1. Information Systems Selection
Susan R. Miller, RN, FACMPE
Administrator, Family Practice Associates of Lexington (KY)
Independent Consultant
Medical Group Management Association (MGMA)
Health Care Consulting Group
The Health Information Technology Summit: Day Three – Saturday, October 23, 2004, 11:00 AM
Session Physicians and Physician Organizations: Making the Purchasing Decision – Developing Your Requirements and Making Your Selection

2. MGMA Information Exchange
Information Systems Selections – RFIs and RFPs – 282 respondents (Item #4879 – December 2002)
Who selects?
Administrator (93%),
Physicians (46%),
Support Staff (53%),
CIO (27.8%),
Medical Director (31%)
Consultant used – 9%

3. Evaluation Methodology
Formal RFI Process – 24%
Formal RFP Process – 25%
Establish
Essential elements,
Current system uses,
Expectations
“On-line” demos

4. The selection process…
Know your vision
Gain buy-in of the stakeholders
Assemble a selection committee
Do an internal needs assessment
Research available technology
Develop the RFP
Create a shopping list
Project costs
Narrow the list of vendors
Net demos and/or on-site demos
Due diligence
Vision - long-term based on the organization’s business strategy. Consider workflow linkages between business and clinical processes. Update the strategic plan prior to IT vision.
Buy-in is critical - both from the people paying for it and the people using it!
Selections committee should be multi-disciplinary
Market analysis - part of SWOT process - where is the group going? Where is technology going?
Internal needs assessment - again, part of SWOT analysis - assess current system & hardware, network in place, etc…
Available technology - consider interface w/current system; read, read, read; ask, ask, ask…
Budget - buying the present AND the future…upgrades, maintenance, etc.

5. Creating an RFP… Practice section: Vendor section:
Description of the practice
Statement of MIS needs
Current systems – software/hardware/network
Instructions for response including timeline
Vendor section:
Headquarters, background, financial information
Number of installations, number of physicians, specialties
Description of software/capabilities (checklist provided)
Description of database, integration capabilities
Support and maintenance requirements including upgrades
Cost projections
Implementation schedule
Specimen agreement

6. Core Functionalities of an EHR System Institute of Medicine Committee on Data Standards for Patient Safety Letter Report May 2003 (
Health information and data
Results management
Order entry/management
Decision support
Electronic communication and connectivity
Patient support
Administrative processes
Reporting and population health management

7. 6 Key Selection Factors Functionality Flexibility Support availability
Integration capability
Scalability
Cost
Functionality - easy to learn, easy to use (intuitive interface for full use); automate in stages; prioritize-billing & A/R first…
Scalability - individual components must be “scaleable to meet future requirements; open-system architecture to allow customization, expansion, easy maintenance and be upgradeable.
Support availability - from installation to phone support; check the track record, visit the service center, check training schedules
Flexibility - customize reports and change minor settings; user capability to create templates
Cost - software, hardware, downtime, staff training
Integration - avoid double entry

8. Return on investment... Savings: Transcription Paper charts Printing
Storage
Personnel
Gains
Coding
Documentation
Quality of care
Efficiency
Value-added services

9. Concluding the selection process…
Negotiate the contract
Set implementation guidelines
The contract -
NEVER accept a standard contract on this huge investment.
Make sure all of the group’s needs are addressed without any expensive, unnecessary extra’s thrown in.
Have legal review
Negotiating will reflect vendor’s style on future interactions
Include damages for failure to meet deadlines or performs as spec’ed
Implementation guidelines - next week

10. Other considerations... Your practice, your needs…
Internal capabilities
Cycle of service...
Knowing what areas have service needs is the same as knowing what areas might benefit from technology…
Know your technology quotient
Return to the cycle of service...

11. Susan R. Miller RN, FACMPE
Administrator
Family Practice Assocs. of Lexington (KY)
Independent Consultant
Medical Group Management Association (MGMA) Health Care Consulting Group
Englewood, CO