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Foundation Members:
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CHIME Presents:
The CIO’s Guide to Implementing EHRs in the HITECH Era
CHIME Member Comments on
Chapter 11: HITECH Heightens Need for Providers and Vendors to Work on Partnerships
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Question posed to members:
What changes do you expect to occur in your process for assessing vendors’ products in seeking to achieve meaningful use? Will the product assessment process slow down or speed up for you?
Comments:
“Our vendor strategy is core vendors, so our assessment process is typically for specific modules of a project. Aside from requiring certification and data exchange information, the assessment process will not change substantially in content or timing.”
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“My goal is for our customer to experience no change in the time it takes to complete this process. I anticipate it will require additional work to be completed by my staff in a slight more compressed timeframe to account for the assessment process we will follow to validate a solution that will fit our MU plans and direction.”
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“The product assessment in a post-EHR world will likely cause the health system to first look at how another product integrates with the EHR. This answer will be weighted much higher than another head-to-head analysis of products today.”
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“Certainly now at the top of the qualification list will be about certification status and implications on MU. Once we get a little deeper into the certification process, and Cert Bodies begin to do their work, things should get a little more streamlined, but for now, no one is certified, so we are kind of in a slow down for the moment. It is difficult to make a decision right now that has anything to do with MU until we know who will be certified. I think it is a safe bet that those of market repute, especially those that were CCHIT certified in the past, will get there. I am lucky in that even after the final rule, I think I am able to attest right now. I just need to capture the data. However, I am banking on my partners obtaining Certification or we will not be there. All that said, I do not currently have a lot to acquire, and really do not see a change in my process. As mentioned in the first sentence, being certified is now a deal breaker going forward. Certification status will be one of the first qualification points.”
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“We have added questions related to vendor MU certification plans, timeline and interoperability. Expect no major impact on the speed of our process, but delays in the Final Rule have already delayed some
vendor's responses.”
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“I expect that we will include specifications and criteria in our RFP/RFI documentation that tie vendor responses to the need to provide products and services that comply with any MU objectives. We will certainly demand more specificity around claims of full integration where that is appropriate. I would expect this to speed the process by eliminating those who cannot meet the criteria, saving time having to confirm
compliance after the fact.”
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“Vendors will be coming out of the woodwork for software solutions, consulting… anything else that can be sold. Keeping focused on the direction and plan is more important than being distracted by the vendor world.”
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“Our organization expects delays in the vendor certification process and has built in project timeline delays allowing for vendor product certification. If there are long delays, MU projects will begin backing up to meet regulatory mandates such as 5010 Stage 1-2 and ICD 10. These are multi-million dollar projects that require the same work effort to be completed three times due to vendor release dates of software updates to gain compliance effectively, tripling the work needed to reach the end goals. In a time where clearly the government is moving towards bundled payments, it seem odd to drive hard towards ICD-10 and more coding granularity as the payment will be dedicated not as much by the individual codes as the payment bundle.
For our organization, these delays will not caused missed deadlines or systems to be slammed into production without regard for patient safety or workflow efficiency, as we have been working towards a MU strategy for over a decade. Hospitals that have remained on paper over the years have a long way to go and the vendor products are only a third of the work necessary to be successful and safe. I believe most vendors and IT areas will drive for the money without regard to the complex and often ineffective workflows build upon outdated paper processes. These processes will be translated into new electronic systems and the resulting outcome will be elongated workflows, ineffective care plans, missed critical values, reduce in cash flow, and a general slowdown in access to care until the applications implementations can be optimized by taking into account the many process and workflows dedicated by each hospital, physician practice and patient flow.
We are unsure at this time how custom built enterprise products for areas, such as vaccination tracking, will be certified (if necessary) and expect further delays in getting answers concerning certification for these special areas. We do not currently understand how these custom products can be certified or what process to follow to do so.”
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“Swift and precise assessments. Because of the timeline mandated, we cannot afford delays. We already have a vendor of choice but we will need to evaluate/ implement additional modules in order for us to meet MU. We are scheduled to receive a fully certified (CCHIT) version of our software before the end of fiscal 2011. These measures will position us nicely to meet MU in a timely manner.”
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“Our organization has a strong process for the evaluation of various vendor software solutions. Certainly product functionality is a focus, but vendor financial stability, vendor commitment to software development and R&D, vendor long-term positioning, integration with existing client software solutions, product acquisition and maintenance costs, and vendor client support reputation are equally important in reaching a final solution decision. I don't see this disciplined approach changing in any significant manner due to the final ruling of MU.
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“We’re in the final days of negotiations and I think we’re slightly behind. If you’re still selecting I think you better speed it up.”
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“Because of the deadlines for MU, I suspect the assessment process will speed up, as there is some concern about pent up demand, and vendor's ability to meet it, so implementation schedules will be delayed because of the vendors’ inability to meet the demand. We will not want to miss meeting MU because a vendor cannot implement a selected solution in time. I believe the assessments will still be as comprehensive, but because of the deadlines and potential impact on funding, they will receive priority, and the resources used to do the assessment will free up, so the process can be shortened.”
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“I do not expect a change in our process or timing. We know what MU gap are and have a plan to bridge that gap.”
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“No change since we have our vendor already selected and are well on our way to full use of the EMR, both inpatient and ambulatory.”
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“I do not believe it will slow or speed things. I will continue to hold vendors to a high standard. While assessing vendors, I will make sure I understand the timelines for product release to meet MU and contractually bind them to meet the deadlines with penalty clauses.”
