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Page 1: Preparing the Request for Proposal EHR
Page 2: Preparing the Request for Proposal EHR

Preparing the Request for Proposal EHRPreparing the Request for Proposal EHR

Bill French VP eHealth StrategiesBill French VP eHealth StrategiesWisconsin Office of Rural Health HIT Wisconsin Office of Rural Health HIT

ImplementationImplementationStevens Point, WIStevens Point, WIAugust 24, 2007August 24, 2007

Page 3: Preparing the Request for Proposal EHR

Presentation Will CoverPresentation Will Cover

Description and use of the RFPDescription and use of the RFP

Difference between RFP and RFIDifference between RFP and RFI

Structure of the RFPStructure of the RFP

Suggestions for the RFPSuggestions for the RFP

Opportunity to Practice what you learnedOpportunity to Practice what you learned

Page 4: Preparing the Request for Proposal EHR

What is an RFP?What is an RFP?

Legal, proprietary document prepared by Legal, proprietary document prepared by the Hospital to identify and attract the right the Hospital to identify and attract the right vendors to supply the software, hardware, vendors to supply the software, hardware, operating system and interoperability operating system and interoperability required for a successful e Electronic Health required for a successful e Electronic Health RecordRecord

Part of the life cycle of the EHR application Part of the life cycle of the EHR application

Page 5: Preparing the Request for Proposal EHR

What is an RFP? (Cont)What is an RFP? (Cont)

Its purpose is to provide the information to Its purpose is to provide the information to the decision maker's required to select the the decision maker's required to select the vendor finalist(s) vendor finalist(s)

Eliminate the vendors the hospital no longer Eliminate the vendors the hospital no longer wishes to considerwishes to consider

Page 6: Preparing the Request for Proposal EHR

First ImpressionsFirst Impressions

RFP may be the first contact with the RFP may be the first contact with the vendorvendor

Will set the tone for a professional Will set the tone for a professional relationship with the vendorrelationship with the vendor

Will become part of future agreements Will become part of future agreements (contracts) (contracts)

Instrumental in due diligenceInstrumental in due diligence

Page 7: Preparing the Request for Proposal EHR

Code of Conduct for Vendor SelectionCode of Conduct for Vendor Selection

Educate all members of the staff on the Educate all members of the staff on the Code of ConductCode of Conduct

Will reduce your risk that a vendor can Will reduce your risk that a vendor can claim unfair treatmentclaim unfair treatment

Portrays the appropriate professional Portrays the appropriate professional climate climate

Page 8: Preparing the Request for Proposal EHR

The Difference Between the RFP and the RFIThe Difference Between the RFP and the RFI

RFP-RFP-

Small number of final Small number of final vendors, 4 or lessvendors, 4 or less

ComprehensiveComprehensive

Information gathering Information gathering tool on specific tool on specific vendorsvendors

Asks for pricingAsks for pricing

RFI-RFI-

Large number of Large number of potential vendors >5potential vendors >5

Limited in scopeLimited in scope

Information gathering Information gathering tool on the industrytool on the industry

May not ask for May not ask for pricing pricing

Page 9: Preparing the Request for Proposal EHR

Step TwoStep Two

You did Step One during the Planning You did Step One during the Planning PhasePhase

If you did not go through a Planning Phase If you did not go through a Planning Phase do not attempt Step Twodo not attempt Step Two

Page 10: Preparing the Request for Proposal EHR

During Step One You:During Step One You:

Accomplished your need’s assessment, goal Accomplished your need’s assessment, goal setting, process mapping, etc.setting, process mapping, etc.

