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Diane Gaddis

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    Diane Gaddis Diane Gaddis Presentation Transcript

    • Building Systems That Grow: The RFP Process By Diane Gaddis CEO & President November 2007 Copyright 2007 1
      • CHCA is a 501(c)(3) Health Center Controlled Network for section 330 safety-net health care centers and systems throughout Florida.
      • CHCA facilitates the selection, implementation and support of services and technologies that allow its members to expand access to health care while improving quality outcomes.
      • CHCA members leverage resources across the network to enhance patient care while maintaining independent management structures
      • Members choose from a range of technology and services to enhance their health center operations, including health information technology (HIT) and the sharing of information across operational specialties.
      2
    • CHCA Network Aggregate 2006 Results
      • Total sites: 77
      • Providers across the network:
        • 159 physicians, 60 mid-levels
      • Users: 311,489
      • Encounters: 1,268,669
      • Served 52% of Florida’s Rural Areas
      3 2006 Service Area With EHR Project
    • CHCA Professional Services
      • Project management
      • Training
      • Report Writing
      • Technical Assistance
      • Workflow/Process Consultation
      • Go-Live Choreography
      • Day-to-day application support
      4
    • 5 “ Take one of these as often as you can afford to.”
    • EHR Vendor Selection Due Diligence
      • Early 2003: Began market scan and research
      • Mid 2003: Started Workflow Analysis Process
      • Early 2004: Sent our RFI package to six vendors
      • Spring 2004: Two full day presentations by top two contenders for over 30 providers; began contract negotiations with both vendors
      • Summer 2004: Two full day hands-on demonstrations by vendors with select providers
      • Fall 2004: Announced primary vendor choice; continued negotiations with both vendors
      • Nov 2004: Primary vendor eliminated; continued negotiations with other
      • Dec 2004: Contract signed with GE for their Centricity EHR Product
      • Sep 2005: First Go-Live
      6
    • Selection Process Overview
      • Process Analysis
      • Request for Information
      • Self-Education
      • Dog n’ Pony Show
      • Request for Proposal
      • Scoring Assessment
      • In-depth / Situational Vendor Presentations
      • Site Visits
      • Vendor Selection
      • Contract Negotiations
      7
    • Selection Committee
      • Physicians, ARNPs, PAs, CNMs, etc
      • Nursing
      • Finance
      • Operations
      • Medical Records
      • And More Providers!
      8
    • Request for Information
      • Tool for self-education
      • Items to request –
        • Corporate information
        • General client information
        • Target markets
        • Support / Implementation methodologies
        • Features / Competitive Advantages
      9
    • Mini-Demos / Education
      • Vendors perform mini-demos
      • Schedule “Lunch and Learn” sessions
      • Deliver via Webex type services
      • Education component – not final selection
      • Seek out peers, technical assistance
      10
    • KLAS, TEPR, etc
      • Investigate their methods
        • Statistically sound?
        • Interactive competition?
        • How are customers found?
        • Judges relationships to vendors?
        • Vendors members / sponsors of ranking organization?
        • Is organization a stakeholder?
      11
    • Narrowing the Field
      • Thoroughly read the RFIs
      • The more eyes the better
      • Compare and contrast
      • Look past the gloss
      • Evaluate the quality of responses
      • Listen to colleagues
      • Reflect upon mini-demo sessions
      12
    • Dog n’ Pony Show
      • Top two choices invited
      • One day for each
      • Primary attendees – providers, nursing
      • Use patient visit scenarios
      • Control the demo
      13
    • Using Patient Visit Scenarios
      • At least 6 sample visit scenarios
      • Cover the spectrum of service types
      • Provide 3-4 days prior to demo
      • Establish moderator / interaction
      • Use a Scorecard
      14
    • The Demo Scorecard
      • Limit scope
      • Cover scenarios and only key areas
      • All providers participate in scoring
      • Weight each area or item
      • Allow free text comments
      15
    • Request for Proposal
      • Only top 2 vendors
      • Must be very controlled
        • Give single point of contact
        • Dictate format for responses
        • Adhere to deadline
      • Document vendor questions and replies
        • To share or not to share with all?
      16
      • Provide short- and long-term projections
      • Technical infrastructure
      • Current in-house staffing and support plans
      • Leadership
      • Contracting entity
      Request for Proposal, cont’d 17
    • Crafting the RFI / RFP Package
      • Vendor Information:
        • Request references that will provide satisfactory as well as dissatisfied responses
        • Commitment to CHC market?
        • Are references or show sites paid?
        • Project management samples
      18
    • Crafting the RFP Package
      • Functional Requirements:
      • Very Important RFP Component!
