3 Overview of HIE and HIT Vendor Selection

Section 3.1 Select

Section 3 Select—Overview of HIE and HIT Vendor Selection - 1

Overview of HIE and HIT Vendor Selection

This document describes the steps to take and provides tools to help you acquire health information exchange (HIE) services and other health information technology (HIT) applications.

Time needed: 16 – 20 hours
Suggested other tools: Section 2.1 Planning for HIE and e-Health

How to Use

Review the information and use the tools within this tool to: understand what you are buying and the marketplace; prepare a request for bid; and select and negotiate a contract with your vendor for HIE or other HIT.

What Are You Buying?

The first question you should ask in the process of acquiring HIE or HIT is: What are we buying? This may seem like a strange question, but you may set out to acquire some form of HIE or HIT and find considerable variation in the types of HIT available for your social service agency.

· HIT for social services may be focused on internal business processes and processes connecting social service agencies to each other rather than connecting you with health care providers. A focus on the specific needs of social services is certainly helpful; however, some products may be more suitable for county or state governments than social service agencies themselves. Carefully consider which these tools are best suited for your setting. Business process technology may include software for:

o Budgeting and staffing support

o Business intelligence

o Collaboration tools

o Document scanning

o Executive reporting systems, including data analytics, predictive modeling, and decision support

o Medicaid management

o State data reporting

· HIT for social services may also focus on direct support that social service agencies can supply their clients, such as those for:

o Assessment technology (using sensors to assess, for example, an individual’s cognitive status or risk of falling; or questionnaires to evaluate level of depression or suicide risk)

o Assistive technology, such as computer enhancements, phone amplifiers, etc.

o Home health monitoring includes both assurance systems designed to track behavior and provide information to a caregiver and compensation systems that intervene to assist individual in completing an activity.

· HIT that is designed to help social service agencies interact with the health care provider community. This includes:

o Collaboration tools, or groupware, may include formal teleconferencing, webcasts, project management tools, data conferencing, desktop sharing, enterprisewide brainstorming, and others. Directory services, which may simply list potential resources or support engagement of the services.

o Health information exchange. Considerations relating to HIE include:

§ Potentially limited offerings. For example, within your geographic area there may be (or at least appear to be) only one state-certified HIE organization (HIO). In other states there may be regional, specialty, private, and vendor-based options.

§ There may be alternatives to participating in a formal HIO. Consider the functionality desired and then determine who or what offers the support you need. For example, you do not need to belong to a formal HIO to use the Direct protocol for secure exchange of email (see Section 4.2 HIE Using Direct or CONNECT).

Approaching the Marketplace

In any procurement process, there is an opportunity for issues to arise relative to bias and other inappropriate and even illegal actions. Prior to initiating any contact with vendors, including Web-based demonstrations, all who may be involved in the selection process should review and approve a vendor selection code of conduct. Invoke the code of conduct any time during the selection process when a need arises. This may include reminding staff not to discuss the selection process with any vendor (including peripheral vendors, such as copy service suppliers, who may ultimately find their business impacted by your move to HIT), advising a member of the board of directors that a favorite vendor does not meet selection criteria, or advising both the steering committee and the vendor that gifts are inappropriate. (See Section 3.2 Vendor Selection Code of Conduct for a sample code).

Product Certification

There is a comprehensive certification program for electronic health records (EHRs), especially as they relate to the federal incentive program for providers making meaningful use (MU) of EHRs. It addresses products for hospitals and physician offices. It does not address products for for social services. Because no systems are certified for social services, you must perform the necessary due diligence activities (see below for more details) to ensure that the HIT meets your requirements.

Certification of HIOs does exist and is new. Some state departments of health are certifying HIOs or HIE capabilities in vendors. There currently is no national certification program for HIOs.

Soliciting Bids

The formality of your solicitation of a bid for products and services varies depending upon what you are acquiring, and whether there are any relevant governmental regulations. In general, there are three approaches:

· Request for information (RFI). This may be as informal as a call to a vendor to send you a price quote for a specific product or service, or it may be a written request stating briefly who you are and what you are looking for. In the past, the RFI was a formal request for specifications on various products in which you are interested. Because of the widespread availability of this information on the Web, RFIs no longer are used for this purpose.

· Request for bid (RFB). This is generally a written request for products or services in which you describe your key requirements. Your resource for preparing the RFB should be a Requirements Analysis and Prioritization for HIE and HIT (see Section 2.5). When using this list of requirements, however, you do not want to reveal your priorities to the vendor. You will want to supply the vendor with information on the nature of your agency, size, volume of clients, which HIOs you may connect with, and any other information you think the vendor needs to be able to supply you with a realistic price quote.

· Request for proposal (RFP). This is a formal, detailed document that describes all of your requirements and requests formal, structured proposals from vendors. Any government-sponsored organization is generally required to issue an RFP. You may find that small vendors are less inclined to respond to a formal RFP.

Request for Bid

Use the following template to describe the products and services you are seeking. Send these to between four and six vendors who you have identified as potentially having the product you seek.

Date:
Re: Request for Bid for Insert Description of Product
Due Date for Response: Designate a date by which you would like a bid returned.

To: Obtain name of regional sales manager and address in your area.

From: Include the name, address, phone number, and email address of the individual in your organization who will be responsible for all communications with vendors.

Additional Instructions for Responding to this RFB:

Include directions concerning limitations on contacting organization, number of copies of responses to be supplied via paper and/or preference for electronic submission, instructions for vendors to request additional information, etc.

