Structured steps lead to successful RIS purchase/upgrade

Jun 23, 2005

Writer Anne Lamott, in her book Bird by Bird: Some Instructions on Writing and Life, tells the story of when she was a child facing a next-day deadline for an extensive report on birds. When she asks her father how she's going to get her assignment completed in so short a time, he replies: "Bird by bird." Although buying or upgrading a RIS can appear equally as daunting a task as a term paper started the night before it's due, the adoption of a series of defined tasks can result in a successful project realization.

"When a systems analysis approach is used, several very structured steps should be followed when selecting and implementing or upgrading a new system," said healthcare informatics expert Janice Honeyman-Buck, Ph.D., of the department of radiology at the University of Florida in Gainesville, FL, in a presentation at the Society for Computer Applications in Radiology (SCAR) meeting in Orlando, FL, earlier this month.

Specify

The first step that Honeyman-Buck advises a facility take is to create a requirements specification. The process of developing this specification should be done by a group consisting of technologists, radiologists, administrators, and representatives from registration and billing. The team's first task is to extensively document complete examination workflows, as this ensures that no requirements are missed, she said.

If a practice is buying its first RIS, the requirements specification will state what procedures the group wants the application to perform. If a the practice is upgrading its RIS, it will want to list the features it likes and doesn't like in the current system, as well as specify what data must be saved or migrated, Honeyman-Buck advised.

An effective way of framing requirements is to state the goals and objectives of each area of workflow and how a RIS can positively impact that particular process. Once this has been accomplished, the requirements can be written in short, bulleted phrases. For example, the RIS must implement scheduling on specific equipment, or the RIS must allow alphanumeric characters in the medical record number. According to Honeyman-Buck, detail is a key element in the requirements specification.

If the facility is upgrading its RIS, the requirements should specify exactly what needs to be migrated and the timeframe for the migration. In addition, it should state who will do the work and the project staffing requirements.

"Each of the requirements should be assigned a score or ranking that can be agreed upon by the group," she advised. "One way to do this is to set up a scale of 1 to 5, with 5 as the most important and 1 as the least important rank. These rankings are important communication tools to the vendors who are proposing products to you."

Propose

Once a consensus has been reached as to the requirements and their importance to the practice, a request for proposal (RFP) will need to be drafted. When it comes to crafting an RFP, Honeyman-Buck is unequivocal in supporting the use of outside resources.

"If no one in your organization has expertise in writing an RFP, hire a consultant," she said. "Maybe hire one even if you do have the expertise. Personnel in most organizations have full-time jobs and cannot give the amount of attention to this process that is needed."

Honeyman-Buck said a good RFP should include the following elements:

Institutional background, size of institution, number of beds, and number of studies
Installed information systems (manufacturer, model, and system iteration) that must be integrated with the new RIS
If replacing a RIS, data migration requirements
Contact people at the facility
Timeline for bidding, vendor selection, and full implementation
Thorough and complete instructions for the proposal format, and sections with questions the vendors must answer to keep uniformity of responses
The requirements and the ranked importance of each one
An explanation of how proposals will be ranked and graded
Any restrictions under which the practice may be operating
Training requirements
Implementation timelines and an estimate of personnel time required to configure and maintain the RIS
A section for a vendor to demonstrate its financial structure, ability to perform the proposed project, and references for other systems similar to the one proposed, as well as contacts at those locations for more information

When the RFPs are returned, the requirements team should rank each proposal against the value of each element in the requirements specification. In this manner, a side-by-side comparison can be performed with each vendor, and a numeric ranking assigned to each one.

Contract

Once a vendor for the new or upgraded RIS has been determined, a contract will have to be created. Honeyman-Buck advised using a consultant to match the proposal from the vendor with the contract. In addition, she strongly emphasized the importance of having penalties in the contract for nonperformance, implementation delays, and nondelivery of promised enhancements.

The contract should also include the facility's specifications for project timelines, cost, training, and the time commitment for the practice's personnel. And, of course, the practice's attorney should vet the document prior to signing.

Finally, Honeyman-Buck shared 10 common mistakes to avoid from the On-Line Consultant Software Web site: