Axolotl

CMIO Magazine

By Gina Narcisi

For an organization looking to build a health information exchange (HIE), a solid request for proposal (RFP) is vital for garnering accurate vendor proposals and a realistic estimation of costs. The RFP also is instrumental in honing technology and business requirements for all stakeholders before inviting vendors in.

What belongs in an HIE RFP? Specifics vary, but the best RFPs include:

* Specifications based on extensive input from stakeholders
* A clear vision of the tasks the HIE will perform
* Well-defined technical expectations
* Maintenance and upgrade needs
* And be sure to include that the vendor must be cooperative and roll with technological and administrative changes.

Regional approach

One RFP won't fit all; each community involved follows a different pathway to HIE selection and implementation, says Todd Rowland, MD, executive director of HealthLINC, an HIE in Southern Indiana.

In the case of HealthLINC, the process "was lengthy, and required significant community physician engagement, as would any selection of a system that we expected multiple physicians to use," Rowland says.

Committees had to be developed for the creation of a RFP that would include multiple organizations and stakeholders, including tech support staff from hospitals, large physician practices and radiology facilities, Rowland says. "With multiple organizations weighing in, we had a pretty good level of participation for that process," he says.

A detailed RFP was developed and deployed in 2006. "We received eight responses [and] were able to narrow the choices to six immediately, because two of the vendors did not meet basic requirements that were seen as mission-critical," recalls Rowland. These included a requirement to work with HL7 codes. If the organization were creating an RFP today, prospective vendors' products would need to be compatible with additional standards, such as Continuity of Care Document (CCD) and RxNorm, he adds.

"We also wanted to know if [the vendors] had experience with scaling to a community of our size, and we wanted to [know] the number of deployed sites," he says. This was a challenge in 2006, because there was much less information regarding HIE successes and failures than is available today. "Many people didn't know what HIE was at the time," he notes. "We had really excellent consultants, however, who understood how this related to any other community process or technology, and helped us through this process."

Technical assessment was a big part of the RFP process: "We wanted to make sure a lot of options presented to the larger medical community would be technologically supportable," he says. Two vendors emerged from the technical assessment phase.

The final evaluation was "a two-day process where we had 65 people involved, including a technical group, physicians, practice administrators and hospital leaders, all having the opportunity to see the different software systems and ask their different sets of questions."

Participants then completed a formal survey. "We basically spent two full days running the vendors through the paces, and in that process it was clear that the Axolotl/Healthbridge combination came out of that process for us," he says.

Please visit CMIO Magazine to read complete story.