Archive for January, 2009

House Passes Economic Stimulus Bill – Over $20 Billion For HIT

Thursday, January 29th, 2009

View the February 20, 2009 UPDATE to this post here.

UPDATE – See the February 9, 2009 UPDATE to this post here.

The House version of the Stimulus Bill passed on January 28, 2009 and is worth some $819 Billion. The Senate will vote on its version of the bill next week, which is worth close to $900 Billion and includes an additional $3 Billion for HIT.

Funding That Will Become Available

The bill creates the “Health Information Technology for Economic and Clinical Health Act” or the “HITECH Act”. You can view the approved House version of the HITECH Act here (scroll down to Page 30).

Independent Professionals

Under the HITECH Act, “eligible professionals” (which does not include “hospital-based professionals”) who are “meaningful EHR users” can receive up to $41,000 over five (5) years. (Section 4311)

Hospital-Based Professionals

“Hospital-based professionals” are not excluded from incentive payments, but their eligibility and maximum incentives will be extablished through subsequent rulemaking. (Section 4311)

Hospitals

“Eligible hospitals” that are “meaningful EHR users” will receive a “base amount” ($2 Million) plus a “discharge amount” (based on annual Mecidare discharges), times a “transition factor” applied over five (5) years. The transition factor starts at unity (1) for the first year, and declines to zero (0) in the fifth year. (Section 4312)

Positive Effect

There will always be naysayers and detractors, but to me these are substantial sums, and they demonstrate the federal government’s commitment to HIT (though mixed with its commitment to economic stimulus). These monies will no doubt save many HIT jobs–not just within hospitals and clinics, but across HIT vendors and consultancies–and in the best of worlds, the dollars may be sufficient to create new HIT jobs over time.

NOTE: The figures above are based on my quick read of the House version of the HITECH Act, which has not yet been enacted. My interpretation of this version may not be accurate, and in all events, all of its provisions are subject to further revision and amendment prior to enactment.

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New eRFX Tool for Procurement

Tuesday, January 27th, 2009

VendorSelect

Nuckles Technology Law Firm and Olive Consulting Group LLC are pleased to announce introduction of their new eRFX Tool. It’s called VendorSelect, and it was designed from the ground up as a sophisticated, stand-alone electronic RFI and RFP solution.

We’re proud to offer these eRFX features exclusively to clients in support of their procurement efforts:

Web Hosted – No software to buy or download.
Intuitive User Interface – Incredibly easy to set up and administer projects.
Excellent Vendor Acceptance – Increases vendor response rates.
Flexibility – Suitable for use with small and large projects. 100% scalable.
Numerous Configuration Options – You’re not forced to work from a canned template.
Document Management – Easy import and export of project documents and attachments.
Scoring Options – Numerous scoring and weighting options, including multi-group scoring.
Logging – Embedded logging feature tracks every sponsor and vendor transaction.
Dedicated Hosting – Supports the firm’s close and secure collaboration with clients.
Undisclosed Principal – We can conduct your RFI and RFP processes anonymously.

As a buyer, you can access many market- and industry-specific RFI and RFP templates to jumpstart development of your requirements, questionnaires and vendor selection criteria for your procurement projects. As a vendor, you can develop your own response templates and attachments and add them to your library for easy access and re-use, allowing you to respond to solicitations more efficiently.

Our new VendorSelect eRFX Tool is the perfect complement to our process-driven approach to information technology procurement, whose objectives are to compress the sourcing phase for your projects, reduce vendor negotiation cycle times, obtain the best overall short- and long-term pricing, obtain the most appropriate buyer protections and remedies (reduce project risk), and save you time and money at every step of your process.

Learn more about the features of VendorSelect here.

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Is Your Software Vendor Like Your Cable Company?

Monday, January 26th, 2009

cable-guyDoes your software vendor or reseller keep raising fees year after year? Do you feel less like a long-term, loyal customer and more like an abused customer?

If so, you’re not alone. In a normal year, I get lots of questions about controlling mature-deployment costs for major app’s and shrinkwrap software products. These are long-term customers, using app’s their organizations depend on and value. But they’re looking to roll back the hands of time to the earlier days of their relationships with their software vendors and resellers, back to the days of attractive pricing that they under-appreciated at the time. Since about November 2008, these inquiries have increased dramatically. So, I thought I should offer up some tips for everyone to consider.

