Healthcare information systems outsourcing

Investigating the Impact of Outsourcing on IT Flexibility

Modern healthcare organizations try to leverage their IT infrastructures to enhance the efficiency of processes and the quality of patient services. The flexibility of the IT infrastructure is a critical factor in the process of establishing strategic and operational value. The authors examine how applied principles of Conceptual Independence (CI) in information systems (IS) influence the flexibility of IT infrastructures. Furthermore, it is presumed that IT outsourcing plays a role in IT flexibility. The second question asks whether IT outsourcing configurations change when CI has been applied or not. Quantitative and qualitative data have been collected in 9 mental healthcare organizations. Findings – based on integration of the data with a mixed-method approach - suggest that the healthcare organizations that apply the principles of CI are better equipped to adapt their IT infrastructure to changing demands, requests and needs. Likewise, results suggest that they have changed the government of IT outsourcing thereby increasing IT flexibility even further.

A Systematic Literature Review on IT Outsourcing Decision and Future Research Directions

During the recent decades, some academic research on the subject of information technology outsourcing (ITO) decision has appeared in different outlets, which may impede the use of such resources and as a result, repetition of research by various researchers is very likely. The purpose of this paper is then to conduct a systematic literature review (SLR) pertaining to research on ITO decision. Then, this review intends to 1) classify ITO decision literature, 2) provide a list of factors affecting ITO decision, and 3) identify ITO strategies. To this end, 91 ITO articles published between 2000 and 2018 in 51 unique journals were reviewed. The results yielded three kinds of descriptive, relational, and comparative ITO decision studies. The determinants of ITO decisions are classified into technological, organizational, environmental and user adoption factors. Furthermore, the trend of studied ITO strategies in the reviewed literature is analyzed, and future sourcing varietals are proposed. Finally, some insights and future research directions are proposed based on the review results.

Selected factors determining outsourcing of basic operations in healthcare entities in Poland

BACKGROUND

In light of insufficient financial resources allocated to the functioning of the health care system in Poland, healthcare entities undertake several restructuring measures aimed at cost reduction, improvement of effectiveness and optimisation of operations. One of the elements of this restructuring is outsourcing.

OBJECTIVE

The objective of the study is to determine the significance of selected factors determining the outsourcing of basic operations in healthcare entities in Poland.

METHODS

The research tool was the authors' questionnaire. The study was conducted at healthcare entities using the CAWI method in 2018. The outsourcing of laboratory diagnostics, diagnostic imaging and medical personnel was examined.

RESULTS

Out of 750 healthcare entities, 241 outsource medical personnel, 484 outsource laboratory diagnostics, 445 outsource imaging diagnostics. The use of outsourcing primarily results from the excessively high cost of maintaining own employees, the desire to gain access to the top-quality knowledge and technology as well as the need for financial savings.

CONCLUSIONS

The scale of outsourcing of medical personnel may be greater than it results from the obtained study results. Excessively high costs of maintaining own employees as the most important reason for using outsourcing is a consequence of high personnel costs occurring in the case of establishing cooperation on the basis of an employment relationship.

Outsourcing of facilities management (FM) services in public hospitals

Purpose

– The purpose of this paper is to extend the body of knowledge on health care facilities management (FM) by investigating the extent to which public hospitals in Nigeria have fared in terms of outsourced FM services.

Design/methodology/approach

– The paper relied on two strands of methodology common with pragmatic research. Questionnaire survey (QS) used data from 74 respondents representing 74 hospitals, while 3 of the 74 hospitals involved in the QS were selected based on their willingness to enter the case study interview. Data collected were analysed using descriptive statistics (QS) and using narrative techniques by discussing themes, sub-themes and interconnecting themes through a chronology of events, as in grounded theory.

Findings

– Findings revealed that most public hospitals do not have a policy framework for outsourcing in general and FM services in particular, giving room for duplication of functions and non-establishment of functional FM units to handle FM activities, while six FM services are outsourced in all the hospitals. Cleaning, security and catering services received the highest satisfaction ratings, while plant maintenance services, however, received the least satisfaction rating.

Originality/value

– The paper provides the first ever survey based on empirical evidence about the state of FM services outsourced in Nigeria’s public hospitals. The survey suggests a relatively low level of usage of outsourcing for its services, as only a handful of FM services are outsourced in most of the hospitals.

