Request for Proposal
A request for proposal (RFP) a critical element of the selection process for any major capital investment for a healthcare system (e.g. purchasing an electronic medical record (EMR). The RFP is a more formal agreement between a healthcare system and the potential vendor. The healthcare system clearly articulates its needs to the vendor, and the vendor illustrates how its services will benefit the healthcare system. The RFP often includes pricing information that cannot be disclosed, and in turn, the healthcare system may disclose information about its business that the vendor cannot make public. An RFP should be distinguished from a request for information (RFI). An RFI is useful in obtaining preliminary information from multiple vendors. There is no binding contract between the healthcare system and the vendor in an RFI.
An evaluation of desired electronic medical record functionality is an important first step in the development of the request for proposal (RFP). Forrester Research has developed an evaluation tool made available through the California HealthCare Foundation. These and other tools assist in listing desired EHR functions that will be part of the RFP. The American Academy of Family Physicians (AAFP) Center for Health Information Technology has tutorials on selection of EHR’s that also assist in the “pre-work” required before a specific RFP can be developed. Developing a “features list” for the RFP is facilitated by comparison of different vendor offerings. These are available through membership in various professional organizations such as the Healthcare Information and Management Systems Society ( HIMSS Ambulatory EHR Selector), the AAFP’s (Center for HIT product reviews) , the American Academy of Pediatrics (AAP) Council on Clinical Information Technology, or the American College of Physicians.
Certification Commission for Healthcare Information Technology
The Certification Commission for Health Information Technology (CCHIT) can also offer assistance in determining desired EMR functionality that should be part of the RFP. Additionally, the Centers for Medicare & Medicaid Services sponsors the Doctor’s Office Quality – Information Technology (DOQ-IT) program which offers direct assistance in EHR implementation planning through medical review organizations in various states such as North Carolina or California. Specific evaluation tools funded by DOC-IT are available through MedQIC. Certain states have established similar initiatives through the Improving Performance in Practice (IPIP) program of the Robert Woods Johnson Foundation.
Evidence from Holbrook et al indicates that a rigorous approach to EHR selection involving clinical usability, data quality, and vendor maturity was associated with successful implementations. Development of an RFP should be expected to be part of such a detailed process. This implementation methodology has been the basis for technical assistance in EHR implementations.
Sample request for proposals
Samples of RFP’s are available online from software developers or consultants or can be developed with advice from journal publications or books. A sample RFP is also available through the MedQIC website that was developed with the federal funding support of the DOQ-IT program. The RFP is a list of questions to the EHR vendor that follows a description of the practice’s environment and requirements. Sections of a typical RFP include:
- Practice Profile: This section allows the practice requesting the proposal to describe the background and specifics of their practice setting and the important features and expectations of an EHR that they are looking for.
- Vendor Profile: This and the following sections specify questions posed to the vendor. In this section vendor background and information is requested.
- References from Vendor including information about other client installations
- EHR System Features: This section can refer to a features list (see above) developed by the practice or can specify all possible functions and request vendor commentary on each.
- System Maintenance and Support
- Implementation and Training Plan
- Technical Environment: These are questions about the hardware and network environment proposed
- Practice Management System Integration and Other Interfaces: Examples include interfaces to lab systems, radiology systems, personal health record systems in addition to billing and scheduling systems if not bundled into the proposed software.
- Report Generation: This section includes questions about both standard and ad hoc reports. This should include questions about obtaining “pay for performance” data from the system that could pertain to the quality of care provided by the practice.
- Security and HIPAA Compliance
- Pricing, Contracts and Warranties
In summary, the attention to details in the development of a Request for Proposal document can improve the likelihood of success in the EHR implementation process.