Provider organizations and physician practices continue to change their EHR systems at a staggering pace. Recent estimates suggest between 30 and 50 percent of current EHR sales are for replacements of existing systems. In looking at the national healthcare landscape, it is clear that large integrated delivery networks, single hospitals with greater than 250 beds and academic institutions are actively implementing, have recently completed their implementation, or are currently replacing their EHRs.
While those findings represent a large segment of the market, we can’t forget about the smaller, independent physician practices specialties with very specific needs struggling to evolve their EHRs. A recent Black Book Rankings poll reveals that 80 percent of nephrologists, urologists, and ophthalmologists reported their EHR did not meet their basic needs. This same report shows a dissatisfaction rate of more than 70 percent among gastroenterologists, orthopedists, and immunologists. In view of these statistics, it would stand to reason the market for specialty specific EHRs will surely continue to grow.
Vendor selection — Is it REALLY necessary?
It was not long ago that a detailed vendor selection process might take organizations months — in some cases years — to complete. This process entailed calculating and recalculating the total cost of ownership, developing a complex return on investment, and ensuring board approval and agreement in a 5 to7 year return.
Organizations no longer have the luxury of completing a laborious selection process nor can most afford to do so. Unfortunately, that means many are inadequately assessing the needs of their organizations. Black Book Rankings reports that 79 percent of practices did not adequately assess needs before selection. This statistic is telling and the implication of this lack of frontend exploration speaks loudly to the fact that a vendor selection process is important and necessary now and going into 2014. So what do organizations do if they can’t afford a full vendor selection yet a true assessment needs to be completed?
Focus on stralection
While a well-defined process and approach is ideal in a perfect world, it is unrealistic to expect organizations to revert to the days of the multi-year vendor selection process. Instead, they should merge a clear organizational strategy with a streamlined version of vendor selection to manage a “stralection” process.
Stralection is a plan of action involving the marriage of strategy development and vendor selection in order to expedite the selection process. This process ensures that organizations do not lose sight of their overall strategic goals and objectives; moreover, it provides confidence to your board and executive leadership that decisions made are responsibly completed.
A few “stralection” best practices to keep in mind:
This is NOT an IT project: If you don’t have operational ownership, your EHR project is doomed. Recruit your organization’s CMIO, CNO and medical director to lead the process. This can’t, and shouldn’t, be driven by the CIO.
Don’t make this a C-suite decision: Appoint a steering committee who pledges full commitment to the process by actively participating and scoring each vendor demonstration. Engage as many end users as possible to participate in EHR demonstrations and submit their feedback. Though the system decision still resides with the steering committee, their input will be invaluable.
Vendor management is an art: While a full RFI/RFP isn’t necessary, select two to four legitimate vendors to participate in the process. Provide global and functional requirements to your selected vendors four to five days prior to the scheduled demonstration. This forces the vendor to demonstrate functionality live — not the system as seen through rose-colored glasses.