Timing and Initial Price – I realize it’s not what you want to hear, but the best time to control costs for a software acquisition is at the time of acquistion. However you accomplish it, you have to get the best possible initial price that you can. Arm yourself with market knowledge, pit reseller against reseller, use a reverse auction process–whatever it takes. If your benchmark is 30% off of list, and you apply this benchmark across all of your new software acquisitions to the exclusion of other price negotiation strategies, you’re leaving good money on the table. Initial cost is important to everyone, and everyone likes to think they got a good deal on everything they buy. But in terms of software purchases, initial cost is especially important because, regardless of what good cost-containment measures you might negotiate into your license, nearly all will be tied to your base pricing.

Terms and Conditions – If you want to control the long-term license and service fees for any software purchase, you need to add appropriate terms and conditions to your license agreement at the time of purchase. It’s much more difficult (and sometimes impossible) to get these terms and conditions later. What Total Cost of Ownership (TCO) terms and conditions should you add? This probably deserves a separate post or two, but you should not ignore the following:

License Structure – Most software buyers will negotiate a particular license structure (seat, user, block, tiered user, etc.) that is best for them at the time of purchase, and leave it at that. What you should do instead is provide for alternative license structures, provide associated pricing for each now, and eliminate any penalties associated with switching from one structure to the other down the road. Then tie the alternative license structures to your other cost-containment provisions.

Most Favored Nations Clause – Use a meaningful Most Favored Nations Clause (MFNC), not the one your software vendor is willing to provide if you think to ask. A meaningulf MFNC must be interlinked with the other provisions of your license, and it must be auditable to be enforceable. It’s possible to weave in language that deals with the fact that new customers typically receive better pricing that older, loyal customers (the Cable Company phenomenon).

Price Escalation Clauses – Again, don’t stop with the standard CPI or other cap your vendor will provide–if you think to ask. Any meaningful Price Escalation Clause (PEC) will state that license and other fees will not increase by X% year over year. But this alone is not enough. Your goal is to create ceilings for price increases, not floors (typical PECs function as floors; next year’s price is automatically base plus X%). With the price increase ceiling concept, you leave each successive price increase open to negotiation, but in no event will it be more than X%.

What if I didn’t get all this good stuff at the time of my initial software acquisition? – Well, I would say you are the norm and not the exception. But all hope is not lost. Remember, everything is negotiable. And remember, too, that “negotiable” includes “re-negotiable”.

If you are looking to re-negotiate existing licenses with your software vendors and resellers, there are many approaches you can take. What approach you choose depends on your particular starting point. But for any situation, you should probably conduct a Software Asset Management (SAM) exercise before you launch into your re-negotiation process. A good SAM exercise will help you determine where you’re at presently with with your software deployments and corresponding licensures, and it should help you determine where you want to go for the future. A good SAM effort will help you determine the objectives of your re-negotiation process and how best to achieve them. For example, you may find that your organization’s preference is to keep SoftCo’s Tarantula module, but you could live without it. Use this and other information about your current use and licensure of SoftCo’s products to your advantage.

Lastly, if you will undertake a re-negotiation process, that will be a good time to get (attempt to get) all of the good stuff mentioned above (buyer-favorable license terms and conditions). You don’t want to go through the whole re-negotiation process and get some good price compression resluts, but find yourself wanting to roll back the hands of time again in 3-5 years.

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Healthcare IT In $350 Billion Stimulus Plan

Thursday, January 22nd, 2009

View the February 20, 2009 UPDATE to this post here.

UPDATE – See the February 9, 2009 UPDATE to this post here.

The House Appropriations Committee approved a $358 billion portion of an economic stimulus package that includes funds for healthcare IT. Of this total amount, roughly $20 Billion has been earmarked for IT-related healthcare spending.

Earlier announcements tied a good portion of the the $20 Billion to Medicare and Medicaid providers to improve their EMR platforms. Regardless of how these dollars are ultimately targeted and spent, this is good news for HIT professionals.

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Which EMR Solution Will You Buy?

Wednesday, January 21st, 2009

If your organization is considering an EMR solution, be sure to check out EMRmatch, the definitive EMR evaluation and selection tool, here.

Also, be sure to check out CattailsMD, the relatively new kid on the block.

You can visit the firm’s website here.

If you look into the CattailsMD EMR solution, or you have recently purchased some part of the solution, please add your comments to this post. I, and I’m sure others, would like to hear your comments and observations about how CattailsMD stacks up against EPIC and other EMR market leaders’ offerings.

If you do not see the comments window below, click on the post’s title. You DO NOT NEED TO REGISTER in order to post comments.

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First SaaS or More SaaS for Your Organization?

