1.3.3 vendor selection handouts ppt

HIT Toolkit

Understanding the Marketplace and Vendor Selection

Sponsors:

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• Sponsored by Aging Services of Minnesota and its subsidiary, Alliance Purchasing for nursing homes

• Produced by Stratis Health

HIT Toolkit for Nursing Homes

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• Margret AmatayakulRHIA, CHPS, CPHIT, CPEHR, FHIMSS

President, Margret\A Consulting, LLC Schaumburg, IL

• Independent information management and systems consultant, who focuses on achieving value from electronic health records, HIPAA, and health information exchange

• Adjunct faculty College of St. Scholastica, Duluth, MN, masters program in health informatics

• Founder and former executive director Computer-based Patient Record Institute, associate executive director AHIMA, associate professor University of Illinois

• Active participant in standards development, HIMSS BOD, and co-founder of and faculty for Health IT Certification

Presenter

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Stratis Health● Stratis Health is a nonprofit organization that leads

collaboration and innovation in health care quality and safety, and serves as a trusted expert in facilitating improvement for people and communities

● Stratis Health works toward its mission through initiatives funded by federal and state government contracts, and community and foundation grants, including serving as Minnesota’s Medicare Quality Improvement Organization (QIO)

● Stratis Health operates the Health Information Technology Services Center for health care organizations seeking to use health information technology in support of their clinical transformation

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• What are you buying?• Vendor state of affairs• CCHIT certification• Requirements analysis

• Going to market with request for proposal• Due diligence• Key differentiators• Contracting

Agenda

HIT Migration Path: What Are You Buying?

Timeline Current Phase I Phase II Phase N

Goals Support documentation

Patient safety Quality of care

Applications:- Financial/

Administrative- Operational

- Clinical

ADT/CensusAccountingPayroll/T&ALaboratory IS Provider Portal

MDS

Order Entry w/e-RxEMAR

AssessmentsCare PlansExecutive Dashboard

Technology- Database- Network &

Infrastructure- Interfaces

DOS-basedDSL for Internet

T1

Data RepositoryWindows XPNCPDP Interface with O/E and SureScripts

Operations- People- Policy- Process

IS contractor Project ManagerNo Lab PrintoutsProcess Redesign

IT staffHL7 ComplianceRetail Pharmacy Readiness?

Data AnalystClinical Guidelines

Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.

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Reality for Many Nursing Homes

• Buy from incumbent– What incumbent offers

• Or – Depend on standalone systems– Utilize expensive interfaces– Wait for the vendor to catch up

• If part of corporate structure– Take what you get– But hopefully address the people, policy, and process issues well

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Vendor State of Affairs/CCHIT(Certification Commission for Health Information Technology)

0

50

100

150

200

250

1995 1997 1999 2003 2008A 2008H LTC

# EHRvendorsw/same name as previous year on annual EHR market survey

Total Number of Ambulatory EHR VendorsCCHITEstimates 24 AcuteCare EHRVendors

CCHITCertified

CCHIT Certified

LTC # Vendors*20052008No CCHITCertification

Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.

* Provider

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CCHIT 2007 Hospital Certification

RadiologyLab InpatientPharmacy

CPOEClinicalDocumentation EMAR Results

ManagementReporting

Imaging

BloodBank

Dietary/Nutrition

MedicineDispensing

DevicesRobotics

Smart Infusion Pumps

MonitoringEquipment

“Smart” Peripherals

Departmental Clinical Applications

Core Clinical Applications

IntensiveCare

Perioperative/Surgical

Cardiology OncologyEmergencyMedicine

Labor &Delivery

Specialty Clinical Applications

EHR FoundationR-ADT, Order Communication

Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.

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Goal to Provide to CCHIT

180 pages of functional requirements

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Requirements Analysis• Work flow and process

mapping• Scenario development• Use case analysis

• Performance-based RFP• Due diligence• Contract• System build• Testing• Training• Benefits realization Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.

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Going to Market• Goal is to ultimately narrow the

field to your vendor of choice• Initial canvass of marketplace

– Trade publications

– Trade shows

– Association colleagues

– Vendors implemented in community

– Online demos

• Use a code of conduct to remove any bias from process

Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.

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Request for Proposal• Document to request detailed

information about – Vendor– Suite of products– Product functionality– Technical requirements– Implementation, testing,

and training strategies– Contractual considerations– Formal bid

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Due Diligence

• Investigation into the elements of a major investment

• For HIT and EHR– RFP response analysis– Product demonstrations– Site visits– Reference checks– Corporate analysis

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RFP Analysis

1. Develop a key differentiator tool* to focus review

2. Review complete RFP response for: a. Completeness

b. Serious weaknesses

3. Review RFP response to score key differentiators

4. Plan to append response to RFP to contract

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*Key Differentiators

Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.

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Contract Negotiation• Negotiation is an iterative

process of give and take• Do not plan to work out details

after contract is signed. There is no leverage after contract signing

• Get it in writing. What you are told in demos, see on site visits, or are promised by sales staff have no contractual impact.

• Maintain validity of business points

• Keep a list of contract issues and resolutions

• Read and verify the final contract version prior to signing

• Manage to the contract

Price is an offer to sellCost is what you pay to vendorTotal cost of ownership is all costsPayment is transfer of funds.Value is what you get

Schedule Vendor Buyer

Down payment 50% 10%

Software install 25% 10%

# days after software install 25%

Completion of training 20%

Completion of testing 20%

Go live 20%

90 days after go live 20%

Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.

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Contact:

Stratis Health

2901 Metro Dr., Suite 400

Bloomington, MN 55425

952-854-3306

1-877-787-2847 (toll free)

www.stratishealth.org

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