Combined Written Deliverable (1)

8/13/2019 Combined Written Deliverable (1)

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Jones Consulting, Inc.Matthew Casciani

Sarah Daniels

Conner Lunsford

Harrison Morris

November 12, 2013


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Table of Contents

Executive Summary3

Industry Research...4

Porters Five Forces Analysis9

Company Research...10

Process Model Improvements..11

Database Design13

Business Intelligence Systems..14

Enterprise Systems Strategy14

Social Media Strategy...15

Mobile Strategy.16

International Expansion...21

Bibliography..23

Implementation Review24


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Executive Summary

Background

South Arkansas Orthopedics and Sports Medicine (SAOSM)is Arkansas premier orthopedic

and sports medicine center. With nearly 17 years of experience, SAOSM is looking to continueto innovate in a changing medical field that demands the cutting edge of technology. In an effort

to improve social media presence, to update internal business processes, and to prepare for

possible expansion, SAOSM has looked to Jones Consulting to provide recommendations on the

integration of business technology into their existing business practices. Jones Consulting plans

to advise SAOSM on how to best transition into a new digital paperwork system, how to utilize

social media to improve patient awareness, and how to establish a foundation upon which

SAOSM can expand internationally.

As a small business orthopedic and sports medicine center, SAOSM benefits from being able to

personalize patient care; however, it is faced with the challenge of preparing for future expansionand developing modern digital business practices while not isolating its current patients.

Recommendations

SAOSM has always valued positive doctor-patient interactions and stressed the importance of

the consumer. We recommend that SAOSM integrate a Customer Relationship Management

(CRM) digital records system in order to meet and improve upon these needs. In the medical

business world it is important to know as much information about the patient as possible and,

utilizing a CRM system, doctors and patients would spend less time on paperwork and more time

on helping the patient. This system would also have other benefits such as maximizing theproductivity of doctors and nurses, increasing the security of patient medical history and billing

information, and significantly lower operating costs.

Jones Consulting also recommends the creation and utilization of social media to promote its

business. Currently SAOSM is not using any form of social media to connect with its patient

base. SAOSM can use social media to advertise and promote its business, provide patients with

relevant health information and life improvement information, and provide safety tips and other

health tips.

SAOSM should also develop a mobile application to increase the productivity of their nurses and

doctors. This mobile app would spur use of the new database and allow doctors to pull up patient

records utilizing smartphones and tablets. This will notably improve the current process as it

allows doctors to participate in difficult diagnoses without being in office.

Below, Jones Consulting provides a more detailed analyses of the current industry position and

how implementing the recommendations can significantly improve SAOSM.


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Industry Research

Locall y, in the U.S.

Key Performance Indicators

The Specialist Practice Industry is directly affected by a few a major external components. Oneof which is the number of people withprivate healthcare insurance. More than half of therevenue in this industry is generated from private health insurance payments. Another key driverisfederal fundingfor Medicare and Medicaid. This directly affects the price of services andincreases the number of people that can utilize the practice. Also, theportion of the populationthat is 65 or olderplays a large role in this industry. This older group of people makes up themajority of specialty doctors practices. One other key factor is the per capita of disposable

income. About 14.5% of industry revenue comes from disposable income payments.

Since the recession in 2008 the Specialist Practice Industry has been on the incline and isexpected to continue its growth with revenue rising 3.4% to $283.5 billion in 2013. In the last

five years this industry has seen an annual growth of 2.3%.

Year Revenue $ millionGrowth

%

2002 186,202.8 0.0

2003 201,850.1 8.4

2004 212,724.2 5.4

2005 220,966.6 3.9

2006 229,207.4 3.7

2007 243,440.1 6.2

2008 253,450.9 4.1

2009 259,344.1 2.3

2010 262,153.0 1.1

2011 269,704.9 2.9

2012 274,261.7 1.7

2013 283,525.8 3.4


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Key Competitors

South Arkansas Orthopedics & Sports Medicine (SAOSM)competes in the specialistpractice sector. Domestically within the United States this industry is highly fragmented andoperates on a local scale.

