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Rethinking the Vendor Relationship

May 26, 2011
by Mark Hagland
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When it Comes to Clinical Implementations in the Current Operating Environment, CIOs are Reconsidering What They Need from Their Vendors

EXECUTIVE SUMMARY: As the landscape around contracting with EHR vendors evolves rapidly forward because of meaningful use, CIOs need to think very carefully and very strategically about their relationships with vendors-both those they are now beginning to enter into contracts with, and those they've already partnered with.

Edmund Collins, vice president and CIO at the two-hospital, 350-bed Martin Memorial Health Systems in Stuart, Fla., is like a lot of CIOs these days, who are faced with the need to go through a full selection process on EHR vendors in a relatively short period of time in order to try to move forward quickly on meaningful use under the federal Health Information Technology for Economic and Clinical Health (HITECH) Act. Collins recently helped lead his colleagues through an accelerated vendor selection process, which included his organization's existing vendor and three other vendors-all of them among the best-known names in the business.

Edmund Collins
Edmund Collins

“We were focused mostly on the fact that we wanted an integrated solution, first and foremost, because of our large and growing physician presence,” says Collins, referring to the fact that Martin Memorial already employs more than 100 physicians, and is looking to add additional salaried physicians to the organization's roster. In addition, he says, he and his colleagues were hyper-aware of the need to get all the internal and external implementational talent they needed as soon as possible, given the current HITECH-driven rush for help implementing EHRs.

THE MAIN MISTAKE I SEE IS IN THE MAINTENANCE SIDE OF A VENDOR SOFTWARE OR HARDWARE CONTRACT, AND IS SOMETHING OFTEN OVERLOOKED ON THE CONTRACT SIDE. -STEVE GARSKE, Ph.D.

WE STACKED THE VENDORS UP ONE EVERY WEEK, AND WE GAVE EACH VENDOR THREE FULL DAYS EACH TO MAKE A PITCH. AND AT THE END OF EACH DEMO, IF THEY DIDN'T STACK UP, WE WENT AHEAD AND CUT THEM OUT OF CONTENTION RIGHT AWAY. I DON'T THINK YOU CAN OFFER THE VENDORS SECOND CHANCES THESE DAYS. -EDMUND COLLINS

Steve Garske, Ph.D.
Steve Garske, Ph.D.

Interestingly, Collins says, that time pressure ended up working to his and his colleagues' advantage. “We stacked the vendors up one every week, and we gave each vendor three full days each to make a pitch,” he says. “And at the end of each demo, if they didn't stack up, we went ahead and cut them out of contention right away. I don't think you can offer the vendors second chances these days,” he says. In addition, he says, allowing all the stakeholders more time to ponder things would not have helped, “because you can run into analysis-paralysis.”

In fact, Collins says, the four finalist vendors' demos varied considerably in quality; and in the end, his organization chose to go with a vendor that was not their incumbent vendor (they ended up choosing the Verona, Wis.-based Epic Systems), based on calculations around strong referrals and track record with customers, and the belief that the vendor they ultimately chose had the best chance of delivering exactly what it had promised. Certainly, a great deal was on the line, including the fact that the organization's IT department has swelled from 45 people to 105, in order to support the implementation.

I THINK IT'S IN THE CIO'S INTEREST TO LISTEN TO THE DEPARTMENTAL VENDORS IN TERMS OF WHAT WILL CONSTITUTE-THEY NEED TO BE SENSITIVE TO BALANCING CLINICAL NEEDS VERSUS THE NEEDS FOR INTEGRATED HOSPITAL SOLUTIONS. THAT WAS A MAJOR PORTION OF DISCUSSION AT ACC. -JOE MARION

Most of all, says Collins, “We've made a huge commitment to achieving meaningful use,” with an internal goal of the physicians going live this October and hospitals live by December. And this EHR vendor relationship is “exactly like a marriage, so I was really cautious to educate everyone that hey, you need to look at this as being a partnership for the next 20 years. So you can't look at the relationship as transactional. And getting the contract signed by a certain date, that's only one step.”

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