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HIT Toolkit
Understanding the Marketplace and Vendor Selection
Sponsors:
22
• Sponsored by Aging Services of Minnesota and its subsidiary, Alliance Purchasing for nursing homes
• Produced by Stratis Health
HIT Toolkit for Nursing Homes
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• Margret AmatayakulRHIA, CHPS, CPHIT, CPEHR, FHIMSS
President, Margret\A Consulting, LLC Schaumburg, IL
• Independent information management and systems consultant, who focuses on achieving value from electronic health records, HIPAA, and health information exchange
• Adjunct faculty College of St. Scholastica, Duluth, MN, masters program in health informatics
• Founder and former executive director Computer-based Patient Record Institute, associate executive director AHIMA, associate professor University of Illinois
• Active participant in standards development, HIMSS BOD, and co-founder of and faculty for Health IT Certification
Presenter
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Stratis Health● Stratis Health is a nonprofit organization that leads
collaboration and innovation in health care quality and safety, and serves as a trusted expert in facilitating improvement for people and communities
● Stratis Health works toward its mission through initiatives funded by federal and state government contracts, and community and foundation grants, including serving as Minnesota’s Medicare Quality Improvement Organization (QIO)
● Stratis Health operates the Health Information Technology Services Center for health care organizations seeking to use health information technology in support of their clinical transformation
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• What are you buying?• Vendor state of affairs• CCHIT certification• Requirements analysis
• Going to market with request for proposal• Due diligence• Key differentiators• Contracting
Agenda
HIT Migration Path: What Are You Buying?
Timeline Current Phase I Phase II Phase N
Goals Support documentation
Patient safety Quality of care
Applications:- Financial/
Administrative- Operational
- Clinical
ADT/CensusAccountingPayroll/T&ALaboratory IS Provider Portal
MDS
Order Entry w/e-RxEMAR
AssessmentsCare PlansExecutive Dashboard
Technology- Database- Network &
Infrastructure- Interfaces
DOS-basedDSL for Internet
T1
Data RepositoryWindows XPNCPDP Interface with O/E and SureScripts
Operations- People- Policy- Process
IS contractor Project ManagerNo Lab PrintoutsProcess Redesign
IT staffHL7 ComplianceRetail Pharmacy Readiness?
Data AnalystClinical Guidelines
Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.
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Reality for Many Nursing Homes
• Buy from incumbent– What incumbent offers
• Or – Depend on standalone systems– Utilize expensive interfaces– Wait for the vendor to catch up
• If part of corporate structure– Take what you get– But hopefully address the people, policy, and process issues well
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Vendor State of Affairs/CCHIT(Certification Commission for Health Information Technology)
0
50
100
150
200
250
1995 1997 1999 2003 2008A 2008H LTC
# EHRvendorsw/same name as previous year on annual EHR market survey
Total Number of Ambulatory EHR VendorsCCHITEstimates 24 AcuteCare EHRVendors
CCHITCertified
CCHIT Certified
LTC # Vendors*20052008No CCHITCertification
Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.
* Provider
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CCHIT 2007 Hospital Certification
RadiologyLab InpatientPharmacy
CPOEClinicalDocumentation EMAR Results
ManagementReporting
Imaging
BloodBank
Dietary/Nutrition
MedicineDispensing
DevicesRobotics
Smart Infusion Pumps
MonitoringEquipment
“Smart” Peripherals
Departmental Clinical Applications
Core Clinical Applications
IntensiveCare
Perioperative/Surgical
Cardiology OncologyEmergencyMedicine
Labor &Delivery
Specialty Clinical Applications
EHR FoundationR-ADT, Order Communication
Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.
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Goal to Provide to CCHIT
180 pages of functional requirements
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Requirements Analysis• Work flow and process
mapping• Scenario development• Use case analysis
• Performance-based RFP• Due diligence• Contract• System build• Testing• Training• Benefits realization Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.
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Going to Market• Goal is to ultimately narrow the
field to your vendor of choice• Initial canvass of marketplace
– Trade publications
– Trade shows
– Association colleagues
– Vendors implemented in community
– Online demos
• Use a code of conduct to remove any bias from process
Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.
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Request for Proposal• Document to request detailed
information about – Vendor– Suite of products– Product functionality– Technical requirements– Implementation, testing,
and training strategies– Contractual considerations– Formal bid
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Due Diligence
• Investigation into the elements of a major investment
• For HIT and EHR– RFP response analysis– Product demonstrations– Site visits– Reference checks– Corporate analysis
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RFP Analysis
1. Develop a key differentiator tool* to focus review
2. Review complete RFP response for: a. Completeness
b. Serious weaknesses
3. Review RFP response to score key differentiators
4. Plan to append response to RFP to contract
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*Key Differentiators
Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.
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Contract Negotiation• Negotiation is an iterative
process of give and take• Do not plan to work out details
after contract is signed. There is no leverage after contract signing
• Get it in writing. What you are told in demos, see on site visits, or are promised by sales staff have no contractual impact.
• Maintain validity of business points
• Keep a list of contract issues and resolutions
• Read and verify the final contract version prior to signing
• Manage to the contract
Price is an offer to sellCost is what you pay to vendorTotal cost of ownership is all costsPayment is transfer of funds.Value is what you get
Schedule Vendor Buyer
Down payment 50% 10%
Software install 25% 10%
# days after software install 25%
Completion of training 20%
Completion of testing 20%
Go live 20%
90 days after go live 20%
Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.
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Contact:
Stratis Health
2901 Metro Dr., Suite 400
Bloomington, MN 55425
952-854-3306
1-877-787-2847 (toll free)
www.stratishealth.org
For More Support