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Enterprise Resource Planning (ERP) Implementation in an Egyptian Healthcare Entity: motives and expected impacts Ahmed A. Fares*and Mohamed M. Mandour Department of Accounting, Alexandria University, Alexandria, Egypt *Corresponding Author: [email protected] ABSTRACT Understanding the motives and the impacts of Enterprise Resource Planning (ERP) systems is an important issue for ERP customization process as well as for the evaluation process of such investment. This research aims to investigate the motives and the expected impacts of ERP implementation in an Egyptian healthcare entity using case study research method. We investigated motives according to six groups of motives labeled managerial-operational, managerial-strategic, clinical-operational, clinical-strategic, technological, and financial motives. Five categories for the impacts of ERP implementation were also proposed, including technology, people, process, patient, and financial. The results indicate that managerial-operational and clinicaloperational are important groups of motives. Furthermore, the impacts of ERP system on people is the highest compared to other impact categories. Keywords: ERP, Motives, Impacts, Healthcare, Egypt

1. Introduction Enterprise Resource Planning (ERP) system is an information system consists of an integrated package of modules through a common database for specific functions. The system is designed using the best practices approach. It remains the important technological tool in today working environment for two reasons: firstly, the type of integration that the entities have among business processes, people, and technology. Secondly, ERP system is mainly a transactional oriented system (Vakalfotis, Ballantine, & Wall, 2011), Which means it represents the technological platform for any other enterprise systems such as supply chain management (SCM) and customer relationship management (CRM). The advantages of the ERP systems lead to wide implementation of the systems in almost all business sectors especially manufacturing sector (Botta-Genoulaza & Milletb, 2006). As a result, there is a great concern from scholars and vendors to understand and investigate the value beyond the investment in ERP systems. On the other hand, there is an increase in the role of service sector in modern economies. One of the most expanding service industries is healthcare, which gains its importance because of its socio-economic impact on all aspects of life. Extant literature have found evidence that adopting ERP systems by healthcare entities result in better organization of the processes, integration of all administrative functions into a single system, improved quality of operations, and ability to trace information in the whole system (Botta-Genoulaza & Milletb, 2006; Trimmer, Pumphrey, & Wiggins, 2002). The authors acknowledge the valuable comments made by Dr. Ismail I. Gomaa, Professor of Accounting at Alexandria University, on an earlier draft of this paper.

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The aim of this research is to investigate the motives as well as the expected impacts of ERP implementation in a healthcare entity in Egypt as a developing country using case study research method. This research argues that clear understanding of the motives and the impacts of ERP systems will lead vendors to perfectly customize the system to fit the needs of the healthcare units. From the healthcare units‟ perspective, such knowledge may be used in defining its preliminary needs for the investment process in ERP systems. The remainder of this paper is organized as follows: Section 2 covers the literature review and the theoretical foundation of the research. The research design is described in Section 3. Analysis and discussion of the results are presented in Section 4. Finally, Section 5 includes concluding remarks.

2. Theoretical Foundation Allocating scarce resources among different investments is based on the value that the entities expect to realize as a result of the investment decision. But, defining and measuring the value of information systems in general is a challenge particularly in the case of ERP systems (Koha, Gunasekaranb, & Rajkumarc, 2008). This fact can be explained by the complex nature of the ERP systems; as an integrated system, a process oriented system, a customized system, and, most importantly, it will put entities in a continuous change (Davenport, Harris, & Cantrell, 2004). It should be clear that motives or impacts of ERP systems are about the same thing, value. Despite that, these are two streams in literature dealing with the motives beyond the adoption of ERP systems, and the impact of the implementation of such systems.

2.1 Motives beyond ERP systems: Motives are what entities expect from the ERP systems based on their needs. Many methods were used to classify these motives. Trimmer et al. (2002) tested the classification method to technology motivations and operational motivations that identified by Sandoe, Corbitt, and Boykin (2001) in two rural hospitals. Technology motivations include system not Y2K compliant, disparate systems, poor quality/visibility of information, business process or systems not integrated, difficult to integrate acquisitions, obsolete systems, and inability to support growth. Whereas, operational motivations include poor or uncompetitive business performance, cost structure to high, not responsive enough to customers or suppliers, complex and ineffective business process, inability to support new business strategies, business becoming global, and inconsistent business processes. They identified the importance of all motives except Y2K motive. This method of classification limited the results of ERP systems in healthcare entities. Therefore, Kamhawi (2008) added two more categories of motives named strategic and decision making and based on testing this method in Bahrain the four groups of motives were perceived to be high. In further classification method, Poba-Nzaou, Uwizeyemungu, Raymond, & Paré (2012) tried to classify the motives depending on the analysis of 180 successful stories of ERP systems in healthcare entities that were published on the vendors‟ websites. The analysis of these online stories reveals six groups of categories named Managerial-operational, Managerial-strategic, Clinical-operational, Clinical-strategic, Technological, and Financial. In further cluster analysis the motives underlying ERP

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systems were classified according to three clusters named Business view, Clinical view, and Institutional view. The interesting result was that approximately half of the sample (51%) was explained to implement the ERP systems under institutional view which emphasizes the importance of context when considering the motives of the ERP systems “in terms of external or environmental pressures rather than rational decisions by top management”. The above evidence identifies specific set of motives for ERP systems in healthcare sector. Moreover, motives are expected to differ among healthcare entities based on the environment where they operate. Therefore, there is a need to get inside the Egyptian case to realize how it could differ. This discussion raises the question of why Egyptian healthcare entities implement ERP systems?

2.2 Impacts of ERP systems: Impacts of ERP systems are what entities realized as a result of the implementation. The major concern, as every traditional IT investment, was to measure the financial impacts of ERP systems. This relationship is known as the direct relationship (Dehning & Richardson, 2002). A huge amount of research came in that regard. Many entities realized positive market reaction once announce of ERP systems investment (Benco & Prather, 2008; Hayes, Hunton, & Reck, 2001). While others obtained positive actual abnormal returns in the five years after the implementation (Morris, 2011) or as predicted by financial analysts (Hunton, McEwen, & Wier, 2002). In healthcare sector, however, the impacts of ERP systems came in terms of benefits. Botta-Genoulaza & Milletb (2006) reported benefits result from ERP systems such as integration of all administrative functions, improved quality of operations, software reliability, and ability to trace information in the whole system. Also, they attributed the benefits of the ERP systems because of the change of processes. Additionally, achieve better management for the deterministic processes in hospitals (Merode, Groothuis, & Hasman, 2004) and better compliance with HIPAA (Health Insurance Portability and Accountability) law (Pumphrey, Trimmer, & Beachboard, 2007). Furthermore, successful implementation of the business processes reengineering (Huq & Martin, 2006). There is little known about specific methods that help in defining the impacts of the ERP systems in healthcare sector particularly. Hence, another question needs to be answered in this research which is related to how ERP systems affect Egyptian healthcare entities?

3. Method The research method used in this research is the case study. Case study research method is the relevant research method to investigate the research questions in the why? and how? forms (Yin, 2003). Moreover, it represents the appropriate way to study the complex organizational processes that include changing in business processes or implementing new information systems (Bhattacherjee, 2012). It gives researchers more advantages over other research methods; it helps researchers to study the phenomenon under investigation in a more realistic context rather than an

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artificial one, the researchers have the ability to collect and analyze both quantitative as well as qualitative data (Yin, 2003), and having the opportunity to include different levels of analysis such as individual level or organizational level (Bhattacherjee, 2012). Despite that, there are limitations naturally related with the case study research method. These limitations are mainly about the subjectivity issue and external validity (Bhattacherjee, 2012; Yin, 2003). However, there are certain ways to reduce the subjectivity issue and the purpose of the study can be better understanding and collecting new evidence in specific context rather than external generalizability.

