1. Comp 14 - Special Topics in Vendor-Specific Systems
Unit 3 - How Do Organizations Select an EHR? Lessons From the Front Lines
This material 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

2. Health IT Workforce Curriculum Version 2.0/Spring 2011
Outline
RFP Process
Stakeholders involved
Cost (capital, maintenance, staffing)
Financial strength of vendor
RFP Process
Stakeholders involved
Cost (capital, maintenance, staffing)
Financial strength of vendor
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

3. Request for Proposal Process
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
RFP:
Primary document sent to suppliers that invites them to submit a proposal to provide goods or services
For complex projects that require supplier creativity
Assists with internal alignment:
Forces an organization to describe needs before involving a vendor
Helps organization compare vendors and understand potential project risks
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

4. Request for Proposal Process (cont.)
However
Time consuming for purchaser and vendor
Difficult to accurately describe requirements
Not easy to score responses
However
Time consuming for purchaser and vendor
Difficult to accurately describe requirements
Not easy to score responses
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

5. Request for Proposal Process (cont.)
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
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

6. Health IT Workforce Curriculum Version 2.0/Spring 2011
Other Request Formats
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
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
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

7. Other Request Formats (cont.)
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
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
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

8. Other Request Formats (cont.)
A request for qualifications (RFQ) is a document often distributed before initiation of the RFP process
A request for qualifications (RFQ) is a document often distributed before initiation of the RFP process
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

9. RFP Sample Documents - HIMSS
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
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
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

10. RFP Sample Documents - HIMSS
Access requires active HIMSS membership
Access requires active HIMSS membership
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

11. RFP Sample Documents - HIMSS
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
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
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

12. Stakeholders Involved
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
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
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

13. Stakeholders Involved
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”
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”
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

14. Stakeholders Involved
Examples of Stakeholders
Physicians
Nurses
Patients
Clerical staff
Lab staff
Management
Suppliers
Community
Examples of Stakeholders
Physicians
Nurses
Patients
Clerical staff
Lab staff
Management
Suppliers
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

15. Stakeholders Involved
Engage Stakeholders in the following
Communication Planning
Design Benefits Plan and Tracking
Process Gap Analysis
Policy and Procedure Changes
Learning Plan
Engage Stakeholders in the following
Communication Planning
Design Benefits Plan and Tracking
Process Gap Analysis
Policy and Procedure Changes
Learning Plan
Community
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

16. Health IT Workforce Curriculum Version 2.0/Spring 2011
Project Cost
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
Capital
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
License
Definition: Official or legal permission to do or own a specified thing
Applies mainly to software projects, both applications and operation systems
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

17. Health IT Workforce Curriculum Version 2.0/Spring 2011
Project Cost
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
Maintenance
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
Staffing
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
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

18. Health IT Workforce Curriculum Version 2.0/Spring 2011
Project Cost - Example
Staff Costs
Enterprise Data Backup support
Physician Champion
Network Support
Project Director
Security Coordinator
Project Manager
Workstation Management
EMPI Cleanup
Workstation/Printer Systems Support
Application Coordinator RN
Database administrator
Application Coordinator MD
Principal Trainer
Application Coordinator analysts
Supplemental trainers
Medical Records Abstractors
Go live support
Reporting Applications Coordinator
Helpdesk support
Reports/Designer/Analyst
Staffing Contingency
Database Extract and Load Administrator
Staffing total
31%
3rd Party Reporting Tool Administrator
Programmer/Analyst
Subtotal staffing with fringe
Database DBA
Hardware/OS support
Storage Support
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

19. Health IT Workforce Curriculum Version 2.0/Spring 2011
Project Cost - Example
OTPS
Power Conditioning system for Data Centers
Software License Fees
Server Racks
Software Maintenance
Fiber installation Data Center #1 to Data Center #2
Interfaces License Fees
Fiber switch
Interfaces Maintenance
Third Party License fees
V-LAN
Third Party Maintenance
Contingency for cabling rooms for PC's
Database - License fees
Consulting fees
Database Maintenance
Contingency for OTPS expense
Estimated Implementation fees
Additional rent for space of staff supporting Product
Estimated hardware costs
Contingency for software
Scanners
Contingency for hardware
Travel, room and board for vendor staff
Subtotal OTPS
Cabling/Network Infrastructure expenses
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

20. Financial Strength of Vendor
Companies who supply credit information on businesses and corporations
Dun & Bradstreet
Experian
Equifax
MarketWatch
InfoUSA
Yahoo! Finance
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011

21. Financial Strength of Vendor
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
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
Component 14/Unit 3
Health IT Workforce Curriculum Version 2.0/Spring 2011