The low level of concentration in this industry, due to high barriers to entry has led to a greatdispersion in the revenue the sector generates. In fact The largest four firms are estimated toaccount for less than 4.0% of industry revenue, and only one provider is expected to generatemore than 1.0% of total industry revenue. The leading market share firms include:

1. Memorial Sloan-Kettering Cancer Center (Estimated market share: 1.1%; $3.1 billion)o The Memorial Sloan-Kettering Cancer Center (MSKCC) is dedicated to cancer

research and treatment. It is located in New York City.

2. Children's Hospital of Philadelphia (Less than 1.0%; $2.1 billion)o As a leading pediatric hospital, the Children's Hospital of Philadelphia (CHOP)

also has one of the largest pediatric research programs in the world.

3. NYU Hospital for Joint Diseases (Less than 1.0%; $2.0 billion)o NYU Hospital for Joint Diseases (HJD) is the country's largest specialty hospital

dedicated to the prevention and treatment of musculoskeletal diseases.

4. Children's Hospital Boston (Less than 1.0%; $1.5 billion)o Children's Hospital Boston offers acute healthcare and specialty services for

children from birth to age 21.

Trends

Currently revenue for small practice, specialist doctors is expected to grow rapidly. Projectionshave the industry revenue growth to increase at nearly 6%, after which growth will hover around4% growth per year. Another notable factor is that there is an expected spike in consumers whowill be getting private healthcare insurance in the next 3 years.


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The industry is expected to continue growing due to an aging population and increasinglycommon chronic disease. As can be seen in the graph above, the industry took a turn for theworse during the recession, possibly due to less people owning health insurance as well asputting off primary care visits, yet still managed to grow. Currently demand for specialistpractices is expected to remain high as the recent healthcare reform should ensure that more

patients have health insurance. This is expected to boost revenue 4.4% per year on average forthe next 5 years.

Stage in Industry Life Cycle

In the United States, the specialty doctors industry is in thegrowth stage of the life cycle. Theindustry is projected to increase 4.8% on average while the US economy is projected to onlygrow 2.1%. This means that the industry of specialty doctors will grow at a faster rate than theUS economy, which is a key feature of a growth industry. Specialist doctors are enjoying agrowing demand for their services. The overall demand is increasing because of demographic

trends in America, such as the aging United States population. The aging population of theUnited States, because of the Baby Boomer generation, leads to an increase in the demand forspecialty doctors. Also technological improvements have greatly helped this field of medicine bymaking it much more efficient. New technologies allow doctors to treat previously untreatableproblems, and this allows them to treat a higher percentage of the population leading to revenuegrowth.Specialist doctors have seen an increase in cost because of the high amount of

regulations and increased labor wages. These factors have encouraged specialist doctors to join agroup practice. Normally this would indicate decline or maturity in the industry, but for specialistdoctors this actually increases industry growth. Doctors are able to spread out costs and have lessadministrative duties, which increase efficiency and the amount of patients able to be cared for.


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Globally

Key Performance Indicators

Two of the largest indicators for the global healthcare market aregovernment spendingas well asdisposable income. Countries that spend more money on healthcare will create a greater

incentive for businesses to enter the market and for existing businesses to expand. Some of thelargest spending countries are the United States, Germany, and Canada. These countries spend17.7%, 11.3%, and 11.2% of their GDP (gross domestic product) respectively. These countriesnaturally then have some of the largest healthcare systems in the world.

The second indicator, disposable income, shows how available healthcare is to citizens. Peoplewho have low disposable incomes will defer spending money on medical care in favor of morepractical expenses. Minor medical care such as flu vaccinations and yearly checkups will not beviable options for those with little disposable income.

Key Competitors

On a global scale, there are three main competitors in the healthcare industry. Capio, whichprovides health care and diagnostic services and is based in Goteborg Sweden. HCA, which islocated in Nashville, TN, is the largest operators of healthcare facilities in the United States.Lastly, Ramsey Health Care Limited, an operating system of private hospitals and day surgeryfacilities, located in New South Wales.

Major Markets

The Americas dominate the health care market with 49.9% of all healthcare revenue. TheAmericas are the largest healthcare provider followed by Europe with 28.8% of revenue, and theAsia-Pacific areas with 19.6%. Africa and the Middle East only account for 1.7%. Thus, healthcare is more prevalent in developed countries. African and Middle Eastern nations lack theinfrastructure and money to support a good health care system.