3.1 Case Study Selection: An Egyptian healthcare entity implementing the ERP system was selected for the purpose of this study. The system was provided by a local vendor in a customized form for healthcare entity called MYLINE. The case was applicable to investigate the two research questions. A pilot study identified the team who is responsible for the implementation process. The team consisted of five persons; Medical Module Administrator (MMA), Human Resources Module Administrator (HRMA), Accounting Module Administrator (AMA), Project Manager (PM), and Information Technology Manager (ITM). The vendor‟s point of view represented by MMA, HRMA, AMA, and PM. On the other hand, the entity‟s point of view was represented solely by ITM. Beyond the two points of view, richness of evidence lies in terms of “Data Triangulation” (Sekaran & Bougie, 2009). Furthermore, the vendor‟s perspective is the result of applying the ERP system in different healthcare entities in Egypt. Additionally, realizing the vendor‟s perception of the motives and the impacts of ERP systems in healthcare entities will help more when the Egyptian vendors move from the system as a product (SAAP) to the system as a service (SAAS) using the cloud computing capabilities.

3.2 Data Collection Methods: Semi-structured interviews and questionnaire were used as the two data collection methods in the study. The objective beyond the two methods is to realize the power of “Method Triangulation” (Sekaran & Bougie, 2009).The description of the interviews is presented in Table 1. The two research questions were the dimensions of the interviews. Then, to minimize the “Biased” interpretation of the qualitative data out of the interviews, member checking method was used (Swanbron, 2010), checking the result with the interviewees. Interview results were delivered for each interviewee via e-mail accompanied with a questionnaire targeting to test the most frequently cited motives of ERP systems as reported by Poba-Nzaou et al. (2012). We obtained a full acceptance of the results through individual phone calls with each one of the interviewees. Then, only three interviewees sent the questionnaire back via e-mail. As a result, we tested the first research question about the motives through interviews and questionnaire. Whereas, the second research question about the impacts was tested solely through interviews.

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Table 1: Interviews Description: Number 1 2 3 4 5

Interviewees Medical Module Administrator (MMA) Human Resources Module Administrator (HRMA) Accounting Module Administrator (AMA) General Manager (GM) Information Technology Manager (ITM)

Time 25 m. 38 m. 19 m. 16 m. 49 m.

3.4 Data Analysis Methods: We used two methods to analyze the data. Firstly, we used content analysis to analyze the qualitative data in the interviews‟ transcript. The first step was to select the coding unit (Sekaran & Bougie, 2009), we identified the “Theme” as the coding unit, any unit of the text hold one single theme. The next step was the categorization process, assigning the coding unit for categories. We analyzed the first research question using categories developed in literature and labeled Managerial-operational, Managerialstrategic, Clinical-operational, Clinical-strategic, Technological, and Financial (PobaNzaou et al., 2012). Then, we analyzed the second research question using five categories named Technology, People, Process, Patient, and Financial. We developed these categories based on the local vendor‟s philosophy in defining the impacts of ERP system in healthcare entities. Secondly, we used Likert scale with seven degrees (1: strongly disagree, 7: strongly agree) to test the importance of each motive. The motives were presented in a questionnaire for each one of the interviewees (see appendix A). We analyzed the data using the median, maximum, and minimum value for each one of motives.

4. Results 4.1 Motives of ERP system: Based on the content analysis, we found the importance of Managerial-operational group of motives as well as clinical-operational group of motives to be high among other groups. These two groups of motives are presented in Table 2. Also, the quantitative method confirms the importance of the two groups of motives but identified the Managerial-operational motives to be higher than Clinical-operational motives as presented in Table 3 and Table 4 respectively. Moreover, „Improve human resources management performance” is the highest Managerial-operational motive with Median=7, Minimum=7, and Maximum=7. Based on the content analysis, we identified only one motive for other groups of motives. Enhance the decision making process was the only Managerial-strategic motive “Increase the velocity of work and providing accurate data for the decision making process are common objectives in all of our projects” MMA, “Without having ERP system we can’t have reports for a specific patient or a specific doctor in a specific period of time that will help us in making decisions … with the existence of the data we can take any sort of decisions” ITM.