A. Background and Information

1. Overview of Organization – briefly describe:

· Number of clients per year:

· Number of staff:

2. Special characteristics of organization

3. Overview of Current IT Environment

· Extent networked – locally/to other sites:

· Wireless capability:

· Internet Service Provider:

· Web site URL:

4. List of software applications currently in place

B. Vendor Information

1. Vendor primary contact

· Name:

· Title:

· Office/location address:

· Email address:

· Organization’s Internet home page:

2. Identify the location of the following if different from above:

· Corporate headquarters:

· Field support offices:

3. Briefly describe your company in terms of number of staff, proportion of staff devoted to sales and marketing vs. implementation vs. research and development, how long the company has been in business, and alliances and partnerships (e.g., do you partner with another vendor to supply knowledge databases, report writing tools, HIE, etc.).

C. Product Information

1. Describe the major version history for the product being sought through this RFB, including the release proposed for this organization and any other planned new releases.

2. How are enhancement and new release priorities determined? How are clients supported during these releases? How much system downtime is required during these upgrades?

3. In how many organizations similar in size to our organization did you install the system you are proposing during the last fiscal year?

D. References

1. Provide references for at least three similar organizations.

2. Supply information about (and invitation for, if applicable) the next user group meeting you are holding.

E. Product Requirements

For each of our requirements specified below, identify whether it is available in your product and a brief description or other notes to help us understand how your product fulfills the requirement.

Requirements for ______ / Available?
(Y/N) / Description/Notes
1. Insert your list of requirements from 2.5 Requirements Analysis in this first column.
2.
3.
4.
Technical Requirements
1.
2.
Operational Requirements
1.
Transitional Requirements
1.
2.
3.

F. Price Proposal

Provide—in a separate response—a pricing proposal for the software, implementation, interfaces, and hardware as described in our profile. In the pricing proposal, specify how your products are priced. If you do not supply certain capabilities or technologies, acknowledge these and specify any recommendations.

RFB Response Analysis

Once you send requests to vendors, allow four to six weeks to receive responses. During this time

ensure that only one person serves as the communication point with vendors so that all are treated the same. Vendors have many ways of attempting to ingratiate themselves within your organization to cultivate internal sales people.

Once all bids are received, review all but the sealed price proposals thoroughly, using a representative team of staff members. (Have the CFO or other designated staff member review the price proprosals to determine if any vendor appears completely out of line. However, do not bias the rest of the reviewers with pricing information. All HIT prices are negotiable. Higher-priced products may have functionality that will provide a higher return on; or a product may have functionality that you would have bought as a separate product, making the single product lower in price than the two combined.)

It can be helpful to use a scoring scale such as this to score each product:

0 = product does not address the requirement and there is no indication that it will in the future

1 = product does not incorporate the requirement today but appears likely to in the near future

2 = product is marginal and lacking in some but not all aspects of the requirement

3 = product is satisfactory in terms of the requirement

4 = product fully meets or even exceeds requirement

Vendor Bids: / A / B / C / D / E
Functional Requirements
Technical Requirements
Operational Requirements
Transitional Requirements

Making the First Cut

Based on analysis of the bids, you should be able to narrow the field of vendors to two or three. Note: your review group should still not review prices. Unless there is one vendor that the CFO has deemed completely out-of-line with all others, prices should not be a factor at this time.

Communicating with Vendors

Once you have narrowed the field, you may want to contact the rejected vendors. Many organizations prefer to make some contact to avoid distracting calls from vendors who want to know whether they can conduct product demonstrations, etc. From this point forward, do not communicate further with these vendors. You do not need to elaborate or explain your decision.

Conduct Due Diligence

Due diligence refers to further evaluation of a select few vendors. Ideally, after each form of due diligence is concluded, a process similar to the bid analysis is conducted by the review group and one or more vendors is rejected to further shorten the list. It can be helpful to use a version of the tool above for each form of due diligence. Due diligence may include:

¨ Product demonstrations. Arrange for a Web-based or in-person product demonstration that is tailored to your specific requirements. You should be able to ask questions, be shown alternative pathways, and discuss different options.

¨ Site visits. Although site visits mean that travel costs must be incurred, consider using site visits if it is becoming difficult to differentiate between products. Because most sites will not “expose their dirty laundry” during a site visit, many facilities find that focusing on reference checks yields as much information and more people can be contacted.

¨ Reference checks should be performed for all vendor products you consider close to being finalists. Reference checks should focus on questions you have that have not been answered during other forms of due diligence, or for which you are getting conflicting information. Reference checks can also be great resources for tips on implementation. The vendor should supply you with a complete list of references. If the list is limited, this may be telling in itself. You may need to work your own personal network to find additional references. It is advisable to use a tool to structure your reference check interviews so you don’t forget any key points. Note that the tool below includes a few similar questions asked in slightly different ways. This strategy enables you to “break the ice” at the start of the conversation and then re-ask questions at the end after rapport has been established—usually yielding more complete answers.

Reference Check Guide

Site: ______Host: ______Product: ______
Person(s) contacted at reference site: ______
Caller(s) from your organization: ______Date: ______

Establish similarity with your organization and learn about implementation:

Verify which of the following reference criteria are met by this call:
o Similar client volume o Similar number of staff o Similar in type of services
o Same base system o Other similar source systems o Same version of product

Establish basic understanding of the agency’s level of implementation and adoption: