87. meditech part 5

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  • 1. H.I.S.-toryby Vince CiottiEpisode #87:Meditech Part 5 Which One Would You Buy in 1993? 2012 by H.I.S. Professionals, LLC, all rights reserved.

2. Big Win From 20 Years Ago We left off last week with an RFI from Brooks Memorial, a 200-bed hospital in upstate NY, being issued to the 10 leading HISvendors back in 1993 to see how Meditechbeat them so often. Before we wasted our time & their money flying in demo teamsto frozen Dunkirk NY (located near Anchorage), we reviewed theRFI results to determine which of the vendors were: Large &stable enough to last the expected 10 year life cycle Had a strong NY state presence to meet regulatory needs Were affordable, in terms of capital, operating and TCO Had clients of our bed size, apps, interfaces & conversionThe results are summarized in the table on the following page. If you dont recognize the acronyms for the vendors on thetoprow, then you didnt read last weeks episode that describedthem! You can find all these past episodes at hispros.com 3. 1993 Vendor RFI Responses Compu First Medi- CHC care DataGTEHBOHCS IBAX Keane tech SMSSDSYears inHIS biz212025 18182512202525 15Revenuein 000s$43,400 $23,200$200,000 $60,000 $280,000$10,000 $50,000$90,000 $92,300 $470,000 $14,000# ofFTEs260 2151,031222 1,814 755822441,1054,000 148Nearestoffice TexasVirginia N. Carolina Phila.Pitts. New JerseyFloridaNew York Mass.New Jersey Iowa# of US (Notclients4234 128 238188 provided) 200 15 10454 85NY stateClients 23 7 5 2169 10 31Hard- DG Aviion DECDG Aviion DECware HP, G309500 "Alpha" IBM AS/4005240IBM AS/400DEC 5000 DG or DEC 4000/AlphaCapitalCosts $984,624$1,124,604$650,750$904,991 $1,375,306$1,162,938 $1,496,000 $909,800 $1,335,000$950,000$824,082Opera-tingCost$131,516$104,052 $86,268$137,652 $126,325$178,553$125,880 $79,200$148,200$96,000 $77,7655 yearTCO$1,642,205 $1,644,864$1,082,090$1,593,251 $2,006,931$2,055,701 $2,125,400 $1,305,800 $2,076,000$1,430,000 $1,212,90610 YearTCO$2,299,787 $2,165,124$1,513,430$2,281,511 $2,638,556$2,948,464 $2,754,800 $1,701,800 $2,817,000$1,910,000 $1,601,730 4. Winnowing the Field We presented these RFI resultsto our selection committee, withthe caveats in red ink for those vendors with weak responses: smallannual revenue, minimal NY presence, etc. Meditechs only issuewas high capital costs, however CFO Ralph Webdale said he wouldgladly pay top dollar if they turned out to be the best system! So we next scheduled demos at Brooks for the 6 RFI winners,making each vendor follow the same agenda (1-2 hours per userdepartment) and grading each through a numeric checklist on: User-friendly GUI (or not), patient search,reports, security, flexibility, report writer, etc. The checklists also helped to guide the committee into evaluating the system, rather than just liking the demo dollie (or dude) with the nicest personality, so totally irrelevant after the sale! 5. Brooks Demo Results And here, 20 years later, are the results, which took afew thousand keystrokes to update from MS Works 1.0 to Excel 2012! As you can see, the highest score went to Meditech, but HBO and CHC did pretty well too. An no one really stunk, showing the committee that all modern systems beat their old SAINT Next we made phone calls to the top 3 vendors, but a lot different approach than the near-perfect 98.5 scores KLAS comes up with:- Ours were peer-to-peer: RN to RN, biller-to-biller, IT to IT, etc.- And not to flagship sites, but our bed size, state, version, etc.- And scored with another thorough checklist, with these results: 6. Telephone Reference Calls Meditech led again, but only a tad ahead of HBO. It waspoor CHC whos few users in NY state were only so-so Weve doneover HIS 150searches bynow, and ourphone scoresare about 70%,helping lowerend usersexpectations. The next step in our process hardly anyone ever does: look at theuser manuals before you buy! Paper binders were a pain to ship in93, but todays CDs and web sites are easily available. And you getmuch lower scores than on any RFP feature checklist response! 7. User Manual Review You sure dont get many 98.5 scoreshere either! Indeed, some up-and-coming vendors dont even have user doc They claim their systems are so user-friendly, no manuals are needed!? (tell that to an RN on the 3rd shift trying to help a physician figure out how to DC a med via CPOE) As you can see above, Meditech had superb user manuals back then,HBOs were pretty good, but CHC had a long way to go in this regard. So we pretty much had our two finalist vendors for the next steps: - Site visits, once again peer-to-peer, with no sales chaperones! - Detailed cost review, with over 10 pages per (poor) vendor - And concurrent contract negotiations (no VOC beforehand) 8. Contract Questionnaire As you figured out by now, we dont place much stock in an RFPFeature Checklist, defined as a Request For Prevarication. One checklist we do make vendors fill out is for contract Ts & Cs.Back in 1993, we had 25 items we drilled vendors on, such as: Sub-1-second system response times, or the vendor buys more hardware Veteran installers: 5 years in Healthcare, 2 with the vendor, 1 prior install By today, we have over 70 such nasty items on ARRA, ICD-10, etc. This is the one area where Meditechdid poorly, as illustrated on the right: The boys in Boston are just toughnegotiators, and we struggle to getthem togrant any concessions... At our next committee meeting, wesummed up all these scores & voted 9. Brooks Committee Vote Here is how Brooks 10 user departments ranked the 3 vendors;we inverted their ranking for scores so the highestscore wins: 3points to their first choice, 2 to runner up, and 1 for 3rd choice. CHCFDCHBOCMeditech Pharmacy 21 3 Data Processing12 3 Human Resources21 3 Radiology3 12 Medical Records 2 3 Nursing1.51.5 3 General Accounting 1.51.5 3 Laboratory 0.52 3 Nursing12 3 Patient Accounting 2 13 Totals:12.541329 No contest! Meditech just swept the vote except for Radiology(maybe they had a deeper view?). It was so overwhelming, Ralphcalled off the remaining steps in the process (site visits, etc.). 10. Meditech Recap So there you have it: how a handful of MIT grads formed a start- up HIS vendor that swept the small to mid-range hospital market! Strengths: Satisfied clients (functionality & support), TotalHIS (financial & clinical systems), low operating costs (12% oflicense fee/yr), and a stable management team/direction (noacquisitions, C-Suite change, nor 90-day Wall Street panic). Weaknesses: High capital costs (you getwhat you pay for?), proprietary data base(tough interfaces this ad is a lie!), androokie installers. Today, one might alsoquibble about multiple product lines Next week? We shift to the 6th ranking vendor oftoday: GE Healthcare, and their roots in anotherfrozen northland Burlington, Vermont. Any HISveterans who worked for Burlington DataProcessing please write: vciotti@hispros.com