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Table 2: Important motives of ERP system in healthcare entities Categories Managerialoperational

Clinicaloperational

Motives Having patients‟ records.

Respective statements “Hospitals implement ERP systems to have patients’ records” HRMA. Data storage and security. “ERP system store huge data and less exposed for manipulation or missing and these are main merits for patients’ records” HRMA. Improve administrative data and “ERP system connects and information accuracy and coordinates functions and relevance. machines to boost data accuracy level in different medical reports” PM. Achieve business process “ERP system is the integration of integration. all business” HRMA. “Accounting departments in hospitals are in isolated islands… But when entities have ERP system the data is gathered at one time which reduce errors and reduce the time needed for tasks” AMA. Improve working environment “To set friendly environment for and save employees‟ efforts. employees in healthcare units and ease the work … We can save great efforts for employees” MMA. Improve the effectiveness and “What distinguishes hospitals efficiency of care provided to from other service entities is its patients. sensitive service for patients’ life. This service should be implemented accurately and precisely presented” HRMA. “To have fast execution, accurate implementation, and precise results” MMA. Facilitate access to clinical “Employees and therapists can information. access the data in any time through the system” MMA. “The doctor needs to check the medical history for the patient” PM. Enhance the preservation of “Because patients’ data should be patients‟ privacy. stored in a secret place and no one can access it without permission” MMA.

MMA: Medical Module Administrator, HRMA: Human Resources Module Administrator, AMA: Accounting Module Administrator, PM: Project Manager.

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Table 3: Managerial-operational group of motives

Valid Missing Median Minimum Maximum N

Managerial- Managerial- Managerial- Managerial- Managerialoperational operational operational operational operational (1) (2) (3) (4) (5) 3 3 3 3 3 0 0 0 0 0 7.00 7.00 7.00 7.00 7.00 6 6 7 6 6 7 7 7 7 7

1: Improve administrative processes effectiveness, 2: Improve administrative information availability and accessibility, 3: Improve human resources management performance, 4: Improve administrative data and information accuracy and relevance, 5: Search for business process integration.

Table 4 Clinical-operational group of motives ClinicalClinicaloperational operational (1) (2) Valid 3 3 N Missing 0 0 Median 6.00 5.00 Minimum 6 5 Maximum 7 7

Clinicaloperational (3) 3 0 7.00 5 7

Clinicaloperational (4)

Clinicaloperational (5)

3 0 7.00 6 7

1: Improve the effectiveness and efficiency of care provided to patients, 2: Improve clinical processes effectiveness, 3: Facilitate access to clinical information, 4: Improve patient safety, 5: Enhance the preservation of patients‟ privacy.

Eliminating data redundancy was the only technological motive “Only one person is responsible for the transactions data entry” AMA, while Enhance or monitor profitability and return on investment was the only financial motive “To take the purchasing order we need first to identify the expected number of patients that will use the new service and the period of time needed for investment returns” ITM. Furthermore, we didn‟t obtain any Clinical-strategic motive underlying the ERP system. On the other hand, we confirm the importance of enhancing the decision making process as the highest important motive among Managerial-strategic group of motives as presented in Table 5 with Median=7, Minimum=7, and Maximum=7. Also, all of the financial motives are perceived to be high as presented in table 6. In addition, the project manager added, in the interview, a motive concerning the realization of vendor‟s experiences as a result of applying the system in other healthcare entities “Having an ERP system implemented in 50 healthcare entities previously for example, these experiences will be available for the new entity” PM. Also, the human resources module administrator added, in the questionnaire, the motive of using the system to obtain ISO 9001 certificate (one of the quality certificates of the International Standards Organization).