      • Expand with details
      • Designating “required” vs “optional” requirements
      • Attaches to the contract
      • Use HRSA guidelines as starting point
      • Clinicians must provide input
      19
    • ftp://ftp.hrsa.gov/healthit/ehrguidelines.doc 20
    • The RFP Scorecard
      • Tie back to functional requirements
      • User friendly, allow for comments
      • Committee to weight each area
      • Limit areas – High priority focus
      • Grade RFP response thoroughness and quality
      21
    • Investment / Recurring Costs
      • What is included in the license fee?
        • Formulary subscription / updates?
        • Drug interaction subscription / updates?
        • Database licensing?
        • Patient education materials?
      • Perform five year investment / cost analysis
      22
    • License Fees
      • Must understand licensing
        • Per Physician
        • Per Provider
        • Per Named User
        • Per Concurrent User
      • Thoroughly understand vendor definitions
      • Thoroughly understand how they audit license compliance
      23
    • Support Structure
      • Hours of operations
      • Methods of support
      • User community
        • Local
        • Regional
        • National
      • Special Interest Groups
      • After hours support access / costs
      • Service Level Agreements (SLAs)
      24
    • Corporate Comparisons
      • Positioned as a buyer
        • Acquisitions build benefit to customers or dilute resources?
      • Positioned for a buy
        • Future less known – new buyer impact?
      • History of reorganizations?
      • History of management changes?
      25
    • Contract Comparisons
      • To Vendors: “Put your money where your mouth is”
      • Get it in writing
      • Comparison tracking
      • What’s not included
      26 If they won’t put in writing what they verbalize, walk away
    • Negotiate - Both Vendors
      • A lot of work! Saves time later.
      • Negotiator must be armed with knowledge
      • Conduct with integrity
      • Document, document, document
      • Thoroughly reread every version of contract sent
      • Involve attorney before signing
      27
    • Dog n’ Pony #2?
      • Don’t be afraid to require
      • Use to clarify functional differences
      • Limit participants
      • Use that scorecard
      • Document key differences
      • Have vendor append functional requirements document
      28
    • Resource Ideas
      • Certification Commission for Healthcare Information Technology
      • www.cchit.org/work/products.htm
      • AAFP’s Center for Health Information Technology
      • www.centerforhit.org
      • BPHC Functional Requirements Sample
      • ftp://ftp.hrsa.gov/healthit/ehrguidelines.doc
      • Health Information Management Systems Society (HIMSS)
      • www.himss.org
      29
    • Baby Step Versus Big Bang 30
    • Baby Step Versus Big Bang
      • Big Bang Cons :
      • Takes 2+ years to build
      • More functionality at Go-Live may impact productivity levels for a longer period of time
      • Large staffing infrastructure needed to support at Day one
      • Larger investment required up-front
      • Longer time frame to recoup investment dollars
      • Big Bang Pros :
      • A more complete, comprehensive system is deployed to providers
      • More time available for configuration and testing
      31
    • Baby Step Versus Big Bang
      • Baby Step Cons :
      • Patience required as all functionality not available initially
      • Baby Step Pros :
      • Return on Investment comes more quickly
      • Growing champions is easier
      • Implementation and support can be built slowly
      • Productivity levels return more quickly
      32
    • CHCA Network: EHR Today 33
      • Over 68 providers
      • Three multi-site CHC organizations
      • Serving six counties
      CHCA Network: EHR Today- 11/1/2007 Current Implementation Reach 34
    • 35
      • Strong history and commitment in the healthcare arena
      • Real-time and interactive clinical guidelines
      • Oracle platform
      • Works well in Citrix environment
      • User Friendly interface
      • NCQA certification for its diabetes reporting capabilities
      • Strong user forum
      CHCA Network: EHR Today Selected Vendor Strengths 36
      • CCHIT (Certification Commission for Healthcare Information Technology) Certified:
        • Formed in July 2004, the Certification Commission is a recognized certification body for electronic health records and their networks, and a private, nonprofit initiative.
        • Rigorous criteria and processes to receive certification
        • HRSA continues to encourage adoption of products that have received this certification
      CHCA Network: EHR Today Selected Vendor Strengths, cont’d 37
      • Lessons Learned & Other Advice In the RFI / RFP Process:
      • You don’t know what you don’t know
      • Be prepared to dedicate a substantial amount of time
      • Once the contract is signed, the majority of your leverage is gone.
      CHCA Network: EHR Today 38
    • #1 Point to Remember: “ It’s not about the hardware and the software; it’s about the people and the process.” For More Information, Contact: Diane Gaddis, CEO & President [email_address] 39