1. Participatory Vendor Selection Farrokh Alemi, Ph.D.

2. Alemi at Georgetown 2 Objectives Facilitate communication Create consensus Improve documentation The cost of EHR could bankrupt us. This is all a waste of time I hate computers It should save me time Let us redo the entire process What is it?

3. Alemi at Georgetown 3 What is a model of values? Quantify preferences Higher numbers more preferred options Assumptions Decision makers have options Selection is based on preferences Preferences are based on attributes

4. Alemi at Georgetown 4 Additive Multi-Attribute Value Model Overall Value = V (A 1 ) + V (A 2 ) +... + V (A n ) Value on Attribute 1 Value on Attribute 2 Value on Attribute n

5. Alemi at Georgetown 5 Misleading Numbers Numbers approximate preferences Focus should be on building behavioral consensus

6. Alemi at Georgetown 6 Steps in Participatory Vendor Selection 1. Invite stakeholders to participate 2. One-on-one interviews 3. Group meeting 4. Construct group’s scoring 5. Discuss major differences 6. Measuring vendor performance 7. Documentation

7. Step 1: Invite Stakeholders Many decision makers CIO, CMIO, CNO Clinicians People with budget authority Clinicians expected to use the system Alemi at Georgetown 7

8. Step 2: One-on-One Interviews Individual interviews before group meeting Can be done on phone Takes about 1 hour Models preferences of the participant Introduction to the process Attributes used Associated scoring system Alemi at Georgetown 8

9. Step 3: Group Meeting Construct straw model Display model in flip chart sheets Arrange participants facing the sheets Introduce the task Ask participants to introduce themselves Review all attributes & attribute levels Alemi at Georgetown 9

10. Step 4: Construct Group’s Scoring Which is more important, cost per physician or ease of use? ______________ If we assign 10 to the least important attribute, how many times more important is the other? ____ times Alemi at Georgetown 10

11. Step 4: Construct Group’s Scoring Which is more important, cost per physician or ease of use? ______________ If we assign 10 to the least important attribute, how many times more important is the other? ____ times Alemi at Georgetown 11 Discuss major differences Ignore minor difference

12. Step 5: Discuss Major Differences Discuss reasons not the ratings Check assumptions Accept some differences and re-rate Alemi at Georgetown 12

13. Step 6: Measure Vendor’s Performance Expert rating Standardized cases Committee ratings Demonstrations Site visits Alemi at Georgetown 13

14. Alemi at Georgetown 14 Scoring Procedure Vendor AVendor BVendor C AttributeWeightLevelRatingLevelRatingLevelRating Ease of use2 minutes3 minutes5 minutes Cost11,000/bed15,000/bed9000/bed ReputationGoodExcellentGood Total

15. Alemi at Georgetown 15 Scoring Procedure Vendor AVendor BVendor C AttributeWeightLevelRatingLevelRatingLevelRating Ease of use 0..3 2 minutes1003 minutes805 minutes0 Cost 0.4 11,000/bed 70 15,000/bed 0 9000/bed100 Reputation 0.2 Good0Excellent100Good0 Total1.0

16. Alemi at Georgetown 16 Scoring Procedure Vendor AVendor BVendor C AttributeWeightLevelRatingLevelRatingLevelRating Ease of use 0..3 2 minutes1003 minutes805 minutes0 Cost 0.4 11,000/bed 70 15,000/bed 0 9000/bed100 Reputation 0.2 Good0Excellent100Good0 Total1.0 =100*.3+70*.4 =58 =80*.3+100*.2 =44 =100*.4 =40

17. Step 7: Documentation Who participated Meeting process Group’s consensus scoring system Attributes, attribute levels & associated scores Performance of vendors Conclusions and next steps Alemi at Georgetown 17

18. Take Home Lesson Process Matters