1. Contracting and Negotiation DOQ-IT Education Session Contracting and Negotiations

2. Footer text goes here 2 Should be able to: Identify 1-2 areas of EHR contract review and negotiation. Name 2 financing options for EHR purchase. Objectives For This Session

3. Footer text goes here 3 So you have selected an EHR… Based on… –A vision for your practice utilizing an EHR Project Charter Communication Plan You have selected… –An EHR that meets your expectations and goals You can explain why you selected it You know what it is expected to do

4. Footer text goes here 4 Let’s Sign The Contract! Contracts protect the vendor Contracts require your review and negotiation STOP

5. Footer text goes here 5 Sections of a Contract General Terms Software Interfaces and Conversions Services (Implementation and Training) Support and Maintenance Payment Schedule Hardware

6. Footer text goes here 6 General Terms General Contract Structure Items –The legal ‘stuff’ Limitation of liability Indemnification Force Majeur Warranties Disclaimers –How to get out of the contract Default Bilateral termination Transferability

7. Footer text goes here 7 General Terms Protecting your work –Data ownership –Source code escrow –HIPAA –Government regulations

8. Footer text goes here 8 Software Two types of contracts: –License Term or perpetual –Subscription Term

9. Footer text goes here 9 Software 3 rd party and ancillary software required –Additional cost System upgrades –Process –Frequency –3 rd party patches and updates –Service fees

10. Footer text goes here 10 Interfaces and Data Conversions Interface –Electronic source of information Real-Time Batch Data conversion –Electronic load of data One time Two (2) payment options: –Flat fee –Time and materials

11. Footer text goes here 11 Interfaces and Data Conversions Evaluate –All data sources to determine number/type of interfaces –All data currently stored electronically that you want in your EHR Cost considerations –Leverage existing interfaces (hospital or community) –Negotiate flat fee when possible –Interface upgrade process –Costs on both sides of the interface –Support fees

12. Footer text goes here 12 Services Implementation Training

13. Footer text goes here 13 Services: Implementation Understand Services and Costs –Description of Services Project Management System Customization Operational Redesign Hardware/Network Implementation –Resources –Timeline

14. Footer text goes here 14 Services: Training Training –Who is Trained? Train The Trainers vs. Train The End-Users –Resources Number and Type –Additional Training Resources Online courses, take home CDs and Manuals, Other Re-Training –Availability and Costs

15. Footer text goes here 15 Typically 20% of Software Cost –Calculated on List Price Includes Software Upgrades and Documentation Support During Normal Business Hours Annual Increase –Suggest 3% Support and Maintenance

16. Footer text goes here 16 Support and Maintenance Define Standard Support Services –Hours –Process –Turnaround Time Respond vs. Resolve –After-Hours –Escalation Process –What is Supported? Software, Hardware, 3 rd Party Applications, Interfaces

17. Footer text goes here 17 Payment Schedule Milestones Based On… –Productivity 25% Upon Contract Signing 50% Upon 1 st Physician Live 15% Upon 5 th Physician Live 10% Upon All Physicians Live –Timeline 25% Upon Contract Signing 25% Upon Software Delivery 25% Upon Go Live 25% Upon 60 Days Post Go Live –Hybrids

18. Footer text goes here 18 Payment Schedule Guaranteed Pricing –Optional Modules

19. Footer text goes here 19 Hardware Two Options: –Local You Own and Support the Hardware –ASP Hosted at Remote Location Minimum vs. Recommended Configuration

20. Footer text goes here 20 Hardware: Local – You own and support the hardware Guidance on proper backup procedures and maintenance –Daily, weekly, monthly maintenance Service level agreement (SLA) –Priority escalation for hardware failures Know how to acquire a new server Downtime Procedures

21. Footer text goes here 21 Hardware: ASP Hosted at Remote Location –Service level agreement (SLA) 99.999% Uptime Escalation path Penalties –Understand disaster recovery plans –Downtime procedures

22. Footer text goes here 22 Other Considerations Help Is Available –Attorney –IPA/PHO –Consultants Clarifying Contract Language Timing –End of Month –End of Quarter

23. Footer text goes here 23 Other Considerations IPA/PHO Collective Bargaining Power Discounts –Affiliations –Industry Partners Understand Your Responsibilities and Contractual Commitments Make Sure Your Contract Is Win/Win

24. Footer text goes here 24 How do I pay for this?

25. Footer text goes here 25 How Do I Pay for This? Capital Financing –Traditional bank financing –Lease financing

26. Footer text goes here 26 Comparisons of Financial Models on a Year By Year Basis Examples Sub - Hosted Sub - Owned Lic - Finance Lic - Purchase

27. Footer text goes here 27 Conclusion Did we meet the objectives? Should be able to: Identify 1-2 areas of EHR contract review and negotiations. Name 2 financing options for EHR purchase.

28. Footer text goes here 28 Contact Us