Medical Tourism in Poland: The Effectiveness of E-Commerce

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Executive Summary The main objective of this dissertation is to investigate the effectiveness of e-commerce in international trade with a case study of dentistry-based medical tourism in Poland. To focus on this objective, the first chapter concentrates on the background of the problem, the rationale of the research, the scope of this study, and designs three research questions those address the theoretical issue of the e-commerce system, implication of the system at Polish dentistry-based medical tourism, local legislation and the barriers for the implication of e-commerce practice. On the other hand, the literature review provides a theoretical framework of e-commerce, types of e-commerce, and reimbursement of e-commerce, e-commerce business models, and the present e-commerce status of Poland. However, the research methodology chapter focuses on the research approach to measure the effectiveness of e-commerce, primary data collection procedures from target respondents to know the position of dentistry-based medical tourism in Poland, secondary sources, data analysis process, and limitation of data collection procedures. However, the subsequent finding chapter of this dissertation focuses on the survey reports, and the discussion chapter concentrates on secondary resources regarding the effectiveness of the e-commerce system and dentistry-based medical tourism in Poland.

Introduction The effectiveness of e-commerce in international trade is growing at a faster speed through technology in every aspect of the business while ICT1 has been recognized as the most modern aspect of applied technology in the commercial world. It influences the dentistry-based medical tourism of Poland for discovering newer customs from the globally expanding competitive marketplace; draw the attention of overseas customers through customization of their offerings and format of the overall process and functions to ensure efficiency and effectiveness via website and e-mail marketing. Polish dentistry belongs to the agent-based Dutch model of e-commerce which is incapable to meet the rising demand and urged immediate modification to accelerate the growth of Polish dentistry and its concerning tourism. The existing process of polish dentistry conducting international trade of their service offering globally through digital networks, the internet, static websites and other similar technologies can be termed e-commerce. While the actual e-commerce practice involves direct selling to the end-users, multi-purpose business involves serving multiple products and services to customers with differentiation of the process for presenting an entity or its offerings unique from market competitors by using most modern software of ERP, SPSS, and SAP. Various patterns of e-commerce applications are helpful in obtaining comparative uniqueness of service selling by the Polish dentistry for their multi-purpose businesses in terms of internet service, network facilities, cable networking, and digital channels or even ease of selling through online networks, which are not yet addressed by the dentil clinics of Poland. For this reason, many mega or even small clinics of Polish dentistry today are inclined for successfully implement visual attractiveness and usability of upgraded techniques of e-commerce to gain more overseas customers. For quick materialization of the existing e-commerce practice in Poland is necessarily concerned with gaining competitive uniqueness through integration with e-commerce strategies, obtaining financial investment, innovation, quality, amusement, and vision of differential advantage with global standards, but the dental sector of the country has lacking with concerned skills. Although the evolution of e-commerce has originated for the basic purpose of the Polish dentistry-based medical tourism, the modern business environment is more complicated with diversified customer needs and expectations for which dental clinics have pressurized most since they have to keep deeper conjunction with customer feelings. Under this circumstance, dental clinics have to initialize several steps, which could be used to create different images of their organisations for generating greater customer base through online. Customers are generally engrossed to get various benefits including product mix, price competitiveness, prompt service, well- communicated promotion, well-organized service package, and free flow of information regarding the service delivery. All of the concerned tasks can be well fitted with different e- technologies through developing communication, transaction, distribution channels, improved customization and business processes, involvement in e- trading, modified structure and level of specialization, making strong tie with present customers to retain them and gathering newer customers with a speedy rate. Other important technique involves innovation of new offers and gathering new customers, which are possible to develop via internet as an effectual mean of accumulating information, customer identification, and product offering towards the target customers globally taking into account of existing and new rivals. Thus, e-commerce strategies for the Polish dentistry can be more effective here for creating most modern