Vendor Selection Criteria: Evaluation post implementation

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Dr. Sittig's Overview of EMR Vendor Selection

  1. Make The Plan
    1. Identify Decision makers
  2. Set Goals
    1. Make a Checklist of what should the EMR accomplish
    2. Map your Workflow
    3. Do a thorough Scan of your environment
  3. Prioritize needs
    1. Make EHR Functionality Checklist
  4. Develop a Request For Proposal (RFP)
  5. Select RFP recipients
    1. For example up to 5 vendors
  6. Narrow the field
    1. EHR Evaluation Form
  7. EHR Vendor Demonstrations
  8. Narrow the field
    1. For example up to 3 vendors
    2. Ask additional questions to vendors
  9. Check references
    1. Examples: consulting KLAS, Gartner etc
  10. Rank the vendors
    1. Functionality vs cost vs vendor characteristics
      1. functionality can be the institution's most important function
      2. cost can include the total amount from hardware, software, training, and support
      3. vendor characteristics can be important traits that are aligned with the institution's core values [1]
    2. Vendor selection tools
  11. Site visits
  12. Select a finalist (between the last 2 competitors)
  13. Verify Commitment
    1. Determine approval of selection committees and discuss choice will all the key stakeholders.
    2. If possible repeat the Demo to all the staffs
    3. For uncovered concerns, verify all the references and repeat verification steps if necessary
  14. Formal Contract Negotiation
    1. Ask vendors to spell out all the current as well as the future costs including the vendor time commitments for training and implementation
    2. Ask vendor to put source code in escrow just in case Vendor go out of business
    3. Before signing the software contracts,make sure you have familiar attorney to review
  15. Follow all the above process
    1. Know that the process takes time and do not rush because the end result can be expensive.
    2. Follow the process without skipping any steps.

Clinical Process Assessment and Improvement

  • The EMR vendor, in response to requirements defined in the request for proposal (RFP), should describe a plan for evaluation and assessment of the as-is clinical processes and workflows, identification of needed improvements and a proposal for implementing workflow optimizations necessary to launch the EMR. [2]
  • The EHR vendor must specify the duration of post implementation support including troubleshooting and triage. The RFP should mention the discussion of a post implementation action plan that would document all "go live" issues. A healthcare facility can request an estimate for a post implementation maintenance contract from the vendor. Depending on funding and the facility needs, a contract can be discussed in a separate addendum. [3]

New Non Traditional Approach Overview

New adaptive methods to be considered regarding the successful HIT (Healthcare Information Technology) implementation: R.T.Blake et al., did an interesting case study about The Christ Hospital which underwent a world class successful HIT implementation. The Christ Hospital (TCH) is 555 bed nonprofit acute care hospital in Cincinnati, Ohio. It has successfully implemented HIT by firmly focusing to the goals set and following a strategic yet non-traditional methods in every area, and was exceptionally exemplary in collaboration with the different stakeholders. For more information on The Christ Hospital visit their website. [4] There are many adoptable methods for Healthcare Organizations (HCO) to be learnt from TCH HIT Implementation.

Stakeholder Analysis

It is important to recognize the role of key Healthcare Organizations (HCO) Stakeholders.[5] Stakeholders in healthcare can be broadly divided into internal and external. Internal stakeholders consist mainly of physicians, nurse, hospital administrators while external comprise of IT providers, vendors, and consultants.

Physicians and nurses have direct contact with patient, more so nurses with monitoring, administering medications and discharge/after care services. There are many healthcare workers under the supervision of registered or licensed practical nurses.Hospital administrators have often challenging workforce, hospital missions, complex regulatory and day- to day operations which target directly or indirectly quality of patient care.Hospital administrators have often challenging workforce, hospital missions, complex regulatory and day- to day operations which target directly or indirectly quality of patient care. [5]

In order to increase the probability of a successful collaborative process, at least four issues related to stakeholders should be addressed:

  • clarifying appropriate levels of participation by different groups and establishing mechanisms for that participation
  • deciding on the composition of the negotiating or decision-making group
  • specifying the desired characteristics of participants in the group
  • deciding how representatives will be selected[6]

Post-Implementation Assessment

The post-implementation phase of a health IT project is equally as important as all other stages of the project plan. The following are some significant post-implementation assessment questions: [7]

  • Was the implementation process efficient?
  • Did project activities occur as planned?
  • What were the benefits and drawbacks of the project?
  • Did everyone in the facility participate and feel involved?

EHR Evaluation Resources

  • American Academy of Family Physicians Vendor Rating Tool
  • American Academy Of Family Physicians HR Demonstration Rating Form EHR Demonstration Rating Form [1]
  • American Academy of Family Physicians vendor's references verification form [2]
  • American College of Physicians EHR Feature Checklist
  • Bureau of Primary Health Care. BPHC Electronic Medical Record Resources page. [3]
  • Doctor's Office Quality - Information Technology Guidelines for Evaluating EHR Vendors
  • The National Learning Consortium Vendor Evaluation Matrix Tool. [8]
  • California Health Care Foundation, EMR Evaluation Tool and User Guide - A Guide for Small Physician Practices: [4]
  • American Medical Association - 15 questions to ask before signing an EMR/EHR agreement [9]
  • Health Resources and Services Administration How to Select a Certified EHR [10]
  • Select or upgrade to a certified electronic health record vendor [5]

Close Procurement

Tools and techniques for closing out procurements are identified in the PMBOK Guide: [11]

  • Procurement Audits
  • Procurement Negotiations

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  1. Weber, M. Selecting an EHR, now what???? [PDF document]. Retrieved from Lecture Notes Online Web site:
  2. McDowell, S. W., Wahl, R., & Michelson, J. (2003). Herding cats: the challenges of EMR vendor selection. Journal of healthcare information management, 17(3), 63-71.
  3. Applied Management Systems. EHR Implementation Workplan.
  4. The Christ Hospital
  5. 5.0 5.1 Blake, R.T., Massey, A.P., Bala, H., Cummings,J., Zotos,A. (2010).Driving health IT implementation success: Insights from The Christ Hospital.53(2),131-138
  6. Futaki,K. Stakeholder selection strategy.
  7. Nancy M Lorenzi, Angelina Kouroubali, Don E Detmer and Meryl Bloomrosen (2009). How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings.
  8. The National Learning Consortium Vendor Evaluation Matrix Tool.
  9. Health Resources and Services Administration
  10. Project Management Institute. (n.d.). A Guide to the Project Management Body of Knowledge (Pmbok Guide) - 5th Edition, 138.