The Office of the National Coordinator for Health Information Technology (ONC) recently issued a comprehensive 56-page guide titled “EHR Contracts Untangled: Selecting Wisely, Negotiating Terms, And Understanding The Fine Print.” The guide opens with a few cautionary tales of engagements gone bad and a discussion of how to plan for an EHR purchase or upgrade, noting that providers ‘should be well prepared before considering making an IT investment.’
Over the course of my career, I’ve given presentations to the American Medical Association and state Medical Societies and others on how best to engage with EHR vendors and what makes a good EHR engagement contract.
In that same spirit, and in well under 56 pages, I’d like to share some essential questions you should answer before starting your next EHR purchase or upgrade negotiation cycle. I’ll also share advice from a career spent helping practices make the most of their technology investments. Because regardless of the EHR system…
You Can’t Get What You Want Until You Know What You Want
Determine what your organization needs and wants first, and then do your product research. Sounds obvious, but many clients start with a short list of EHR systems, without fully understanding the needs of their organization. Match the software against your needs and wants. If you’re not sure what you need, poll your clinical and administrative staff first and create a checklist.
No matter the price or the popularity of the EHR software, one size does not always fit all.
Some software may be better for specific specialties and what works well for one practice, may not work well for yours. Flexibility is key for efficiency.
Other important considerations:
- Is the software certified?
- Is there any guarantee?
- Will it play nicely with others? Efficiency is gained from the ability to work with other systems, devices, etc.
- What kind of hardware and connectivity will you need? Most healthcare providers today need access to their EHR 24/7 in the office and remotely, on tablets and mobile phones.
- What other technologies are you considering, like speech recognition?
Assuming you’ve done your research and used a collaborative, interactive process to identify the right system from the right vendor for your organization, what’s next?
Good Contracts Make Great Engagements
A good contract benefits all parties and supports strong ongoing business relationships.
In my experience, a successful contract should set clear expectations on how the parties will work together including delivery and other timelines, and it should be simple. Compare contracts from several vendors to see what each is offering, asking for and protecting.
Specific details to consider for EHR contracts:
- Who owns and has access to YOUR data?
- Pricing models – Per provider, concurrent user, etc.
- Be careful when comparing – make sure you are looking at apples and apples
- Do your homework to determine whether a monthly subscription is better for you that an outright license purchase.
- Look carefully at what is included in structures where you are paying a percentage of revenue or collections. Are you saving or losing?
- What is included in the price and what is extra? How does training work?
- What is the guarantee for regulatory compliance like Meaningful Use, MACRA, etc.?
- Get estimates/caps on travel costs for installation and support.
- Negotiate the ability to purchase additional licenses at a discounted price in the future
- Set schedules and milestones in the contract.
- Don’t pay for everything up front – hold back a portion until after implementation.
- Make sure there is clear language regarding termination. What happens? Who has responsibility for the transition? How do you get your data? What happens to the licenses?
If you want some help with your EHR process please contact us. Our professional services consulting team works with healthcare providers in private practices, clinics, federally qualified health centers (FQHC), health information exchanges (HIE) and hospitals to optimize their EHR technology investments.