Criteria for the evaluation of a cloud-based hospital information system outsourcing provider

As cloud computing technology has proliferated rapidly worldwide, there has been a trend toward adopting cloud-based hospital information systems (CHISs). This study examines the critical criteria for selecting the CHISs outsourcing provider. The fuzzy Delphi method (FDM) is used to evaluate the primary indicator collected from 188 useable responses at a working hospital in Taiwan. Moreover, the fuzzy analytic hierarchy process (FAHP) is employed to calculate the weights of these criteria and establish a fuzzy multi-criteria model of CHISs outsourcing provider selection from 42 experts. The results indicate that the five most critical criteria related to CHISs outsourcing provider selection are (1) system function, (2) service quality, (3) integration, (4) professionalism, and (5) economics. This study may contribute to understanding how cloud-based hospital systems can reinforce content design and offer a way to compete in the field by developing more appropriate systems.

Developing IT Infrastructure for Rural Hospitals: A Case Study of Benefits and Challenges of Hospital-to-Hospital Partnerships

This article presents a study identifying benefits and challenges of a novel hospital-to-hospital information technology (IT) outsourcing partnership (HHP). The partnership is an innovative response to the problem that many smaller, rural hospitals face: to modernize their IT infrastructure in spite of a severe shortage of resources. The investigators studied three rural hospitals that outsourced their IT infrastructure, through an HHP, to a larger, more technologically advanced hospital in the region. The study design was based on purposive sampling and interviews of senior managers from the four hospitals. The results highlight the HHP's benefits and challenges from both the rural hospitals' and vendor hospital's perspectives. The HHP was considered a success: a key outcome was that it has improved the rural hospitals' IT infrastructure at an affordable cost. The investigators discuss key elements for creating a successful HHP and offer preliminary answers to the question of what it takes for an HHP to be successful.

To outsource or not to outsource

BACKGROUND

Outsourcing of information technology (IT) functions is a popular strategy with both potential benefits and risks for hospitals. Anecdotal evidence, based on case studies, suggests that outsourcing may be associated with significant cost savings. However, no generalizable evidence exists to support such assertions.

PURPOSE

This study examines whether outsourcing IT functions is related to improved financial performance in hospitals.

METHODOLOGY

Primary survey data on IT outsourcing behavior were combined with secondary data on hospital financial performance. Regression analyses examined the relationship between outsourcing and various measures of financial performance while controlling for bed size, average patient acuity, geographic location, and overall IT adoption.

FINDINGS

Complete data from a total of 83 Florida hospitals were available for analyses. Findings suggest that the decision to outsource IT functions is not related to any of the hospital financial performance measures that were examined. Specifically, outsourcing of IT functions did not correlate with net inpatient revenue, net patient revenue, hospital expenses, total expenses, cash flow ratio, operating margin, or total margin.

PRACTICE IMPLICATIONS

In most cases, IT outsourcing is not necessarily a cost-lowering strategy, but instead, a cost-neutral manner in which to accomplish an organizational strategy.

Outsourcing in public hospitals: a Greek perspective

PURPOSE

The purpose of this research is to investigate the extent of outsourcing, the decision-making process, the impact of outsourcing, and the future trend of outsourcing in public hospitals in Greece.

DESIGN/METHODOLOGY/APPROACH

A survey instrument was designed and mailed to a random sample of 100 public hospitals in Greece and 43 usable questionnaires were received, representing a response rate of 43 percent. The survey instrument focused on the extent to which public hospitals outsource services, the decision-making process for choosing an external service provider, the impact of outsourcing, and the future trend of outsourcing in public healthcare organisations.

FINDINGS

Public hospitals in Greece outsource a variety of activities. Cost savings and customer satisfaction are the main factors affecting the outsourcing decision. The cooperation with a contract service provider has led to significant improvement in service quality levels. Most users are satisfied with the performance of these companies and believe that there will be an increase in the usage of these services in the future.

PRACTICAL IMPLICATIONS

It provides a decision-making framework regarding outsourcing in public healthcare organisations.

ORIGINALITY/VALUE

This research fills the gap in the area of outsourcing in public hospitals in Greece.