category of customer’s satisfaction along with complying with both organisational and individual exchange objectives of the dental clinics. The success factors in integrating such idea in the dentistry-based medical tourism could be visualised as below – Figure 1: Success model of information and technological implementation at Polish Dentistry. Source: Self-generated. Research question and objectives This present dissertation has aimed to formulate an appropriate e-commerce mechanism for gaining effectiveness of e-commerce at the dentistry-based medical tourism of Poland for their service selling in the international market. To serve this purpose this dissertational effort has engaged to answer the basic research question as- which e-commerce techniques are most influential for developing competitive advantage for acquisition of customer satisfaction by the dentistry-based medical tourism of Poland. The answer to this question will enable the marketing managers of dental clinics of Poland for implementing various forms of e-commerce tools to differentiate corporate offerings far from competition by increasing customer level of satisfaction and arguing to the research questions as – To what extent is the theoretical framework of e-commerce encouraged, the implication of the system at Polish dentistry-based medical tourism? How the local legislation would safeguard further improvement of e-commerce in Poland comparing with global standard? What are the barriers that prevent the Polish Dental clinics in general for Scopes of the study: – As e-commerce is considered an effective tool for the medical service providers, this dissertation has unlimited scope to discuss the topic with real life evidence; however, the key scopes can be summarise as following way – It has scope to analyze that involvement and dealing with e-commerce system would be the most effective marketing tools in terms of advertising, communication, and profit generation to the dentistry-based medical tourism in Poland; At the same time, integration of latest technologies regarding social networking, media sites, and proposal outlining are increasing the number of loyal customers; This dissertation has the opportunity to examine both negative and positive side of e-commerce system for the dentistry-based medical tourism in Poland; Moreover, it has scope to include the chronological development of e-commerce system in Poland, the impact rule and regulation on the system, and the impact on the financial situation of Dental medical service providers; This dissertation has also scope to provide the conceptual framework of the traditional e-commerce system, various models of this system, several issues of marketing, management, customer service, IT, IS and internal process development; As Dental service providers are the significant factor for the sustainable economic development of Poland, this dissertation has scope to explore the effectiveness of E-commerce system on this industry with identification of present dilemmas. Relevant Literature Review The chapter of the dissertation has delivered in the form the general theoretical background of the study with definitions and proliferations of various variables have depicted to form the basis of analysing the performances of the Polish dentistry-based medical tourism with following sub chapters- Get your 100% original paper on any topic done in as little as 3 hours

Theoretical Framework of E-Commerce Laudon and Traver (2007) explained that the e-commerce is the process of enabling the digital transactions between and among assorted institutions and persons by using ICT enabled services; here the term digital transactions comprise every type of digitally reconciled transactions commenced through online. Moreover, these transactions took place through the exchange of value transversely institutional or individual borders by means of products or services and the transaction would occur at one though the delivery of the product or serviced may take time (Laudon & Traver, 2007). Kalakota and Robinson (1999) argued more succinctly that e-commerce is the process of buying and selling over digital medium that may integrate all concerned parties including banks and complete supply chain just through a few clicks. Types of E-commerce Laudon and Traver (2007) classified the e-commerce is mainly of three types, which are, B2C, B2B, and C2C e-commerce, in spite there are G2B, G2C, M2B and so on, this study predominantly focuses on B2C e-commerce and B2B e-commerce – B-to-C E-commerce: Under this category, the consumers of this segment purchase product and services for final consumption at their end, for instance, Amazon.com has B-to-C e-commerce portal at its website; B-to-B E-commerce: Under this category, the customers of this segment purchase goods and services from the material supplies or intermediates those become part of final products after value addition, for instance, E-city is a B-to-B e-commerce portal; The Reimbursement of E-commerce Hoffman et al (2004) pointed out that modern e-commerce provides businesses with various benefits, such as large market base, low operating costs, one to one interaction, and huge area staring form online supply chain and generally resulted towards marketing, distribution, and operational benefits. Kurnia (2007) pointed out the most prominent benefits of e-commerce