light of the system, describe the decisions to be made in the area of strategic planning , managerial control and operational control? What information would you require to make such decisions?
• What would make the system a more complete MIS rather than just doing transaction processing?
• Explain the probable effects that making the system more formal would have on the customers and the management.

Solution of Management Information System in Restaurant Case Study:

1. A management information system (MIS) is an organized combination of people, hardware, communication networks and data sources that collects, transforms and distributes information in an organization. An MIS helps decision making by providing timely, relevant and accurate information to managers. The physical components of an MIS include hardware, software, database, personnel and procedures.

Management information is an important input for efficient performance of various managerial functions at different organization levels. The information system facilitates decision making. Management functions include planning, controlling and decision making. Decision making is the core of management and aims at selecting the best alternative to achieve an objective. The decisions may be strategic, tactical or technical. Strategic decisions are characterized by uncertainty. They are future oriented and relate directly to planning activity. Tactical decisions cover both planning and controlling. Technical decisions pertain to implementation of specific tasks through appropriate technology. Sales region analysis, cost analysis, annual budgeting, and relocation analysis are examples of decision-support systems and management information systems.

There are 3 areas in the organization. They are strategic, managerial and operational control.

Strategic decisions are characterized by uncertainty. The decisions to be made in the area of strategic planning are future oriented and relate directly to planning activity. Here basically planning for future that is budgets, target markets, policies, objectives etc. is done. This is basically a top level where up-to-the minute information on the food items ordered and breaks out percentages showing sales of each item versus total sales is provided. The top level where strategic planning is done compares the weekly sales totals versus food costs, allowing planning for tighter cost controls. Executive support systems function at the strategic level, support unstructured decision making, and use advanced graphics and communications. Examples of executive support systems include sales trend forecasting, operating plan development, budget forecasting , profit planning , and manpower planning .

The decisions to be made in the area of managerial control are largely dependent upon the information available to the decision makers. It is basically a middle level where planning of menus is done and whenever an order is voided, the reasons for the void are keyed in which later helps in management decisions, especially if the voids are related to food or service. The managerial control that is middle level also gets customer feedback and is responsible for customer satisfaction.

The decisions to be made in the area of operational control pertain to implementation of specific tasks through appropriate technology. This is basically a lower level where the waiter takes the order and enters it online via one of the six terminals located in the restaurant dining room and the order is routed to a printer in the appropriate preparation area. The item’s ordered list and the respective prices are automatically generated. The cooks send ‘out of stock’ message when the kitchen runs out of a food item, which is basically displayed on the dining room terminals when waiter tries to order that item. This basically gives the waiters faster feedback, enabling them to give better service to the customers. Transaction processing systems function at the operational level of the organization. Examples of transaction processing systems include order tracking, order processing, machine control, plant scheduling, compensation, and securities trading.

The information required to make such decision must be such that it highlights the trouble spots and shows the interconnections with the other functions. It must summarize all information relating to the span of control of the manager. The information required to make these decisions can be strategic, tactical or operational information.

Advantages of an online computer system:

• Eliminates carbon copies
• Waiters’ handwriting issues
• Out-of-stock message
• Faster feedback, helps waiters to service the customers

Advantages to management:

• Sales figures and percentages item-wise
• Helps in planning the menu
• Cost accounting details

2. If the management provides sufficient incentive for efficiency and results to their customers, it would make the system a more complete MIS and so the MIS should support this culture by providing such information which will aid the promotion of efficiency in the management services and operational system. It is also necessary to study the keys to successful Executive Information System (EIS) development and operation. Decision support systems would also make the system a complete MIS as it constitutes a class of computer-based information systems including knowledge-based systems that support decision-making activities. DSSs serve the management level of the organization and help to take decisions, which may be rapidly changing and not easily specified in advance.

Improving personal efficiency, expediting problem solving (speed up the progress of problems solving in an organization), facilitating interpersonal communication, promoting learning and training, increasing organizational control, generating new evidence in support of a decision, creating a competitive advantage over competition, encouraging exploration and discovery on the part of the decision maker, revealing new approaches to thinking about the problem space and helping automate the managerial processes would make the system a complete MIS rather than just doing transaction processing.

3. The management system should be an open system and MIS should be so designed that it highlights the critical business, operational, technological and environmental changes to the concerned level in the management, so that the action can be taken to correct the situation. To make the system a success, knowledge will have to be formalized so that machines worldwide have a shared and common understanding of the information provided. The systems developed will have to be able to handle enormous amounts of information very fast.

An organization operates in an ever-increasing competitive, global environment. Operating in a global environment requires an organization to focus on the efficient execution of its processes, customer service, and speed to market. To accomplish these goals, the organization must exchange valuable information across different functions, levels, and business units. By making the system more formal, the organization can more efficiently exchange information among its functional areas, business units, suppliers, and customers.

