Electronic Medical Records Application Development: Perspectives of the Service Provider

Healthcare Information Technology (HIT) is a relatively new phenomenon and refers to the use of computer applications to store, process, and use clinical, administrative, and financial information among various health care entities. HIT is widely regarded as a key to improving the quality of healthcare in the United States and potentially reducing its cost. Yet, its implementation is a continuous challenge for the healthcare industry. One of the key applications of HIT is Electronic Medical Records (EMR). The implementation of an EMR system may result in improved and more efficient care and patient safety, but it may also incur additional costs. Furthermore, if the development of the application is undertaken by an offshore vendor, it adds another layer of complexity. This research case documents the experiences in the development and implementation of an EMR system for a U.S. client by an offshore vendor. While client experiences abound in the literature, this study is unique in that it draws from the perspective of the service provider. Key findings of the study show that the major issues related to EMR development by an offshore vendor include gaining domain knowledge, requirements generation, and access to expertise. Like offshoring projects in general, client-vendor communication remains perennially important. Beyond EMR, this vendor's critical success factors in HIT projects offshore development additionally include scope containment, need for a client liaison, and managing non-functional expectations

An empirical evaluation of client-vendor relationships in high maturity Indian software outsourcing companies

The study presented in this thesis investigates offshore software outsourcing relationships. Offshore software outsourcing has been increasing continuously for the last decade. More and more software vendor companies from different countries such as India, Russia, Brazil and China are joining the offshore `bandwagon'. Indian software companies especially have managed to secure a leading position as offshore software outsourcing vendors. However, with more client companies outsourcing their software operations offshore, issues associated with the establishment and management of offshore outsourcing relationships have become more important. With the growing volume of offshore outsourcing, the number of failures is also increasing. A review of the literature suggests that success or failure is mainly dependent on the management of relationships between client and vendor. Subsequently, it is imperative to identify critical factors that can help to better manage offshore software outsourcing relationships. Furthermore, it is also important to identify the difficulties faced in managing offshore relationships and also how clients and vendors develop mutual trust. Trust is important to understand in the offshore software outsourcing context as it has been reported as the most significant contributor to the management of any human relationship. Nonetheless, different advantages that motivate clients to outsource are also important in understanding offshore software outsourcing. In this study, motivators, difficulties, critical relationship management factors and trust building factors are studied by means of empirical investigation into eighteen high maturity Indian software companies and six of their clients based in the USA and Europe. Multiple case studies with grounded theory analysis techniques are used to conduct the empirical investigation. Grounded theory, which is a part of qualitative research, helps to develop emergent model from empirical data. Furthermore, multiple case studies are used as objects to collect qualitative data and organise overall investigation. The research methods used were piloted with two Indian software companies before conducting the full empirical investigation. The results of this investigation suggest that client companies are motivated to outsource their software offshore by cost savings, quality, flexibility, core competence, skills availability, higher productivity, faster development, technical expertise and high maturity of vendor. The results also uncovered difficulties faced by clients and vendors in managing relationships. Difficulties include managing cultural differences, expectation mismatch, language differences, loss of control, distance, time zone differences, workforce reshuffling and post-contractual matters. This investigation further identifies critical factors to managing offshore outsourcing relationships such as effective communication, a process driven approach, commitment to the project, transparency in actions, consistency in performance, value addition and allocating resources effectively in the project. Furthermore, results from this study suggest that previous work reference, experience and reputation in the offshore outsourcing business, background of the key vendor employees, investments, prototyping and personal visits from the client are important for achieving trust. This study also identifies that to maintain trust in the relationship both clients and vendors perceive critical factors such as commitment, process driven approach, communication, confidentiality, performance, honesty, transparency, demonstrability, personal relationships and working together in outsourcing project. Based on the results of the empirical results and their discussions, this study presents an emergent model and practical guidelines for managing offshore software outsourcing relationships. The uniqueness of this investigation is in its large scale empirical investigation into high maturity software companies. Furthermore, most previous studies have investigated either clients or vendors, whereas this study investigates vendors and their corresponding clients. An investigation into trust in offshore software outsourcing relationships is also a significant addition to the existing literature relevant to software outsourcing. The empirical investigation gave rise to proposals for discussions and to an emergent empirical model. Thus the current body of knowledge in offshore software outsourcing is enhanced by this work. Moreover, practical guidelines, based on empirical results are proposed for client and vendors to help them manage their offshore software outsourcing relationships