are as the following – Innovative applications: During the e-commerce integration, there are huge player who uses newly innovated applications and hence those firms frequently enjoy strategic advantage rather than the competitors, for instance, FedEx provides consumers parcel tracking amenities; Competitive weapons: To some extent the e-commerce has also used as the key competitive weapon by integrating different application software necessity for the organisations, for exemplifies, one-click shopping system of e-bay is the firm’s competitive weapon; Changes in processes: Any size of firm can usually cover a large geographic area through its e-commerce processing bypassing the border barriers, hence, a number of alterations occur in the operation of the business; Links with business partners: An entrenched e-commerce process allows the companies to manage its partners sited in different areas and improve its supply chain network globally for which it is essential to gain efficacy and aptitude has to achieve within the process; Cost reductions: The major implementation of e-commerce usually let companies to enjoy large cost reduction for its communication purpose, for consideration, a usual bank transaction in USA costs around US$ 1.07, whereas it’s processing cost in the web-based system is 1 cent or less. Meanwhile, for the traditional mailing, air ticket processing cost is US$ 8 whereas the e-ticket cost is only $1. Mäkeläinen (2006) argued that since the cost of operation is low in this method, the cost reduction is usually availed by all companies to compete in the global market; Relationships with suppliers and customers: The complete e-commerce process paves the way to get real time feedbacks from suppliers and customers and by this way, the firm enjoys strong bargaining power over these two parties; New products: To persuade consumers of any particular segment overcoming the border barrier, a brand needs to construct something new and offer a number of new attributes which is very easy going with the technique and gives required competitive edge in the marketplace; Competitive intelligence: With updated IT applications joining together with e-commerce would generally help the business communities to increase competitive advantages and it is essential to restructure IT applications frequently by collecting information regarding products, markets, and competitions as well; E-commerce business models Mäkeläinen (2006) argued though there are several e-commerce business models to institute the system and to build business strategies accordingly, but no business model is well enough to suit every e-commerce activity, this dissertation has discussed following models concerned with the materialisation of the ecommerce at the Polish dentistry- The Electronic Areas Model The e-commerce procedure could be either used for integrating the higher profitability in a traditional business structure or as a completely a new electronic venture that discerns traditional business from electronic business through product, agent, and process, marketing, sales and financial transaction. The following model shows the relationship of an organisation allied to technology but it does not pursue any strategy for its success – Figure 2: The Electronic Areas Model, Source: Mäkeläinen (2006). The Hierarchical Framework of E-commerce Zwass (1998) argued that this model formulates three levels of e-commerce integration such as product and structures, services, and infrastructure where each of these levels depends on the previous levels to acquire strength to integrate digital gateway for payment. Hence, the more the precedent levels of e-tools will provide strong outcomes, the more will be the antecedent levels where the bottom up approach has to apply to build strategies of e-commerce business. To get success, the organisations need to have strong ICT systems, wide area infrastructure along with strong e-commerce products though the levels of the models are not those much flexible to be applied but it illustrates to take care about the key components of an e-commerce process. Figure 3: The Hierarchical Framework of E-commerce, Source: Zwass (1998). The Electronic Commerce Value Grid Böhle (2002) pointed out that this business model sorts out the storefronts to gain profitability. A firm needs to work in all five breadths of commerce by using interaction modes to compete in terms of time and distance and provide products to its customers through a chain of relationships among the players. In this perspective, any company can enjoy competence on the fifteen bases, since the efficacy of IT has been measured through efficiency generation, effectiveness, and strategic benefits and ultimate revenue generation. Furthermore, the model reveals the idea of information on demand and suggests appropriate strategies or strategic choices that can be handy to gain competitiveness over competitors in the market place. Thus, the success of the model is relied on the firm’s capability to change the business perception that belongs to the existing practice and the strategic standpoints to avail benefits of new technologies (Grant and Huston, 2001) We will write a custom essays specifically for you! Get your first paper with 15% OFF