3 0 6.00 5 7

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Table 5: Managerial-strategic group of motives

Valid Missing Median Minimum Maximum N

Managerial- Managerial- Managerial- Managerial- ManagerialStrategic (1) Strategic (2) Strategic (3) Strategic (4) Strategic (5) 3 3 3 3 3 0 0 0 0 0 7.00 6.00 6.00 7.00 7.00 5 3 6 6 7 7 7 7 7 7

1: Leverage the ERP system to improve management capabilities, 2: Leverage the ERP system to enhance compliance with laws and regulations, 3: Leverage the ERP system to support organizational growth and expansion, 4: Leverage the ERP system to facilitate connectivity with major stakeholders, 5: Leverage the ERP system to improve decision-making processes.

Table 6: Financial group of motives Financial (1) Financial (2)

N

Valid Missing

Median Minimum Maximum

3 0 7.00 7 7

3 0 7.00 7 7

Financial (3) 3 0 7.00 4 7

1: Monitor cost trends, 2: Enhance or monitor profitability and return on investment, 3: Improve financial transparency.

4.2 Impacts of ERP system: In this level of analysis, we indicated many factors underlying four of the proposed five dimensions of ERP impacts in healthcare entities. We perceived the people dimension to have the first priority among other dimension and the only mentioned factor underlying technology impacts came in that regard as to improve information system productivity in reports concerning human resources “Before the system there wasn’t any report about human resources, there were reports just about revenues, expenses, and investments” HRMA. These impacts are presented in Table 7.

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Table 7: Impacts of ERP system in healthcare entities Dimensions People.

Impacts Save employees‟ efforts.

“With the existence of the system the accountant has to entre just two things: the asset name and the expected price for selling and he will get automatically the asset’s depreciation and the capital profit or loss. But in the manual system he had to count many formulas to get that results” AMA.

Good understanding of the work flow and the role of each employee.

“The system has an impact on the employees in defining the correct work flow in their mind and identifying the role and the duties of each one of them. The final result will be better performance for the healthcare entity and high quality of employees as well” MMA. “In the electronic system there is identification for the one who responsible for the data entry and the one who responsible for the information assurance and the one who responsible for the information presentation” ITM. “The role of HR module is to present information to direct the decisions for human resources development” HRMA. “When the employee gets the English language course, they become qualified to treat with customer which in turn make them feel that they become important elements in organization and become more loyal for the organization” HRMA. “ERP system will improve the skills as well as the capabilities of the human resources” PM. “In some cases there will be a reducing in employees numbers in specific functions while in others there will be new functions that enhance the quality of the service” PM. “Another point is the control; through the system the financial manager can check the balance of the cash at any time in any place throughout the entity” AMA. “ERP system helps in eliminating previous errors in recording the

Human resources development. Increase the employees‟ loyalty for the healthcare entity.

Improve the capacity of the human resources. Efficiently manage the human resources.

Financial.

Respective Statements

Achieve financial control.

Eliminate accounting errors.

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Monitor cost trends.

Efficiently manage inventory balances.

Process.

Process integration.

Process standardization.

Effectively manage business processes. Patient.

Patients‟ data availability, accessibility, and storage.

Reduce the time needed for patient services. Patient satisfaction.

services on the patients as well as the problem of unmatched balances” AMA. “The system helps in identifying the inventory balance of any item as well as the depreciation rates” MMA. “The ERP system facilitates the efficient inventory management and periodically renew the medical supplies after the expiry date” PM. “We need to customize the ERP system to be implemented in an integrated manner in all departments in the healthcare entities” ITM. “The entity can never achieve that without having a specific standard for each business process” PM. “Hospital is one of the entities that have various functions and there are no specific procedures tell you how to implement” ITM. “Entities need to manage its business processes entirely to achieve its goals” PM. “Once the patient registration process ended, the patient’s data will be available for all users and the accessibility for them will be available through the user name and password, It will be saved and never lose” MMA. “Patients get payment service in fifteen minutes for example” MMA. “Entity needs to manage its processes and achieve quality standards to obtain patient satisfaction” PM.

MMA: Medical Module Administrator, HRMA: Human Resources Module Administrator, AMA: Accounting Module Administrator, PM: Project Manager, ITM: Information Technology Manager.

