Difference between revisions of "Vendor Selection Criteria"

From Clinfowiki
Jump to: navigation, search
(Demonstrate Clinical Functionality (25%))
(Future Vision (5%))
Line 125: Line 125:
 
* Improved billing accuracy and charge capture
 
* Improved billing accuracy and charge capture
 
* Electronic replacement for traditional reportable disease notifications to health departments, may become part of biosurveillance in the future.[1]
 
* Electronic replacement for traditional reportable disease notifications to health departments, may become part of biosurveillance in the future.[1]
 +
* Does the EMR require vendor intervention or an additional fee each time in order to change forms, queries, and reports? To what extend are reports customizable. Can reports be made to be generated automatically on a recurring basis?
  
 
=== Extra Credit (optional) ===
 
=== Extra Credit (optional) ===

Revision as of 04:39, 16 September 2011

Example Vendor Evaluation Criteria

Demonstrate Clinical Functionality (25%)

  • If EMR software provides CPOE Functionality then does it enable a user to electronically record, store, retrieve, and manage, at a minimum, the order types like 1) Medications 2) Laboratory, 3) Radiology and Imaging and 4) Provider referrals according to certification criteria defined by the ONC’s Interim Final Rule.
  • Will the system support utilization review with the Milliman and Interqual clinical criteria for Quality Management and discharge planning.
  • Joan Breuer, Ph.D. 01/27/2010 17:20 There needs to be a plan so In-house developers can work with the Vendor such that all algorithms are carried out seamlessly.
  • Is the system’s data entry interface intuitive for new users?
  • Can the system pull from clinical documentation for billing and patient safety reporting?
  • Does the EHR vendor provide a test version of EHR product for training and quality assurance (QA) purposes as well as the full production environment that is installed in the clinic? (The test version is a segmented area where users can make changes to templates or forms without it affecting the live environment) (http://www.americanehr.com/Home.aspx)
  • Will the EHR company build custom templates to the practices specifications? (http://www.americanehr.com/Home.aspx)
  • Can patients be scheduled for appointments in multiple practices, facilities, etc.?
  • How easy would it be to query infection related patient data and electronically submit to state health department and CDC? That way the facility would not have to look into a separate vendor.
  • Will the EMR capture and or implement the meaningful use standards as mandated?
  • Will the vendor provide an exact demonstration of their product for each of the workflows for each type of physician or clinician (i.e. OBG-YN, nurse)? Meaning, the workflow for a physician is different than that of a nurse or an administrative clinician. Is the vendor willing to conduct exact scenarios in their own product to specifically tailor the needs of all personnel?
  • Does the EHR system provide the ability to merge patient information from two patient records. Such that if a duplicate is created, information could be merged into one chart?
  • Does the EHR system provide the ability to calculate and display body mass index (BMI)?
  • Does the EHR system provide the ability to automatically generate reminder letters for patients who are due or are overdue for disease management, preventative, or wellness services?
  • The system shall include documentation of the minimal privileges necessary for each service and protocol necessary to provide EHR functionality and/or serviceability. [1]
  • The system shall require documentation of the audit support functionality in the vendor provided user guides and other support documentation, including how to identify and retrospectively reconstruct all data elements in the audit log including date, time. [1]
  • The system restore functionality shall result in a fully operational and secure state. This state shall include the restoration of the application data, security credentials, and log/audit files to their previous state. [1] --Sfjafari 12:41, 13 September 2011 (CDT)
  • Can system identify the chronic disease sufferer’s subgroups? --Sfjafari 12:41, 13 September 2011 (CDT)
  • Does the EHR system include clinical decision support based on patient’s demographic and clinical data including detection of medication prescription error (including interactions, contraindications, dosing errors, etc.) and appropriate immunization administration?
  • Does the EHR system include clinical decision support based on patient’s demographic and clinical data including laboratory test ordering, i.e. the ability to suggest relevant and patient-specific lab tests, appropriate secondary tests, and specific parameters for multiple lab orders (including avoidance of unnecessary duplication, and reminders of orders that are time-sensitive or situation-specific.)?
  • Does the EHR system support accurate, consistent and effective clinical documentation by appropriately balancing data auto-population, structured data entry, and unrestricted physician entry of natural-language narrative?
  • Does the EMR require vendor intervention or an additional fee each time in order to change forms, queries, and reports? To what extend are reports customizable. Can reports be made to be generated automatically on a recurring basis?

