Kridel says that about half of Ambient’s work is in the health care industry. Local clients include Medtronic and UnitedHealthcare. Virtelligence focuses more heavily in health care. Chaudhri also names Medtronic and UnitedHealthcare as clients, as well as Allina, Fairview, and North Memorial hospitals.

“We chose health care as our niche because, though it is highly regulated, it is not highly automated,” Chaudri says. Health care is “years behind” industries such as transportation and financial services in developing enterprise-level systems, he says, “so that’s where we see the growth now.”


First, Nail it Down

While U.S. companies no longer worry much about “sending American jobs overseas,” they do worry about “the reputation of projects failing in offshore environments,” as Wisniewski puts it.

And plenty can go wrong when an IT project is sent to a foreign country, despite the skills of the offshore workers involved. Language barriers, cultural differences, and sheer distance are all threats to clear communication—and communication is vital.

E-mail, phone calls, and videoconferencing can handle a lot of communication needs, but they can't get the entire job done.

Even if the only part of a software development project sent overseas is the coding—in Java or Microsoft .NET, for instance—a great deal of work is required on the front end to ensure that the specifications are crystal clear. Consultants agree that the best parts of a project to send offshore are those that can be very clearly defined and documented, and that are unlikely to change before the project is complete.

The worst kinds of work to send offshore are projects, or parts of projects, that are not yet fully nailed down or are difficult to document at all. “A lot of knowledge about [in-house] IT processes often exists in people’s heads,” Hults says. When a company wants to update or replace a legacy system, for instance, “they may not know why some particular coding was put in 15 years ago. If you have problems like that onshore, I guarantee they’ll only get worse if you move the project elsewhere. The group offshore will be even more confused, because at least you understand your business better than they do.”