5. Conclusion The results of this research show that the motives and impact of ERP system implementation in an Egyptian healthcare unit are consistent with the evidence provided by other research conducted in western countries (e.g., Botta-Genoulaza & Milletb, 2006; Trimmer et al., 2002). The results show that strategic motives are not important except for the motive of enhancing the decision making process similar to the evidence provided in Bahrain (Kamhawi, 2008). Yet, the Egyptian case did not realize the technological as well as the strategic capabilities of ERP systems. Therefore, the Egyptian context truly affects the motives of ERP systems in healthcare entities similar to Poba-Nzaou et al., (2012) study. Even though, the main characteristics of four dimensions of the proposed impacts of ERP were obtained

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especially in the impacts of ERP system on people. Furthermore, the results reveal the essential characteristics of the business processes in the ERP systems domain in terms of the process integration as well as the process standardization. Also, we obtained impacts of the ERP systems on patients and we claim that understanding and defining these impacts will help the Egyptian entities when considering the patients as systems‟ users. Future research is needed to retest the proposed dimensions of ERP systems‟ impacts. In summary, we tested the motives and the impacts of ERP systems in an Egyptian healthcare entity. We proposed five categories to define the impacts of ERP systems. The Egyptian case identified the ERP system as an operational tool for the entity in terms of the Managerial-operational group of motives and Clinical-operational group of motives. Moreover, the impacts of ERP system on people is the highest impacts compare to other impacts. Although the results of this study cannot be generalized due to the limitation of the case study method, it provides evidence on the motives and impacts of ERP system implementation in a healthcare unit in Egypt. Further research might extend the analysis to other settings using different research methods.

Acknowledgment This research is based on a MSc thesis by Ahmed A. Fares under the supervision of Professor Ismail I. Gomaa and Dr. Mohamed M. Mandour. REFERENCES Benco, D. C., & Prather, L. 2008. Market reaction to announcements to invest in ERP systems. Quarterly Journal of Finance and Accounting, 145-169. Bhattacherjee, A. 2012. Social Science Research: principles, methods, and practices: USF Tampa Bay Open Access Textbooks Collection. Botta-Genoulaza, V., & Milletb, P.-A. 2006. An investigation into the use of ERP systems in the service sector. International Journal of Production Economics, 99 (1-2), 202-221. Davenport, T. H., Harris, J. G., & Cantrell, S. 2004. Enterprise systems and ongoing process change. Business Process Management Journal, 10 (1), 16-26. Dehning, B., & Richardson, V. J. 2002. Returns on Investments in Information Technology: A Research Synthesis. Journal of Information Systems, 16 (1), 730. Hayes, D. C., Hunton, J. E., & Reck, J. L. 2001. Market Reactions to ERP Implementation Announcements. Journal of Information Systems, 15 (1), 318. Hunton, J. E., McEwen, R. A., & Wier, B. 2002. The Reaction of Financial Analysts to Enterprise Resource Planning (ERP) Implementation Plans. Journal of Information systems, 16 (1), 31-40. Huq, Z., & Martin, T. N. 2006. The recovery of BPR implementation through an ERP approach. Business Process Management Journal, 12 (5), 576-587. Kamhawi, E. M. 2008. Enterprise resource-planning systems adoption in Bahrain: motives, benefits, and barriers. Journal of Enterprise Information Management, 21 (3), 310-334.