You have to be able to reflect this in the You have to be able to reflect this in the RFP so the potential vendor understands RFP so the potential vendor understands what you want to accomplish with your what you want to accomplish with your EHR EHR

Page 11: Preparing the Request for Proposal EHR

A Structure for the RFPA Structure for the RFP

Contact InformationContact Information

Hospital background and informationHospital background and information

Vendor background and informationVendor background and information

References References

System FeaturesSystem Features

Pricing and ContractsPricing and Contracts

Page 12: Preparing the Request for Proposal EHR

A Structure for the RFP (cont)A Structure for the RFP (cont)

System SupportSystem Support

ImplementationImplementation

Documentation and trainingDocumentation and training

Technical design and operational requirementsTechnical design and operational requirements

Report generation and toolsReport generation and tools

Security Security

ConfidentialityConfidentiality

Page 13: Preparing the Request for Proposal EHR

Contact InformationContact Information

Legal Name of the HospitalLegal Name of the Hospital

Name of single contactName of single contact

Method of contact Method of contact Mail-address for deliveryMail-address for delivery

EmailEmail

Deadline for responseDeadline for response

Page 14: Preparing the Request for Proposal EHR

Hospital Background and InformationHospital Background and Information

Hospital demographics-Hospital demographics-

Type of hospitalType of hospital

Number and locations of hospital sitesNumber and locations of hospital sites

Number of providers and other staffNumber of providers and other staff

Number of visits for past three yearsNumber of visits for past three years

Number of new patients for future three Number of new patients for future three yearsyears

Page 15: Preparing the Request for Proposal EHR

Other Information About the HospitalOther Information About the Hospital

Anticipated changes in the hospitalAnticipated changes in the hospital

Share your vision of the hospital and what Share your vision of the hospital and what you wish to accomplish with the productyou wish to accomplish with the product

Touch on the major applications Touch on the major applications (documentation, decision support, (documentation, decision support, e-prescribe) to give the vendor the scope of e-prescribe) to give the vendor the scope of your EHR your EHR

Page 16: Preparing the Request for Proposal EHR

Primary ContactPrimary Contact

One person with ultimate responsibility for One person with ultimate responsibility for preparation of the RFP and contact with the preparation of the RFP and contact with the vendorsvendors

Okay to have a Steering Group, but the Okay to have a Steering Group, but the person doing the RFP should manage the person doing the RFP should manage the processprocess

Prevents vendor from doing the “end run” Prevents vendor from doing the “end run”

Page 17: Preparing the Request for Proposal EHR

Requested Vendor BackgroundRequested Vendor Background

Contact InformationContact Information

ReferencesReferences

Research ActivitiesResearch Activities

StaffingStaffing

Recent acquisitions and mergersRecent acquisitions and mergers

Financial StatementsFinancial Statements

Page 18: Preparing the Request for Proposal EHR

Requested Vendor Background (Cont)Requested Vendor Background (Cont)

Business alliances and partnershipsBusiness alliances and partnerships

Years in the businessYears in the business

Page 19: Preparing the Request for Proposal EHR

Contact InformationContact Information

Vendor’s primary contact informationVendor’s primary contact information

Vendor’s preferred method of Vendor’s preferred method of communicationcommunication

LocationsLocationsCorporate HeadquartersCorporate Headquarters

Field support offices Field support offices

Page 20: Preparing the Request for Proposal EHR

ReferencesReferences

Total number of installationsTotal number of installations

Client installations similar to your hospitalClient installations similar to your hospital

Contact information for three hospitals Contact information for three hospitals similar to yourssimilar to yours

Page 21: Preparing the Request for Proposal EHR

Research ActivitiesResearch Activities

Product DevelopmentProduct Development

Number of new products/applications in the Number of new products/applications in the last 3-5 yearslast 3-5 years

Good place to ask about what is an upgrade Good place to ask about what is an upgrade and what is an enhancementand what is an enhancement

Page 22: Preparing the Request for Proposal EHR

Number and Breakdown of Number and Breakdown of Vendor’s EmployeesVendor’s Employees

Skill sets availableSkill sets available

Level of sub-contracting Level of sub-contracting

What personnel resources are included in What personnel resources are included in the basic contract and what is an additional the basic contract and what is an additional chargecharge

Page 23: Preparing the Request for Proposal EHR

Recent Acquisitions and MergersRecent Acquisitions and Mergers

Some indication of the vendor’s role in a Some indication of the vendor’s role in a larger organizationlarger organization

Is the EHR product a “leader” or “feeder” Is the EHR product a “leader” or “feeder” application? application?