As the transactions are taking place every day, the system stores all the data which can be used later on when the hotel is in need of some financial help from financial institutes or banks. As the inventory is always entered into the system, any frauds can be easily taken care of and if anything goes missing then it can be detected through the system.

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5 thoughts on “ Case Study on MIS: Information System in Restaurant ”

please give me solution of case study urgent.

Just read the post thoroughly, you’ll find the solution there.

Please I have a similar case study. Can you help me with the solutions

A small company has for some years being using a manual system for processing of billing, payment of creditors and payroll system. The company is considering purchasing a computer on which it will run these application and others that it will develop in the near future. You have been asked to prepare a report on the implication of this proposed course of action.

1. Identify and describe six major issues which would be considered in an investigation of the feasibility of the proposal. 2. Suggest the outline structure of the report.

In fact am much impressed with your trend and solution layout. Thanks

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Information systems of logistic management: a case study

J F Andry 1 and J Loisa 1

Published under licence by IOP Publishing Ltd Journal of Physics: Conference Series , Volume 1280 , Issue 4 Citation J F Andry and J Loisa 2019 J. Phys.: Conf. Ser. 1280 042052 DOI 10.1088/1742-6596/1280/4/042052

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1 Department of Information Systems, Bunda Mulia University, Indonesia

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Established in 2005, XYZ Cargo, a Freight Forwarding and an agency Company specialized in the logistic, shipping in Jakarta. Experience in both ocean freight and air freight agency which more than sixty branch of partnership around the world. XYZ Cargo has operated Information Systems (IS), IS make it possible for company to get the right output to the right people at the right time by increase the interaction between the company's people, the data collected in its various IT/IS systems. This paper primarily deals with the role of Logistics in Jakarta. Framework of thinking used systems development life cycle (SDLC) is a method by which the systems can be developed in a systematic manner and which will enhance the probability of completing the IS project within the time deadline and maintain the quality of the IS product as per the standard. Expected from the implementation of this information systems logistic management can achieve several objectives desired by user requirement, the IS to be more effective and efficient, provide convenience in terms of process data and information. Implementation of IS compared to the manual process of recording which facilitates decision-makers to be able to monitor transactions and report in a short time.

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Two cases about Hertz claimed top spots in 2021's Top 40 Most Popular Case Studies

Two cases on the uses of debt and equity at Hertz claimed top spots in the CRDT’s (Case Research and Development Team) 2021 top 40 review of cases.

Hertz (A) took the top spot. The case details the financial structure of the rental car company through the end of 2019. Hertz (B), which ranked third in CRDT’s list, describes the company’s struggles during the early part of the COVID pandemic and its eventual need to enter Chapter 11 bankruptcy. 

The success of the Hertz cases was unprecedented for the top 40 list. Usually, cases take a number of years to gain popularity, but the Hertz cases claimed top spots in their first year of release. Hertz (A) also became the first ‘cooked’ case to top the annual review, as all of the other winners had been web-based ‘raw’ cases.

Besides introducing students to the complicated financing required to maintain an enormous fleet of cars, the Hertz cases also expanded the diversity of case protagonists. Kathyrn Marinello was the CEO of Hertz during this period and the CFO, Jamere Jackson is black.

Sandwiched between the two Hertz cases, Coffee 2016, a perennial best seller, finished second. “Glory, Glory, Man United!” a case about an English football team’s IPO made a surprise move to number four.  Cases on search fund boards, the future of malls,  Norway’s Sovereign Wealth fund, Prodigy Finance, the Mayo Clinic, and Cadbury rounded out the top ten.

Other year-end data for 2021 showed:

• Online “raw” case usage remained steady as compared to 2020 with over 35K users from 170 countries and all 50 U.S. states interacting with 196 cases.
• Fifty four percent of raw case users came from outside the U.S..
• The Yale School of Management (SOM) case study directory pages received over 160K page views from 177 countries with approximately a third originating in India followed by the U.S. and the Philippines.
• Twenty-six of the cases in the list are raw cases.
• A third of the cases feature a woman protagonist.
• Orders for Yale SOM case studies increased by almost 50% compared to 2020.
• The top 40 cases were supervised by 19 different Yale SOM faculty members, several supervising multiple cases.

CRDT compiled the Top 40 list by combining data from its case store, Google Analytics, and other measures of interest and adoption.

All of this year’s Top 40 cases are available for purchase from the Yale Management Media store .

