PurposeThe last decade has seen much interest in small and medium‐sized enterprises (SMEs) from successive UK Governments highlighting the importance of this sector to the wealth‐creating process of the UK economy. World‐class manufacturing (WCM) is a set of methodologies that are used by organisations to compete globally and continuously improve their competitiveness. Original equipment manufacturers (OEMs) are now competing at a global level and many are world‐class. The majority of the companies that make up the OEM's supply chains are SMEs. It is, therefore, imperative that SMEs also improve their competitiveness to a world‐class level. This paper aims to address these issues.Design/methodology/approachThe paper uses a triangulation methodology consisting of a literature review, analysis of a 150‐company survey and semi‐structured interviews in the development of the business process improvement (BPI) framework and performance assessment methodology (PAM) tool.FindingsThis study advocates a planned and integrated approach for the gradual achievement of WCM in SMEs by a strategy of BPI through continuous improvement and structured training.Practical implicationsThe work is of value to SMEs since the study encapsulates the requirements of SME management into the BPI framework and considers their critique of present frameworks; hence a practical framework that is honed for SME application.Originality/valueThis paper fulfils an identified need for SMEs to achieve WCM status and offers a novel/practical framework and PAM tool which are timely because the DTI is promulgating the need for SMEs to become world‐class.

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THE ROLE OF TECHNOLOGY IN TELEHEALTHTechnology strongly influences the way we work and is creating opportunities and new demands for a range of different approaches to telehealth (Feldman and Gainey, 1997). Telecommunications have evolved and have been accompanied by an evolution in attitudes to information and communications technologies (Stanworth, 1998). Previously, only companies owned computers and it was the IT specialists, rather than ordinary users, who determined their use and application. Today's response to technological change is profoundly different. On average, around 1 in 4 European households already owns a personal computer; in some countries this rises to more than 50% and in some local communities it is even higher.A recent study confirms this trend and predicts that, in two years time, it is expected that the use of information communication technology will increase markedly (Marien, 1989). The ease with which we use them and the take-up of remote working in the European Union continues at a rapid pace. Recent estimates (European Telework Organization, 1999) show that approximately 6.7 million Europeans (4.5% of the workforce) were practising remote working in one form or another at the beginning of 1999.Social, cultural, economic and regulatory factors determine how we organise our business, our work and, hence, our lives (Stanworth, 1998). Technology-led change opens up opportunities for new working methods in three main ways: allowing existing activities to be carried out more rapidly, with more consistency and at a lower cost than could previously be achieved.

Knowledge Management is an expanding field of study. In this paper we clarify and explain some of the terms and concepts that underlie this field. In particular we discuss knowledge and its related philosophies; how the sociotechnical aspects of organizations can assist in knowledge management and how communities of practice can thus be supported; how knowledge can be valued in an organization; and the idea of intellectual capital. We conclude that knowledge management is not an easy 'fix' to an organisation's problems. Implemented well it can increase productivity, improve worker collaboration, and shorten product development times. Implemented badly it may incur significant costs without delivering these benefits. Keywords: knowledge management, communities of practice, intellectual capital Editor's Note: This article is intended as a basic primer for those who are not familiar with the ideas now being discussed in knowledge management. This academic field is not yet well established. It is an interdisciplinary topic with many writers and theories intersecting

An integrated Lifetime Health Record (LHR) is fundamental for achieving seamless and continuous access to patient medical information and for the continuum of care. However, the aim has not yet been fully realised. The efforts are actively progressing around the globe. Every stage of the development of the LHR initiatives had presented peculiar challenges. The best lessons in life are those of someone else's experiences. This paper presents an overview of the development approaches undertaken by four East Asian countries in implementing a national Electronic Health Record (EHR) in the public health system. The major challenges elicited from the review including integration efforts, process reengineering, funding, people, and law and regulation will be presented, compared, discussed and used as lessons learned for the further development of the Malaysian integrated LHR.