How much does the primary vendor How much does the primary vendor control?control?

Answer the “off shore” questionAnswer the “off shore” question

Page 24: Preparing the Request for Proposal EHR

Financial StatementsFinancial Statements

Ask for last five yearsAsk for last five years

Should provide indication of the financial Should provide indication of the financial stability of the companystability of the company

Be prepared for refusal to provide financial Be prepared for refusal to provide financial statements if the vendor is not a traded statements if the vendor is not a traded companycompany

Page 25: Preparing the Request for Proposal EHR

First Practice ExerciseFirst Practice Exercise

Based on the needs assessment and the goals Based on the needs assessment and the goals you have set for your hospital, in 75 words you have set for your hospital, in 75 words or less, write a paragraph to include in the or less, write a paragraph to include in the description of your hospital section of the description of your hospital section of the RFP that will provide the vendor an RFP that will provide the vendor an overview of how you will use the EHR.overview of how you will use the EHR.

Page 26: Preparing the Request for Proposal EHR

System FeaturesSystem Features

EHR FeaturesEHR Features

Pricing and ContractsPricing and Contracts

System SupportSystem Support

ImplementationImplementation

Documentation and TrainingDocumentation and Training

Page 27: Preparing the Request for Proposal EHR

System Features (Cont) System Features (Cont)

Technical Design and Operational Technical Design and Operational Requirements Requirements

Integration with billing and other systemsIntegration with billing and other systems

Other InterfacesOther Interfaces

Report Generation and ToolsReport Generation and Tools

SecuritySecurity

Page 28: Preparing the Request for Proposal EHR

EHR FeaturesEHR Features

Clinical ManagementClinical Management

Clinical DocumentationClinical Documentation

WorkflowWorkflow

Clinical ContentClinical Content

Page 29: Preparing the Request for Proposal EHR

Clinical ManagementClinical Management

Ability to manage information about your Ability to manage information about your patient population:patient population:

Ability to search and report on prescribed Ability to search and report on prescribed medications in case of a drug recallmedications in case of a drug recall

Ability to transfer demographic information Ability to transfer demographic information between the HER and other systemsbetween the HER and other systems

Page 30: Preparing the Request for Proposal EHR

Clinical DocumentationClinical Documentation

Documentation at the patient level:Documentation at the patient level:

Ability to build notes from drop down Ability to build notes from drop down menusmenus

Web based patient interviewing that can be Web based patient interviewing that can be incorporated into a noteincorporated into a note

Ability to carry forward review of systems, Ability to carry forward review of systems, problem list, and medicationsproblem list, and medications

Page 31: Preparing the Request for Proposal EHR

WorkflowWorkflow

Care for patient as they move through the Care for patient as they move through the system-system-

Generate task lists for providers and other Generate task lists for providers and other hospital staffhospital staff

Page 32: Preparing the Request for Proposal EHR

Clinical ContentClinical Content

Clinical ToolsClinical Tools

Patient education materialsPatient education materials

Integrated evidence based guidelines for Integrated evidence based guidelines for adult medicineadult medicine

Page 33: Preparing the Request for Proposal EHR

Pricing Pricing

Separate pricing for software, Separate pricing for software, implementation, interfaces, hardware, etcimplementation, interfaces, hardware, etc

Method of pricing – it can beMethod of pricing – it can beNumber of providersNumber of providers

Number of usersNumber of users

Concurrent usersConcurrent users

Patient censusPatient census

Page 34: Preparing the Request for Proposal EHR

Pricing (cont)Pricing (cont)

Maintenance and support pricing – does it Maintenance and support pricing – does it include?include?