And the Top 40 cases studies of 2021 are:

1.   Hertz Global Holdings (A): Uses of Debt and Equity

2.   Coffee 2016

3.   Hertz Global Holdings (B): Uses of Debt and Equity 2020

4.   Glory, Glory Man United!

5.   Search Fund Company Boards: How CEOs Can Build Boards to Help Them Thrive

6.   The Future of Malls: Was Decline Inevitable?

7.   Strategy for Norway's Pension Fund Global

8.   Prodigy Finance

9.   Design at Mayo

10. Cadbury

11. City Hospital Emergency Room

13. Volkswagen

14. Marina Bay Sands

15. Shake Shack IPO

16. Mastercard

17. Netflix

18. Ant Financial

19. AXA: Creating the New CR Metrics

20. IBM Corporate Service Corps

21. Business Leadership in South Africa's 1994 Reforms

22. Alternative Meat Industry

23. Children's Premier

24. Khalil Tawil and Umi (A)

25. Palm Oil 2016

26. Teach For All: Designing a Global Network

27. What's Next? Search Fund Entrepreneurs Reflect on Life After Exit

28. Searching for a Search Fund Structure: A Student Takes a Tour of Various Options

30. Project Sammaan

31. Commonfund ESG

32. Polaroid

33. Connecticut Green Bank 2018: After the Raid

34. FieldFresh Foods

35. The Alibaba Group

36. 360 State Street: Real Options

37. Herman Miller

38. AgBiome

39. Nathan Cummings Foundation

40. Toyota 2010

Case Study: Information Systems and Information Technology at Zara

• Post published: May 6, 2017
• Post category: Information Systems Management
• Post comments: 0 Comments

A case study for Information Systems at Zara. Zara is by far the largest, most profitable and most internationalized fashion retail chain. Zara’s success is based on a business system that depends on vertical integration, in-house production, quick response, one centralized distribution centre and low advertising cost. It can be summarized as follows:

Design : The goal of the information system at Zara is to discover the best design trends. Designers estimate what sells well by collecting vital information such as daily sales numbers. The real-time information helps designers to decide about fabric, cut and colors when modifying existing clothes or designing new ones. IT has shortened the time from design conception to the arrival of clothes at the distribution centers and finally to the stores to be placed on racks.

Zara use IS to track customer preferences and sales. Store managers lead the intelligence gathering effort. This helps to determine what ends up on each store’s racks. Personal Digital assistants (PDAs) or handheld PCs are used to gather customer input. Staffs talk to customers to gain feedback on their preferences and issues. The valuable data gathered helps the firm to plan styles and issue re-buy orders based on feedback. Zara uses software like C-Design and Corel Draw. C-Design and Corel Draw Graphics Suite allows Zara to create and market its collections quickly and efficiently.

Distribution: Zara has its own centralized distribution system. It keeps almost half of its production in-house and uses smart technologies to have a competitive advantage. Instead of relying on outsourcing, the company manages all design, logistics , warehousing and distribution functions itself. It uses latest technologies to keep up with latest trends. The company manufactures and distributes products in small batches. Using the computerized system, the company has reduced its design to distribution process to just 10 to 15 days.

The IT implementation of the operation research requires establishing dynamic access to compute several large live databases (store inventory, sales, and warehouse inventory) under very strict time constraints. This helps Zara to change about three-quarters of the merchandise on display every three to four weeks and customer’s average time between visits to its stores is more than its competitors at 17 times a year.

Pricing is market-based. Zara uses information systems for customer profiling, to analyze the purchase patterns and direct targeting. The company quickly respond to fluctuating customer demands in fashion trends.

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Geospatial solution for sustainable waste management: a case study

• Technical Paper
• Published: 22 May 2024
• Volume 9 , article number  218 , ( 2024 )

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• Anushka Ashok Borase 1 ,
• Shantini Bokil 1 &
• Vishakha Sakhare   ORCID: orcid.org/0000-0001-6640-0603 1  

The development of any country relies on several factors, including a growing population, a robust economy marked by high-rise buildings, improved living standards, and heightened consumption levels. However, these positive developments also lead to a significant increase in solid waste generation, necessitating advanced techniques and technologies for effective management. It is a tedious job to reduce the amount of waste production, so it becomes essential to have an appropriate recovery and management system that helps mitigate the complications associated with a solid waste management system. The research leverages Geographic Information System (GIS) software to investigate this matter to determine, effective, and efficient solutions for managing waste operations. The assimilation of GIS into the discipline of solid waste management enhances the efficiency of the system, eases the burden of the work, ultimately saves time, and costs, and helps in decision-making. The basic objective of this paper is to propose a solution for the entire Pimpri village in the Thane district and to identify suitable sites required for the disposal of municipal solid waste generated daily. Additionally, the paper concludes by determining an optimized waste collection route that ensures complete waste collection with higher efficiency adhering to cost, time, and scope constraints.

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Mohammed FMA, Waheeja AQ, Siham F, Alazaiza MYD, Mohammad KY (2022) Site selection of municipal solid waste incineration plant using GIS and multicriteria decision analysis. J Air Waste Manag Assoc 72:1027–1039

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Department of Civil Engineering, Dr. Vishwanath Karad MIT World Peace University, Kothrud, Pune, 411038, India

Anushka Ashok Borase, Shantini Bokil & Vishakha Sakhare

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Conceptualization: [Anushka Borase]; Methodology: [Anushka Borase]; Formal analysis and investigation: [Anushka Borase]; Writing—original draft preparation: [Anushka Borase]; Writing—review and editing: [Anushka Borase and Shantini Bokil, Vishakha Sakhare]; Funding acquisition: [NA]; Resources: [Anushka Borase, Vishakha Sakhare]; Supervision: [Shantini Bokil, Vishakha Sakhare].

