Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Lessons From the Front Lines This material (Comp14_Unit3) was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC

How Do Organizations Select an EHR? Learning Objectives 2 RFP Process Stakeholders involved Cost (capital, maintenance, staffing) Financial strength of vendor Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR?

Request for Proposal Process 3 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Primary document sent to suppliers that invites them to submit a proposal to provide goods or services RFP: For complex projects that require supplier creativity Forces an organization to describe needs before involving a vendor Assists with internal alignment: Helps organization compare vendors and understand potential project risks

Request for Proposal Process (cont.) 4 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? However Time consuming for purchaser and vendor Difficult to accurately describe requirements Not easy to score responses

Request for Proposal Process (cont.) 5 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Elements include: An overview of the business issue A description of the product or services required A detailed business requirements A proposal format A due date Selection criteria Time line, questions How to respond Point of contact

Other Request Formats 6 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? A request for quotation (RFQ) is used when discussions with bidders are not required (mainly when the specifications of a product or service are already known) and when price is the main or only factor in selecting the successful bidder

Other Request Formats (cont.) 7 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Request For Information (RFI) A proposal requested from a potential seller or a service provider to determine what products and services are potentially available in the marketplace to meet a buyer's needs to know the capability of a seller in terms of offerings and strengths of the seller

Other Request Formats (cont.) 8 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? A request for qualifications (RFQ) is a document often distributed before initiation of the RFP process

RFP Sample Documents - HIMSS 9 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? These Request for Proposal (RFP) sample documents are provided as tools for use by a healthcare organization and other healthcare providers in developing its own RFP Documents are designed to be a starting point for your RFP; the questions and requirements are meant to be illustrative, not exhaustive

RFP Sample Documents - HIMSS 10 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Access requires active HIMSS membership

RFP Sample Documents - HIMSS 11 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Title: Ambulatory EHR Summary: These sample documents are provided as tools for use by a healthcare organization and other healthcare providers. They provide a structured approach for the various criteria that may be relevant to the organization’s own RFP process, including general information and experience, technical information regarding architecture, applications and services

Stakeholders Involved 12 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? A corporate stakeholder is a party that can affect or be affected by the actions of the business as a whole The concept was first used in 1963 at the Stanford Research institute It defined stakeholders as "those groups without whose support the organization would cease to exist" The theory was later developed and championed by R. Edward Freeman in the 1980s rg/wiki/Stakeholder_ (corporate)

Stakeholders Involved 13 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? The stakeholder theory: A theory of organizational management and business ethics that addresses morals and values in managing an organization Originally detailed by R. Edward Freeman Identifies and models groups which are stakeholders of a corporation Recommends methods by which management can give due regard to the interests of those groups In short, attempts to address the “Principle of Who or What Really Counts”

Stakeholders Involved 14 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Examples of Stakeholders Physicians Nurses Patients Clerical staff Lab staff Management Suppliers Community

Stakeholders Involved 15 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Engage Stakeholders in the following Communication Planning Design Benefits Plan and Tracking Process Gap Analysis Policy and Procedure Changes Learning Plan

Project Cost 16 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Definition: One-time setup cost of a plant or project, after which there will only be recurring operational or running costs Materials, e.g. software/hardware, and labor can be capitalized Amortization: accounting concept in which the recorded cost of a capital asset is distributed over its estimated useful life Capital Definition: Official or legal permission to do or own a specified thing Applies mainly to software projects, both applications and operation systems License

Project Cost 17 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Definition: the recurring operational or running costs Includes labor costs and other than personal costs (OTPS) Licensed products typically incur maintenance costs of 15 – 20% annually Maintenance Critical component of a project Must remember to include all costs of staffing, e.g. fringe benefits and other administrative overhead costs Adequate funding can make or break a project Staffing

Staff Costs Physician Champion Project Director Project Manager EMPI Cleanup Application Coordinator RN Application Coordinator MD Application Coordinator analysts Medical Records Abstractors Reporting Applications Coordinator Reports/Designer/Analyst Database Extract and Load Administrator 3rd Party Reporting Tool Administrator Programmer/Analyst Database DBA Hardware/OS support Storage Support Enterprise Data Backup support Network Support Security Coordinator Workstation Management Workstation/Printer Systems Support Database administrator Principal Trainer Supplemental trainers Extra Staff for training/go-live periods Go live support Helpdesk support Staffing Contingency Staffing total 31% Subtotal staffing with fringe Project Cost - Example 18 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR?

OTPS Software License Fees Software Maintenance Interfaces License Fees Interfaces Maintenance Third Party License fees Third Party Maintenance Database - License fees Database Maintenance Estimated Implementation fees Estimated hardware costs Contingency for software Contingency for hardware Travel, room and board for vendor staff Cabling/Network Infrastructure expenses Power Conditioning system for Data Centers Server Racks Fiber installation Data Center #1 to Data Center #2 Fiber switch V-LAN Contingency for cabling rooms for PC's Consulting fees Contingency for OTPS expense Additional rent for space of staff supporting Product Scanners Subtotal OTPS Project Cost - Example 19 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR?

Financial Strength of Vendor 20 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? Companies who supply credit information on businesses and corporations –Dun & Bradstreet –Experian –Equifax –MarketWatch –InfoUSA –Yahoo! Finance

Financial Strength of Vendor 21 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR? In addition, other things to review: Audited financials Vendors should be willing to share Proven management Tenure and industry experience Liquidity Does the company generate cash Trade references Check customer references Call the vendor Talk directly with the CFO

How Do Organizations Select an EHR? Summary RFP is a core component of the selection process Always important to involve the key stakeholders Need to consider all costs, both capital and operating Do not forget to ascertain the financial health of vendors involved in the project 22 Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR?

How Do Organizations Select an EHR? References References: 1.Wheaton, G. (2008). Request for proposal. Retrieved on September 8 th,2010 from Stakeholders. Retrieved on September 8 th, 2010 from 3.Financial Strength of vendors. Retrieved on September 8 th, 2010 from Health IT Workforce Curriculum Version 3.0/Spring 2012 Special Topics in Vendor-Specific Systems How Do Organizations Select an EHR?