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Trends

Globalization within the healthcare industry is growing at a moderate 5% per year on average.Revenues within the healthcare industry are also expected to increase with the Europeancompound annual growth rate (CAGR) sitting at 3.4% and the Asia-Pacific (CAGR) sitting at6.5%.

Most business within the healthcare market revolves around outpatient care with 37.3% of thesector being outpatient care and 24.4% being inpatient care. This percentage is expected toincrease as outpatient care is increasingly more profitable in comparison to inpatient.

The global healthcare industry has high barriers to entry due to the expensive start up costs andthe inability for companies to differentiate themselves. This has led to large-scale healthcarecorporations such as Capio AB and HCA Holdings, Inc. to dominate their respective markets.

These companies focus mainly on hospital treatment as well as the production of medicalsupplies.

That being said, specialist medicine is not necessarily a global market. The point of the industryis that it provides excellent, cost-efficient care to local areas. In countries that have highlydeveloped healthcare systems, specialist medicine is more likely to be available, however thelargest market is still located in the United States with nearly half of the entire healthcareindustry being contained within the Americas.


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Porters Five Forces Analysis

Industry: Specialist Doctors

PowerHIGH LOW Justify

Buyer Power

X

The buying power of the specialty doctor industry is low because thesupplies they utilize are so unique that they dont have a lot of options on

where to purchase supplies. Also, location is critical because there arecertain amenities that these doctors need in order to properly service theirpatients.

Suppli er Power X

The supplier power is high because in this industry the physiciansspecialize in one type of medicine. Also the concentration of suppliers inthe industry is low which attributes to the high supplier power. Another

key component is there are few substitute inputs. If a patient needs to see aspecialty doctor there is no real and effective substitute for their services.Switching costs are high due to the development of a patient-doctorrelationship and there are not a lot of options available when choosing aspecialty doctor. This industry is highly differentiated because thephysicians are specialized.

Thr eat of

Substi tute Products

or Services

X

The threat of substitutes is relatively low. Since the industry is so heavilyreliant on doctor-patient relationships, buyers are extremely unlikely tosearch for alternative treatment centers or other medical practices even ifthe cost is lower. This means that the relative price/performance ofsubstitutes is also a non-issue as customers will only switch if the cost isextremely high or the experience with a doctor is extraordinarily bad.

Switching costs will also be high for any customers as the transferring ofmedical data and regulatory paperwork will slow down the process.

Threat of New

Entrants X

Threats of new entrances into the Specialist Doctors industry are relativelylow. It is difficult for new practices to join the industry due to a number ofbarriers including: the highly specialized and regulated nature of the field,the report you must build with clients, and the limited facilities availableto such practices. Each of these components of a practice, take a great dealof time to develop. Although the industry is rather difficult to enter, thehigh number of small establishments suggests that the low levels of fixedcosts and the strong demand for specialized doctors often compensates formany of these barriers.

Rivalry Among

Exi sting Competitors

X

The rivalry among existing competitors is low. The price of visiting thedoctor or getting a surgery is the same no matter where a patient will go.This reduces rivalry because the specialty doctors industry does not haveprice wars. Most specialty doctors establish strong relationships with theirpatients, and patients are loyal to their original doctor. Also keeping thesame doctor is much easier than moving to a different physician makingthe switching cost high. Most specialty doctors work in established firms,which means the quality of their work, and patients wont switch to adifferent practice.


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Company Research

Background

Product/Service Description

South Arkansas Orthopedics and Sports Medicine (SAOSM)is an orthopedic medicalpractice that has been serving the southern region of Arkansas for over 17 years. SAOSM offersan all in one experience for their patients. The office, surgery center, and physical therapyfacility are all conveniently located in two side-by-side state-of-the-art buildings. The physiciansare expertly trained and experienced in the areas of sports injuries, joint replacement surgery,carpal tunnel surgery, trauma, and arthroscopic surgery.

Mission Statement

Our role in the South Arkansas medical community is to bring 21st century bone and joint careto a local address. This improves patient care by removing the pain and hassle of long trips out of

town, allows greater family member involvement, and decreases lost time away from work.

Locations in the United States

SAOSMs main practice location is El Dorado, AR. They have several satellite offices in the

South Arkansas, including: Crossett, Camden, Magnolia, Warren, Fordyce and Monticello.