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Borase, A.A., Bokil, S. & Sakhare, V. Geospatial solution for sustainable waste management: a case study. Innov. Infrastruct. Solut. 9 , 218 (2024). https://doi.org/10.1007/s41062-024-01539-w

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Artificial intelligence  is being used in healthcare for everything from answering patient questions to assisting with surgeries and developing new pharmaceuticals.

According to  Statista , the artificial intelligence (AI) healthcare market, which is valued at $11 billion in 2021, is projected to be worth $187 billion in 2030. That massive increase means we will likely continue to see considerable changes in how medical providers, hospitals, pharmaceutical and biotechnology companies, and others in the healthcare industry operate.

Better  machine learning (ML)  algorithms, more access to data, cheaper hardware, and the availability of 5G have contributed to the increasing application of AI in the healthcare industry, accelerating the pace of change. AI and ML technologies can sift through enormous volumes of health data—from health records and clinical studies to genetic information—and analyze it much faster than humans.

Healthcare organizations are using AI to improve the efficiency of all kinds of processes, from back-office tasks to patient care. The following are some examples of how AI might be used to benefit staff and patients:

• Administrative workflow:  Healthcare workers spend a lot of time doing paperwork and other administrative tasks. AI and automation can help perform many of those mundane tasks, freeing up employee time for other activities and giving them more face-to-face time with patients. For example, generative AI can help clinicians with note-taking and content summarization that can help keep medical records as thoroughly as possible. AI might also help with accurate coding and sharing of information between departments and billing.
• Virtual nursing assistants:  One study found that  64% of patients  are comfortable with the use of AI for around-the-clock access to answers that support nurses provide. AI virtual nurse assistants—which are AI-powered chatbots, apps, or other interfaces—can be used to help answer questions about medications, forward reports to doctors or surgeons and help patients schedule a visit with a physician. These sorts of routine tasks can help take work off the hands of clinical staff, who can then spend more time directly on patient care, where human judgment and interaction matter most.
• Dosage error reduction:  AI can be used to help identify errors in how a patient self-administers medication. One example comes from a study in  Nature Medicine , which found that up to 70% of patients don’t take insulin as prescribed. An AI-powered tool that sits in the patient’s background (much like a wifi router) might be used to flag errors in how the patient administers an insulin pen or inhaler.
• Less invasive surgeries:  AI-enabled robots might be used to work around sensitive organs and tissues to help reduce blood loss, infection risk and post-surgery pain.
• Fraud prevention:  Fraud in the healthcare industry is enormous, at $380 billion/year, and raises the cost of consumers’ medical premiums and out-of-pocket expenses. Implementing AI can help recognize unusual or suspicious patterns in insurance claims, such as billing for costly services or procedures that are not performed, unbundling (which is billing for the individual steps of a procedure as though they were separate procedures), and performing unnecessary tests to take advantage of insurance payments.

A recent study found that  83% of patients  report poor communication as the worst part of their experience, demonstrating a strong need for clearer communication between patients and providers. AI technologies like  natural language processing  (NLP), predictive analytics, and  speech recognition  might help healthcare providers have more effective communication with patients. AI might, for instance, deliver more specific information about a patient’s treatment options, allowing the healthcare provider to have more meaningful conversations with the patient for shared decision-making.

According to  Harvard’s School of Public Health , although it’s early days for this use, using AI to make diagnoses may reduce treatment costs by up to 50% and improve health outcomes by 40%.

One use case example is out of the  University of Hawaii , where a research team found that deploying  deep learning  AI technology can improve breast cancer risk prediction. More research is needed, but the lead researcher pointed out that an AI algorithm can be trained on a much larger set of images than a radiologist—as many as a million or more radiology images. Also, that algorithm can be replicated at no cost except for hardware.

An  MIT group  developed an ML algorithm to determine when a human expert is needed. In some instances, such as identifying cardiomegaly in chest X-rays, they found that a hybrid human-AI model produced the best results.

Another  published study  found that AI recognized skin cancer better than experienced doctors.  US, German and French researchers used deep learning on more than 100,000 images to identify skin cancer. Comparing the results of AI to those of 58 international dermatologists, they found AI did better.

As health and fitness monitors become more popular and more people use apps that track and analyze details about their health. They can share these real-time data sets with their doctors to monitor health issues and provide alerts in case of problems.

AI solutions—such as big data applications, machine learning algorithms and deep learning algorithms—might also be used to help humans analyze large data sets to help clinical and other decision-making. AI might also be used to help detect and track infectious diseases, such as COVID-19, tuberculosis, and malaria.

One benefit the use of AI brings to health systems is making gathering and sharing information easier. AI can help providers keep track of patient data more efficiently.

One example is diabetes. According to the  Centers for Disease Control and Prevention , 10% of the US population has diabetes. Patients can now use wearable and other monitoring devices that provide feedback about their glucose levels to themselves and their medical team. AI can help providers gather that information, store, and analyze it, and provide data-driven insights from vast numbers of people. Using this information can help healthcare professionals determine how to better treat and manage diseases.

Organizations are also starting to use AI to help improve drug safety. The company SELTA SQUARE, for example, is  innovating the pharmacovigilance (PV) process , a legally mandated discipline for detecting and reporting adverse effects from drugs, then assessing, understanding, and preventing those effects. PV demands significant effort and diligence from pharma producers because it’s performed from the clinical trials phase all the way through the drug’s lifetime availability. Selta Square uses a combination of AI and automation to make the PV process faster and more accurate, which helps make medicines safer for people worldwide.

Sometimes, AI might reduce the need to test potential drug compounds physically, which is an enormous cost-savings.  High-fidelity molecular simulations  can run on computers without incurring the high costs of traditional discovery methods.

AI also has the potential to help humans predict toxicity, bioactivity, and other characteristics of molecules or create previously unknown drug molecules from scratch.

As AI becomes more important in healthcare delivery and more AI medical applications are developed, ethical, and regulatory governance must be established. Issues that raise concern include the possibility of bias, lack of transparency, privacy concerns regarding data used for training AI models, and safety and liability issues.

“AI governance is necessary, especially for clinical applications of the technology,” said Laura Craft, VP Analyst at  Gartner . “However, because new AI techniques are largely new territory for most [health delivery organizations], there is a lack of common rules, processes, and guidelines for eager entrepreneurs to follow as they design their pilots.”

The World Health Organization (WHO) spent 18 months deliberating with leading experts in ethics, digital technology, law, and human rights and various Ministries of Health members to produce a report that is called  Ethics & Governance of Artificial Intelligence for Health . This report identifies ethical challenges to using AI in healthcare, identifies risks, and outlines six  consensus principles  to ensure AI works for the public’s benefit:

• Protecting autonomy
• Promoting human safety and well-being
• Ensuring transparency
• Fostering accountability
• Ensuring equity
• Promoting tools that are responsive and sustainable

The WHO report also provides recommendations that ensure governing AI for healthcare both maximizes the technology’s promise and holds healthcare workers accountable and responsive to the communities and people they work with.

AI provides opportunities to help reduce human error, assist medical professionals and staff, and provide patient services 24/7. As AI tools continue to develop, there is potential to use AI even more in reading medical images, X-rays and scans, diagnosing medical problems and creating treatment plans.

AI applications continue to help streamline various tasks, from answering phones to analyzing population health trends (and likely, applications yet to be considered). For instance, future AI tools may automate or augment more of the work of clinicians and staff members. That will free up humans to spend more time on more effective and compassionate face-to-face professional care.

When patients need help, they don’t want to (or can’t) wait on hold. Healthcare facilities’ resources are finite, so help isn’t always available instantaneously or 24/7—and even slight delays can create frustration and feelings of isolation or cause certain conditions to worsen.

IBM® watsonx Assistant™ AI healthcare chatbots  can help providers do two things: keep their time focused where it needs to be and empower patients who call in to get quick answers to simple questions.

IBM watsonx Assistant  is built on deep learning, machine learning and natural language processing (NLP) models to understand questions, search for the best answers and complete transactions by using conversational AI.

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• Announcements
• Copilot Studio

Microsoft Copilot Studio: Building copilots with agent capabilities

Omar Aftab , Vice President, Conversational AI , Tuesday, May 21, 2024

At Microsoft Build 2024 , we’re excited to announce a host of new powerful capabilities in   Microsoft Copilot Studio —t he single conversational AI tool you can use to create your very own custom copilots or extend Microsoft C opilot experiences with your own enterprise data and scenarios.

The first of these are c opilots that can now act as independent agents— ones that can be triggered by events— not just conversation— and can automa te and orchestrate complex, long-running business processes with more autonomy and less human intervention.

For instance, consider the potential of a copilot that can react when an email arrives, look up the sender’s details, see their previous communications, and use generative AI to trigger the appropriate chain of actions in their response. From understanding the intent of the email, to look ing up the sender’s details and account , see ing their previous communications, checking inventory,   responding to the sender asking for their preferences, and then taking the appropriate actions to close a ticket — orchestrating and shepherding an entire process over days.  

With such capabilities, copilots are evolving from those that work with you to those that work for you. They can be designed to handle specific roles or functions, such as IT, marketing, sales, customer success, and finance across various industries, including travel, retail, and financial services.  

With these new capabilities, here are some examples of the kinds of copilots our customers can build:  

• IT help desk .  IT support is complex, involving tickets, order numbers, approvals, and stock levels . O pening and closing a ticket can be a long-running task that spans days. A copilot can now handle this process, interfacing with IT service management applications, resolving IT tickets with context and memory, creating purchase orders for device refresh, and reaching out and getting managers approvals — all independently .
• Employee onboarding . Onboarding new employees is often expensive and slow. Now, imagine you’re a new hire. A copilot greets you, reasons over HR data, and answers your questions. It introduces you to your buddy, provides training and deadlines, assists with forms, and sets up your first week of meetings. Throughout all of this, the copilot is in touch, guiding you through the weeks -long onboarding and account set up processes.  
• Personal concierge for sales and service . Balancing exceptional customer experience while meeting ambitious revenue goals can be challenging. When a copilot serves guests, i t can use the memory of previous conversations with guests to remember their preferences, make reservations, handle complaints, and answer questions related to the products and services on offer. The copilot learns from its interactions and proposes new ways of handling customer scenarios. By doing so, copilots can increase upsell and attachment rates, driving revenue for the resort while simultaneously enhancing guest experience, satisfaction rates, and repeat business.

Let’s dig deeper into a few of the underlying capabilities that make all this possible:

• Asynchronous orchestration of complex tasks . The first is the ability to use generative AI- powered   planning and reasoning to manage complex, multi step, long-running tasks. For example, reacting to a new order means determining the need to verify inventory, trigger ing the right payment processes, pinging a supervisor for approval if the amount is above a certain threshold, and replying with a confirmation. Many of these events can take hours—or even days— to complete, but the copilot will run through them , maintaining the necessary state and context to do so.
• Memory and context . One of the frustrating things about support has traditionally been having to repeat information: who you are, what your policy number is, what your address is. There is no continuity of conversation. Copilots will now learn from previous conversations from the users and utilize this knowledge to continually personalize interactions . A copilot may not need to ask you for your laptop model or your address when you call again for the same issue. Conversations will thus become long-running, contextual, and deeply personalized.
• Monitor, learn, and improve . Copilots can now learn and adapt, offering monitoring and teaching capabilities to make their interactions better. Each copilot records a comprehensive history of its activities, providing transparency into its performance, including user interactions, actions taken, and feedback received, and you can see what decisions it made — and correct and teach them — with just a few clicks.

• Delegation with confidence and guardrails . When developing copilots with agent capabilities, establishing clear boundaries is paramount. Copilots operate strictly within the confines of the maker-defined instructions, knowledge, and actions. The data sources linked to the copilot adhere to stringent security measures and controls, managed through the unified admin center of Copilot Studio. This includes data loss prevention, robust authentication protocols, and more.

The se advanced new capabilities in Copilot Studio are currently accessible to customers participating in a limited private preview  where organizations such as Centro de la Familia are excited to explore agent capabilities that support teachers and case workers, allowing them to spend less time on administrative tasks and more time working with children, ultimately leading to better child outcomes . Based on feedback from program participants, we will continue to iterate and refine these capabilities for broader access in a preview planned for later this year .  

Additional innovations with Copilot Studio

There’s a lot more to share at Microsoft Build with Copilot Studio, and we’ll touch on just a few of our new capabilities here. To learn more — just sign up and try it out for yourself here .

It’s easier than ever to create c opilots .  With Copilot Studio, creating and testing copilots is now incredibly simple. You can create your copilot with our brand new conversationally driven experience — simply describe what you want it to do, and what knowledge you want it to have, and Copilot Studio will create your very own c opilot. You can then immediately test it out, add additional capabilities, such as your own actions, APIs, and enterprise knowledge — and then publish it live with a few clicks.

Connect all your enterprise data with Copilot c onnectors .   Customers want copilots connected with data from their own enterprises business systems and apps. Copilot connectors enable anyone to ground their copilot in business and collaboration data. This makes it possible for copilots to use various data sources, including public websites, SharePoint, OneDrive, Microsoft Dataverse tables, Microsoft Fabric OneLake (coming this calendar year), Microsoft Graph, as well as leading third-party apps. You can even create your own custom generative prompts to configure how a copilot handles a response from an API or connector.

Here are a few examples of how Copilot connectors can transform copilot experiences for specific personas or functions:

• Legal and Compliance . Navigate complex legal landscapes with a Copilot extension that queries specific legal datasets, ensuring controlled and compliant responses without overwhelming users with extraneous information.
• HR Helper . Assist employees with accessing essential resources for benefits and PTO policies, and even book time off directly through Copilot.
• Incident Report Coordinator . Workers can locate the right documentation, report incidents, and track them efficiently, all within the context of the chat.

Starting in June 2024, developers can access the preview for Copilot connectors and stay informed on updates here .

