<![CDATA[This study investigated the decision criteria guiding hospitals in formulating policies on insourcing or outsourcing their Hospital Information Systems (HIS). It examined how these decisions affect stakeholders' satisfaction, using perceived system usability as a proxy. This study adopted a sequential mixed-methods design involving qualitative site visits to six hospitals, followed by a quantitative survey of 80 HIS stakeholders. Findings from site visits indicated that performance, reliability, and quality were common decision criteria across sourcing strategies. Hospitals that insourced their HIS emphasized security, access, and control over source code and data, whereas those that outsourced prioritized maintainability, adherence to standards, and implementation time efficiency. Interestingly, regardless of sourcing strategy, cost was consistently ranked among the least important decision criteria, suggesting that HIS stakeholders prioritize system performance over budgetary considerations. Regarding the impact of sourcing decisions, insourced HIS achieved significantly higher usability scores than outsourced HIS, indicating greater stakeholder satisfaction. Overall, this study presented an integrated view of the criteria driving HIS sourcing policies and their implications for HIS stakeholder satisfaction.]]>
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