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When to Call it Off, When to Stick Around

June 13, 2012
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Experts weigh in on what to do when vendor relations go awry

For a feature in the upcoming annual HCI100 edition of Healthcare Informatics, I talked with a number of industry experts on the subject of vendor relations and how to develop a contract, whether it be for an EHR system or something else. Experts like Chuck Podesta, senior vice president and CIO at Fletcher Allen Health Care, and Massachusetts-based Fran Turisco, a director at the Pittsburgh-based consulting firm Aspen Advisors, talked at-length about various subjects including the vendor search process, contract flexibility, and creating a valuable partnership.

Unfortunately, as is the case many times when writing an article on a compelling topic for a print magazine, some good insights got left on the cutting room floor. However, thanks to the magic of the web, I can share one additional, bonus topic on vendor relations!

I asked the experts if it was ever appropriate for a provider to switch vendors when things weren’t working out, or if they would be better served to stick it out. Unsurprisingly, I got some perceptive answers. Podesta told me the situation truly depends on what is not working out.

“If your physicians are boycotting the system after you go live, and you spend 6-8 months working with the vendor to get the system to a point where they will adopt it, and they still don’t – you’re not going to survive in that situation,” Podesta said. “The physicians have to adopt it. That’s an area where you have to sit back and realize it’s time to move on.”

On the other hand, Podesta says if a specific module within the system such as an O.R. module, is having trouble, that’s something you should be able to work out. The best method for dealing with that, he says, is to gather up a team, work with the vendor, and get it back and functioning.

Like Podesta, Joe Marion, founder and principal of Healthcare Integration Strategies, told me that the answer really depends on the situation. Marion, who specializes in imaging consulting, said in many cases, there are too many incentives to stick with the same vendor and work it out. However, if a vendor is continuously unresponsive, he says, it’s okay to pull the plug.

Strangely enough, Turisco told me this was a question she had been asked the same day I had interviewed her. According to Turisco, a CFO of a large hospital said his core clinical vendor was not yet optimized with a high level of functionality, and some of his physicians wanted a Cadillac-type EMR. For Turisco, the response to this kind of situation elicits an important point about whether or not a provider should stick with a vendor.  

Fran Turisco

“I think people think the answer is the vendor and the product, and many times the answer is the way it was installed and the processes that are in place,” Turisco said. “I’ve seen that more often than not, those are the reasons big system implementations fail. You don’t get buy-in, you don’t get adoption, you don’t configure it right, you don’t change the processes to optimize what the system has to offer or to make the most of an opportunity when things aren’t working in the first place, and then you blame it on the vendor.”

Turisco said most of the times, it’s not the product; it’s a combination of things, mainly that the provider didn’t put the effort in. She said, only in some cases, such as when you have an immature product that can’t stabilize, is it okay to ditch the vendor.

What do our readers think? Leave some comments below, and be sure to check out the “Strategizing Vendor Contracts” feature in the June/July issue of HCI.



As a consultant in integrated health delivery system development and the CEO of the world's largest globally integrated health delivery system, I know from experience that when arranging such a costly IT project, the client is an integral part of the specifications development, installation and testing phase. Perhaps since the author is not a consultant in this domain, I can give him a pass on this little detail.

To quote "experts" that suggest abandonment and pointing at a vendor is quite lame, imho. Reading this article brings my mind to a comparison of a homeowner building a house from the plan stages up, and then complaining and threatening to move out because they don't like it once the certificate of occupancy is granted, and want their money back from the builder and architect. Do you see the similarity? There's accountability on the part of the client too!

Something is wrong with the premise of the article and its offered solution.

Hi there,

First off, I appreciate you reading my piece and responding to it. Thanks very much!

I think my experts do have accountability, and I'm going to have to respectfully disagree with you there. For one thing, near the end of my blog, Ms. Turisco mentioned that most of the times when an installation goes awry "it is the way it was installed and the processes that are in place." In this circumstance, she was definitely was pointing to the client, saying that it isn't right to blame the vendor when 9 times out of 10 the fault lies with the provider themselves.

I believe the people quoted in this blog, who come with many years of experience like yourself, aren't promoting outright abandonment. However, like any careful leader, who thinks out all options, they aren't ruling it out altogether. As Mr. Podesta says, if your physicians are boycotting the system after you go live, and you spend 6-8 months working with the vendor to get the system to a point where they will adopt it, and they still won't...it seems practical to go in another direction, regardless of whose fault it is.

As for the premise of the article, certainly you'll agree that not everything in life goes as planned. I think it's fair to look at all possible outcomes in an EHR implementation, even if they aren't desirable. I know for a fact there are people out there who have had to split off from their original vendor. As John Steinbeck once poetically wrote, sometimes the best laid plans of mice and men often go awry!

Thanks again for the comments.

Gabriel Perna