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“If it isn’t MU, or ICD10, I really don’t have time for it. An exaggeration, but not by much. As the EHR needs to be certified, I suspect the burden will be on me if I cobble together multiple systems. We will need to have an increasingly myopic focus.”
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“Not particularly - we will definitely work in the MU and certification criteria into our contracts and vendor incentives.”
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“Things that probably a couple dozen folks have already mentioned… Any future assessments will include vendor and product certification requirements (now and ongoing), if the system will be used for any of the current or known future MU requirements. The system will be required to comply with all HIE standards as published and required through the various standards and integration bodies (NIST, IHE, etc.).”
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“The process will be similar to that currently employed for other purposes, but with a focus on the MU criteria.”
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“We are working with our vendor on meeting the MU criteria. Our vendor publishes a monthly review document, for both inpatient and ambulatory, highlighting our status. As it relates to vendors other than ours, we are past the evaluation process and have signed contracts for implementations that are already in flight, and will be completed before the end of 2010.”
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“We discussed our vendor(s) - meaning multiple for clinical applications impacted by MU - and decided that we needed a single clinical solution to both provide the clinical data integration that our physicians were expecting, and also to meet MU and recoup our share of the ARRA dollars.”
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“Don’t really expect much to change. The hospital has a single vender strategy. That doesn’t mean we don’t presently use or consider venders other than the primary but there must be a REALLY good reason. That being said, our primary vender doesn’t have the functionality we want or it is vastly inadequate. We have and will endeavor to involve our clinicians, and medical staff in particular, in the decision making process. Having physicians involved and engaged has sped the process up. Having them involved but not engaged has occasionally slowed it down.”
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“Vendors will need to be far more cognizant of integration rather than just interfacing. We have already gone through the product assessment for the EMR vendor. Now we will proceed through the selection of bolt-on products as needed. This process will be hastened because of the timeline to install the EMR.”
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“I expect that we will look to use the function and expanded modules of existing systems more in meeting the MU standards and use less ‘best of breed’ solution approaches. MU will cause a large number of new systems/automation, new workflow, etc., which on its own will introduce greater complexity. The complexity will be exponentially greater and the solution more confusing for clinical customers (users) if we utilize many different systems that are interfaced on site with varying degrees of interfaced data and interoperability. In short, I feel that use of the tools, interoperability, and access will trump best function.”
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“I don't expect a significant change. We currently have detailed an RFP process that includes regulatory questions. We will review that template to make sure it will include MU requirements where applicable. In addition, we have a technical questionnaire that covers our security and integration/interoperability requirements. This technical data is gathered once we have narrowed down our vendor list. Our process will require more analysis of each vendor, but I don't think it will add a lot of time to the process. Our challenge may be educating our IS staff on what to look for as the requirements evolve.”
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“Since we’ve already made our investment in EHR technology there is no real impact to our process for assessing vendors. We have full expectation that our vendor will be certified and therefore do not expect to have to go to market for new solutions. Compared to others, that will allow us to speed up our progress.”
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“We have a single vendor solution for most of our clinical needs, so the process will not slow down. It may speed up because we are concerned that our vendor will have enough resources to help all of their customers.”
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“We have already accelerated our product assessment processes.”
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“Our process will probably speed up, but I’m not sure the vendors will be able to keep pace with the increased demand.”
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“Be sure they are certified, or in the process of becoming certified. Another element would be to evaluate how vendors say their systems can meet MU.”
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“MU will be part of the criteria used to evaluate products, but it will be only one component. Right now MU is and has been, a strategic initiative focusing on compensation and quality, and is weighed accordingly. If/when MU dollars dry up, strategy will change and HIT will focus on complementing the strategies of the organization.”
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“We will certainly incorporate a requirement for certification of specific objectives. This will require more diligence on the part of the clinicians to define application objectives, to align them with our strategic imperatives and MU objectives, and to ensure a certified vendor is selected for the specified objective. This will lead to more involvement of IT, to facilitate the validation of the certification process. I anticipate the long term benefit to be more integration of solutions and more clinical focus with specific benefits identified up front.”
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“I think this push to get MU money is a little bit like bait and switch; I am concerned that everyone (clients and vendors) is going to be so focused on meeting the qualifications that they are going to overlook the 95% other system capabilities that ensure what we are all here to do: take care of patients. I don’t know the certification process; I would certainly hope that they are going to concentrate on the requirements, but I also hope they are not going to overlook everything else. Overall, I think the product assessment, if conducted properly, should slow down; however, not significantly.”
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“Not really anticipating changes in this process. We are pretty settled with our vendors, and if they become MU-certified, and keep moving in the right directions, we’ll stay entrenched with them. For other modules, yes, we’d evaluate their appropriateness to our MU needs, but I don’t see it slowing us down; we’re fairly small and compact, low amount of bureaucracy to navigate for our forward progress and expenditures.”
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“It will slow down since we will now have to validate that the vender has been certified and is able to meet MU. We will also have to make sure the integration with the other vendors is there as well.”
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“We don’t expect any changes in the assessment process. Our current system has most of the modules required for MU in place or already acquired. Our challenge now is to use them in a meaningful way.”
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“Not many, for we already have an EMR in place.”
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“I really don’t think it will have any impact. We had already started viewing our vendors as strategic partners and hoping that we’re making good decisions that can be built upon.”
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“We have a very close partnership with a large vendor and have actively been working with them on their roadmap to achieving MU. They hold regular customer conference calls which we attend. I do not see this slowing down.”
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