Warranty PeriodsWarranty Periods

Future EnhancementsFuture Enhancements

Operating system and related environmental Operating system and related environmental softwaresoftware

Migration to emerging technologies Migration to emerging technologies

Page 35: Preparing the Request for Proposal EHR

ContractContract

Ask for a copy of the vendor’s standard Ask for a copy of the vendor’s standard contractcontract

Check the contract to see if modification is Check the contract to see if modification is prohibitedprohibited

Page 36: Preparing the Request for Proposal EHR

System Support System Support

Disaster RecoveryDisaster Recovery

Support coverage hoursSupport coverage hours

Response Time Response Time

Range and average system downtimeRange and average system downtime

Help Desk Help Desk

Page 37: Preparing the Request for Proposal EHR

ImplementationImplementation

Overview of implementation processOverview of implementation process

Sample project plan with a timelineSample project plan with a timeline

Typical time from contract signing to start Typical time from contract signing to start of implementationof implementation

Page 38: Preparing the Request for Proposal EHR

System Documentation System Documentation

Description of documentation providedDescription of documentation providedApplication manualsApplication manuals

System administrator manualsSystem administrator manuals

Operating system manualsOperating system manuals

Training manualsTraining manuals

Documentation media – hardcopy, CD, webDocumentation media – hardcopy, CD, web

Page 39: Preparing the Request for Proposal EHR

Training DocumentationTraining Documentation

Training offeredTraining offeredDurationDuration

LocationLocation

Associated costsAssociated costs

Provider specific?Provider specific?

Retraining/training of new employees Retraining/training of new employees

Training/test system providedTraining/test system provided

Page 40: Preparing the Request for Proposal EHR

Technical Design Documentation Technical Design Documentation

Information on the environment in which the Information on the environment in which the system functions:system functions:

Application web based or client/server?Application web based or client/server?

Year of development?Year of development?

Internally developed or acquired from a Internally developed or acquired from a third party?third party?

Backup environment and proceduresBackup environment and procedures

Page 41: Preparing the Request for Proposal EHR

InterfacesInterfaces

Interfaces have two sides:Interfaces have two sides:Identify additional interface costs from the Identify additional interface costs from the vendorvendorIdentify interfaces required from other Identify interfaces required from other vendorsvendors

Page 42: Preparing the Request for Proposal EHR

Report GenerationReport Generation

Is the report writing application supplied by Is the report writing application supplied by a third party?a third party?

Is there more than one report writer Is there more than one report writer application?application?

Ask the vendor to specify which data Ask the vendor to specify which data elements can be queriedelements can be queried

Any special training provided?Any special training provided?

Page 43: Preparing the Request for Proposal EHR

SecuritySecurity

Another opportunity to ask the “off shore” Another opportunity to ask the “off shore” questionquestion

Ask for detailed approach to Ask for detailed approach to data/information security, especially with data/information security, especially with regards to internet technologiesregards to internet technologies

Page 44: Preparing the Request for Proposal EHR

ConfidentialityConfidentiality

Does the system log all accesses at the user Does the system log all accesses at the user level?level?

Does the system provide a disclosure log to Does the system provide a disclosure log to track releases of information outside the track releases of information outside the hospital?hospital?

Page 45: Preparing the Request for Proposal EHR

Preparing the RFPPreparing the RFP

Be conciseBe concise

Don’t ask “can” ask “tell me how”Don’t ask “can” ask “tell me how”

Some questions are yes/noSome questions are yes/no

Some questions require a narrativeSome questions require a narrative

Some questions require bothSome questions require both

Page 46: Preparing the Request for Proposal EHR

Be ConciseBe Concise

Two-three sentence questions that can be Two-three sentence questions that can be answered in two-three paragraphsanswered in two-three paragraphs

Want to be able to compare responses from Want to be able to compare responses from different vendorsdifferent vendors