Conversational analytics (private preview) : One of the most common asks from customers has been the need for deeper insight into what their copilot is doing, how generative AI is responding, when it was unable to give the right answers and why — and recommendations on what to do to improve it.

Templates : If simply describing your copilot to build it wasn’t easy enough, Copilot Studio will now also include a variety of pre-built copilot samples for departments and industries. Some templates — such as Safe Travels for comprehensive travel support, Organization Navigator for organizational clarity, Kudos Copilot for fostering recognition, Wellness for employee health insights — are available now, with many more releasing in the coming months.

Enhanced security and controls (public preview ) : Administrators can now configure advanced settings beyond the default security measures and controls. With Microsoft Purview , Copilot Studio administrators gain access to more detailed governance tools, including audit logs, inventory capabilities, and sensitivity labels. They will be able to review comprehensive audit logs that cover tenant-wide usage, inventory (with API support), and tenant hygiene (such as data loss prevention violations and inactive copilots), enabling them to effectively monitor business impact. Both creators and end-users will be able to view sensitivity labels when responses are generated using AI-powered answers based on SharePoint documents.

With all the amazing innovations, numerous organizations are using Copilot Studio to build transformative generative AI-powered solutions. Check out this story from Nsure on how they are using Copilot Studio:

Get started today with Copilot Studio

This is just a glimpse of all the exciting innovation around copilots and Copilot Studio — we have a host of exciting new capabilities to share in our sessions at Build. So, join us in watching the sessions below, and try out Copilot Studio yourself and build and share your very own copilot in minutes.

Watch the sessions at Microsoft Build:

• “ Microsoft Build opening keynote ”
• “ Next generation AI for developers with the Microsoft Cloud ”
• “ Shaping next-gen development: the future of Copilot in Power Platform ”

Deeper dives:

• Breakout: “ What’s new with Microsoft Copilot Studio ”
• Breakout with demos: “ Build your own copilot with Microsoft Copilot Studio ”
• Breakout with demos: “ Build Microsoft Copilot extensions with Copilot Studio ”
• Demo (live only): “ Build your own Copilot extension with Microsoft Copilot Studio ”

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• About Adverse Childhood Experiences
• Risk and Protective Factors
• Program: Essentials for Childhood: Preventing Adverse Childhood Experiences through Data to Action
• Adverse childhood experiences can have long-term impacts on health, opportunity and well-being.
• Adverse childhood experiences are common and some groups experience them more than others.

What are adverse childhood experiences?

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). Examples include: 1

• Experiencing violence, abuse, or neglect.
• Witnessing violence in the home or community.
• Having a family member attempt or die by suicide.

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding. Examples can include growing up in a household with: 1

• Substance use problems.
• Mental health problems.
• Instability due to parental separation.
• Instability due to household members being in jail or prison.

The examples above are not a complete list of adverse experiences. Many other traumatic experiences could impact health and well-being. This can include not having enough food to eat, experiencing homelessness or unstable housing, or experiencing discrimination. 2 3 4 5 6

Quick facts and stats

ACEs are common. About 64% of adults in the United States reported they had experienced at least one type of ACE before age 18. Nearly one in six (17.3%) adults reported they had experienced four or more types of ACEs. 7

Preventing ACEs could potentially reduce many health conditions. Estimates show up to 1.9 million heart disease cases and 21 million depression cases potentially could have been avoided by preventing ACEs. 1

Some people are at greater risk of experiencing one or more ACEs than others. While all children are at risk of ACEs, numerous studies show inequities in such experiences. These inequalities are linked to the historical, social, and economic environments in which some families live. 5 6 ACEs were highest among females, non-Hispanic American Indian or Alaska Native adults, and adults who are unemployed or unable to work. 7

ACEs are costly. ACEs-related health consequences cost an estimated economic burden of $748 billion annually in Bermuda, Canada, and the United States. 8

ACEs can have lasting effects on health and well-being in childhood and life opportunities well into adulthood. 9 Life opportunities include things like education and job potential. These experiences can increase the risks of injury, sexually transmitted infections, and involvement in sex trafficking. They can also increase risks for maternal and child health problems including teen pregnancy, pregnancy complications, and fetal death. Also included are a range of chronic diseases and leading causes of death, such as cancer, diabetes, heart disease, and suicide. 1 10 11 12 13 14 15 16 17

ACEs and associated social determinants of health, such as living in under-resourced or racially segregated neighborhoods, can cause toxic stress. Toxic stress, or extended or prolonged stress, from ACEs can negatively affect children’s brain development, immune systems, and stress-response systems. These changes can affect children’s attention, decision-making, and learning. 18

Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. 18 These effects can also be passed on to their own children. 19 20 21 Some children may face further exposure to toxic stress from historical and ongoing traumas. These historical and ongoing traumas refer to experiences of racial discrimination or the impacts of poverty resulting from limited educational and economic opportunities. 1 6

Adverse childhood experiences can be prevented. Certain factors may increase or decrease the risk of experiencing adverse childhood experiences.

