Jones Consulting, Inc.

Matthew Casciani Sarah Daniels Conner Lunsford Harrison Morris

November 12, 2013

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 continue to 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 expansion and 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 the productivity 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
Locally, in the U.S.
Key Performance Indicators The Specialist Practice Industry is directly affected by a few a major external components. One of which is the number of people with private healthcare insurance. More than half of the revenue in this industry is generated from private health insurance payments. Another key driver is federal funding for Medicare and Medicaid. This directly affects the price of services and increases the number of people that can utilize the practice. Also, the portion of the population that is 65 or older plays a large role in this industry. This older group of people makes up the majority 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 is expected 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 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Revenue $ million 186,202.8 201,850.1 212,724.2 220,966.6 229,207.4 243,440.1 253,450.9 259,344.1 262,153.0 269,704.9 274,261.7 283,525.8 Growth % 0.0 8.4 5.4 3.9 3.7 6.2 4.1 2.3 1.1 2.9 1.7 3.4

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Key Competitors South Arkansas Orthopedics & Sports Medicine (SAOSM) competes in the specialist practice sector. Domestically within the United States this industry is highly fragmented and operates on a local scale. The low level of concentration in this industry, due to high barriers to entry has led to a great dispersion in the revenue the sector generates. In fact The largest four firms are estimated to account for less than 4.0% of industry revenue, and only one provider is expected to generate more 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. Projections have the industry revenue growth to increase at nearly 6%, after which growth will hover around 4% growth per year. Another notable factor is that there is an expected spike in consumers who will 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 increasingly common chronic disease. As can be seen in the graph above, the industry took a turn for the worse during the recession, possibly due to less people owning health insurance as well as putting off primary care visits, yet still managed to grow. Currently demand for specialist practices 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 for the next 5 years.

Stage in Industry Life Cycle In the United States, the specialty doctors industry is in the growth stage of the life cycle. The industry is projected to increase 4.8% on average while the US economy is projected to only grow 2.1%. This means that the industry of specialty doctors will grow at a faster rate than the US economy, which is a key feature of a growth industry. Specialist doctors are enjoying a growing 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 the United States, because of the Baby Boomer generation, leads to an increase in the demand for specialty doctors. Also technological improvements have greatly helped this field of medicine by making it much more efficient. New technologies allow doctors to treat previously untreatable problems, and this allows them to treat a higher percentage of the population leading to revenue growth.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 a group practice. Normally this would indicate decline or maturity in the industry, but for specialist doctors this actually increases industry growth. Doctors are able to spread out costs and have less administrative 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 are government spending as well as disposable 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 the largest spending countries are the United States, Germany, and Canada. These countries spend 17.7%, 11.3%, and 11.2% of their GDP (gross domestic product) respectively. These countries naturally then have some of the largest healthcare systems in the world. The second indicator, disposable income, shows how available healthcare is to citizens. People who have low disposable incomes will defer spending money on medical care in favor of more practical expenses. Minor medical care such as flu vaccinations and yearly checkups will not be viable options for those with little disposable income.

Key Competitors On a global scale, there are three main competitors in the healthcare industry. Capio, which provides health care and diagnostic services and is based in Goteborg Sweden. HCA, which is located 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 surgery facilities, located in New South Wales.

Major Markets The Americas dominate the health care market with 49.9% of all healthcare revenue. The Americas are the largest healthcare provider followed by Europe with 28.8% of revenue, and the Asia-Pacific areas with 19.6%. Africa and the Middle East only account for 1.7%. Thus, health care is more prevalent in developed countries. African and Middle Eastern nations lack the infrastructure 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 European compound annual growth rate (CAGR) sitting at 3.4% and the Asia-Pacific (CAGR) sitting at 6.5%. Most business within the healthcare market revolves around outpatient care with 37.3% of the sector being outpatient care and 24.4% being inpatient care. This percentage is expected to increase 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 and the inability for companies to differentiate themselves. This has led to large-scale healthcare corporations 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 medical supplies. That being said, specialist medicine is not necessarily a global market. The point of the industry is that it provides excellent, cost-efficient care to local areas. In countries that have highly developed healthcare systems, specialist medicine is more likely to be available, however the largest market is still located in the United States with nearly half of the entire healthcare industry being contained within the Americas.