Good times and bad: Client and vendor insights on ITO relationship quality

The success of Information Technology Outsourcing (ITO) today is intrinsically linked to the quality of the relationship formed between client and vendor. The academic literature has already defined the key characteristics of a quality relationship - one which will weather the test of time. Researchers have also portrayed how an ITO relationship should mature and that the focus should move over time from cost and transactional drivers to an outcomes-based alliance. While these studies answer the questions of why relationships are central to ITO success, what form they take, and when they evolve, they do not answer the question of how to create a quality relationship. This research complements this existing body of research by tapping in to the best practices client and vendor practitioners use every day to make their ITO relationships successful. For those seeking to establish a new relationship, invigorate an existing one or mitigate the risk of failure this report provides a valuable resource of validated and prioritised best practices along with descriptions and recommendations on how and when to apply them

Using communication to mitigate the challenges of outsourced projects

Abstract: The multi-organisational mode of outsourcing projects increases the significance and complexity of project communication. Communication is essential for any organisation, offering the necessary structures within which people may successfully work together, make decisions and act to accomplish organisational goals. If project necessities are not communicated accurately, negative outcomes are frequently the result, proving detrimental to the organisation and the outsourced project. Literature review revealed ten common challenges to the outsourcing of projects, with mitigation strategies identified to minimise the impacts of such challenges. This study makes use of the case study research method and semi-structured interviews as the primary means of data collection. The method of analysis chosen for the study was the qualitative approach of thematic analysis. A cross-case analysis was done, similarities and variations were grouped together, and themes were identified based on participants’ responses. These were compared to the literature findings. It was found that six of the ten challenges were experienced in all three case studies. Four were unique to particular projects. The findings indicate that challenges affected project teams’ ability to communicate effectively, and that the identified mitigation strategies all included the component of communication, whether synchronous or asynchronous. With the achievement of the research objective, this study will contribute to the existing body of knowledge within the project management fraternity and within academia. Knowledge gained may be used by project management professionals and will, it is hoped, enhance the way projects are outsourced and managed in the engineering sector.M.Phil. (Engineering Management

Success factors of selective information technology outsourcing in enterprise resource planning projects in Israel

IT Outsourcing (contracting-out of Information Technology services) has become a pivotal economic trend in recent decades. This study traces the interlacing of IT Outsourcing with Enterprise Resource Planning (ERP) software systems. Little research has considered the reciprocal relations between these two phenomena. This was the gap in knowledge addressed by the research. More specifically, the research investigated: why organisations turn to IT Outsourcing providers to implement and maintain ERP systems and what are the success factors for selective IT Outsourcing within ERP projects in Israel. Field research was conducted in organisations during 2006-2008, employing IT Outsourcing for ERP systems in two stages: Stage One used qualitative data-collection tools: five semi-structured interviews and fifteen open-ended questionnaires. Inductive content and thematic analysis conducted on data from these tools produced themes that formed the basis for a closed-ended questionnaire used in the next stage. Stage Two employed seventy two closed-ended questionnaires. Quantitative data from this questionnaire underwent deductive statistical analysis to test and confirm findings from Stage One. Results indicated that significant differences between ERP package-based centralised cross-organisational systems and the out-dated self-developed legacy IT systems produced different organisational requirements for IT Outsourcing services. Respondents thought it essential to employ IT Outsourcing for ERP projects, noting different motivations for this strategy. Respondents identified four success factor groups for IT Outsourcing in ERP projects, grading the factors according to relative importance. Management commitment and support was the most important success factor group. The research showed that organisations that implement ERP systems regard it as essential to employ the IT Outsourcing services since they provide experienced updated experts. Organisations stress that they need these services to ensure effective, operable systems, understanding that initially there is little cost reduction. Management commitment, wise choice of vendors and intelligent contracting can establish successful vendor-organisation collaboration. Contribution to knowledge is made by offering a better understanding of the unique phenomenon of IT Outsourcing within ERP projects in Israel, motivations to use and success factorsEThOS - Electronic Theses Online ServiceGBUnited Kingdo