Cur rent Strategy

Niche Differentiation

SAOSM is a specialized practice focusing on orthopedics. They provide their patients withexpert care and quality results. The goal of SAOSM is to get the patient back on track to ahealthy life. The convenience of having all the required amenities on site sets them apart fromother practices in the areas.


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Process Model

This process model depicts a patients clinic visit at South Arkansas Orthopedics and Sports

Medicine (SAOSM). The clinic visit process consists of four distinct phases: Customer, Check-

in/Processing, Screening, and Checkout Process.

Beginning with the Customer phase, customers either conduct their own research to find an

orthopedics and sports medicine specialist or they are referred to SAOSM and call to schedule an

appointment.

Once an appointment is arranged patients enter the Check-In/Processing phase. In this segment

of the process patients arrive on location and check-in with the receptionist to fill out any

necessary documentation needed prior to a screening. If a patient is new, have a new injury or

have not been in for treatment in the past six months they will have to fill out paperwork. Should

the patient be returning for a follow up visit they may be excluded from the paper work step and

immediately go into the Screening phase of their clinic visit.

During the Screening phase patients are first evaluated by a nurse, who gathers all the

information necessary for a doctor to evaluate, diagnose, and treat an injury. The doctor then

diagnoses the injury and recommends an X-Ray, prescription, surgery, or refer a patient to a

physical therapist and decides whether a patient requires a follow up visit or not.

After a patients screening is complete they initiate the final stage of the clinic visit process, the

Check-out phase. In this segment, if the doctor felt a patient required a follow up, the patient

would schedule another appointment with the receptionist, beginning the whole process again;

then begin the billing sub process. However if there is no follow up visit necessary, the patient

may jump immediately to the billing sub process.

The four distinct sections, to further classify how patients are processed, functions to segment

task phases.

This process model would prove beneficial to SOASM. It will help staff visualize and

understand how a clinic visit should be processed. It will also help pinpoint any flaws or

possible improvements SOASM could look to implement. Overall, this process model will serve

as an invaluable utility that SOASM could implement in the future.


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Database Design

E-R Diagram

An entity relationship (E-R) data model would be extremely useful to SAOSMs daily processes.

By going digital and by moving patient records away from a paper system, SAOSM can serve itspatients in a better capacity. This E-R diagram represents what Jones Consulting recommends beimplemented, in order to preserve patient data integrity and to relate patient data to other aspectsof the business.

Database Users

As SAOSM is a small specialty orthopedic business, there are two major departments that wouldbenefit from the implementation of this database. Medical staff, such as doctors and nurses,would be able to access patient history in order to facilitate accurate and more efficient care. Dueto confidential patient data being stored on this database, only registered doctors and nurses willbe able to access patient history; however, administrative staff will be able to edit non-confidential information such as basic patient information and billing information. By allowingadministrative staff to utilize the database they too can benefit from the decreased paperwork

needed for patient records, thereby increasing productivity.


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Business Intelligence Systems

South Arkansas Orthopedics and Sports Medicine can benefit from the use of BusinessIntelligence Systems. We have come up with four possible systems that would be helpful forSAOSM. The first is a system that tracks patient traffic on a month-by-month basis. This would

give the practice information on which months are the busiest. Collected data could be helpful inmanaging supply orders and staffing. Another suggestion would be to implement a system thatwould pull all appointment scheduled for the following day and send them an email reminder oftheir appointment. This push publishing system would help decrease the number of no-shows,thus increase overall practice efficiency. Also a system that would pull a patients insurance

information and calculate what their specific policy would cover for their procedure would allowpatients more information on the front end of what they would be responsible for paying out ofpocket. A final suggestion would be the use of system that tracked a patients physical therapysessions. This would streamline communication between the doctors and the therapists, andwould also allow for more accurate treatment for each patient based on their progress.

Enterprise Systems Strategy

Recommended Enterprise Solution

We believe that the implementation of an Enterprise Systems Strategy would be beneficial for

SAOSM. There are two different types, Enterprise Resource Planning (ERP) and Customer

Relationship Management (CRM). ERP systems are fantastic for manufacturing companies that

deal with high volume, production, and sales. As we are a small orthopedic center that has no

interest in the extra services offered by an ERP system, the implementation of this type of system

would not be advisable.

A CRM system would apply directly to the services we are offering as a business. In the medical

business world it is important to know as much information about the patient as possible. To that

end a CRM data enterprise system perfectly meets our needs of recording every patient-doctor

interaction. As a small orthopedic center, we focus on relationships between the customer and

the doctor and do not have to deal with large scale production and inventory management. As

such, SAOSM would be best supported by a CRM data enterprise system.

Recommended Vendor

There are many different vendors that provide CRM systems. For the medical field, Act! and

Salesforce are the top two vendors. Both offer a variety of functions that would be beneficial to

SAOSM. Act! offers integrated calling from the computer and mainly focuses on Contact

Management. It has both Mobile and Web options and is flexible in terms of working well with

other programs. An added bonus that Act! provides is the vendor will train SAOSM staff on how

to properly utilize the system. As for disadvantages, it is not currently compatible with Windows

8, it entails a lengthy installation and has high system requirements. The other option,


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Salesforce, emphasizes sales and support. It is flexible in the functions and features SAOSM

would choose to use and can easily grow with the practice. It utilizes statistical analysis and is a

Cloud based system. Unfortunately, Salesforce is expensive and the lower cost packages often

charge for options that competitor vendors typically offer for free. Because the system is Cloud

based vital data is stored out-of-house which incurs higher security risks.

For SAOSM, Jones Consulting recommends using the Act! Contact system. As SAOSM is in the

medical business, SAOSM requires consistent access to patient records and information. Act!

allows SAOSM to maintain a running system both in house and in the cloud, which should

provide a level of security to the customers data. Act! also offers a flexible program that will

work with any of the existing data recording software currently in use. Additionally, training

offered by Act! will ease the transition to a CRM system. In comparison, Salesforce is

exponentially more expensive and requires consistent updates via an opt-in-pay-later system.

Their lower end packages, an option SAOSM would seriously consider, lack features that are

typically offered for free in other CRM systems.

Potenti al Challenges

The transition to the Act! CRM data enterprise system should be relatively simple; however,there are a few challenges SAOSM will have to face. The first challenge deals with the lost timedue to training of employees. Employees will need to be trained on how to properly use the newsystem. Fortunately, Act! provides training once purchased, however this will require either losttime during normal office hours or the need for additional hours at the end of the day. Thesecond challenge involves the transfer of physical records to the new system. In order forSAOSM to function in its most efficient manner, all the existing charts and records will need tobe imported into the new system. This will take an extensive period of time and possibly require

the hiring of another position solely dedicated to this task. Implementing a new system is goingto cost SAOSM upfront, in addition to periodic updates as time progresses, in order to maintainthe functionality of the system. Also because Act! is not written specifically for SAOSM, therewill be features that are not available. Such as a lack in contact features or integrated bankingfeature; SAOSM would have to take the options available and make them work for their needs.

Social Media Strategy-Analysis and Recommendations

Currently SAOSM is not using any form of social media to connect with its patient base. While

using social media to promote a medical practice seems frivolous, other practices are using

several forms of social media to their advantage.

Facebook

Key competitors utilize Facebook to advertise and promote business. Also, they use it to share

prevention measures for common injuries and other health tips. SAOSM should create a

Facebook page to connect with patients and provide their followers with health information and

use the site to promote the practice. This page would create a forum of direct communication


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between the practice and patients where questions could be answered or moral support through

tough recoveries could be provided.

Twitter

The Twitter account provides helpful health tips for patients and serves as an additionalpromotion tool. Also, it can be used to communicate with patients on a more personal level.

SAOSM should create a Twitter account in order to have a more active patient- practice

relationship. An account would allow further promotion and the sharing of trending articles

related to the practice. It could be used to direct patients to SAOSMs other social media sites to

promote greater awareness of the services provided by the practice.

YouTube

The YouTube channel provides safety tips and other health tips. They also use the channel as a

promotional vehicle by posting videos that highlight the practice and the services they offer. A

YouTube account should be created to provide SAOSM with an additional outlet for

advertisement of the practice, and as another way to provide patients with information on injury

prevention and general health improvement. SAOSM could be used as a community connection

tool by running short videos on local sports stars and their recent successes. Behind-the-scenes

clips could be used as a promotional tool, targeted at increasing transparency of the practice.