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Porters Five Forces Analysis

Industry: Specialist Doctors

Power

HIGH

LOW

Justify
The buying power of the specialty doctor industry is low because the supplies they utilize are so unique that they dont have a lot of options on where to purchase supplies. Also, location is critical because there are certain amenities that these doctors need in order to properly service their patients. The supplier power is high because in this industry the physicians specialize in one type of medicine. Also the concentration of suppliers in the 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 a specialty doctor there is no real and effective substitute for their services. Switching costs are high due to the development of a patient-doctor relationship and there are not a lot of options available when choosing a specialty doctor. This industry is highly differentiated because the physicians are specialized. The threat of substitutes is relatively low. Since the industry is so heavily reliant on doctor-patient relationships, buyers are extremely unlikely to search for alternative treatment centers or other medical practices even if the cost is lower. This means that the relative price/performance of substitutes is also a non-issue as customers will only switch if the cost is extremely high or the experience with a doctor is extraordinarily bad. Switching costs will also be high for any customers as the transferring of medical data and regulatory paperwork will slow down the process. Threats of new entrances into the Specialist Doctors industry are relatively low. It is difficult for new practices to join the industry due to a number of barriers including: the highly specialized and regulated nature of the field, the report you must build with clients, and the limited facilities available to such practices. Each of these components of a practice, take a great deal of time to develop. Although the industry is rather difficult to enter, the high number of small establishments suggests that the low levels of fixed costs and the strong demand for specialized doctors often compensates for many of these barriers. The rivalry among existing competitors is low. The price of visiting the doctor or getting a surgery is the same no matter where a patient will go. This reduces rivalry because the specialty doctors industry does not have price wars. Most specialty doctors establish strong relationships with their patients, and patients are loyal to their original doctor. Also keeping the same doctor is much easier than moving to a different physician making the switching cost high. Most specialty doctors work in established firms, which means the quality of their work, and patients wont switch to a different practice.

Buyer Power X

Supplier Power

Threat of Substitute Products or Services

Threat of New Entrants

Rivalry Among Existing Competitors

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Company Research
Background
Product/Service Description South Arkansas Orthopedics and Sports Medicine (SAOSM) is an orthopedic medical practice that has been serving the southern region of Arkansas for over 17 years. SAOSM offers an all in one experience for their patients. The office, surgery center, and physical therapy facility are all conveniently located in two side-by-side state-of-the-art buildings. The physicians are 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 care to 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.

Current Strategy
Niche Differentiation SAOSM is a specialized practice focusing on orthopedics. They provide their patients with expert care and quality results. The goal of SAOSM is to get the patient back on track to a healthy life. The convenience of having all the required amenities on site sets them apart from other 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, Checkin/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 its patients in a better capacity. This E-R diagram represents what Jones Consulting recommends be implemented, in order to preserve patient data integrity and to relate patient data to other aspects of the business.

Database Users
As SAOSM is a small specialty orthopedic business, there are two major departments that would benefit 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. Due to confidential patient data being stored on this database, only registered doctors and nurses will be able to access patient history; however, administrative staff will be able to edit nonconfidential information such as basic patient information and billing information. By allowing administrative 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 Business Intelligence Systems. We have come up with four possible systems that would be helpful for SAOSM. 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 in managing supply orders and staffing. Another suggestion would be to implement a system that would pull all appointment scheduled for the following day and send them an email reminder of their 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 allow patients more information on the front end of what they would be responsible for paying out of pocket. A final suggestion would be the use of system that tracked a patients physical therapy sessions. This would streamline communication between the doctors and the therapists, and would 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, 14 | P a g e

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.