Needs to support due diligenceNeeds to support due diligence

Links responses to contract termsLinks responses to contract terms

Page 47: Preparing the Request for Proposal EHR

Distribution of the RFPDistribution of the RFP

Done by the Primary ContactDone by the Primary Contact

Send it to all vendors at the same timeSend it to all vendors at the same time

If possible, distribute to all vendors by the If possible, distribute to all vendors by the same methodsame method

Do not send the RFP to vendor you have no Do not send the RFP to vendor you have no intention of engaging intention of engaging

Page 48: Preparing the Request for Proposal EHR

Distribution of the RFP (Cont)Distribution of the RFP (Cont)

Provide a minimum of 8-10 weeks for the Provide a minimum of 8-10 weeks for the vendor to respondvendor to respond

Determine how you will handle late Determine how you will handle late responsesresponses

Need to be consistent with all vendorsNeed to be consistent with all vendors

Be consistent with all vendors if you need to Be consistent with all vendors if you need to request additional informationrequest additional information

Page 49: Preparing the Request for Proposal EHR

Response to RFP Response to RFP

Acknowledge receipt of response to RFPAcknowledge receipt of response to RFP

Indicate when a decision will be madeIndicate when a decision will be made

Notify all vendors of the decision at the Notify all vendors of the decision at the same timesame time

Non-selection communication is importantNon-selection communication is important

Timely follow-up with selected vendor to Timely follow-up with selected vendor to start the next stepsstart the next steps

Page 50: Preparing the Request for Proposal EHR

Some Things to Look ForSome Things to Look For

Did the vendor “outsource” the response to Did the vendor “outsource” the response to the RFPthe RFP

Ratio of “Marketing Material Content” Ratio of “Marketing Material Content” (glossies) vs. an original response tailored (glossies) vs. an original response tailored to the RFPto the RFP

Beware of vendor supplied RFP templates Beware of vendor supplied RFP templates

Page 51: Preparing the Request for Proposal EHR

Some Things to Look For (Cont)Some Things to Look For (Cont)

Some vendors suggest that an RFP is “not Some vendors suggest that an RFP is “not necessary”necessary”

The Standard Contract that cannot be The Standard Contract that cannot be modifiedmodified

The free lunch – If the first response to the The free lunch – If the first response to the RFP is “to do lunch” say “no thank you”RFP is “to do lunch” say “no thank you”

Page 52: Preparing the Request for Proposal EHR

Second Practice ExerciseSecond Practice Exercise

One of the vendor recipients of the RFP calls One of the vendor recipients of the RFP calls you on the telephone. The person has a list you on the telephone. The person has a list of questions “to more fully respond to the of questions “to more fully respond to the RFP.” The caller wants to meet at your RFP.” The caller wants to meet at your hospital and wants to meet the physicians hospital and wants to meet the physicians and other members of the staff.and other members of the staff.

How do you respond? How do you respond?

Page 53: Preparing the Request for Proposal EHR

Third Practical ExerciseThird Practical Exercise

The deadline for the vendor to respond is in The deadline for the vendor to respond is in two days. The vendor calls and requests an two days. The vendor calls and requests an additional:additional:

DayDay

WeekWeek

Two weeks Two weeks

How do you respond?How do you respond?

Page 54: Preparing the Request for Proposal EHR

Fourth Practical ExerciseFourth Practical Exercise

You have informed the vendors they were You have informed the vendors they were either selected or not selected. One of the either selected or not selected. One of the vendors you did not select calls and wants vendors you did not select calls and wants to meet with you. The vendor wants to to meet with you. The vendor wants to bring their CEO.bring their CEO.

How do you respond?How do you respond?

Page 55: Preparing the Request for Proposal EHR

Contact InformationContact Information

MetaStar, Inc.MetaStar, Inc.2909 Landmark Place2909 Landmark PlaceMadison, WI 53713Madison, WI 53713

Phone number 608 441-8246Phone number 608 441-8246

www.metastar.comwww.metastar.com

[email protected]@metastar.comThis material was prepared by MetaStar under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 8SOW-WI-PO-06-49