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As the founder and CEO of a small HIT vendor, I've got my biases. I think small is good, flexible is great and personal service is the best. Let's throw reliable and responsive into the mix. These are trademark attributes that hospital CEOs, CIOs or other C-suite executives should expect of their vendors given the millions their organizations spend on health care IT.
Sadly, the antithesis is too often the case. A cursory read of the health care IT blogs tells us that very little has changed in the past decade: "Big-box" health care IT vendors are often late to deliver, over-budget and unresponsive when you "need someone now." And whether the technical issue is interoperability, integration, scalability or portability, their largely character-based products are typically rigid, cumbersome and decidedly non-portable.
To paraphrase a current line about bailing out the big banks, the big HIT vendors are "too big to succeed" in an Internet-driven, mobile world where rapid-response time and light footprints are imperative. Still, big vendors have been superior in one area: spin. They've controlled the conversation. In my effort to take the conversation back, I've highlighted the ways small HIT vendors excel as true partners with hospitals and health systems. Because, at pivotal moments such as these, we have to prove that terms like partnership are more than just marketing slogans.
Great technology
Let's start with the basics. In the case of HIT, good partnerships arise from good products. Absent a foundation built from innovative technology solutions, no partnership can get off the ground. The technology must be comprehensive, integrated and portable. In this era, that means a browser-based electronic health record (EHR) that combines the heavy lifting of CPOE with the light footprint of an iPhone. Small vendors are the hidden treasure here because they are able to satisfy the need to move to a standardized, unified platform that also accommodates the mobility that's a benchmark of the current generation. We've built our clinical and financial platforms from the ground up for the Web era. That's unlike the big-box HIT vendors, most of whom are still using systems built on MUMPS and other character-based language from the 1960s and 70s. In sandbox lexicon, it's time to build technology that "plays well with others."
Measurement & review
Any vendor who doesn't insist on a clinical review prior to implementation of an EHR is not worth the title "partner." We always have our clients undergo this four- to five-week review, which involves a comprehensive mapping of the clinical processes -- and gaps -- that will be impacted by the new automation. It's worth it. Otherwise a client gets 18 months into an IT initiative and suddenly realizes they're digitizing spaghetti and can't turn back. Automating a really bad process just makes a really bad process electronic -- it will just be bad faster. Integral to this review is the embedding of a continual measurement process of key performance indicators supplied by the provider organization in consultation with the vendor.
Communication
It seems like the proverbial no-brainer, but it's a reflection of the deplorable track record of big HIT vendors that communication is near the top of the list when discussing the need for true partnerships between vendors and customers. The warmest response I ever received from an audience was when I promised as their HIT vendor to give them my cell phone number so they could call me any time. This has never been an idle promise -- my customers know they have direct access to me 24 hours a day, seven days a week. When you're the CEO of small HIT vendor, you can do that. In contrast, big vendors may give you a telephone number but it's most assuredly not the CEO's cell phone.
Follow-up
What would great communication be without follow-up? Good partners are humble enough to catch the next flight to your site to follow up on the myriad issues endemic to IT implementations. Customers may even get sick of seeing us -- but that's better than a "big" disappearing act.
Risk sharing
Mutual risk- and reward-sharing is the new order for delivery organizations and vendors to not only survive but thrive going forward. Small vendors are used to going at risk -- we do it every day -- and innovation is the result. Being a partner in innovation means not only sharing clever new technology solutions but also business arrangements. Big vendors are typically loath to do this as it disrupts their traditional parasite/host business model.
Transparency
Economic realities are dictating a new partnership paradigm that favors collaboration and transparency of information. As vendors, that means we must encourage our customers to talk, to share information. Let's not keep customers away from each other. This sharing should not be limited to just user-group meetings. The Internet has fostered a new community model that we're only beginning to understand. As technology and service providers, we have to find ways to foster this same sharing among our own customer base.
Renewal
Savvy executives should view the current economic crisis as an opportunity to renew and reengineer partnerships with IT vendors. Nothing should be kept off the table in pursuit of this reinvigoration. Small, innovative HIT vendors are willing and able to share in the risk and the reward to achieve this goal.
Mr. O'Pry is CEO IntraNexus, based in Virginia Beach, Va.
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