Potential 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 time due to training of employees. Employees will need to be trained on how to properly use the new system. Fortunately, Act! provides training once purchased, however this will require either lost time during normal office hours or the need for additional hours at the end of the day. The second challenge involves the transfer of physical records to the new system. In order for SAOSM to function in its most efficient manner, all the existing charts and records will need to be 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 going to cost SAOSM upfront, in addition to periodic updates as time progresses, in order to maintain the functionality of the system. Also because Act! is not written specifically for SAOSM, there will be features that are not available. Such as a lack in contact features or integrated banking feature; 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 15 | P a g e

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 additional promotion 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 Media

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. Most large medical practices, as well as an increasing number of small practices, are switching their 16 | P a g e

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

Ideas
Jones Consulting has provided three unique options on how to implement these mobile applications and integrate them into current business procedures. The first option is a mobile application 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 as appropriate. The second option is a mobile application that allows easy access for doctors and nurses to patient records. This information would be accessible on tablets and smartphones and any changes 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 to users and inform them on whether they need to come in to see a physician. While these are three options 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 increase the usability and interconnectedness of their database by allowing doctors easy access to edit patient records.

Best Idea Functionality

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 will only be provided to approved doctors and nurses. These approved personnel will then have to log in using their user credentials in app. Once logged in, personnel can access the schedule for the day, 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 with SAOSMs database and make changes to patient records.

Benefits
SAOSM stands to receive multiple benefits by incorporating this mobile app into their business practices. 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 time patients spend in the office would also be reduced by implementing this mobile app. It also allows doctors to participate in difficult diagnoses, even if out of the office, thereby increasing diagnosis 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 the patient 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 optimal country 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.

IS 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 be the 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 culture is 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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Information 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 functionality needed, 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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Bibliography
References Adamski, & Finnegan (2011). Microsoft Access 2010. New Perspectives Series- Comprehensive with DVD Video Companion. Boston , MA: Cengage. Advanced Orthopaedic Association -- Wichita, KS. (n.d.). Advanced Orthopaedic Association -Wichita, KS. Retrieved November 6, 2013, from http://www.aoaortho.com/ CRM Software Review. (n.d.). 2014. Retrieved November 6, 2013, from http://crm-softwarereview.toptenreviews.com/ CRM from Salesforce.com - Customer Relationship Management. (n.d.). Salesforce.com. Retrieved November 6, 2013, from https://www.salesforce.com/crm/ ERP Software Selections. (n.d.). ERP Software Selection Help. Retrieved November 6, 2013, from http://erpselectionhelp.com/top-10-erp-solutions/ Kroenke, D. (2013). Experiencing Mis + Mymislab With Pearson Etext Access Card. Pearson College Div. Orthopaedic research reveals trends in practices. (2013, July 9). Andrews Institute for Orthopaedics & Sports Medicine. Retrieved November 6, 2013, from http://www.theandrewsinstitute.com/News/Research/Article.aspx?id=468061 South Arkansas Orthopaedics & Sports Medicine - About Us. (n.d.). South Arkansas Orthopaedics & Sports Medicine - About Us. Retrieved November 6, 2013, from http://southarkortho.com/about_us.html Specialist Doctors in the US. (n.d.). IBIS World. Retrieved November 6, 2013, from http://clients1.ibisworld.com/reports/us/industry/default.aspx?entid=1555 Vogelsong, J. (2012, October 26). Central Penn Business Journal. Aging population adds booming business for orthopedic surgeons in midstate. Retrieved November 6, 2013, from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=d308afb9-112e-45ce8ce6-49ab1ed4078a%40sessionmgr15&vid=5&hid=20 We're excited. (n.d.). Contact & Customer Relationship Management (CRM) Software. Retrieved November 6, 2013, from http://www.act.com/

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Implementation Review
Matthew Casciani

Sarah Daniels
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 detail and 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.

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Conner Lunsford

Harrison 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 recently individually 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.

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