Figure 4: The Electronic Commerce Value Grid, Source: Mäkeläinen (2006). Present E-commerce Status of Poland Badica et al (2005) pointed out that the existing e-commerce practice in Poland has surfed from the origins of Dutch Auction based traditional flower sales used- different buyer would gather at a platform and fid for the products while the highest bidder would be capable to purchase. For e-commerce practice this model the product and services gathered to the e-shops for selling, buyers agents start for bidding at a lower to higher price while seller’s agent interact and commence the deal. Following diagram illustrates the whole process including buyer, seller and their agents – Figure 5: Existing Agent-Based Dutch Ecommerce Model in Poland. Source: Badica et al (2005). Buyer has corresponded to the CA2that allowed for acting entirely self-directed, while the buying decision made for M units of goods or services as a price P would be correspond to the User-Client server to get confirmation from the seller’s agent, who would like to wait for a certain deadline to maximize his price. The offered bid would be active until it has not neglected due to getting higher price and the CIC3 agent would act to complete the deal by interacting with the database to comply with predetermined terms and successfully complete the deal at the optimal point. At the same time rather than complete e-commerce model of B2B, B2C, C2C, G2C, or G2B, dentistry service providers of Poland are using a backward agent based Dutch e-commerce model of that concerned with many analogy interface rather than full automation. The Polish dentistry is under challenge to integrate complete e-commerce including its, supply chain automation and e-payment option for online transaction. To check and balance the situation it is essential for the government to address quick ICT reviews to identifying the necessary areas of cooperation required by the sector to upgrade fully automated e-commerce model (Wrycza, et al 2007). Polish Legislative Frameworks for E-commerce The e-commerce system and prolonged practice of this mechanism in Poland has chronologically developed through the political motivation toward liberalization of several legislative frameworks, which are facing different dilemmas and raised emergence for immediate reforms for being a member of the European Union. Meanwhile the government is eager to sustain its remarkable GDP growth while the dentistry service providers of Poland are keeping continuous contribution to the GDP growth by earning foreign exchanges through exporting the non-traditional item. The dental clinics of Poland are concerned with international trade through the e-commerce interface and facing different challenges due to weak ICT backbone, inefficient e- banking, and e-supply chain management (Garnik, 2006). OECD (2006) pointed out that the GATS4 has approved online service delivery as an exportable item with particular categories of four ‘modes of supply’ rather than physical movement of the service provider where the dentistry of Poland has categorized under its mode -1 and 2 may not cover by the national medical insurance. The cross-border supply of Polish dental care services has gained marvelous attractiveness but the e-commerce practice in this sub-sector fasces restraining or inequitable types of limitations prolonged from the pre-Internet era to like bureaucratic red tape for bandwidth allocation, and online connectivity (Herrick, 2007). UNCTAD (2005) published it information economy report 2005 where it has mentioned that Poland has started it a journey of the Internet use with 2,800,000 users in 2000 which increased 35.7 % in 2001, 133.7 % in 2002, 1.0 8 % in 2003 and 0.3% in 2004 while only the 47 % of the small and medium sized companies have internal access facilities. With backward internet gateway of connectivity, 34% of the ICT market of Poland is dominated by the EU member states rather than local players where banking and financial service sector is the main IT service subscriber and among the existing users 60% have analogy modem for connectivity rather than broadband access (Tamowicz et al., 2000). The security measures for data protection in Poland not yet enough strong even the awareness for data protection does not evident, as a result, hazards of hacking and viruses attacks are increasing. The Polish Ministry of Economic Affairs has set out its strategic objectives to accelerate the e-commerce integration opportunities for both product and service-oriented local and foreign companies (IBRKK, 2008). The aim of this project is to generate excellence at implication and practice of e-commerce with proper research that would ultimately provide commercial corporations with highly qualified service delivery and accelerated revenue generation. It has already set out the standards for dentistry-based medical tourism clinics by ensuring the principles of existing e-commerce legislation. However, it remains huge gaps in synchronizing the perceptions of Dental clinics and regulatory objectives (Heiderhoff and Zmij, 2005). E-commerce implication at SME of Poland Wrycza et al (2007) pointed out that among the Polish SMEs5 95 % have internet assets, 63% of them have at least a static website, 32 % have already integrated e-commerce and 5% have complete e-business setup with c-supply chain management including CRM and ERP, the position has demonstrated in the following diagram-