Acquisition and Implementation Cost (25%)

  • Are training materials provided by the vendor or is the organization responsible for producing in house?
  • Does the vendor bid include the product's ability to be used as a tool for research. If "no", is an add-on solution for research capability needed and will it entail extra cost. Ref – Kannry J et al: Using an Evidence-based Approach for System Selection at a Large Academic Medical Center: Lessons Learned in Selecting an Ambulatory EMR at Mount Sinai Hospital. Journal of Healthcare Information Management — Vol. 20, No. 2, pg 84.
  • In calculating the Total Cost of Ownership (TCO), the Break out costs should include who pays for the additional costs due to delays in implementation, especially those due to the Vendor. In fairness, the Vendor's rate for successful, on-time and under-budget implementation should be discussed as well.

--Sfjafari 12:42, 13 September 2011 (CDT)

  • Does system minimizes or ease the data input, so that doctor spend more time with patient?

--Sfjafari 12:42, 13 September 2011 (CDT)

Hardware Platform and Technical Requirements (20%)

  • For already existing software functionality, does the vendor employ reliable and trustworthy software like an open-source MySQL or Apache server? Or do they develop their own system, or do we have to license a proprietary one (extra cost)?
  • How the vendor estimates the total amount of users and licenses needed? Will they be concurrent user licenses or asynchronic?
  • Will technical support remain active even if the Hospital is running a non upgrade system? For how long?
  • Does the system use DICOM standards for the transmission of image data?
  • How frequently does the vendor provide patch upgrades for the product?
  • Is the system using standards such as Snomed, ICD 10; HL7 Version 2 or 3; HL7 infobutton…)
  • How does the system handle multiple logins of the same user at different locations/instances?
  • How does the system handle user inactivity? (auto-logout, discarding\saving changes, draft creation)
  • If the system includes hardware, the system shall include documentation that covers the expected physical environment necessary for proper secure and reliable operation of the system including: electrical, HVAC, sterilization, and work area.[1]

--Sfjafari 12:44, 13 September 2011 (CDT)

  • Can system allow login remotely – off site transcription or home or other clinic?

--Sfjafari 12:44, 13 September 2011 (CDT)

  • How well does the EMR work with antivirus, antispyware and other security software? What is the vendor’s history with cyber attacks?

Implementability (15%)

