for information; the vendor eventually
got back in touch with the hospital but its
unresponsiveness was telling, says CNO
Karen Ford. ;e hospital asked vendors
to conduct a live Web seminar to demonstrate their system, and three complied.
Another didn’t respond and was cut.
While the winning vendor o;ered two
weeks of peer-to-peer support after go-live, a competing vendor o;ered training
during the system build period—too early
in the process—and one nurse to support
the go-live.
;e winning vendor, veEDIS, also set
up the hospital’s medication lists and order
sets while building the system, a task many
vendors leave to the provider, Ford notes.
;e company also had reporting modules
in the emergency department system that
support meaningful use quality reporting,
a feature other vendors lacked.
Game plan
Vince Ciotti and his colleagues at HIS Pro-
fessionals have done 170 selections and
190 negotiations over the past 25 years.
Here’s their game plan:
• Not surprisingly, Ciotti’s ;rst rule is to
engage a consultant. Consultancies that spe-
cialize in vendor selection have methodolo-
gies that have proven their value over time.
No consultant will get everything from
a vendor that a provider wants. But a disciplined approach and experience brings a
higher rate of vendor concessions.
• Start with a request for information,
not a feature checklist, and send it to a
maximum of ;ve or six vendors. Ask for a
ballpark cost to immediately eliminate the
ones way too big for your hospital’s budget.
Don’t send the RFI to inappropriate vendors, a practice that providers have a habit
of doing. “Johns Hopkins should never talk
to CPSI, nor should a critical access hospital ever talk to Siemens,” he asserts.
• While waiting for the RFI responses,
schedule demos with likely vendors—
primarily those who specialize in your size
and type of hospital. Don’t take demos too
seriously. Vendors “sell like crazy,” Ciotti
contends, “and demos basically are a PowerPoint presentation. Consider it an education for your users in the state-of-the-art.”
• Next, narrow the ;eld to three or
four vendors, based on the scoring of the
demos and costs that seem to be reasonable. ;en, issue a request for quotation
with detailed questions on costs ( 12 pages
at HIS Pros) and contract terms (about 75
questions). ;ose 75 questions are terms
and conditions you want the vendor to
concede to you, and in the end you’re
looking to get at least 25 percent and maybe up to half of the concessions.
• While waiting for the RFQ responses,
have your end users calls their counterparts at vendor clients. Doctors call doctors,
nurses call nurses, billers call billers, and I. T.
sta; call I. T. sta;. Don’t call the vendor’s ;ag-ship hospital, call hospitals in your state and
close to your bed size. HIS Pros has a two-page score sheet for these calls with ratings
of 1 to 10. Peer-to-peer vendor scores average about 70 points out of 100 total; a ;ag-ship hospital might give a score in the 90s.
• While doing the calls, review vendor
user documentation—on paper, via CD
or online—that vendors will give to you
if selected. Don’t wait until signing to review the documentation. Almost all vendors will give it early and use a checklist
to score the results. “Don’t continue with
any vendor that either won’t give it to you
or doesn’t have any,” Ciotti advises.
• When requests for quote are returned,
narrow the ;eld from three or four candidates to two—never a single vendor. ;e
next step is contract negotiations, and competition is the only way to get concessions.
While the consultant and/or attorney negotiate, you follow-up with peer-to-peer site
visits at clients of the two ;nalists. Again,
bring a nurse, doctor, biller, I. T. professional,
etc., to meet in private with their peers.
• Concurrently, ask to meet the implementation team. Insist the ;nalists send
in the actual project manager that you’ll
get, not a corporate VP. “You want the guy
or gal you’re going to live with for the next
year.” ;is is important because imple-
mentation of a system often costs as much
as the software these days.
• While you are reviewing the implementation process and team, hold a physician fair with both ;nalists’ systems in
adjacent rooms and have physicians try
out the products.
If putting in an electronic health record
system with computerized physician order
entry, have each physician try to enter an
order, see what alerts look like, and how easy
it is to ;nd results. It takes a doctor only ;ve
minutes to decide if he or she can navigate
and like one system more than the other.
“Doctors also are thrilled that their opin-
ion was asked,” Ciotti adds. “Don’t let some
salesman put on a PowerPoint; you want the
vendor to send a physician and allow hands-
on of the real system—no BS.”
• Now, it’s decision time. ;e user com-
mittee will hold its ;nal meeting and vote,
and the administration will then make the
;nal decision based on cost, contract terms,
and the user vote. Under the scoring system
of HIS Pros, a perfect score is 10,000 points
and the typical winner gets 7,000 to 8,000,
with the loser getting 5,000 to 6,000. “;ere’s
no silver bullet; you’re not picking the per-
fect product,” Ciotti says. “;at doesn’t exist.
You are picking the least of the evils.”
• Final negotiations get underway with
the winning vendor. ;e consultant and/
or attorney already has gotten some of
the 75 concessions you are asking. Now,
they’ll go back to the vendor and try to
get more. ;e vendor then will come to
the hospital to meet with the CIO, who
will dig into technical issues and get some
more concessions. ;en the CEO will have
a ;nal crack at the vendor to get one or
two more. “So, make multiple slices at the
vendor to get the best deal,” Ciotti says.
