Outsourcing has been one of the most influential factors contributing to changes in information systems development in the last decade. The paper presents findings from an action research project of information systems development in an outsourcing context at a large university hospital in Denmark. The research, and general findings in the literature, indicates that the intended positive effects of outsourcing are hard to achieve without negative bi-products. Decision frameworks to guide the decision-making in this respect are evaluated based on the empirical findings. It is illustrated that the issues of flexibility and controllability are among the most important when an IT-department determines its outsourcing policies. Continuity issues are also important in understanding the relationship between buyer and seller in IS-acquisition as being more complex than in a simple market model.