  • How does the vendor compare in KLAS rankings of similar systems and applications?
  • How long is the training that is required for each subgroup to fully implement the system?
  • What are the training requirements for the vendor? For the clinic/hospital?
  • What is the vendor's track record for successfully training a new system for your clinic/hospital size?
  • What training manuals, user guides, on-line training assets, and any other training materials will be made available to the clinic/hospital?
  • Will the implementation require a consulting "team" and how much will this cost?
  • Is the vendor sufficiently well known that most health care consulting firms have familiarity with the system?
  • How will legacy patient record data be integrated into the new system?
  • How is the evaluation procedure for the approval of the ongoing stages of implementation? How objective will be the defined how to proceed with the approval and payment?
  • Is the vendor's system compliant with ISO standards for EHRs?
  • Does the system have a proper data recovery plan in case of an crash or any other unexpected event? Can the system be restored without any data loss? Does the vendor have a proper disaster recovery plan?
  • How does a legacy Practice Management System integrate with the EHR system? Is there a list of successful PM vendor integrations? MikeField 20:47, 29 January 2010 (CST)
  • What is the legacy Practice Management System conversion process for legacy data import into the EHR system? Time/cost and loose-ends? What reference clients are there for particular legacy PM systems? MikeField 20:47, 29 January 2010 (CST)
  • Does the vendor have a List of Lessons Learned from previous implementations?
  • Does the vendor have a legal license to essential code sets, such as the AMA Current Procedural Terminology (CPT®) file? Will the vendor maintain this license annually as part of your service or maintenance agreement?American Medical Association
  • Does the vendor offer a “test environment” in which upgrades are loaded to allow you time to test and learn their functionality without affecting your live system? American Medical Association
  • What is the vendor's rate for on time & under budget implementations?
  • Are other consulting firms certified to implent the vendor's product? If so will the vendor provide system updates and customer service if system issues (not related to implementation) arise?
  • Check whether the vendors EMR products are CCHIT certified (http://www.cchit.org/products/cchit)
  • What training mechanisms are used by the EHR Vendor? (http://www.americanehr.com/Home.aspx)
  • What services does the EHR vendor offers for post-implementation optimization of the system with respect to training and system customization? (http://www.americanehr.com/Home.aspx)
  • What is the company policy regarding data ownership for the ASP EHR?
  • Does the EHR vendor provide any guarantees regarding the ability of a practice to meet meaningful use requirements? (http://www.americanehr.com/Home.aspx)
  • The system shall include documentation that describes the patch (hot-fix) handling process the vendor will use for EHR, operating system and underlying tools (e.g. a specific web site for notification of new patches, an approved patch list, special instructions for installation, and post-installation test).[1]
  • The system shall include documented procedures for product installation, start-up and/or connection.[1]
  • The system shall allow an authorized administrator to enable or disable auditing for events or groups of related events to properly collect evidence of compliance with implementation-specific policies. Note: In response to a HIPAA-mandated risk analysis and management, there will be a variety of implementation- specific organizational policies and operational limits.[1]
  • What options does the EMR have for upfront abstraction and scanning? Are these costs included in the purchase of the EMR?

Vendor Partnership and On-going viability (10%)

  • Please provide audited financial statements for the last five years, including Balance Sheet, Income Statement, and Statement of Cash Flows, as well as any accompanying footnotes.
  • Provide a list of customers who have implemented the systems and applications that you are recommending to us.
  • Create a list of vendor selection criteria, and evaluate the vendors and software: review responses to the RFP; schedule demonstrations; check references; and, use proven tools/templates for assessing and consistently comparing vendors.
  • Research available EMR systems and vendors: determine if your jurisdiction has a "pre-approved" vendor list; develop checklists & questionnaires to assist with product comparison; and, prepare a Request for Proposals (RFP).
  • An important consideration is whether the vendor or any of its industry partners have done an analysis of processes in healthcare
  • In a HIPAA complaint product, one should consider the feasibility of implementing future mandates. The cost should be considered in terms of both money and time.
  • Obtain references of current customers that are similar in size, have similar patient population, and have similar required functionality needs to your practice and evaluate the ease of implementation, current satisfaction, and costs.
  • What kind of service level agreements are offered by the vendor and what is their track record for maintaining those SLAs?
  • When you're getting started, it's critical to determine the economic vitality of the vendors. (This information is available from surveys, vendor Web sites or by contacting the vendor directly.) Make sure you include the following key questions when talking to vendors: yearly sales in dollars; years in business; total number of systems sold to date (systems, not licenses);geographic spread of customers; and number of employees designated for customer support. Carter, Jerome (2004)
  • Ensure there will be well-laid out contractual agreement regards the 'source code' that will satisfy/cover necessary conditions: "When does the company get the 'source code?, How does the company get the source code?"
  • If there are workflow changes within the organization, after the product is implemented, is the product flexible enough to allow for changes without major outages or disruptions to daily activity?
  • What are the vendors’ contingency plans if technical glitches occur, post implementation?
  • In terms of clinical decision support, how often are drug list and drug interaction list updated? Once updated, how long will it take for the changes to be accessible by the end users?
  • What is the average time the vendor takes to address and resolve bug reports?
  • What is the training of the vendor's customer support employees? What is their level of expertise with the software?
  • Is it possible for the vendor to provide a personal customer support representative to be the first to address any future issues?

