Information Systems Selection Susan R. Miller, RN, FACMPE Administrator, Family Practice Associates of Lexington (KY) Independent Consultant Medical Group Management Association (MGMA) Health Care Consulting Group The Health Information Technology Summit: Day Three – Saturday, October 23, 2004, 11:00 AM Session 7.01 Physicians and Physician Organizations: Making the Purchasing Decision – Developing Your Requirements and Making Your Selection

MGMA Information Exchange Information Systems Selections – RFIs and RFPs – 282 respondents (Item #4879 – December 2002) Who selects? Administrator (93%), Physicians (46%), Support Staff (53%), CIO (27.8%), Medical Director (31%) Consultant used – 9%

Evaluation Methodology Formal RFI Process – 24% Formal RFP Process – 25% Establish Essential elements, Current system uses, Expectations “On-line” demos

The selection process… Know your vision Gain buy-in of the stakeholders Assemble a selection committee Do an internal needs assessment Research available technology Develop the RFP Create a shopping list Project costs Narrow the list of vendors Net demos and/or on-site demos Due diligence Vision - long-term based on the organization’s business strategy. Consider workflow linkages between business and clinical processes. Update the strategic plan prior to IT vision. Buy-in is critical - both from the people paying for it and the people using it! Selections committee should be multi-disciplinary Market analysis - part of SWOT process - where is the group going? Where is technology going? Internal needs assessment - again, part of SWOT analysis - assess current system & hardware, network in place, etc… Available technology - consider interface w/current system; read, read, read; ask, ask, ask… Budget - buying the present AND the future…upgrades, maintenance, etc.

Creating an RFP… Practice section: Vendor section: Description of the practice Statement of MIS needs Current systems – software/hardware/network Instructions for response including timeline Vendor section: Headquarters, background, financial information Number of installations, number of physicians, specialties Description of software/capabilities (checklist provided) Description of database, integration capabilities Support and maintenance requirements including upgrades Cost projections Implementation schedule Specimen agreement

Core Functionalities of an EHR System Institute of Medicine Committee on Data Standards for Patient Safety Letter Report May 2003 (www.nap.edu) Health information and data Results management Order entry/management Decision support Electronic communication and connectivity Patient support Administrative processes Reporting and population health management

6 Key Selection Factors Functionality Flexibility Support availability Integration capability Scalability Cost Functionality - easy to learn, easy to use (intuitive interface for full use); automate in stages; prioritize-billing & A/R first… Scalability - individual components must be “scaleable to meet future requirements; open-system architecture to allow customization, expansion, easy maintenance and be upgradeable. Support availability - from installation to phone support; check the track record, visit the service center, check training schedules Flexibility - customize reports and change minor settings; user capability to create templates Cost - software, hardware, downtime, staff training Integration - avoid double entry

Return on investment... Savings: Transcription Paper charts Printing Storage Personnel Gains Coding Documentation Quality of care Efficiency Value-added services

Concluding the selection process… Negotiate the contract Set implementation guidelines The contract - NEVER accept a standard contract on this huge investment. Make sure all of the group’s needs are addressed without any expensive, unnecessary extra’s thrown in. Have legal review Negotiating will reflect vendor’s style on future interactions Include damages for failure to meet deadlines or performs as spec’ed Implementation guidelines - next week

Other considerations... Your practice, your needs… Internal capabilities Cycle of service... Knowing what areas have service needs is the same as knowing what areas might benefit from technology… Know your technology quotient Return to the cycle of service...

Susan R. Miller RN, FACMPE Administrator Family Practice Assocs. of Lexington (KY) Independent Consultant Medical Group Management Association (MGMA) Health Care Consulting Group Englewood, CO 859.977.2123 Millrfpa@iglou.com