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Figure 6: E-commerce of the Polish SMEs. Source: Self-generated from Wrycza et al (2007). Wrycza et al (2007) added that the expansion of knowledge based economy in Poland deeply concerned with the momentum efficiency of integrating ICT application for any kinds of business solution where the big firms have adopted ICT at the first tire with best solutions but SMEs are going under grave dilemmas to implementing e-commerce with global standards. The Polish SMEs have imperative role in the national economy with their innovation initiatives accommodating 70% of the country’s workforce, thus it is crucial to emphasis e-commerce integration at the SME level and policymakers needed to facilitate them with easy going legal framework and also allocating financial resources to upgrade e-commerce practice. At the concurrent implication it has been evidenced that the SMEs are under practice of either ‘ladder model’ or ‘transporters model’ that denotes the process as – common access to the internet for e-mailing and web browsing, developing the company website, and by communicating through the website commencing sales of goods and services. Drives for E-commerce Materialisation Ward et al (2008) pointed out that experiential evidence of radical change in the post-socialist economy of Poland has experienced a better outcome from the market economy and the policymakers enormously aligned for more reformation aimed to the successful e-commerce integration to generate quick economic growth. The Polish academia and scholars have recently started to address the need of improving the performance of e-commerce integration and urged for major reconfiguration. Dental clinics are the major player in the sustainable economic growth of Poland by producing foreign exchange and creating huge employment opportunities in this sector, though, there are huge gaps to address in terms of e-commerce integration compared with the global standard of e-commerce practice by the business concerns. IST-Africa Consortium (2006) presented the evidence of B2C model of e-commerce model has most terrific scenarios that pointed out that most of the companies with B2C model have turned into bankrupt and shut down while about 600 e-portals are sustaining with narrow turnover and are supposed to be closed. The major dilemmas of such e-portals are mainly they made their transactions by traditional means rather than online credit card pay system and faces the challenge of e-distribution and logistic support failure for which they cannot deliver orders in time and the customers are losing their confidence level in this concern. Garnik (2004) compared the growth e-commerce of Poland with US and pointed it as a saddening cheaper measuring the growth of eCommerce in Poland three times lower than the US within the same time frame and identified the limitation of inferior progress belongs to the influence of the previous socialist economic system. At the same time, narrow interface of ICT infrastructure, high price of connectivity, lower speed, lower rate of user growth, drawbacks of the legislative framework, bureaucratic documentation system, and lack of skills at the user end. Moreover, the historical and cultural background of the people, trust, and confidence to the system, complicated factors of internet access, including the quality and graphics of the website are all accounted as lower growth of e-commerce in this territory (Badica el al, 2007) and (Badica el al, 2005). E-commerce implication at the Tourism Industry Kim (2004) argued that WTO has recognized the e-commerce integration in the tourism industry pointing to the continuous popularity of the Internet and business application of ICT while the tourists are interested to get booking, schedule, and payment directly with the tour operators rather than any intermediation of agents. E-commerce in tourism has facilitated both the service buyer and seller at a single platform to interact, negotiate, and execute tour itinerary while the operators have huge opportunity to introduce new solutions aimed to outsized, steady, and globally recognised tour operator may not be interested for diminutive dynamics of tourism industry. Figure 7: Tourism e-Commerce Model. Source: Liu (2006). Liu (2006) presented that the tourism e-commerce model has been going through quick shifts due to technological development and such trend has flourished to bring radical transform in the industry, to illustrate the model- it may rise from the traditional viewpoint of tourism but implement under completely new scenario. The above diagram demonstrates that the traditional tourism operator can adopt e-commerce due to their technological motivation while at the same time with new conceptual framework, new operators and get entry in the market with specialization in the e-commerce mechanism. The Strategic perspectives of Polish Dentistry Since there are no specific competitive strategies for the Polish dentistry to gain competitive advantages in the international operation, the following strategic perspectives are more important to work out a particular strategy (Gunnesson and Soderlund, 2001): Informational economy perspective: At Polish dentistry, the prolonged idea is that, the new technological changes around the globe are quite disruptive because of its immense heading around the world and the market space including virtual