Cloud adoption and cyber security in public organizations: an empirical investigation on Norwegian municipalities

The public sector in Norway, particularly municipalities, is currently transforming through the adoption of cloud solutions. This multiple case study investigates cloud adoption and is security challenges that come along with it. The objective is to identify the security challenges that cloud solutions present and techniques or strategies that can be used to mitigate these security challenges. The Systematic Literature Review (SLR) provided valuable insights into the prevalent challenges and associated mitigation techniques in cloud adoption. The thesis also uses a qualitative approach using Semi-Structured Interviews (SSI) to gather insight into informants’ experiences regarding cloud adoption and its security challenges. The study’s empirical data is based on interviews with six different Norwegian municipalities, providing a unique and broad perspective. The analysis of the empirical findings, combined with the literature, reveals several security challenges and mitigation techniques in adopting cloud solutions. The security challenges encompass organizational, environmental, legal, and technical aspects of cloud adoption in the municipality. Based on the findings, it is recommended that Norwegian municipalities act on these issues to ensure a more secure transition to cloud solutions

A framework for evaluating the impact of business process outsourcing (BPO) on the operational performance of the mobile telecommunications industry, South Africa.

Doctoral Degree. University of KwaZulu-Natal, Durban.Mobile telecommunication service providers in developing countries, particularly southern African mobile telecom operators outsource a range of activities like logistics, assembly operations, manufacturing, and design. The results of such decisions have not been proved empirically. Empirical evidence on whether or not outsourcing is beneficial lacks in the industry. Furthermore, there has been a minimum focus on the effects of outsourcing on the operational performance of firms.In light of the above, the study proposes a CPP framework that can be used to evaluate the impact of business process outsourcing (BPO) on the operational performance of mobile telecommunications industry in developing Southern African countries with particular reference to South Africausing cost, productivity and profitability (CPP) as the underpinning quantitative performance metrics by taking into consideration the drivers, benefits, and risks of the business strategy. The study is informed by the positivism research paradigm using deductive approach. A descriptive research design was adopted for the collection of quantitative data. Chi square test were conducted to establish the statistically significant relationship between business process outsourcing and cost efficiency, productivity and profitability and the operational performance of mobile telecommunication firms. A structured closed- ended questionnaire was used to collect raw data using the drop-off method in which questionnaires were distributed to two hundred and ten employees of the two mobile communication companies. The findings of this current study reflect that majority of the participants alluded that there is an improvement in cost efficiency, increase in productivity and profitability after BPO thereby improving the operational performance of the mobile telecom operators. These results suggest that there is a statistically significant relationship between BPO and cost, productivity and profitability. The results were reflected in the proposed cost, productivity and profitability (CPP) framework as part of the business performance outcome. The results are important to corporate management as this avoid relying on managers’ estimates in place of quantifiable metrics in deciding on whether to outsource or