NEW ORLEANS - The request for proposal (RFP) can be more than a dust-dry listing of specifications for a product or service destined for radiology. Crafted carefully, the RFP outlines a relationship between the vendor and the healthcare institution that enables each to prosper and thrive.
"The goal of a well-executed request for proposal is to create a process where both the customer and the service provider make informed, logical, and unemotional decisions that create a positive partnership," said David Coates, regional vice president of Shared PET Imaging of Canton, OH.
Coates, along with David Zanni, nuclear medicine systems operation manager at Columbus, OH-based Mount Carmel Healthcare System, presented their experience with the RFP process in creating a mobile PET service to attendees at the American Healthcare Radiology Administrators annual meeting.
For the originating institution, an RFP provides information that will make vendors want to do business with the group. In addition, it allows the facility to leverage vendors through knowledge of their products, and creates healthy competition among the respondents.
"The goal of your RFP is to raise the standards of service for your project," Zanni said.
On the vendor side of the equation, an RFP provides an introduction to the organization’s structure, as well as insights into the group’s perceived needs. Unlike phone calls or onsite sales calls, the RFP provides a clear line of communication between the parties, thus enhancing potential customer and vendor satisfaction through clearly established expectations.
An RFP should not be a solo exercise, Zanni said. He advocated creating an RFP team that includes stakeholders both in and outside the radiology department. A leader will need to be selected for the team, and tasks should be assigned on the basis of area of expertise. For example, the Mount Carmel RFP group consisted of a radiology administrator, a radiologist, a representative from the purchasing group, an information systems manager, a clinical engineering specialist, and a member of executive management.
Legwork
Before beginning the RFP, an analysis of service need must be conducted in order to assess the viability of the proposal. Coates recommended taking the following steps during the initial evaluation of a PET RFP.
Create a summary of current services available in the institution’s market area.
Try to establish a baseline of what referring-physician support for the modality will be.
Compare current specific referrals, on the basis of ICD-9 codes, to those codes that are supported for PET reimbursement.
Compare usage patterns in similar-sized markets.
Summarize current and potential competition.
Conduct an analysis of potential cardiac and neurology referrals.
Obtain tumor registry statistics, both analytical and nonanalytical data, from the previous three years.
"When querying referring physicians as to their intended support of PET services, it’s wise to take the number of cases they say they will refer to you and divide them by two," Coates said.
An RFP consists of four broad topics: a brief project overview; instructions to the submitters; system design and requirements; and terms and conditions. Each topic area, depending on the scope of the project, can have several subsections.
Zanni recommended that system design and requirements be as specific as possible, but also allow for flexibility in response from vendors. However, if there are proposed changes to the design and requirements specifications, insist that the bidder explain why they need to be altered.
Drilling down to detail
For an imaging center that is considering bringing a mobile PET service to its doors, there are a slew of specifics that must be covered in its RFP. Fundamental questions include the proposed manufacturer and model of the PET system, as well as the mobile coach layout and equipment. A list of radiopharmaceutical suppliers and their distribution locations should also be supplied. Staffing requirements and maintenance support for the system will also need to be provided.
Some of the other considerations to be addressed in the RFP include:
The identification of key technical personnel.
The responsibility for patient preparation.
Where the radiopharmaceutical doses will be administered and who will administer them.
A description of the flow of patient studies.
A written safety plan.
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) certification.
How the radioisotopes will be handled, including regulatory responsibility and disposal.
Responsibility for movement of the medical coaches.
Architecture and infrastructure of the pad site for the coaches.
Cost of site development.
The value-added RFP
According to Coates, there is a lot of hyperbole about the potential success of a PET service. Based on his experience with the modality, he advocates planning for a persistent and consistent marketing and training effort to build patient volume. The RFP can be a powerful tool to accomplish this task.
As part of Mount Carmel’s RFP, Zanni and his team created vendor requirements for the education and training of its hospital and technical staff. In addition, they requested a long-term marketing plan from the bidders that would relentlessly call upon referring physicians to educate them about the service.
"We often spend one to two million dollars for a piece of diagnostic equipment, but do not budget for appropriate training of the staff or marketing of the service," Coates said. "How then can we expect full understanding and capitalization on the equipment’s full potential?"
Zanni also advocated providing a potential supplier with the institution’s long-term goals for the service as part of the RFP, so the vendor can demonstrate how well its product will meet those expectations.
When it comes time to winnow down the RFPs and draw up a contract with a vendor, it is imperative to consider both the price and the quality of the service. Coates said the pain of poor quality would last much longer than the pleasure of the best price.
"Remember, from the patient’s perspective, it doesn’t matter who the service provider is that is performing the PET scan. To them, it’s your institution that is providing the service," Zanni said.
By Jonathan S. Batchelor
AuntMinnie.com staff writer
August 1, 2002
Related Reading
Successful PET centers require planning and persistence, July 15, 2002
New tracers, technologies propel clinical applications in PET, June 14, 2002
Mobile alternative brings PET to the door, August 14, 2001
PET brings surprises in and outside the reading room, August 9, 2001
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