A strange thing happens in health IT solution procurement, and by extension government initiatives that seek to influence it. See if you can disagree with the following characterisation of health provider organisations as solution purchasers.
Think You’re Getting What You Want?
CIOs and CMOs have known for years if not decades that:
- the data used inside their institution are their most important asset – either as a productive resource, or at least as an object of risk management. Most today would understand it as both.
- the data used inside their institution is not all produced inside their institution – lab data often comes from external lab companies; they obtain or would like to obtain GP data such as medications lists, problem lists and so on;
- their main vendor solution never supports the data richness actually required by clinicians – it is well known for example that most hospitals contain dozens if not hundreds of hidden specialist’s databases, often referred to as the ‘Access Database problem’;
- if they want to switch to a new vendor, the changeover costs related to the data alone are massive and the risks so great that this consideration alone paralyses them for years with the current ineffective solution;
- no one vendor can produce all the functionality they require – even the biggest vendor has a ‘roadmap’ containing numerous features the provider wants today; no large procurement doesn’t involve significant and horribly expensive ‘customisation’;
- they cannot possibly afford to buy all the functionality they require in one go – if they wrote down the full wish list and then published a tender for it with an open budget, the resulting price tag would undoubtedly be beyond their means;
- procurement of multiple ‘best-of-breed’ solutions for e.g. inpatient, ER, ambulatory etc, come with huge ongoing cost for data and workflow integration;
- they cannot possibly afford logistically to deploy all the functionality they want in one go – the human costs and challenges of change management not to mention solution integration make this impossible;
- asking for even the smallest change to the data schema or core functionality costs inordinate amounts of money and usually a long wait as well;
- it would be nice if their IT department could have access to ‘their’ data, but of course they can’t, not without the vendor’s say so and price tag.
