1. The System Selection Process: Final Selection Process
NURS 737: Nursing Informatics Concepts and Practice in System Adoption
Module 5, Topic 1
The System Selection Process: Final Selection Process
This document is intended solely for the use of N737. Not for distribution

2. Evaluate RFP Responses

3. RFP Arrives & Evaluation Begins
Make sure all required sections are included
Distribute copies of sections of the proposals
Use a database
Score vendors’ response to objective sessions of the RFP (functional requirements, system costs)
Review and evaluate the vendors’ response to subjective sections
Summarize the results for presentation to the Steering Committee

4. RFP Arrives & Evaluation Begins
Example evaluation: See slides 5 – 12

5. Example: Functional Requirements

6. Response Key Options in Functional Requirement
Example: Scoring of requirements (scales may vary in each organization.)
Response Key Options in Functional Requirement
A = Available & currently installed
B = Available but not installed
C = Report writer/ development tool
D = Under development
E = Customization
F = Not Available
Additional/optional cost column
Y = Yes, available at additional cost
N = No, it is or will be included at no additional cost
Points for the keys during Analysis
A = 6
B = 5
C = 4
D = 3
E = 2
F = 1

7. Example: Evaluation Summary per Category and per VendorB C D E F
Clinical
Operational & Administrative
Security & Confidentiality
Technology Infrastructure
76.6%
82.5%
61%
74.2%
69.4%
49.1%
53%
88.9%
88.1%
83.3%
78%
74.8%
79%
33.3%
65%
47.4%
44.4%
91.7%
47.6%
48.5%
65.2%
40%
90.6%
41%
7.1%
60%
95.2%
80.6%
66%
72.6%
This table shows an example of summary.
This table shows the vendors’ ability to meet Health System’s specific functional requirements.

8. Example: Each Vendor’s Overall RFP Score Summary (example)
Product
Score
Max Score
% Met A B C D E F
HealthBeat
Rhythm
FinalWord
Practitioner
HealthText
Arrest Data
473
416
411
409
332
282
606
68%
69%
78%
47%
55%
67%
This table shows the vendors’ overall ability
to meet Health System’s functional requirements

9. Vendor Evaluation Matrix Tool
HealthIT.Gov
Vendor Evaluation Matrix Tool

10. Vendor Meaningful Use Compare Tool
HealthIT.Gov
Vendor Meaningful-use Compare Tool

11. Determine Vendor Finalists
Evaluation of RFP and selection of systems for further evaluation
For the selected systems
Conduct client reference calls.
Conduct on-site vendor demonstrations
Eliminate vendors as appropriate and narrow down the number of vendors.
Conduct site visits
Prepare evaluation summary

12. Vendor Finalists
Accept the fact that there is no “perfect” system or solution out there.

13. Conduct Reference Checks
Develop telephone reference questionnaire
Schedule telephone interviews
Conduct telephone interviews
Compile and summarize interview notes

14. Demo Evaluation Tool: Scenarios

15. Demo Evaluation Example Tool: Clinical Documentation
O = Outstanding A = Acceptable U = Unacceptable

16. Demo Evaluation Tool: Functional
Ranking* 1) Must Have to Go-live 2) Need Within a Year 3) Desirable
Match** 1) Feature Present & Acceptable 2) Feature Present, Not Acceptable 3) Feature Not Present

17. EHR Demonstration Scenario, Evaluation and Vendor Questions
HealthIT.Gov

18. Site Visits Develop site visit team
Include correct representatives
Select sites similar to environment
Bed size, services
Application portfolio
Hardware
Provide education to site visit team
Evaluation tools

19. Site Visit Questionnaire
What impact does the system have on the department’s procedures?
Are you performing specific procedures manually and why?
Describe the implementation process
Was the training sufficient?
How long did it take users to become proficient?
What benefits were realized?
How many resources maintain the system?
Use the system on-site, watch the users

20. Select “Vendor of Choice”
Identify vendor finalist
Also 2nd place vendor for backup
Present summary of process and recommendations to board
Obtain steering committee approval

21. Debrief Losers
Telling vendors why they did not win the contract decreases animosity and gives the vendor the perception of future opportunities with your organization
Losing vendors will have a better understanding of your organization’s needs when the next RFI is issued

