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11.8 Shared services > 11.8.1 Need for Centralization - Pg. 293

270 Butterworth Health System The multifunctionality will also give providers the capability and the possibility of designing and managing their practice in terms of afford- able and user-friendly packages and programs that are both accessible and relevant to the consumers. They will cooperate with the care sys- tem in the development and continuous improvement of generic mod- els, protocols, and procedures needed to manage the different aspects of HDS. While the core knowledge group is responsible for medical research and education, it will replicate the three-dimensional scheme to create its own special shared services. Shared services in this context will include physician's office management and provider recruiting and creden- tialing. 11.8 shared serVICes Shared services is the other component of the input dimension of the architecture. It will be the provider of specific services required for the proper functioning of the system as a whole. To ensure its proper function- ing, shared services will be designed with close attention to the issues sur- rounding centralization and decentralization, separation of service from control, and customer orientation. 11.8.1 need for Centralization Centralization will be avoided unless one or all of the following situations weigh overwhelmingly against decentralization of a particular service. unIForMITy The aspects of the system that will be centralized are those that are com- mon to all or some of the parts of Butterworth and cannot be left decen- tralized without rendering serious damage to the proper functioning of the system. In areas such as measurement systems and communications, where common language and coordination are of major importance, uni- formity will serve as the criterion for centralization. TECHnologICAl IMpErATIvES Certain technologies, which, because of their nature, are deemed indivisi- ble and therefore require a holistic design, can be centralized. For example, the effectiveness of a comprehensive information system is in its holism, consistency, real-time access, and proper networking to transfer informa- tion as needed to different users. Development of such a system requires cooperation and coordination among all the actors in the system. EConoMy oF SCAlE Although economy of scale is generally considered an important factor in the creation of shared services, the trade-offs between centralization and decentralization of each function should be made explicit to prove that