| |||||||||||||||
|
Home
|
For other articles and previous issues click here. June 27, 2005 On
the Right Path — Preparing an RFP for a Successful PACS Purchase It took several people many months to craft the U.S. Department of Defense’s request for proposal (RFP) for a PACS system for its healthcare institutions. The result was a 500-page document. Government bureaucracy at work? Not at all, says Herman Oosterwijk, MS, MBA, president of OTech Inc., a healthcare technology consulting and training company in Aubrey, Tex. In his book PACS Fundamentals (OTech, 2004), Oosterwijk uses the government example to make his point—when planning on acquiring PACS systems, well-crafted RFPs are a necessity. “You need to make sure you cover all the bases related to what you’re looking for,” agrees Keith Solinsky, manager with The Coker Group, a national healthcare consulting group based in Roswell, Ga. So where do you start? Definitely not on the Internet, says John S. Koller, president of KAI Consulting in Larkspur, Colo. “One of the biggest mistakes that people make when they are going out for bid is to search the Web for canned RFPs and attempt to use them so they can minimize their development work,” he says. “The problem is that canned RFPs won’t reflect your individual environment. Vendors recognize canned RFPs and as a result you’ll get canned answers, and that doesn’t do anybody any good in making decisions.” If you want a system that is going to meet your specific needs, you’re going to need a well-developed RFP based on your individual practice—whether it’s a stand-alone imaging facility or a healthcare network of hospitals and outpatient sites, Solinsky agrees. Do It Yourself? Early on, you must decide whether you have the staff to write your RFP or whether you want to hire a consultant to assist you. “If you have people on staff who can take the time and know what they’re doing, that’s great. Do it in-house,” Koller says. However, experience in writing RFPs is a definite plus. If you don’t have someone with experience, you probably should opt for a consultant. One caution, Koller says: “Some consultants have financial relationships with vendors that provide payment based on lead referrals. Make sure there is full disclosure if you’re dealing with a consultant.” A vendor-consultant relationship is not necessarily bad, says Koller. Sometimes that relationship can give you better access to information, which could be a benefit. “Just go into it with your eyes open and if you’re not comfortable the consultant is giving full disclosure talk to another.” To write your RFP, you’re going to need input from all departments, not just radiology and information technology. A rule of thumb: If the department uses film now, include it, the consultants say. Try and obtain at least one representative from each department to serve on your RFP committee, Solinsky suggests. “I think it’s always good to have physicians involved in the process because they are the ones who are going to ultimately use the system.” Having a committee or team makes it harder to reach consensus, Solinsky concedes, “but everyone goes into it with different wants and needs … and you want to make sure the responses you get will fill those needs.” Gathering Data “That level of granularity will go a long way toward getting back good data,” Koller says. “Otherwise the vendors will just come back to you with lots of questions.” You also need to specify the number of procedures, images, exams, and expected growth rate, Oosterwijk says. “The growth rate will identify where future potential extensions or upgrades will be necessary so the system can be configured accordingly.” Oosterwijk also recommends providing a workflow chart from patient entry until discharge. That way vendors can show how they would match the flow, he says. The next step is to make a wish list. Determine why you want to implement PACS and dream of all the things you would like to be able to do with your system. At this point, don’t leave something out because you fear it may be impossible or too costly, Koller says. If you already have a PACS system and are going for a second generation, you might know what features are useful and what else you would like to have that you don’t now, he says. But if it’s new, explore all possibilities before making any decisions. Oosterwijk suggests writing a mission statement and a clear set of objectives. For example: “We want to be 95% digital within the next two years,” or, “We want to increase our productivity by at least 30% using electronic imaging.” In his book, Oosterwijk says, “the mission statement gives all who are involved with the project a clear goal and purpose. More importantly, it tells the prospective vendor what to aim for.” At this point, there is no need to worry about cost, Koller says. “I would shy away from putting suggestive numbers in an RFP.” You have time to crunch the numbers once you have responses and are choosing from among them. Cost Analysis Koller also recommends making your payment structure clear. He believes it’s a good idea to hold back a significant portion of the payment until you are satisfied with the installation and believe the vendor has kept all its promises. “Five [percent] to 10% is too small,” he says. “If you only hold back 5%, what’s to stop the vendor from saying, ‘What’s 5%?’ and they walk.” A well-crafted RFP will also have the following components, the experts agree: • An expected timeline and phasing-in for the system implementation: “This should be coordinated with other required parts of the infrastructure such as the RIS, connection, network, the changes for power and air-conditioning, etc,” Oosterwijk says. • Communication standard requirements: Nearly every system offered by vendors will support DICOM. However, Oosterwijk says, a simple statement of “thou shalt be DICOM compatible” is not sufficient. “Require the vendor to provide DICOM conformance statements for each of its products.” • Voice recognition, dictation requirements, and other features: If you have an existing speech-recognition system for radiologist transcription, you want to be sure the PACS system you choose can be integrated with it. Other features you may already have or may want should be included, Koller says. For example, can the system automatically check patient history for previous exams and warn users at the time of order entry? Can it automatically check the patient history for allergies or other contraindications and warn users when entering an order? Can it update patient profiles when patients are admitted to the hospital, discharged, or transferred? Koller says he would never implement PACS without first having a RIS in place. “The risk is that if you don’t have a radiology information system you lose the association of the images with the rest of the patient record. There are too many chances for introduction of errors and lost images. Always have a RIS at the same time or before you implement PACS and make sure the two are compatible.” • Failure rates: “Redundancy, back-up, and uptime requirements are critical,” Oosterwijk says. Make it clear what you mean by uptime and how it will be measured. That way you will avoid disputes with the vendor you ultimately choose, he says. Define uptime, determine how much downtime will be tolerable, and vendor response time in the RFP (and in the service agreement, where it really counts). • Training requirements: A wide variety of training packages are available. Spell out for the vendor what you will need—on-site training or e-learning where users can go to a site and train at their convenience, Oosterwijk says. Often training is not itemized in the PACS agreement, he says. “Therefore, it is even more important to make sure that there is an agreement in advance about the training package. In addition, there needs to be specific agreements about the timeframe for which training will be provided.” • Help desk availability: Some vendors offer help desk application-level support 24 hours a day. Some even can take control of your computer and perform necessary actions so the only thing the technologist has to do is drop the film in the scanner, Oosterwijk says. How important such capabilities are depend on your particular situation. If it’s important, make sure it’s part of your proposal, he says. In some cases, help desk availability may be a requirement. • Service requirements: When it comes to service, Oosterwijk says, the rule is you get what you pay for. “This means that if you need 24-hour coverage, seven days a week, with one-hour response time, you will have to pay for it.” Make it clear in your RFP what you will need. Some large systems have a single dedicated service engineer. If that’s what you need, make sure the vendor has a back-up trained. “This could be a necessity when your primary support engineer is sick, training elsewhere, or goes on vacation,” Oosterwijk says. • Contact information, evaluation criteria, and timeframes: As a vendor, Brian Melrose, a contract and RFP specialist for Eastman Kodak Company’s Health Group in Rochester, N.Y., says he finds it helpful when RFPs provide not only a point of contact but also a deadline as to when the contact will accept questions or clarifications. “Before we respond, we often need to clarify any outstanding items,” he says. Are you planning on the vendor making site visits? Suggest in your RFP when that will be scheduled, Melrose says. Must Haves Vendors also need to know your response deadlines.
“Don’t make them too short or too long,” Koller
advises. Deadlines should be based on the size of the opportunity,
he says. A smaller facility that is only interested in talking to
three or four vendors might give vendors three to four weeks to
put together a proposal. A larger hospital may need to give vendors
a month or two, depending on the complexity of the job. “I
know of a bid from the Mayo Clinic where it took most vendors a
couple of months to respond,” he says. Provide vendors a specific format for responses, Koller suggests. Having vendors respond in the same format and order as your RFP will make it easier to compare apples to apples. • References: The last things you need to get are good references, Solinsky says. “We like to tell folks they need to request a complete customer list and not just three or four references. Otherwise the companies can choose which of their customers they want you to call upon and they’re obviously going to give you satisfied customers.” With a complete list, you can randomly call references, Solinsky says. Linda Sweeney, a proposal developer for Philips Medical Systems in Andover, Mass., says vendors are glad to provide financial information about themselves. You want to know the vendor you ultimately choose will be around for a while. “You want to see stability in your investment,” she says. Is there a desired length for an RFP? Not really, the consultants say. It’s more important that it contains all the information vendors need to respond than it be any specific number of pages. “Write as little or as much information you need to make intelligent choices,” says Koller. — Beth W. Orenstein of Northampton, Pa., is a regular contributor to Radiology Today. |
 |
|
3801 Schuylkill Rd • Spring City, PA 19475 Publishers of Radiology Today All rights reserved. |