Future Vision (5%)

  • Does the vendor have a meaningful Product Lifecycle that defines major and minor releases, their associated costs, and delivery (push or pull) methods?
  • What is the vendor's five-year strategic plan?
  • What percentage of revenue is being re-invested into R&D?
  • How does the company capture/communicate client concerns for re-engineering? i.e. Is this a learning company?
  • What "game changers" are on the drawing board? Are these related to one of our organization's core goals?
  • Does the vendors support and training staff meet local needs, and does the staff appear to be adequate for anticipated installations?
  • Has the vendor shown continued and steady growth, as measured by the number of clients installed per year, or is the number of installations declining, indicating decreasing acceptance in the market?
  • Compared retail broker workstation alternatives, including proprietary and third party packages, based on user requirements and technology/operational considerations. Project included EMR development and response evaluation
  • Lifespan and Staying Power: One should consider the track record of the vendor and viability as a company to sustain the ups and downs of the industry. One sub-criteria in this category often used is how long the vendor has been around.
  • Does the vendor plan to offer interoperability options in the event of a nationally implemented CIS?
  • What is the plan to support smart phone applications to enhance interoperability and custom accessibility of EHR data while maintaining security? (DROID, IPHONE)
  • Upon the termination of a license or agreement, is there an orderly process for you to extract your data? This is applicable if you access the vendor’s software within an application service provider (ASP) model.American Medical Association
  • Ability to have HIE compatibility
  • Improved billing accuracy and charge capture
  • Electronic replacement for traditional reportable disease notifications to health departments, may become part of biosurveillance in the future.[1]
  • Does the EMR require vendor intervention or an additional fee each time in order to change forms, queries, and reports? To what extend are reports customizable. Can reports be made to be generated automatically on a recurring basis?

Extra Credit (optional)

  • It is not uncommon for developers or implementers to impose lock-in features in order to protect their IP rights. How mature is the support community for the particular vendor and is there a marketplace for support and services to their product or is support limited to their own team?
  • A multidisciplinary team, usually a subset of the decision team consisting of a physician, IT personnel and a senior management must conduct a site visit to one of the vendor customer sites and vendor headquarters. Informal discussions at this level were quite informative as they bridged the gap between theory and practice for actual software implementation and usage.
  • An unstructured “drive-by” demonstration of the system must be arranged for, wherein the vendors conduct product demos, demonstrate product futures and distribute promotional materials for a majority of the employees to get the feel of the new systems. It facilitates building a comfort level and relationship with the vendor and the product offered.
  • Can the company demonstrate tangible ways that use of the product can increase hospital revenue? If yes, can you validate this/these claims?
  • Is the vendor willing to contract to go "at risk" for any part(s) of the contract?
  • What other services does the company offer (especially useful for rural or small hospitals or practices)? e.g. consultants to do special projects, data transmission/claims, billing
  • Can the record be accessed at home by clinicians and patients, or do they have to be on-site at the facility?
  • Is the vendor capable of adapting to emerging technology such as open source programming, cloud computing, "tablet" PCs/Macs, demand for smartphones (e.g. iPhone), and Web 2.0 technology?
  • Is the vendor capable of integrating it's system with a personal health record and allowing more patient control?
  • Can the company provide return on investment analysis?
  • Does the system have e-prescribing functionality?
  • Vendors may not be chosen if the current managers have been convicted of or have had a civil judgment for the following: fraud, antitrust violations, embezzlement, theft, etc.
  • Reduced pharmaceutical costs derived from having information available at the time it is needed
  • Cost reductions associated with risk reduction of adverse drug events
  • How can this EHR be an asset for the solo practitioner who sees this technology primarily as a financial drain?
  • Is company a CCHIT - Certification Commission for Healthcare Information Technology vendor ?
  • If it is a multiple hospital system, how many training specialist will be dedicated for the whole system implementation?
  • Will the vendor be readily available to conduct training for all shift and service line?
  • How much extra financially will it be to train outpatient clinics that are subset of the system?

References

1 CCHIT’s Ambulatory Certification Criteria 2008 Final Criteria May 13, 2008