Hayes Review: Fall 2009

HIT System Selection: What’s Your approach?

By Phil Kahn

“I can only speak to the selections I’ve been involved with personally, but…any resemblance to an orderly process driven by the needs of clinicians and their patients was purely coincidental.”   Mr. HIStalk, posted 10/5/09

Healthcare systems are selected by various means, for better or for worse. Here are some common scenarios: 1. A clinical department leader attends a software vendor fair and comes back to the hospital excited about one or two packages that will improve the performance of the department. A demonstration has already been scheduled. 2. An influential physician has caught the ear of the COO and they’ve arranged to have several other physicians view a new piece of software that has come on the market.

There’s nothing inherently wrong about these approaches; however, a structured approach to system selection (and the acquisition of technology for that matter) goes a long way toward ensuring that the technology will meet the short, medium and long-term needs of the organizaiton. This is not to say that it’s necessary to perform a rigid, drawn out selection process for each piece of new software. In fact, a structured approach shortens the selection cycle – there is less back-and-forth, fewer last minute changes, etc.

A structured approach to system selection
To start, a minimal screening process should be applied to ensure compliance with the healthcare organization’s standards and guidelines (often call governance).  For example, an organization that is using an enterprise suite of a preferred vendor should investigate whether that vendor has a suitable module for the department in question.  This preserves the enterprise approach and meets the department’s needs.

Once past the screening process, the system must be examined for other requirements. The people selecting the system want to make sure they’ve done a satisfactory job of understanding their options and selecting the best solution.  Employing a methodological approach provides a number of benefits, including:

• Considering the new technology in the context of corporate strategic objectives
• Establishing project governance for critical decision making
• Fully vetting the competing vendor companies in terms of vision, viability, technology platforms, functionality cost, service and support
• Allowing a representative cross section of the organization to participate to facilitate buy-in and adoption

What methodology should be employed?
Within the concept of a structured approach, there are multiple vendor selection methodologies. Most will:

• Consider the organization’s strategic objectives and goals
• Interview key stakeholders to determine organizational needs
• Establish a project governance committee or utilize the organization’s IT steering committee structures
• Develop guiding principles that establish how technology will be managed and utilized and how decisions will be made related to this IT investment
• Establish criteria for determining the best solution
• Perform a preliminary analysis of the appropriate marketplace vendor solutions
• Develop and evaluate vendor responses to a formal Request for Proposal, if this process is appropriate
• Compare each of the qualified vendors against each other, including vendor vision, viability, functionality (including demonstrations), total cost of ownership and service/support
• Facilitate decision making to select the vendor of choice
• Negotiate vendor contract terms and pricing and develop an implementation budget

Hayes’ System Selection Methodology
We have developed our own system selection methodology, culled from our consultants’ cumulative experience over the past 15 years. It’s easy to adapt to each client’s needs, and offers an efficient but thorough process for vetting and purchasing new healthcare technology. Hayes’ System Selection Methodology is represented in the diagram below (click for larger view):

Regarding the examples at the beginning: Its’ great to have people excited about new technology. Before any demonstrations are scheduled, the person should just bring a proposal forward through the proper IT governance committee for consideration against all the other organizational priorities.  If the initiative has merit, and fits within the strategic objectives and budget of the organization, vendor selection and demonstrations can be scheduled and a formal process can begin.

Phil Kahn is a senior strategy consultant at Hayes, specializing in IT strategic planning, system selection, revenue cycle improvement, rolling out technology to community physicians and more. He has been a CIO for a large community hospital and has 15+ years of health care experience.