This document discusses different system acquisition strategies for health information systems, including custom development, packaged software, and outsourcing. Custom development allows flexibility but requires more resources while packaged software has faster implementation but may not meet all needs. Outsourcing reduces costs but loses control. The design phase focuses on selecting an acquisition strategy by gathering information from vendors and an organization's own IT through requests for proposals, quotes, or information. A matrix of alternatives and criteria is used to evaluate options and select the best strategy.