Health care provider organizations buying an information system go through a long process to select the right vendor, but oftentimes a single incident can make a difference in sealing the deal--or killing it.

For Kerry Noble, CEO at Pemiscot Memorial Health Systems in Hayti, Mo., his confidence in a particular electronic health records vendor went way up when Ramsey Evans, CEO of Prognosis Health Information Systems, wrote in the contract that he'd refund the cost of the software if the hospital did not attest to EHR meaningful use within 120 days of go-live. Noble then went to a local bank and got financing to cover the costs of implementation through attestation-with Prognosis' guarantee as collateral. The first meaningful use incentive payment exceeded the cost of the EHR by about $500,000, Noble says.

At 48-bed Sabine Medical Center in Many, La., the willingness of one vendor to make promises-and put them in writing-helped close the deal when the center purchased its first emergency department information system, says Karen Ford, R.N., chief nursing officer. Cost is-and always will be-a big part in the vendor selection process Ford says. But in this case, veEDIS Clinical Systems of Plantation, Fla., promised specific levels of 24x7 on-site, peer-to-peer support by nurses, physicians, and technicians for the first two weeks after go-live. "That is a big deal when you're trying to transition an emergency room," Ford says.

In many I.T. purchases, the final decision really comes down to cost, and at the end of the process there's typically not huge differences between the final candidates. But there are moments in the vendor selection process when the light goes on for an organization that a vendor isn't the right one. In particular, site visits to existing clients of the vendors provide valuable insight if done right, says Paul Burke, director of revenue cycle technology at IMA Consulting in Chadds Ford, Pa. He specializes in vendor selection for financial and enterprise resource planning applications.

Burke advises I.T. decision-makers to insist on a site visit to a hospital with a similar environment and network infrastructure, the same core information system and as close to the same integration package as their facility, Burke advises. If buying contract management software, you don't want to be steered to a McKesson hospital when you are using Siemens.

Bring super-users on the site visit as they know the troublesome day-to-day issues that users of your current software have. The super-users can find common ground with peers and get assurances on how they rectified similar issues. Also, start negotiations before the site visits to keep the sales cycle from going any longer than necessary, but only giving vendors information you think they need at that point, he suggests.

Above all, use whatever leverage you have in negotiations, such as being a long-standing customer with an option to go with a different vendor, or offering to be a flagship site who will host prospective clients. "There's a sense of loyalty to certain vendors. But if a new vendor can provide the same or better service, it's something you really need to explore," Burke says.

Hospitals can do vendor selection themselves if they have an experienced workforce with a lot of institutional knowledge, Burke acknowledges. "But if you have sustained high turnover, an outside voice can be very helpful. Also look at excess capacity. Are employees struggling to get day-to-day work done, or staffed well enough to take on more work?"

Joe Goedert’s feature story in the November issue of Health Data Management examines various vendor selection strategies that providers have employed, and the benefits gained and lessons learned.

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