BMJ Group decided to outsource the typesetting of its specialist journals to reduce costs and improve efficiency. An efficiency review found typesetting costs were high and turnaround times erratic. BMJ conducted an outsourcing review, selecting The Charlesworth Group in the UK to outsource journal typesetting while keeping the BMJ and Clinical Evidence in-house. The implementation involved transitioning over 4 months to the new system while maintaining quality. The outsourcing achieved the goals of reduced costs and improved processes while allowing BMJ to focus on its core business.