in source and can also assist management, policymakers and supply chain Practitioner in developing BPO policies. Abahlinzeki besevisi yezokuxhumana ngomakhalekhukhwini emazweni asathuthuka, ikakhulukazi opharetha bezingcingo zamaselula e-Afrika eseningizimu banikeza ngaphandle uchungechunge lwemisebenzi efana nokuhlela, ukuhlanganisa, ukukhiqiza, nokuklama. Imiphumela yalezi zinqumo ayizange ifakazelwe ngokwamandla. Ubufakazi obunamandla bokuthi ukukhishwa kwemisebenzi kuyazuzisa ukushoda embonini. Ngaphezu kwalokho, kube nokugxila okuncane emiphumeleni yokukhishwa kwemisebenzi ekusebenzeni kwamafemu. Ngokwalokhu okungenhla, ucwaningo luphakamisa uhlaka lwe-CPP olungasetshenziswa ukuhlola umthelela wokukhishwa kwezinqubo zebhizinisi (BPO) ekusebenzeni. ukusebenza kwemboni yezokuxhumana ngomakhalekhukhwini ekuthuthukiseni amazwe aseNingizimu ne-Afrika ikakhulukazi iNingizimu Afrika isebenzisa izindleko, ukukhiqiza kanye nenzuzo (CPP) njengesisekelo samamethrikhi okusebenza esilinganisweni ngokucabangela abashayeli, izinzuzo, kanye nobungozi besu lebhizinisi. Ucwaningo lwenziwa yi-positivism research paradigm kusetshenziswa indlela yokudonsela phansi. Kwamukelwa umklamo wocwaningo oluchazayo ukuze kuqoqwe idatha yobuningi. Ukuhlolwa kwe-Chi square kwenziwa ukuze kutholwe ubudlelwano obubalulekile ngokwezibalo phakathi kokukhishwa kwenqubo yebhizinisi kanye nokusebenza kahle kwezindleko, ukukhiqiza kanye nenzuzo kanye nokusebenza kokusebenza kwamafemu ezokuxhumana ngomakhalekhukhwini. Uhlu lwemibuzo oluvaliwe oluhlelekile lwasetshenziswa ukuqoqa idatha eluhlaza kusetshenziswa indlela yokushiya lapho imibuzo yasatshalaliswa kubasebenzi abangamakhulu amabili neshumi bezinkampani ezimbili zokuxhumana ngomakhalekhukhwini. Okutholwe kulolu cwaningo lwamanje kukhombisa ukuthi iningi labahlanganyeli likhombe ukuthi kukhona ukuthuthuka ekusebenzeni kahle kwezindleko, ukwanda kokukhiqiza kanye nokwanda kwenzuzo ngemuva kwe-BPO ngaleyo ndlela kuthuthukiswe ukusebenza kokusebenza kwabaqhubi bezingcingo zamaselula. Le miphumela iphakamisa ukuthi kunobudlelwano obubalulekile ngokwezibalo phakathikwe- BPO nezindleko, ukukhiqiza kanye nenzuzo. Imiphumela yabonakala ohlakeni v oluhlongozwayo lwezindleko, ukukhiqiza kanye nenzuzo (CPP) njengengxenye yomphumela wokusebenza kwebhizinisi. Imiphumela ibalulekile ekuphathweni kwebhizinisi njengoba lokhu kwagwema ukuthembela esilinganisweni sabaphathi esikhundleni samamethrikhi angabalulekayo ekunqumeni ukuthi bazonikezwa yini inkampani yangaphandle noma emthonjeni futhi kungasiza futhi abaphathi/ abenzi bezinqubomgomo/ Umsebenzi wochungechunge lokuhlinzeka ekuthuthukiseni izinqubomgomo ze-BPO

Understanding task inter-dependence and co-ordination efforts in multi-sourcing: the suppliers' perspective

The last decade has witnessed a significant growth in the outsourcing of information technologies and business processes. Of a particular trend within the outsourcing industry is the shift from the client firm contracting a single supplier to utilizing multiple suppliers, which is also known as multi-sourcing. Multi-sourcing may potentially offer numerous advantages to client firms, however, it might present some challenges to suppliers. In particular, multi-sourcing could create coordination challenges, as there are inter-dependencies between the outsourced tasks to numerous suppliers. While the current outsourcing literature acknowledges the existence of inter-dependencies, little is known about the efforts required for coordinating the work between suppliers and how these coordination efforts are made to manage task inter-dependence. Three case studies at Pactera (case one) and TCS (cases two and three) serve as the empirical base to investigate the inter-dependence between outsourced tasks and suppliers coordination efforts. This research offers theoretical contributions to both coordination studies and the outsourcing body of knowledge