Preventing adverse childhood experiences requires understanding and addressing the factors that put people at risk for or protect them from violence.

Creating safe, stable, nurturing relationships and environments for all children can prevent ACEs and help all children reach their full potential. We all have a role to play.

• Merrick MT, Ford DC, Ports KA, et al. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017. MMWR Morb Mortal Wkly Rep 2019;68:999-1005. DOI: http://dx.doi.org/10.15585/mmwr.mm6844e1 .
• Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Science Direct. 2022; 22:7; 1105-1114. DOI: https://doi.org/10.1016/j.acap.2022.04.010 .
• Smith-Grant J, Kilmer G, Brener N, Robin L, Underwood M. Risk Behaviors and Experiences Among Youth Experiencing Homelessness—Youth Risk Behavior Survey, 23 U.S. States and 11 Local School Districts. Journal of Community Health. 2022; 47: 324-333.
• Experiencing discrimination: Early Childhood Adversity, Toxic Stress, and the Impacts of Racism on the Foundations of Health | Annual Review of Public Health https://doi.org/10.1146/annurev-publhealth-090419-101940 .
• Sedlak A, Mettenburg J, Basena M, et al. Fourth national incidence study of child abuse and neglect (NIS-4): Report to Congress. Executive Summary. Washington, DC: U.S. Department of Health an Human Services, Administration for Children and Families.; 2010.
• Font S, Maguire-Jack K. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions. Child Abuse Negl. 2016;51:390-399.
• Swedo EA, Aslam MV, Dahlberg LL, et al. Prevalence of Adverse Childhood Experiences Among U.S. Adults — Behavioral Risk Factor Surveillance System, 2011–2020. MMWR Morb Mortal Wkly Rep 2023;72:707–715. DOI: http://dx.doi.org/10.15585/mmwr.mm7226a2 .
• Bellis, MA, et al. Life Course Health Consequences and Associated Annual Costs of Adverse Childhood Experiences Across Europe and North America: A Systematic Review and Meta-Analysis. Lancet Public Health 2019.
• Adverse Childhood Experiences During the COVID-19 Pandemic and Associations with Poor Mental Health and Suicidal Behaviors Among High School Students — Adolescent Behaviors and Experiences Survey, United States, January–June 2021 | MMWR
• Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics. 2004 Feb;113(2):320-7.
• Miller ES, Fleming O, Ekpe EE, Grobman WA, Heard-Garris N. Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes. Obstetrics & Gynecology . 2021;138(5):770-776. https://doi.org/10.1097/AOG.0000000000004570 .
• Sulaiman S, Premji SS, Tavangar F, et al. Total Adverse Childhood Experiences and Preterm Birth: A Systematic Review. Matern Child Health J . 2021;25(10):1581-1594. https://doi.org/10.1007/s10995-021-03176-6 .
• Ciciolla L, Shreffler KM, Tiemeyer S. Maternal Childhood Adversity as a Risk for Perinatal Complications and NICU Hospitalization. Journal of Pediatric Psychology . 2021;46(7):801-813. https://doi.org/10.1093/jpepsy/jsab027 .
• Mersky JP, Lee CP. Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample. BMC pregnancy and childbirth. 2019;19(1). https://doi.org/10.1186/s12884-019-2560-8 .
• Reid JA, Baglivio MT, Piquero AR, Greenwald MA, Epps N. No youth left behind to human trafficking: Exploring profiles of risk. American journal of orthopsychiatry. 2019;89(6):704.
• Diamond-Welch B, Kosloski AE. Adverse childhood experiences and propensity to participate in the commercialized sex market. Child Abuse & Neglect. 2020 Jun 1;104:104468.
• Shonkoff, J. P., Garner, A. S., Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, & Section on Developmental and Behavioral Pediatrics (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663
• Narayan AJ, Kalstabakken AW, Labella MH, Nerenberg LS, Monn AR, Masten AS. Intergenerational continuity of adverse childhood experiences in homeless families: unpacking exposure to maltreatment versus family dysfunction. Am J Orthopsych. 2017;87(1):3. https://doi.org/10.1037/ort0000133 .
• Schofield TJ, Donnellan MB, Merrick MT, Ports KA, Klevens J, Leeb R. Intergenerational continuity in adverse childhood experiences and rural community environments. Am J Public Health. 2018;108(9):1148-1152. https://doi.org/10.2105/AJPH.2018.304598 .
• Schofield TJ, Lee RD, Merrick MT. Safe, stable, nurturing relationships as a moderator of intergenerational continuity of child maltreatment: a meta-analysis. J Adolesc Health. 2013;53(4 Suppl):S32-38. https://doi.org/10.1016/j.jadohealth.2013.05.004 .

Adverse Childhood Experiences (ACEs)

ACEs can have a tremendous impact on lifelong health and opportunity. CDC works to understand ACEs and prevent them.