Wednesday, January 21st, 2009

Are budget pressures forcing you to take a look at adding SaaS applications to your organization? If so, keep the following tips in mind to assure a successful hosted deployment.

User Expectations – If you will be replacing an existing on-premises application with an SaaS application, be sure that your user group will experience all of the functionality they enjoyed previously. Track current transaction times under the current application, and measure them against those within the SaaS application in a demo or test environment. Do the same testing in your environment for any new application that you’ll pull off with SaaS.

Your Networks – Evaluate your company’s internet connections. If your user base is already experiencing bandwidth and latency problems, adding more traffic will only strain your connections further. Clear up any of these problems before you launch your new SaaS application.

SaaS Provider’s Service Record – Most Saas providers make their service performance records public. If your SaaS candidate does not, this should raise an eyebrow. In addition, double-check an SaaS provider’s public statistics against actual user experiences. Look for independent reviews and comments posted on the web.

Service Level Agreements – Use an SLA to establish uptime and other performance characteristics that are important to your organization. Although SLAs are a great tool for establishing performance expectations and corresponding penalties for nonperformance, remember two things.

One, if your SaaS provider’s performance is really bad, should you be content knowing that at least you’re getting the bad service at a healthy discount? Or, is the service so bad that it’s hurting your organization? Your SLA should be structured such that it gives you a way out of the deal if service drops below some level. And think about asking for redeployment expense as part of this type of provision.

Second, SLAs are burdensome to administer–both for you and your provider. The more complicated the SLA, the more difficult it is to adminster. For this reason, many SaaS providers (even reputable ones) do not offer an SLA option. In all events, you’d much rather have premium service all the time and not have to worry about tracking performance metrics.

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Nortel Files for Chapter 11 Bankruptcy Protection

Tuesday, January 20th, 2009

Nortel Networks Corporation
Image via Wikipedia
Nortel Networks Corporation, the Toronto-based network equipment provider, filed for U.S. Chapter 11 bankruptcy protection last week. What does this mean for current Nortel customers, and what should you do now to assure continuing viability of your Nortel-based networks? No one is sure just yet, but here are a few tips.

Don’t Panic – Don’t junk your Nortel stuff in a panic. Chapter 11 means reorganization, not liquidation (though, as with any company in Chapter 11 proceedings, Nortel could convert to Chapter 7 liquidation down the road–Circuit City filed Chapter 11 in December 2008, and in January 2009 converted to liquidation). In all events, it appears Nortel will need to shed some of its operations in order provide a meaningful plan to emerge from Chapter 11. If Nortel survives its Chapter 11 experience, expect a leaner, more-focused company for the future.

Dont’ Buy – Don’t buy any more Nortel stuff until a better picture emerges. Postpone noncritical upgrades, etc. Now is not a good time to make a further investment in Nortel’s products and services, some or all of which may not be supported down the road.

Service Deterioration – Expect poorer service (response times, etc.) from Nortel in the coming months. Nortel has been struggling financially for the last four years, and service performance has no doubt taken a hit during this period. So, we’re talking now about perhaps going from bad to worse.

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How Does Your Organization Buy Software? (Part 1)

Tuesday, January 20th, 2009

Tuna AuctionRegardless of size, most organizations fall into one of two categories when it comes to acquiring new software.

Techies Only – One common approach is to allow technologists (whether internal project team, outside consultant, or some combination of both) to do all of the planning, sourcing, negotiation and contracting for the new acquisition.

Techies Plus Procurement (Purchasing) – The other common approach is for technologists to work side-by-side with the organization’s Procurement (Purchasing) function. Technologists provide the necessary technical input, and Procurement tends to focus on sourcing, pricing, and contractual terms and conditions.

Use of Legal Counsel – Under either approach, the organization might involve legal counsel (in-house or outside counsel) to review finalized contracts prior to their execution, or the organization may not use any legal review. When legal counsel is involved, the attorney’s experience with technology transactions can vary widely. And even when experienced technology counsel is available, rarely is the attorney brought into the negotiation process, the point at which the attorney’s exptertise has the greatest potential to positively affect the outcome of the transaction for the software buyer.

One thing that’s remarkable to me about these approaches to buying software is their inflexibility and persistence. Once an organization adopts one or the other approach, it tends to stay with it indefinitely.

In subsequent posts within this category, I will discuss the pros and cons associated with each of these approaches. I’ll also suggest incremental improvements that any organization can adopt in order to reduce the short- and long-term expense and risk associated with software acquisitions.