How to Select HIT Vendors that Deliver True Interoperability

Consider the three C’s: care, collaboration and cost

Providers looking for a vendor to deliver true interoperability to healthcare IT should consider the three C’s: care, collaboration and cost. That’s the word from Philip Payne — co-founder of Signet Accel and inaugural director of the Institute of Informatics, Washington University, St. Louis.

Author of “Nine Key Questions You Should Be Asking about Interoperability,” Payne says, “The search for true interoperability can be time consuming, frustrating and, more often than not, confusing. Wide claims are often made about solutions only to later find they aren’t truly interoperable. The best way to ensure you’re pleased is to ask the right questions from the start.”

He adds: “The most important question we can ask a vendor is how the solution will impact our ability to deliver care to patients and communities. Can the vendor come to the table and have a substantive, critical conversation about care? What is the problem you are trying to solve that will impact patients? How will this solution allow you to do a better job of solving that problem?”

Pat Wise — vice president, Health Information Management Systems Society, Chicago — calls the three C’s “all important considerations in selecting a HIT vendor.” As HIT continues to evolve, “it will be more important for providers to have a solution that meets their needs and allows for a more efficient workflow to improve the overall quality of care for patients.”

Lesley Kadlec, who calls workflow “one of the most important considerations when selecting an HIT vendor,” adds a fourth factor. “The system also must meet the healthcare organization’s business and operational needs to ensure that all information collected is consistently reliable and trustworthy.”

“All information in the HIT system should be viewed as a strategic asset for the organization. That means making this a key consideration when deciding which solution best fits the organization’s needs,” notes Kadlec, director, health information management practice excellence, American Health Information Management Association, Chicago.

Long-Term Solutions

With the Centers for Medicare and Medicaid Services, Baltimore, poised to invoke Meaningful Use Stage 3 in 2017, the relationship between interoperability and federal standards to vendor selection couldn’t be more important. “As we all know, it’s been challenging to navigate the constantly-evolving regulatory frameworks that surround use of health information technology and, in particular, interoperability standards,” explains Payne.

He advises against short-term solutions to long-term issues, saying “Tying our decision-making process to those snapshots, rather than thinking strategically about them, is a missed opportunity that we need to steer away from. A thoughtful vendor will over-deliver relative to regulatory requirements.”

Wise cautions that “While exceeding these standards would certainly fast track progress, that just may simply not be possible for many organizations. The standards offer a realistic goal for many. Should we see that many can, in fact, exceed those goals, we can raise the stakes,” she adds.

However, Kadlec agrees. She says “Exceeding standards for interoperability is important since we have only just begun the journey toward having widespread sharing of information. There needs to be a balance between the goal of interoperability in the future and the current needs of the healthcare ecosystem.”

Price Isn’t Everything

Payne advises providers that “price tag alone is not an indicator of the total cost and impact of a solution over time. When you think about delivering true value, selecting a vendor who can make a compelling argument around the lifetime cost and benefit of their solution is one way of guarding against this over-promising/under-delivering that so many of us have experienced.”

While price isn’t everything, Payne says “Modularity is quite important when we talk about health IT platforms because there is really no single solution that meets all of the needs we have. It is a continually evolving, complex environment. So, we need to select and deploy best-of-breed solutions in a way that can evolve gracefully over time.

“Achieving a degree of modularity requires us to understand the ecosystem of users, technologies, data streams, policy and cultural drivers. To craft a solution with the flexibility to meet current and future expectations, you need to understand why people move data around, how will it be used to improve research and, in turn, impact patients,” explains Payne who offers providers three pieces of advice.

“First and foremost, when selecting a technology vendor in a complex environment, like healthcare, you are not selecting a vendor in a traditional sense. You are selecting a partner.

“Second, technology can and should be a change agent within healthcare delivery and research. Consider how projects deliver strategic value that improves the ability to execute research, deliver high-quality clinical care or educate future healthcare professionals and researchers.

Lastly, he says, “We’re moving to an environment where purchasing a system to use for 10 or 15 years is, in many cases, not an appropriate timeline. Interoperability solutions, data management and infrastructure are the sort of repositories that give us a longitudinal and long-term view of data.”

Importance of Teamwork

Adds Wise: “My advice for hospital executives would be to choose a system that is highly customizable to each department’s needs, where information can be easily shared across the continuum of care to facilitate population health management. Patient care is extremely important when considering an HIT vendor. Teamwork also is important to achieving interoperability across healthcare settings, regions and countries.

“The healthcare sector must work together to develop and adopt standards and implement specifications for use in products and services that hospitals, physician practices, community health clinics and any care setting use to securely share information,” she says.

Kadlec agrees that “All facets of the organization, including executive leadership, must be involved with the selection, adoption and implementation of the selected HIT vendor.

“Executives should remain closely involved in overseeing and guiding selection to ensure the system meets the functional and operational requirements for a health record that can be used for all business, clinical and legal purposes. In addition, executives should look for new ways to use information to achieve the current goals of the organization while continuing to set strategic information goals for the future.”

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