Tips for Negotiating with EHR Vendors

Before signing the contract with a new EHR vendor, think about the immediate and future implications on your healthcare organization, end users, workflow, business operations and the patient community. Be willing to consider the following questions when approaching this daunting IT decision:

  1. What is the main goal we are trying to achieve?

    Don’t buy or opt in for additional or added features when you don’t need them for your practice. Additional functionality and available modules can always be negotiated from a pricing standpoint (which you should be able to be lock in for at least two years) as an option exercised at a later date if the scope of the practice changes and there is a need for the additional product. Another thing to remember is, just like cars and furniture, software is always on sale. The level of discount you are able to achieve will depend on a number of factors, including success of the vendor, timing in the quarter or fiscal year and length of agreement you are willing to enter into.

  2. What’s the best way to achieve win-win outcomes in the negotiation with a new EHR vendor?

    Remember that the best executed software agreement is one that both the customer and the vendor feel good about. The goal is for the agreement to be a win-win result. It should provide a quality and supportable product for the medical practice in an agreement that the vendor feels good about to provide the appropriate support. With a win-win agreement, the vendor is much more likely to go the extra mile in assisting the customer when issues arise outside of the normal support process.

    There doesn’t necessarily need to be a bad guy in the negotiating scenario if open and honest communication is on the table during the negotiation process. Both the customer and the vendor are going to having non-negotiable items that they cannot concede on for various reasons. These should be communicated at the appropriate time during the process. Good representation from the right individuals from both a financial and clinical perspective will help to ensure that expectations are communicated for what is required and what the vendor is offering to meet the needs.

  3. What else should you consider when working with a new EHR vendor?

    Reference checks are the key to making this very important decision for your practice. Ask for a minimum of three references and at least one of those references should be a “bad” reference provided by the vendor. Although it may not have necessarily completely been the vendors’ fault for the bad references, it will provide you, the potential customer, with some insight on why that reference failed with the implementation or has not been able to fully utilize the capabilities the vendor is proposing to your healthcare organization. Good references are just that, but take the time to learn as much as possible from them about how they feel they successfully implemented the product. What was their staffing model? How long did the implementation take? Did it stay within the budget parameters? What would they have done differently to make it an even better implementation? Exchange contact information with the good references in hopes of communicating with them further in the future.

Best of luck with your negotiations!

Reflecting on the Today’s Value of HIT to Celebrate NHIT Week

Image

As we renew the excitement of the 2013 National Health IT Week, members of the Stoltenberg Consulting team have joined together to ponder the value of HIT from the small scale of a personal physician’s appointment, to a wide view of the impact on nationwide healthcare progress.

“While National Health IT week continues, I think about the value of HIT and think back to the beginning of my career in HIT.  At that time there was not the focus on HIT that there is today, but we entered the marketplace with many of the same ideas and values that are being discussed today. As an RN, patient care and patient safety and quality of care have always been at the center. Today, as I consider the value of HIT, I look far beyond where I was once focused. Today, I think of improving quality, safety and efficiency of the system as a whole. We have the ability to use data in ways that where not possible just a few years ago. Today, I see a much bigger picture and a much closer future, in which HIT is a leader and driving force behind the changes and advances in healthcare as we move forward.”

-Daniel O’Connor, Vice President of Client Relations

“Healthcare IT (HIT) is helping to shape the healthcare landscape of today and of the future. Better outcomes and decreased costs is the mantra for healthcare today. HIT is the enabler for both of those mantras. Through the digitization of healthcare data, organizations now have the ability to aggregate that data with patient’s billing data and care outcomes allowing organizations to track costs and outcomes at the micro level.  This linking of data enables an organization to identify methods to decrease the cost of care while elevating the outcomes. This same healthcare data also enables an organization to track trends in population health. By using data and predictive analysis, healthcare organizations can become proactive in delivering healthcare allowing today’s landscape to evolve and continue to provide the greatest healthcare in the world.”

-Shane Pilcher, Vice President

“As a 25-year healthcare IT veteran,  I am happy to have personally witnessed the progress we have made in the maturity of EMRs over the past decades. I saw the direct impact in my own life when I recently went to a specialist physician’s office. In my appointment, my physician was able to electronically look up my medial history, confirm my medications, and confirm if this might have a contributing factor toward my condition. Much to my amazement, through electronic medical records, we were able to confirm some lab results from my primary physician,  which resulted in avoiding retesting, as well as direct time and money savings. It had me feeling that much of my career as a change agent has paid off!”

-Mike Meyer, Vice President of Strategic Accounts

“We hear a lot about reducing costs through health information technology, but the main value is improving quality of care for our patients.  Health Information Technology is a key proponent driving that change.  With the valued goal of increased quality care to our patients, other benefits are trickling down to organizations whom have adopted health information technology every day.”

-Mike Gielata, Director of Strategic Accounts

“As healthcare IT professionals we often forget about the benefit we provide to a patient’s care or outcome, because our “patient touch” is not often felt by the patient in a direct manner. Our passion for healthcare and IT makes us some of the most uniquely qualified people in the world. Never forget that what you do every day impacts someone who is hurt/sick, injured, recovering, or dying as well as their family.

CELEBRATE! You have the privilege of experiencing an important point in history, akin to the impact the Industrial Revolution had on America back in early 19th century. Will future scholars call it the “Healthcare Revolution” or the “Meaningful Use Revolution?” I don’t know, but I’m proud to be a part of it.

NHIT week was brought about by a proclamation by President Obama in 2011. President Obama stated, ‘Everyone can play a role in improving our health care system.’  As a healthcare IT professional, you’re in the trenches.”

 -Paula Ehmer, Director, Strategic Accounts

To read more about the President’s Proclamation visit http://www.whitehouse.gov/the-press-office/2011/09/12/presidential-proclamation-national-health-information-technology-week.

To learn ways to join the NHIT week social media endeavors, visit http://www.healthitweek.org/toolkit_socialMediaStrategy.asp. Finally, check out the agenda of activities for the rest of this week at http://www.healthitweek.org/activities.asp.

Now that we’ve considered our thoughts on the value of HIT, take the time to think about yours and engage with others during this exciting week. Thanks for all you do to personally impact HIT and happy NHIT Week 2013!

Breaking Down How the HIMSS Workforce Survey Reflects the HIT Industry: Part II

Part II

As we revisit the release of the HIMSS Workforce Survey, VP of Client Relations Dan O’Connor adds to last week’s comments:

Outsourcing

Continuing feedback regarding the HIMSS Analytics Workforce Survey, let’s discuss hiring or outsourcing. This is is always a topic that gets a lot of discussion and often has people taking sides. Yet, in today’s ever-changing environment, we may need to look at outsourcing in different ways than in the past.  It is not always easier or less expensive to keep all IT internal. We must look at each situation and apply a set of principles to evaluate staffing and outsourcing.  Each organization should develop a key set of principles to use, but they should include such items as the type of skills, the length of the project or initiative, future projects, and the ability of staff to adapt or learn new skills.  Another critical factor is the make up of the organization. Are they moving as many or to a more centralized system that uses many of the same skills throughout? This may be a situation in which outsourcing is used to support legacy systems that are being replaced by integrated solutions.

Image

Making the Right IT Hire

 How do you make the right IT hire? This is difficult question with today’s ever-changing market and a workforce that is increasingly more technical.  In a market that has a shortage of qualified people, how do we hire the right people to keep our organizations moving forward and projects on time?  Identify key skills and traits that fit with your organization and then look at creative ways to find qualified people.  Look to colleges and university for more technical roles, and use internships to evaluate potential staff before they hit the job market.  For roles that are more application-specific, look to subject areas to supplement. Make sure these individuals fit well with the dynamic of the current team, and consider supplementing these areas with contract employees to fill gaps and help with training and development of subject area staff.

The next wave of healthcare IT professionals are younger with less experience, but with a high desire to learn, they and very motived by salary and benefit plans.  They are much less apt to feel attached to an organization changing firms / organizations frequently. Many are looking for their next opportunity 18 months after starting a new position.  This presents a completely different set of issues for all sectors of HIT.  Staff/employees that have a strong affiliation to an organization are becoming harder to find and a challenge to keep.  This is not all bad though. The right mix of the new generation and older can be very productive and create an environment where learning and sharing of ideas (both new and old) make for very productive projects and teams. The key is creating cohesive teams. A good “fit” is as important as the skill mix of the team.

As the market place continues to grow and mature, organizations that are not afraid to change and adapt and will survive and excel in this environment.  Many HIT organizations are slow to change or adopt new technology, tending to be less on the cutting edge than other industries. Yet, with the current challenges facing the healthcare IT workforce, organizations that are lean and adapt quickly will reap the benefits of this ever-changing marketplace.

Breaking Down How the HIMSS Workforce Survey Reflects the HIT Industry: Part I

The recently released HIMSS Workforce Study highlighted some important issues that many in the industry have been encountering firsthand for a while now. While the factors contributing to the current situation continue to change almost as fast as technology changes around us, we must look at how our organizations can adapt and thrive in this environment. Enacting programs that both attract employees and help increase staff retention are critical. Employee training and development and salary and benefit plans, as expected, are top on most current and potential employees’ lists. Also, as expected, the areas that top the needs lists for the provider and vendor sectors are project managers. Skilled PMs continue to be the hardest to find and in demand the most, followed closely by clinical application support and system design and implementation staff. On the clinical side, RNs and pharmacists lead the needs list for most, and someone with a clinical background with strong PM experience is most desired in the healthcare IT marketplace.

Image

How can organizations avoid implementation shortfalls and delays?  There are some key activities that organizations need to undertake. Strategic IT planning is essential in this environment, both short and long term. Short terms plans must be reviewed and updated frequently to ensure that the IT plans and goals are aligned with the organizations strategic plans and goals.  These plans must then be used to evaluate the skill mix of staff and the coordination of training and development plans for internal staff.  This is an area that can be used to aid in staff retention, as many areas are seeing staffing shortages due to turnover related to rising incentives for contract employees.  Organizations must also look hard before reducing attractive benefits for employees that are high on the lists for provider and vendor sectors, including items such as paid tuition, payment for professional organization memberships, and professional development programs.

 

Stoltenberg Teams with Ohio Northern University on Senior Capstone Projects

http://www.prnewswire.com/news-releases/212918611.html

 

Junior Consultant Program 2[1]

Through its Junior Consultant Program and recent participation in the Ohio Northern University James F. Dicke College of Business Administration senior capstone projects, Stoltenberg Consulting teams with ONU to provide business students with unique opportunities to learn the HIT industry.

Find out more about the ONU relationship here, and find out more about the Junior Consultant Program here .

HIT Policy Leader Places Focus on Client Needs over Vendor Dollars

ImageIn the Feb. 7 Healthcare IT News article, Diana Manos elaborates on comments made by Farzad Mostashari, MD, National Coordinator for Health Information Technology.  His comments came at a meeting of the Health IT Policy Committee.  In these comments, Mostashari eluded to the unfair practices of some EHR vendors.  He also threatened increased governmental regulations to control those practices if they continue.

I do agree there are vendors and consulting firms in our sector that see a dollar as more important than “doing what is best for the client.”  That has plagued HIT for as long as there has been HIT.  Since ARRA and HITECH, this issue has grown.  Any sector that sees the business growth HIT has had over the last couple of years, draws the attention of people that see dollars instead of opportunity to make a difference and impact our healthcare system overall.  This is not new but might be more prolific than in the past.  Mostashari focused on vendors that use unfair “data lock-ins,” contract language that has a chilling effect on clients changing vendors and false claims of interrupted reporting abilities as examples of these unethical but legal practices. In response, he said regulations might be what is required to fix this issue.

My question is why would the regulatory process be required?  As consumers of vendor and consulting firm services, the power rest with the client.  If a vendor or consulting firm is clearly looking only for the almighty dollar and does not have a genuine priority of doing what is best for the client, why would its services be purchased?  As consumers, we all have the ability to set the standards we expect by what we choose to purchase and what we choose not to purchase.  Since there are vendors and consulting firms that clearly have the best intention for their clients, there are other options instead of purchasing services from one that is only driven by the profit.  More regulations are not needed. These vendors and firms can only take advantage of someone when the client signs the contract agreeing to those terms.

In today’s market where so many mergers are occurring, where vendors and consulting firms are becoming behemoths in the HIT market, these practices of putting profits in front of customers will only increase. Using vendors and consulting firms that have resisted this trend to merge so they can continue to focus on each individual client’s needs becomes critical to stopping the growth of unfair practices that put the dollar above the needs of the client. Use your pen to send a message to create the standards you want to see become the norm. Every signature on a contract sends a message to our industry.

Getting Through a Go-Live

Have you survived a HIT go-live?  Just like “this one time, at band camp,” several of us have “this one time, at a go-live” stories to share.

Entire system go-lives, upgrades, even small optimizations can be considered a go-live. This is the time when you find out if all the testing really helped and if the end users truly absorbed the training.

Image

Though go-lives can be a true test of stamina, here are some tips to best tackle the big event:

1)      Has anyone else gone through a similar go-live?  Schedule calls with other vendor clients to go over lessons learned from their go-live.

2)      Know your schedule long in advance to prepare for the longer workdays.  Your family will be without you.

3)      Get plenty of sleep!  It can be difficult to change your sleep patterns, but you need to be alert.

4)      Don’t eat the junk food in the command center.  If food is being provided, have everyone ask for healthy alternatives to cookies and doughnuts.

5)      Document everything.  Make sure you keep good notes on any build done for the go-live.  You or a co-worker may have to undo something if it causes a problem.

6)      Be invisible when not needed and working on tickets.  The command center can get crowded and out of control at times. You want the end users who stop by to see that everything is in control, so they’ll feel comfortable.  They’ve been given a new system or a change to the system to get accustomed to and take care of patients at the same time.  Knowing their support is in control will help them more than you know.

7)      If a quick fix to an issue isn’t available, try to come up with a workaround until a permanent fix can be completed.  End users on all shifts will need to be kept up to date with workarounds and any fixes.

8)      If you’re very lucky and get caught up, ask if anyone can use your help.  You would appreciate the help, right?

9)      Be sure to thank all of your teammates!  Everyone who has supported you through the go-live would be considered your parachute packers.

10)   Once the go-live is complete and everything is working perfectly, offer your lessons learned to other vendor clients to go full circle.

Please share your best go-live stories.  What could have been done differently?  What are your suggestions for your next go-live.