Blogs

The blog is attached to the main website and is used to provide patients with relevant health

information and life improvement information. A blog could be used to give the doctors an outlet

to answer common questions, and it would provide them with a place to discuss another relevant

health issues.

Other Social M edia

Key competitors, thus far, have not ventured into other social media sites. SAOSM could look

into other types of social medias in the future, but for now would be advised to focus on

developing the social outlets discussed above; in order to create a social media presence.

Mobile Strategy

Appropriateness

SAOSM is in an industry that is frequently innovating in the use of mobile applications. Mostlarge medical practices, as well as an increasing number of small practices, are switching their


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patient and doctor relationship online. In order to keep pace, Jones Consulting recommends thatSAOSM develop a mobile app in order to streamline doctor-patient interaction.

I deas

Jones Consulting has provided three unique options on how to implement these mobileapplications and integrate them into current business procedures. The first option is a mobileapplication that allows the user to record physical therapy hours and track their progress.Doctors would receive updates on patient progress and could adjust consulting options asappropriate.

The second option is a mobile application that allows easy access for doctors and nurses topatient records. This information would be accessible on tablets and smartphones and anychanges made in app would automatically synch with the SAOSMs database.

The third option is for SAOSM to implement a self-reporting diagnosis app. The user would send

in info on what, how, and why he or she is hurting. The doctors at SAOSM can then respond tousers and inform them on whether they need to come in to see a physician. While these are threeoptions that Jones Consulting recommends, they are not the only options available to SAOSM.

Regardless, Jones Consulting recommends that SAOSM create a mobile app that would increasethe usability and interconnectedness of their database by allowing doctors easy access to editpatient records.

Best Idea Functional ity

This app will be optimized for tablet and smartphone use in order to make patient data easy to

find and access. In order to provide security to confidential patient information, log in access willonly be provided to approved doctors and nurses. These approved personnel will then have to login using their user credentials in app. Once logged in, personnel can access the schedule for theday, basic information on the patient, x-rays, and MRI images, and if they have been to therapy,if applicable. The app will be synched to the cloud, which will then communicate withSAOSMs database and make changes to patient records.

Benefits

SAOSM stands to receive multiple benefits by incorporating this mobile app into their businesspractices. Paperwork needed for patient processing would be drastically reduced, allowing

instant access to doctors and nurses reduces time spent on finding patient records, and the timepatients spend in the office would also be reduced by implementing this mobile app. It alsoallows doctors to participate in difficult diagnoses, even if out of the office, thereby increasingdiagnosis accuracy and patient satisfaction.


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Design

The following images show what this app would look like and how it would function. This app is

compatible with iPhone, iPad, Android, and Blackberry devices.

The Home Screen contains a menu

that allows the doctor to easily

access all the functions of the app.

The Schedule function of the app

shows the doctor when each

patient is scheduled for the day.


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The Patient Lookup feature allows

the doctor to view patient injury

and basic patient information.

The XRAY/MRI feature allows

doctors to easily access a patient's

imaging reports as soon as they are

ready for viewing.


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The Therapy function allows

doctors to see a patients recent PT

activity which creates a new form

of accountability between thepatient and doctor.


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International Expansion

Location Recommendation

In the future, if SAOSM decides to expand internationally, Jones Consulting recommends that

they establish a practice in San Jose, Costa Rica. We feel that Costa Rica would be an optimalcountry for a new location for a number of reasons. First, we chose San Jose because as the

largest city in Costa Rica this is where the majority of the population. Costa Rica has a rapidly

developing, high quality, and cheap public health care system that is only 10% of a citizens

income. This means that all citizens would have access to SAOSMs care. In addition, Costa

Rica has a large retiree population, 10,000 of which are U.S. citizens, fitting perfectly into the

primary customer demographics of SAOSM. Another advantage to expanding to Costa Rica is

the lower costs of running the practice. Administrative and supplies costs are significantly less

than the costs in the United States.

