System Selection: A defining moment in your organization

System Selection is the process of evaluating, identifying and determining which system or combination of systems would be best for the organization. Every organization is unique, although numerous factors will be similar to other organization. Examples of these include community based hospitals, academic organizations, IDN’s, and pediatric organizations, ambulatory, physician practices and many more. What is important to note is that every organization has multiple layers of variables which needs to be evaluated to understand your system and operational requirements.

It’s easy to take the 10 basic evaluation questions most selection processes review; however, it’s been my experience these just don’t answer enough critical questions to understand which is best. In fact, that wouldn’t even clearly define current state, let alone future criteria. Some organizations simply review it from a clinical perspective and while it’s primary function is as a clinical tool, the days of standalone (functioning) system are gone, modern healthcare information systems (HIS) need to integrate with revenue cycle systems, materials management, pharmacy, ancillary, as well as, back-end operations, service system and modules. Therefore it’s critical for organizations to have strong Strategic Operations and IT plans.

Now, here is where it gets interesting. With the ability to connect and utilize HIE’s and other interfacing and interoperability solutions, we now have to consider future connectivity options for future HIE based services, such as clinical decision support, laboratory and even radiology services. Therefore, your system needs to have flexibility and so does your strategic plans. Historically, we have bought or developed individual interfaces where connectivity was required, unless you happen to be a Best of Breed (BOB) organization then you normally had an interface engine but an expensive option to develop. Now, we will have the ability to exchange this information simply and securely, so expect and increase in services to medical providers.

In my methodologies I use 5 primary areas of focus with more in-depth focus on specific areas within those.

My primary focus areas are;

  • Business Case – It’s imperative to start with a solid, well thought out business case, using KPI’s (Key Performance Indicators) and carefully defined critical success factors.
  • Business/Clinical Process & Workflow Review – Careful identification of all processes and workflows, including current and future areas of concern. We tend to focus our attention on things we know that works, when it’s best to review it based on what currently needs improvement as a priority. This is both system and process improvements.
  • Requirements Definition & Analysis – Carefully analyze and derive key and unique requirements for the system. You will want to analyze  system and process requirements but ensure they don’t limit your future flexibility.
  • Vendor Review – Researching vendor systems needs careful attention. The vendors will naturally provide references and testimonial clients but dig deeper. Do a comparative analysis using health providers similar to you that use that system, independent of the vendor. Prepare a series of questions you will want ‘real’ answers to.  Lastly, require a virtual demo, where the vendor demonstrates not just to you but to your physicians, nurses and all other staff. This will do several things for you; first, it will help pull your clinical staff into the initiative and give them a real perspective on what they could have. Secondly, it requires the vendor to actually demonstrate the things you want will work together the way they say it will. Thirdly, it will let you know what vendors really want your business and are willing to go the extra mile.
  • Contract Negotiations – Negotiations require very special attention and experience. Please make certain to have legal counsel familiar with vendor management and relations. Additionally, make certain the vendor is accountable financially for any delays they cause (code delivery, fixes, etc…), including covering your expense commitments. Put pressure on the vendor to ensure they can and will deliver. Understand the ongoing maintenance requirements and future costs. Be certain to have an exact understanding of what you are getting, what is considered a ‘service’ versus product and therefore ongoing charges and what the vendors goals for the implementation are (trust me, they aren’t the same as yours).

I’ve been through several system selection processes and can say with certainty, the final requirements are usually significantly different from what you expect before going through the process if you do a good review and analysis. Always find an experienced professional to help to assist through the process. Even slight adjustments can have huge effects.


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Filed under Change Management, Clinical, Healthcare Reform, HIE - Health Information Exchange, HIS, Meaningful Use, Project Management, System Selection, Uncategorized

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