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Electronic Medical Records (EMR) studies have broadly tested EMR use and outcomes, producing mixed and inconclusive results. This study carefully considers the healthcare delivery context and examines relevant mediating variables. We consider key characteristics of: 1) interdependence in healthcare delivery processes, 2) physician autonomy, and 3) the trend of hospital employment of physicians, and draw on theoretical perspectives in coordination, shared values, and agency to explain how the use of EMR can improve physicians’ performance. In order to examine the effects of physician employment on work practices in the hospital, we collected 583 data points from 302 hospitals in 47 states in the USA to test two models; one for employed and another for non-employed physicians. Results show that information sharing and shared values among healthcare delivery professionals fully mediate the relationship between EMR use and physicians’ performance. Next, physician employment determines which mediating variable constitutes the pathway from EMR use to physicians’ performance. Finally, we highlight the impact of shared values between the hospital and physicians in enhancing information sharing and physicians’ performance, extending studies of these behaviors among network partners in industrial settings. Overall our study shows that EMR use should be complemented by processual (information sharing), social (shared values) and structural (physician employment) mechanisms to yield positive effects on physicians’ performance.

Purpose – The purpose of this paper is to develop and illustrate a theoretically grounded framework capable of strategic guidance in making sourcing decisions. Design/methodology/approach – Based on literature review and secondary data from the US operation of 7-Eleven, a large international retailer, this study develops and supports a framework for understanding and undertaking business process sourcing decisions. The framework considers internal core competencies, as well as the role of external actors in value creation, in analyzing sourcing decisions for business processes. Findings – Case analysis reveals that a firm's successful sourcing decisions can be explained by resource based view (RBV) and value co-creation theories. RBV is shown to provide an internal view of the firm considering its core competencies, while value co-creation illuminates the external perspective considering the role of customers when making sourcing decisions. Further, these theories can be decomposed and simplified, thereby providing scholars with new theoretical insights for this phenomenon and practitioners with a decision-making tool for undertaking sourcing decisions. Originality/value – This paper explains in granular detail how effective outsourcing decisions can be made. It employs a rarely considered perspective by combining nascent literature from the value co-creation stream with established beliefs about RBV core competencies to make three contributions. First, it shows how sourcing decisions can be explained not only by the RBV perspective but also by the value co-creation view. Second, in considering the role of value co-creation with the customer, it introduces the perspective of the customer as a decision-making consideration for sourcing. Third, it provides practitioners with a sourcing decision-making tool.