value chain would help the marketing activities by providing information while most valued drivers of e-commerce in this respect include time, efficiency (cost and time concerned), and the uniqueness of dental care; Industry organisation perspective: The e-commence strategy from the perspective of Polish dentistry is usually defensive on the ground of following the external forces in the industry, where all firms are required to place itself in the value chain by responding to the industry pressures those have devised by several examinations including value chain analysis; Resource based perspective: All organisations of the Polish dentistry-based medical tourism can enjoy sustainable competitive advantage by using its resources that can eliminate its weaknesses, counteract threats, and exploit strengths while the resources and their subsets get more importance such as one subset of those resources may gain competitive advantage and another subset may sustain long-term performance; Figure: Underlying competitive advantage of Polish Dentistry. According to the above figure, the strategic core resources are the primary resources for competitive advantage, the critical supporting resources usually lie in the line of core resources and are varied to non-transferable attributes of the dental care industry, these should be rare, valuable, not substitute, not imitable by ecommerce implication. Figure: Sustained Competitive Advantage of Polish Dentistry Networks and Relationships Perspectives: From the theoretical viewpoint by focusing on leveraging external contacts Polish Dentistry can gain a competitive advantage where the external contacts may include contacts with suppliers, competitors to create relationships online, organisations need to regard information, transaction, and interaction online; Market Orientation Perspective: Every organization under the Polish dentistry has the wide function of initiation of market intelligence, communication of the intelligence, and providing a response to the intelligence with a strong need of changing marketing orientation according to several environment moderators through e-commerce implication; Brand Perspective: Every organization under the Polish dentistry needed building the strategies on branding requires thinking about the brand awareness, brand image, and brand extensions. Research Methodology The purpose of this chapter is to give a clear perception about the process of research formulation, data collection methods, data analysis system and questionnaire design procedures to analyze the effectiveness of e-commerce in the international trade with the case study of dentistry-based medical tourism in Poland. Research Design This dissertation would be formulated with considering both qualitative and quantitative types of research because Malhotra (2009, p.132) stated that qualitative research plays a significant role to describe the problem and, fin out the solution while the quantitative research approach is the process to quantify data. However, he further added that the main difference of these two approaches is the content questionnaire to collect primary data such as if the questionnaire design to get a descriptive answer then the research can be said qualitative research. Primary research Miles & Huberman (1994) stated that primary data address the exact problem of the present research and they also added that the collection of primary data is a time-consuming factor, and need enough money to conduct field survey, and there is a chance to fabricate the result of the data. At the same time, Marshall and Rossman (1999) pointed out that the researcher need to identify target respondents for the research who have broad knowledge about the research area and the face-to-face interviewing method would be most effective approach for data collection. However, the effectiveness of e-commerce in the international trade and dentistry-based medical tourism in Poland is the vast area for research; thus, there is no way to ignore primary research but it would not be possible to collect data by conducting face-to-face interview. In this circumstance, it would be effective to send the questionnaire by e-mail to get prompt response from the respondents though dentists, medical representatives and others are busy with their own professional activities but it can expect that they will co-operate to conduct this research. To analyze the data and present graphically using Microsoft excel, the collected data need to check and edit to remove error from the research; for instance, the respondent may select more options in one questions or may dropped out blank, those need to send back to the respondents to complete the questionnaire or the researcher need predict the actual response. Secondary data According to the research approach of Sekaran (2006) and Zikmund (2006), secondary data is more valuable than primary data as it is prepared data and recognized by the famous universities and publishers. This dissertation would use many books related with the topic particularly e-commerce- Business, Technology, Society by Laudon, e-Business – roadmap for success by Kalakota and Robinson, structure and macro-level impacts of electronic commerce by Zwass, and law of E-Commerce in Poland and Germany are too effective secondary resource.

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