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Koha, S. C. L., Gunasekaranb, A., & Rajkumarc, D. 2008. ERP II: The involvement, benefits and impediments of collaborative information sharing. International Journal of Production Economics, 113 (1), 245-268. Merode, G. G. v., Groothuis, S., & Hasman, A. 2004. Enterprise resource planning for hospitals. International Journal of Medical Informatics, 73 (6), 493-501. Morris, J. J. 2011. Measuring The Impact Of Enterprise Resource Planning (ERP) Systems On Shareholder Value. Review of Business Information Systems (RBIS), 15 (1). Poba-Nzaou, P., Uwizeyemungu, S., Raymond, L., & Paré, G. 2012. Motivations underlying the adoption of ERP systems in healthcare organizations: Insights from online stories. Information Systems Frontiers, 1-15. doi: 10.1007/s10796-012-9361-1 Pumphrey, L., Trimmer, K., & Beachboard, J. 2007. Enterprise resource planning systems and HIPAA compliance. Research in Healthcare Financial Management, 11 (10), 57-75. Sekaran, U., & Bougie, R. 2009. Research Methods for Business A skill Building Approach (Fifth ed.): Wiley. Swanbron, P. G. 2010. Case Study Research What, Why, and How? : SAGE. Trimmer, K. J., Pumphrey, L. D., & Wiggins, C. 2002. ERP implementation in rural health care. Journal of Management in Medicine, 16 (2-3), 113-132. Vakalfotis, N., Ballantine, J., & Wall, A. 2011. A Literature Review on the Impact of Enterprise Systems on Management Accounting. Paper presented at the International Conference on Enterprise Systems, Accounting and Logistics, Thassos Island, Greece. Yin, R. K. 2003. Case Study Research (3 ed.): Sage Publication.

APPENDIX (A) Questionnaire items (Likert scale: 1=strongly disagree, 2= disagree, 3= somewhat disagree, 4= neutral, 5=somewhat agree, 6=agree, to 7=strongly disagree) Categories Technological.

Managerialoperational.

Items 1. One of the motives underlying ERP implementation is to search for IT integration. 2. One of the motives underlying ERP implementation is to improve IT infrastructure capabilities. 3. One of the motives underlying ERP implementation is to modernize the IS/IT system. 4. One of the motives underlying ERP implementation is to improve IS/IT productivity. 1. One of the motives underlying ERP implementation is to improve administrative processes effectiveness. 2. One of the motives underlying ERP implementation is to improve administrative information availability and accessibility. 3. One of the motives underlying ERP implementation is to improve human resources management performance.

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Clinicaloperational.

Managerialstrategic.

Clinical-strategic.

Financial.

4. One of the motives underlying ERP implementation is to improve administrative data and information accuracy and relevance. 5. One of the motives underlying ERP implementation is to Search for business process integration. 1. One of the motives underlying ERP implementation is to improve the effectiveness and efficiency of care provided to patients. 2. One of the motives underlying ERP implementation is to improve clinical processes effectiveness. 3. One of the motives underlying ERP implementation is to facilitate access to clinical information. 4. One of the motives underlying ERP implementation is to improve patient safety. 5. One of the motives underlying ERP implementation is to enhance the preservation of patients‟ privacy. 1. One of the motives underlying ERP implementation is to leverage the ERP system to improve management capabilities. 2. One of the motives underlying ERP implementation is to leverage the ERP system to enhance compliance with laws and regulations. 3. One of the motives underlying ERP implementation is to leverage the ERP system to support organizational growth and expansion. 4. One of the motives underlying ERP implementation is to leverage the ERP system to facilitate connectivity with major stakeholders. 5. One of the motives underlying ERP implementation is to leverage the ERP system to improve decision-making processes. 1. One of the motives underlying ERP implementation is to use the ERP system to strengthen current or achieve new clinical positioning. 2. One of the motives underlying ERP implementation is to leverage the ERP system to transform care delivery and respond to changing needs. 3. One of the motives underlying ERP implementation is to leverage the ERP system to improve clinical performance management capabilities. 4. One of the motives underlying ERP implementation is to use the ERP system as an opportunity to implement patient safety culture. 1. One of the motives underlying ERP implementation is to monitor cost trends. 2. One of the motives underlying ERP implementation is to enhance or monitor profitability and return on investment. 3. One of the motives underlying ERP implementation is to improve financial transparency.

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This is how to cite the paper: Fares, A. A., & Mandour, M. M. (2014). Enterprise Resource Planning (ERP) Implementation in an Egyptian Healthcare Entity: motives and expected impacts. Paper presented at the e-CASE & e-Tech 2014 - Fall Session Tokyo, Japan.