I S Challenges of the Expansion

SAOSM will experience a few challenges if the expand into Costa Rica. A major initial problem

will be the language barriers between the two countries. Costa Rica is a Spanish speaking

country and this will impede effective communication between SAOSM and the people of Costa

Rica. SAOSM will have to localize the data because of the different language spoken in San

Juan. Costa Rica also has a different legal system than what SAOSM would be used to, and

SAOSM will have to spend valuable money hiring lawyers to figure out the complex medical

practice laws of this new country. Supply chain issues will be another challenge facing SAOSM

in their expansion. How SAOSM gets medical equipment and the cost of getting this equipment

will be more complicated because of international trade laws. Human resources could be a

challenge because of the different cultures. Costa Rica has a much more relaxed and slower

cultural environment than the United States and this could cause friction between doctors and

patients decreasing customer satisfaction. Additional human resource problems will be in finding

doctors willing to move to Costa Rica for work. These doctors will be expecting extra

compensation and benefits for the sacrifice of this move. Project integration will be much more

difficult for international IS because SAOSM will need to integrate patient results and data from

distributed workgroups. Costa Rica is still a developing country that lacks the maintenance of

infrastructure as well as some basic infrastructure. These facts lead to an increase in the risk of

opening a new branch of SAOSM there. A final IS challenge of the expansion of SAOSM will bethe quality of work that is expected by doctors and patients will be different than the United

States branch of SAOSM is used to. As previously discussed Costa Ricas cultureis much slower

paced than the United States and this could potentially cause patients to not be seen on time, or

patients might not even show up on time. This inefficiency throws the entire day off for the

practice and leads to increased operating costs and decreased job and customer satisfaction.


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I nformation System Implementation Recommendations

In order to run a successful practice in Costa Rica, SAOSM will need to make some adjustments

to the existing IS systems. To start, the majority of the population of Costa Rica speaks Spanish,

and SAOSMs existing IS systems are in English. Localization of existing software will need to

occur so that the Costa Rican staff can use it. This will allow them to have all the functionalityneeded, in their primary language. SAOSM is also going to need to implement a partitioned

database. A distributed database that shares data between the Arkansas practice and the Costa

Rica practice is not needed, because data that applies to the main SAOSM practice will not be

applicable to the Costa Rica due to the patient bases being different. Thus a portioned database

will allow the Costa Rican practice to keep its information separate from the information used in

the Arkansas database. Also, the app that the SAOSM staff currently uses during the visit

process will need to be revised to offer a Spanish translation to make it functional for the Costa

Rican doctors. An expansion on the existing IS systems would need to be made to deal solely

with the procurement of necessary supplies that are not available in Costa Rica. This addition to

the IS system would deal with the supply chain aspect of obtaining specialized equipment that

can only be acquired from suppliers in the United States.


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Implementation Review

Matthew Casciani

Sarah Dani els

In general, our team has put forth a collective effort in the completion of our report to SAOSM.

We worked well as a team in making decisions on what would be the best recommendations for

SAOSM. Our analyses were done collectively in order to minimize the over-looking of detailand so that every issue was addressed. I had the specific opportunity to hone in on the

development of the mobile strategy and the final collation of the written deliverable. As for the

mobile strategy, I was interested in the idea of creating an app that would streamline the patient

examination process for doctors. I created an app that would take all the vital parts of an office

day and put them in one place. By implementing this app the physicians have all the information

they need to properly care for their patients in their hands, which will allow them to more

efficiently care for their patients. In regards to the final written deliverable report for SAOSM, I

headed up the organization of putting all the individual pieces together. I went through and read

all the parts and gave them a consistent voice and formatted them so the final report was

uniform. I took on the task of making sure our report was of the highest-quality personally. As I

stated before, our group worked towards our final results together. We felt that in order to best

serve SAOSM we should put all of our knowledge together, thus optimizing the quality of our

report.


25/25

25 | P

Conner L unsford

Harr ison Morris

Our group collaborated together on almost every aspect of this project. Every part of the project

was basically done together at our team meeting every Monday. We felt that by using our

collective knowledge we could give SAOSM a better product. Things that I have recentlyindividually completed are the bibliography of all cites visited and four challenges of

International Expansion for our company. Also I helped determine our competitors social media

strategies to compare with our down at SOASM, and input data into the Access tables. I also

helped complete much of the clients industries research by looking up the key performance

indicators of specialty doctors industries as well as looking up what stage in the industry life

cycle the industry is in. Our group did the majority of the work together as a team and helped

each other complete the individual parts of this project.

Combined Written Deliverable (1)

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