22. Legal Concerns Related to Contracts

23. Contracts
The contract is the most important document in any implementation
It defines the relationship between purchaser and vendor
Agreements made outside of the contract, whether on a handshake or a word, are NOT BINDING
Everything in a contract is open to negotiation

24. Before the Contract
Tell vendors upfront that you will negotiate with more than one vendor at a time
Evaluate the financial and technical viability of the vendor
If your sale is the only difference between bankruptcy and solvency, use a backup
If the company is dependent upon one or two key personnel, find out the vendor’s contingency in the event that they leave the company

25. Negotiate Contracts
Negotiation strategy focuses on what the organization wants from the partnership and the system
Successful negotiation allows everyone to leave the table a winner
Better to have a team instead of an individual negotiate the contract
Team should include procurement representatives, legal counsel and key decision makers

26. Negotiate Contracts Know the vendor
Find out as much as possible about the company and its products
Learn about strengths and weaknesses
Take the power position in the negotiation
Ask for anything, even if it seems unreasonable
You may be surprised at what you can get
Be willing to walk out without a contract

27. Who should write it?
The RFP should specifically state that the purchaser will write the contract
Never use a contract written solely by the vendor
Use an attorney specializing in software law
If you choose to use the vendor’s contract, you have the right to obtain a copy in word-processed form

28. What should be included?
Contracting Parties
Payment
Delivery
Software
Hardware
Data migration
Testing
Training
Insurance
Warranties

29. What should be included?
Payment
Make payment schedules based on milestones
Hardware installation, software implementation, etc.
Include bonuses for early completion and risks for late
Hold back final payment until after the system passes acceptance testing
This 10% - 15% payment gives you a lot of leverage
It is probably their profit

30. What should be included?
Delivery Schedules
Define what will be delivered and when
Includes software, hardware, training, etc.
Link directly to payment

31. What should be included?
Software
Define who owns the licenses and source code
Get copy of source code or put it into an escrow account for use after vendor stops supporting it
Get current, well-written user manuals

32. What should be included?
Hardware
Explicate hardware requirements
Servers, network equipment, clients
Acceptable response times during peak & off-peak use
Define who will install, when, and who will take care of physical facility modifications
Get documentation for every piece of hardware

33. What should be included?
Data Migration
Define who is responsible and when & how it will be done
Testing
Spell out method of testing, what will be tested and when, and what will happen in event of failure

34. What should be included?
Training
Who will conduct it?
Who will be trained?
Who will pay for it?
What are expected outcomes?

35. What should be included?
Insurance
Make sure vendor carries workers’ comp and liability insurance
Get proof

36. What should be included?
Warranties
Performance
What is covered?
Who can fix it?
Is backup provided in event of failure?
Functionality
Maintenance agreements
How long and what is covered?

37. What should be included?
Make sure that there is a glossary with definitions of every possibly ambiguous word

38. Vendor/Client Partnerships
Fallacy
“Vendors hold the majority of the expertise in building and installing systems”
Reality
Need a partnering to optimize success
Share the risk
Technology can be a showcase for vendor and facility

39. Vendor/Client Partnerships
Understanding the vendor perspective
Business relationship
Shareholders and profit margins
In making points, successful negotiation speaks to financial benefits to both parties
Product flexibility is important to vendors
80% rule (vendor is not willing to tailor 100%)

40. Vendor/Client Partnerships
Contributions of Nurse Executives
Strategically minded, while understanding the “trenches”
Operations understanding is critical
Persons who team with the vendor must learn new ways to influence decision-making
i.e., walk the walk and talk the talk

41. Plan Implementation
“A system is only as good as the level of understanding of and enthusiasm for the system by the users.”

42. Plan Implementation
The implementation plan should be defined during the first stages of system selection
Plan should be mutually agreed during contract negotiations
Secure champions in management

43. Plan Implementation (cont’d)
Ensure participants have realistic expectations
Organizational policies and procedures should be integrated into training
Identify early-adopters and power users
They can help their peers develop skills
Demonstrate the system’s advantages to the users and management

44. Lessons Learned Evaluate and select Manage the selection process
Minimize “shopping”
Manage the selection process
Educate the selection committee
Involve the right people
Commit resources

45. Lessons Learned (cont’d)
Perform a rigorous analysis
Evaluate what vendor can do through an RFP
Evaluate how the software works during demos and site visits
Negotiate a fair contract
Develop an implementation plan before signing a contract