Contracting and Negotiation DOQ-IT Education Session Contracting and Negotiations.
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Contracting and Negotiation DOQ-IT Education Session Contracting and Negotiations
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Transcript of Contracting and Negotiation DOQ-IT Education Session Contracting and Negotiations.
Contracting and Negotiation DOQ-IT Education Session
Contracting and Negotiations
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Should be able to:• Identify 1-2 areas of EHR contract review and
negotiation.• Name 2 financing options for EHR purchase.
Objectives For This Session
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So you have selected an EHR…
• Based on…– A vision for your practice utilizing an EHR
• Project Charter• Communication Plan
• You have selected…– An EHR that meets your expectations and
goals• You can explain why you selected it• You know what it is expected to do
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Let’s Sign The Contract!
• Contracts protect the vendor
• Contracts require your review and negotiation
STOP
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Sections of a Contract
General TermsSoftwareInterfaces and ConversionsServices (Implementation and Training)Support and MaintenancePayment ScheduleHardware
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General Terms
• General Contract Structure Items– The legal ‘stuff’
• Limitation of liability• Indemnification• Force Majeur• Warranties• Disclaimers
– How to get out of the contract• Default• Bilateral termination• Transferability
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General Terms
• Protecting your work– Data ownership– Source code escrow– HIPAA– Government regulations
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Software
• Two types of contracts:– License
• Term or perpetual
– Subscription• Term
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Software
• 3rd party and ancillary software required– Additional cost
• System upgrades– Process– Frequency– 3rd party patches and updates– Service fees
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Interfaces and Data Conversions
• Interface – Electronic source of information
• Real-Time• Batch
• Data conversion – Electronic load of data
• One time
• Two (2) payment options:– Flat fee – Time and materials
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Interfaces and Data Conversions
• Evaluate– All data sources to determine number/type
of interfaces– All data currently stored electronically that
you want in your EHR
• Cost considerations– Leverage existing interfaces (hospital or
community)– Negotiate flat fee when possible– Interface upgrade process– Costs on both sides of the interface– Support fees
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Services
• Implementation
• Training
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Services: Implementation
• Understand Services and Costs– Description of Services
• Project Management• System Customization• Operational Redesign• Hardware/Network Implementation
– Resources– Timeline
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Services: Training
• Training– Who is Trained?
• Train The Trainers vs. Train The End-Users
– Resources • Number and Type
– Additional Training Resources• Online courses, take home CDs and Manuals,
Other• Re-Training
– Availability and Costs
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• Typically 20% of Software Cost– Calculated on List Price
• Includes Software Upgrades and Documentation
• Support During Normal Business Hours
• Annual Increase– Suggest 3%
Support and Maintenance
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Support and Maintenance
• Define Standard Support Services– Hours– Process– Turnaround Time
• Respond vs. Resolve
– After-Hours – Escalation Process– What is Supported?
• Software, Hardware, 3rd Party Applications, Interfaces
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Payment Schedule
• Milestones Based On…– Productivity
• 25% Upon Contract Signing• 50% Upon 1st Physician Live• 15% Upon 5th Physician Live• 10% Upon All Physicians Live
– Timeline• 25% Upon Contract Signing• 25% Upon Software Delivery• 25% Upon Go Live• 25% Upon 60 Days Post Go Live
– Hybrids
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Payment Schedule
• Guaranteed Pricing– Optional Modules
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Hardware
• Two Options:– Local
• You Own and Support the Hardware
– ASP • Hosted at Remote Location
• Minimum vs. Recommended Configuration
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Hardware: Local
– You own and support the hardware• Guidance on proper backup
procedures and maintenance– Daily, weekly, monthly maintenance
• Service level agreement (SLA)– Priority escalation for hardware failures
• Know how to acquire a new server• Downtime Procedures
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Hardware: ASP
• Hosted at Remote Location– Service level agreement (SLA)
• 99.999% Uptime• Escalation path• Penalties
– Understand disaster recovery plans– Downtime procedures
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Other Considerations
• Help Is Available– Attorney– IPA/PHO– Consultants
• Clarifying Contract Language• Timing
– End of Month– End of Quarter
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Other Considerations
• IPA/PHO Collective Bargaining Power
• Discounts– Affiliations– Industry Partners
• Understand Your Responsibilities and Contractual Commitments
• Make Sure Your Contract Is Win/Win
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How do I pay for this?
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How Do I Pay for This?
• Capital
• Financing– Traditional bank financing
– Lease financing
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Comparisons of Financial Modelson a Year By Year Basis
• ExamplesSub -
Hosted
Sub - Owned
Lic -Financ
eLic -Purchas
e
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Conclusion
Did we meet the objectives? Should be able to:• Identify 1-2 areas of EHR contract review
and negotiations.• Name 2 financing options for EHR
purchase.
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