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OTB Approach to Healthcare Interface Engine Selection The thirteen steps of highly successful HL7 engine selections John Traeger [email protected]
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Healthcare Interface Engine Selection

Jan 22, 2015

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Health & Medicine

Chad Johnson

Detailed presentation by John Traeger, principal at OTB Consulting, that includes '13 steps of highly successful HL7 engine selections.'

Excellent information here that will help you select the best HL7 interface engine for your organization's needs. Highly recommended.
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  • 1. OTB Approach to Healthcare Interface Engine Selection The thirteen steps of highly successful HL7 engine selections John Traeger [email protected]

2. Table of Contents Introduction The Proven Approach Preparation The 13 Step Process Why Your Requirements are Wrong The Proven Approach Collection and Evaluation So Did You Like What They Said? Who do you invite to do a dog and pony show? What to look for in the demonstration Why Your RFI Doesnt Deliver Information You Need Score each vendor immediately after the demo Dont Forget to Ask About Everything Sounds Good, Now Let Me Do It Why Your RFI Will Be Ignored Define gates in the selection process Develop scoring system Scaling the process for your organization How to make sure you send your RFI to all potential vendors They shoot andScore! Now Lets Talk About Money Lets Talk to the Vendors Friends The Proven Approach Making a Decision So Whats All This Really Going to Cost? May I Have The Envelope Please? Finding the pick of the litter Taking it the last mile Now the Real Work Begins; Avoid Getting Lost in the NoiseJohn Traeger [email protected] modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner2 3. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerIntroduction Selecting an interface engine for your healthcare organization is not a trivial matter. impacts the reliability and flexibility of healthcare data delivery within and outside your organization costs are much broader than what you pay the software vendor; deployment, migration, training, and support hours The importance of fit cannot be overstated internal costs and system effectiveness will vary widely depending on the engines features and the context and culture of your organization Why would I bother with a process when I already know what I want? You only know what you know; what you dont know can cause expensive mistakes Its an opportunity to clearly define the interface teams role in your organization Learn more about how your team functions which leads to improved effectiveness 4. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerIntroduction Who else would care about using a process like this? Anyone who responsible for selecting a new interface engine: IT Director PM Lead Developers IT Portfolio Managers Executive Team The future of healthcare and executive goals are inextricably linked to the movement of data They expect the interface team to be agile enough to meet application changes (new or updates) seamlessly without impacting business planning or strategy When should you start the process and how long is this going to take? Start as soon as possible after internal approval to ensure enough time for a thorough selection process For a large organization making a major investment, this is typically a 2-3 month process For small organizations, this may take as little as 1.5 months 5. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerEight reasons HL7 interface engine selections fail 1. Biases a.Toward a vendorb.Toward a technology2. Rushed decision making 3. Only a single vendor considered 4. Replacing what is known instead of what could be a.Requirements oriented around current stateb.Requirements that are not looking at the art of the possible5. Misjudging skill level of development team 6. Misjudging the level of effort required to change interface engines (replacing an engine while the plane is in flight) 7. Misunderstanding the role of the interface engine in the organizations healthcare ecosystem 8. Not identifying or understanding the stakeholders 6. THE PROVEN APPROACH PREPARATION 7. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 Step Process 1. Develop requirements 2. Create RFI 3. Identify vendors and submit RFI 4. Score RFI 5. Invite vendors for sales demo 6. Score sales demo 7. Invite vendors for Proof of Concept 8. Score Proof of concept 9. Send out RFP/RFQ 10.Score RFP/RFQ including financial component 11.Select Vendor 12.Negotiate the final details and obtain final signatures 13.Socialize the selection in your organization 8. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:1. Develop requirements Why Your Requirements are Wrong Requirements are stated as how instead of what you want accomplish your requirements (yes, even technical ones) should describe what the business/interface team is trying to do, not how they do it. Requirements reflect the current state instead of future state Thinking outside of the box and designing requirements around the art of the possible will ensure a more successful selection and implementation. Enterprise Context is missing Requirements that dont take into account the current and target enterprise context can lead to selections that result in a poor fit. Requirements are biased The team needs to identify and acknowledge preconceived biases to ensure the selection process is objective and well informed. Examples include: The latest and greatest solutions are always best Developer needs and wants are the only criteria considered Pre-existing vendor relationships Cheapest vendor always is best 9. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:1. Develop requirements Why Your RFI Doesnt Deliver Information You Need Who Cares About This? Understanding the requirements by stakeholder Who are the business and technical leaders that your team works with on a regular basis? Who are the key players your team has to consult for specific expertise? Who do you have to call for permission for large projects? Who Are You? Understand the context Understanding the context of your organization is important in finding an engine and technology that is a good fit. Interface Environment Enterprise Portfolio IT Guiding Principles Cultural Fit Organizations decision making processLesson Learned:Clearly understanding the requirements will significantly increase the chance of management and developer buyin at the end of the processLesson Learned:Clearly understanding the context within which the Interface Engine will be implemented makes the questions you ask the vendor more relevant and effective 10. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:2. Create RFI Dont Forget to Ask About Everything Create your RFI questions with intent create an RFI that contains questions that illustrate your intent and reveal you have done your homework Question Types Subjective - These often relate to usability. Is this tool easy to use? Objective These questions are often Binary yes/No questions Does the engine support HL7 3.X? Does the engine support web services? Quantitative - These questions can be about capacity, performance, scalability, etc. What is the maximum number of connections per engine instance? What is the maximum daily message volume? Qualitative These questions typically are about reliability, customer service, etc. What is the failover experience for end users? For developers and support staff? What is the skill level of your on-call support staff? Lesson Learned:Relying too much on subjective questions may lead to a biased selection. A good balance of question types ensures you look at the offerings from multiple perspectives. 11. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:2. Create RFI Categorize questions to create structure Interface team specific: Engine Development Environment and Tools Engine Support Data Migration/ Conversion from old system Training Enterprise context specific: Server Configuration High Availability - Disaster Recovery Software Capacity Network Database Desktop Client and User Devices Web Enabled Standards Remote Access Customer/Vendor Support Security/HIPAA BusinessKeep the door open for the vendors to answer unknown unknowns Make sure there are open ended questions that encourage the vendors to tell you what else they can do that your team may not have thought of. Lesson Learned:Be sure your questions get at the skills and staffing requirements for the vendors solution. You will need to know both quantitative and qualitative answers for implementation, ongoing support and upgrades. The answers to these questions will be important in later evaluation for total lifecycle cost impacts. 12. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:2. Create RFI Why Your RFI Will Be Ignored To get vendors interested your team needs to provide the vendor with: Clear business statement Describe your business goals and timing Demonstrate you understand the scope and scale of an interface engine replacement Organization size Interface team size and structure Number of applications and interfaces Average messages per day State at what level the initiative is funded and approved Executive approval Capital funded, Operations expense, etc. Describe the selection process Purpose of the RFI Demo, POC, and RFP/RFQ phases Scoring process Projected timeline Lesson Learned:The more details you can provide about commitment of funds, organization buy-in and timing, the more interest and response from qualified vendors you will get. Be clear and up front about your process, timing and what you are expecting. 13. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:2. Create RFI Define gates in the selection process Typically there are four scoring rounds: 1. RFI Score 2. Vendor Demo 3. On-site POC 4. RFP/RFQ Score Pricing is NOT mentioned prior to this step Best and final offer made by vendorLesson Learned:By waiting on pricing until the RFP/RFQ stage, the vendor gets a much better understanding of your business and can provide more accurate cost estimate 14. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:2. Create RFI Develop scoring system This system has to be communicated clearly and applied consistently to all vendors: 1. Question/Response elements are grouped by FunctionalityFUNCTIONALITYQUESTIONFactorEngine Support 22Is there monitoring in the application? Please describe.23Does your system have connection alerting? Please describe.24Can your system send emails? Can your system interface with Active Directory distribution lists?25What analytics/metrics can be produced from the system? Is there a "dashboard" view of this? Please describe. Sum of elements in a group = 100 Weights for individual elements should be whole numbers The weights are usually set by the team at the start of the process and not changed after that point26What is the upgrade process?272. Each element within a group is given a factor weighting within that groupWeightingDo upgrades require down time and if so what is the typical duration?28How often are new major versions of your product released? Minor ones?29When was the software first developed and installed? When was the last major release or upgrade?30When is the next major software upgrade planned for this system? Briefly, what will be new?31How are patches delivered?32Does the application allow for logging of outbound messages?33What are the data retention capabilities and recommendations for maintaining history on-line?34What is the process for resending messages both single and batches?35Does the application use standard Windows or UNIX commands?36What system performance monitoring and optimization tools are2 1010 10 5 10 5 1 1 1 10 10 10 5 11included with the application? TOTAL FOR CATEGORYExample group of elements with weights100 15. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:2. Create RFIFUNCTIONALITY3. Each element of the RFI response from each vendor is scored by the team Use "Likert Scale" which includes odd number of choices such as: 0.0Doesn't meet 0.3Partially meets 0.5WeightingVendorTeamFactor Develop scoring systemQUESTIONResponseRaw ScoreEngine Support 22Is there monitoring in the application? Please describe.23Does your system have connection alerting? Please describe.24Can your system send emails? Can your system interface with2Yes10Yes10Yes10No5Yes10Yes5Yes1Yes1Yes1Yes10Yes10Yes10Yes5No11W/Mods0.5 0.5 0.5Active Directory distribution lists? 25What analytics/metrics can be produced from the system? Is0.3there a "dashboard" view of this? Please describe. 26What is the upgrade process?27Do upgrades require down time and if so what is the typical0.5 3.0duration? 28How often are new major versions of your product released?0.5Minor ones?Meets requirement 0.8 effortWhen was the software first developed and installed? WhenWhen is the next major software upgrade planned for thisExceeds out of the box0.3system? Briefly, what will be new? 31How are patches delivered?32 Example group with a vendors raw score by team:0.5was the last major release or upgrade? 30Exceeds with some 1.029Does the application allow for logging of outbound messages?33What are the data retention capabilities and recommendations3.0 0.3 0.5for maintaining history on-line?34What is the process for resending messages both single and0.5batches? 35Does the application use standard Windows or UNIX0.3commands? 36What system performance monitoring and optimization tools are included with the application?TOTAL FOR CATEGORY100Example group with a vendors raw score by team:0.5 16. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:2. Create RFI Develop scoring system 4. The factor weighting times the team raw score equals the weighted score for each element for a vendor. FUNCTIONALITYQUESTIONWeightingVendorFactorResponseTeam RawWeightedScoreScoreEngine Support 22Is there monitoring in the application? Please describe.2Yes0.50.823Does your system have connection alerting? Please describe.10Yes0.55.024Can your system send emails? Can your system interface with Active Directory distribution lists?10Yes0.55.025What analytics/metrics can be produced from the system? Is there a "dashboard" view of this? Please10No0.33.05Yes0.52.510Yes3.030.0describe. 26What is the upgrade process?27Do upgrades require down time and if so what is the typical duration?28How often are new major versions of your product released? Minor ones?5Yes0.52.529When was the software first developed and installed? When was the last major release or upgrade?1Yes0.50.530When is the next major software upgrade planned for this system? Briefly, what will be new?1Yes0.30.331How are patches delivered?1Yes3.03.032Does the application allow for logging of outbound messages?10Yes0.33.033What are the data retention capabilities and recommendations for maintaining history on-line?10Yes0.55.034What is the process for resending messages both single and batches?10Yes0.55.035Does the application use standard Windows or UNIX commands?5No0.31.536What system performance monitoring and optimization tools are included with the application?W/Mods0.5TOTAL FOR CATEGORY11 1005.3 72.3 17. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:2. Create RFI Develop scoring system 5. Total weighted score for each functionality group is calculated and compared with the totals for each vendor.6. Use the same scoring system to re-score the vendors after each round - The financial component is not scored until the final RFP/RFQ round Lesson LearnedBe sure the Factor Weighting within each group are communicated/negotiated with the key stakeholders (especially leadership) before the first round of vendor scoring happens. They will not have adequate buy-in of the final selection unless they are very familiar with how and when the weights are decided. 18. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:2. Create RFI Scaling the process for your organization Not every organization has the resources to commit to a two to three month selection process. Some general guidelines: Medium and Large organizations need to use the full process. The risk associated with an improper fit are high enough to require the full, rigorous approach: Small organizations with their own IT resources can use a more streamlined process. The scale of risk associated with their selection is lower and they can afford a less rigorous yet well informed approach: Small organizations with outsourced IT resources have a unique wrinkle in their process. They may have to evaluate new contract IT resource to support the technology as well:Lesson Learned:Medium and large organizations that dont take the time to do the full due diligence are at high risk of making a selection that results in an improper fit. 19. Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerJohn Traeger ([email protected])The 13 step process:2. Create RFI Scaling the process for your organization Organization size and IT model Medium and LargeSmall with own ITSmall with outsourced ITSteps1.Develop requirements1112.Create RFI22*2*3.Identify vendors and submit RFI3334.Score RFI45.Invite vendors for sales demo5446.Score sales demo6557.Invite vendors for Proof of Concept77**7***8.Score Proof of concept89.Send out RFP/RFQ910. Score RFP/RFQ including financial component108811. Select Vendor1166****12. Negotiate the final details and obtain final signatures129913. Socialize the selection in your organization131010* (Combine with RFQ) ** (Winner only) *** (Software and implementation vendor) **** (includes vendor/contactor for implementation) 20. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:3. Identify vendors and submit RFI How to make sure you send your RFI to all potential vendors Do your homework to ensure you are looking at all the vendors who could potentially meet your needs. web searches HL7 web communities KLAS reports (http://www.klasresearch.com/segment/19) Other comparable healthcare organizations and professional associations. Whitepapers or case studies that are released by vendors can be useful though one should remember the source when reading. Once you have generated a list of vendors, send out an initial communication to identify a sales contact for RFI response.Lesson Learned:Often on the vendor web site there will be a generic sales contact. It may take a few days for them to respond to the initial communication and give you a sales person to work with. 21. THE PROVEN APPROACH COLLECTION AND EVALUATION 22. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:4. Score RFI So Did You Like What They Said? The RFIs are in; how do the vendors look? were they timely? Did they answer the questions? Did they bury you in marketing material? Did they contact you for clarity? If there are problems in terms of clarity with your RFI it will be evident at this stage Take this opportunity to hone the scoring process, and dont be afraid to modify it if there are blocking issues or gaps. This is the last opportunity to change the scoring process significantly without creating the potential for bias. Strive for a consistent sense of the rating scale used for individual elements. Obtain a consensus on what the difference is between Meets requirement, Exceeds with some effort, and Exceeds out of the box. Wait for all of the responses to come in and then score them at the same time or at least in the same week. In cases of many responses, go back to the first ones you scored and reevaluate to ensure that you are consistent. Lesson Learned:The sales engineers can be leave a misleading impression of a company and its product. While the timeliness and quality of the RFI answers should be taken into consideration, dont rely too heavily on those first impressions. 23. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:5. Invite vendors for sales demo Who do you invite to do a dog and pony show? The top 3-5 vendors are invited to do a sales demonstration This can be a virtual meeting, though in-person tends to be more productive and more questions get asked by your team. What to look for in the slide show Features of the product A session on a demonstration server to run through some basic scenarios Elaboration on the key question elements from the RFI New approaches to solving interface engine or business challenges. A simplified development process Automated tool sets Improved documentation model Better visibility/sharing of interface status across roles in an organization. Etc. Snippets of testimonials and case studies for the presentation. Ask for more detailed information on these at the end of the presentation along with a copy of the slide deck or other materials reviewed. 24. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:5. Invite vendors for sales demo What to look for in the demonstration This is the vendors chance to show their application in a best case scenario Pay close attention and takes notes for later evaluation discussions. Provide an ad hoc question during the demo phase to see how each vendor responds without having the ability to prepare. Some key features you should expect to see demonstrated: One-to-many interfaces such as ADT Many-to-one interface such as Clinical Reporting or Charges HL7 versions supported Toolsets used to develop interfaces Web service strategy Look and feel of user interface your operations desk would use to monitor system alerts Self-service features for analysts and operations 25. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:6. Score sales demo Score each vendor immediately after the demo Get an accurate response from the scoring team while the information is fresh. Reduces the confusion in cases where vendors present on consecutive days (or the same day). Use the same core team to score for every vendor to maintain scoring consistency: Interface Developers Interface Analysts Server engineering Operations support Interface Team ManagerLesson Learned:Vendor demonstration interface engine servers will always show best-case scenarios. Dont be fooled by how simple they can make it look, but pay attention to the features they show and drill into them during the POC phase. 26. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:7. Invite vendors for Proof of Concept Sounds Good, Now Let Me Do It Each vendor should be invited to an independent week for POC session Your team will perform hands on work using their product. Your team will vet at least some of their claims made during the sales demo. Watch carefully how your team adapts to the new tools to understand how their skill set fits with the productLesson LearnedYes thats right, three vendors = three separate weeks. Remember, this is a major investment for your team and organization. Both will have to live with your choice for many years. It is critical you take the time to fully understand the products offered. 27. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:7. Invite vendors for Proof of Concept Setting the stage There is a considerable amount of pre-work needed to host successful POC sessions. Key steps to being ready for the event: 1. Develop interface build scenarios with your development team. These should include but not be limited to: Basic ADT interface Complex ADT filtering Basic Orders and Results interfaces Complex Results formatting interface Charges to flat file2. Obtain a large volume of test messages that are relevant to the build scenarios. Ideally these should be de-identified production messages so you can run them through connections to and from your end use applications test instances when validating your build scenarios. If de-identified messages are not available, then volume testing will have to be limited to within the interface engine and not through connecting to the application.3. Obtain from the vendor their Operating System and server requirements needed to run a POC with up to 4-5 interfaces and some potentially having some high volume. 28. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:7. Invite vendors for Proof of Concept Setting the stage There is a considerable amount of pre-work needed to host successful POC sessions. Key steps to being ready for the event: 4. Obtain a Server (either physical or Virtual) Make sure it is accessible by your interface developers. Be sure they have Administrator rights to the server so they will be able to install the vendor software.5. Verify you can establish connectivity between the POC server and the test instances of the applications involved in your build scenarios. 6. Book a conference room with data projector for 5 full days just to make sure there is enough time. 7. Schedule up to 5 days for the demo session with your Developer team. This is critical to get a complete set of opinions on the usability of the vendors interface engine software. If your organization requires the use of server engineers to install software, be sure the server engineer who will be doing the production implementation is available for the first day of each Vendor POC session. Be sure your lead developers are scheduled to attend all five days Invite some junior developers to the second day to observe how they respond to the learning curve of the product. 29. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:7. Invite vendors for Proof of Concept Sample POC Agenda Day Time 1 Afternoon210:00AM 4:00PM310:00AM 4:00PM 10:00AM 4:00PM45Lesson Learned10:00AM NoonActivity Vendor Arrives Introductions Install the software Introductions Build simple scenariosBuild complex scenarios Run large volumes through test interfaces, wrap up session with Vendor Vendor departs Interface team re-scores the vendor in light of what was learned during the POCAttendees Vendor, PM, Server Engineer, Lead Developer Vendor, PM, Lead Developers, Junior Developers Vendor, PM, Lead Developers Vendor, PM, Lead Developers PM, Lead Developers, Junior Developers, Server EngineerConsider this your time with the application. If your team has a problem on their existing interface engine they have been unable to resolve, its OK to let your developers have a crack at it on the new vendor platforms during each POC session. However, be careful of rat holes and avoid letting a single technical problem hijack the process. 30. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:8. Score Proof of Concept They shoot andScore! This is the most important round of scoring for your interface team. The recent hands on the problem solving with the products makes for an informed assessment The scoring must happen at the end of the POC week to maintain consistency and clarity.Lesson LearnedIt is critical you schedule your team for enough time to do this critical round of scoring on each vendor so they will support the final selection. 31. The 13 step process:9. Send out RFP/RFQ Now Lets Talk About Money Most if not all of the feature requirements were discovered during the RFI, demo and POC phases, the RFP/RFQ includes mostly financial components. A detailed list of what you are being offered Number and type of software licenses Specific feature bundles (if any) Professional Service hours Implementation support Initial costs System purchase Recurring costs Annual licensing Server? Connections? Processors? Annual support 24 X 7 or business hours? Phone support Engineering support Response times Server? Connections? Processors? Professional fees John Traeger [email protected] modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner31 32. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:9. Send out RFP/RFQ Now Lets Talk About Money Most if not all of the feature requirements were discovered during the RFI, demo and POC phases, the RFP/RFQ includes mostly financial components. A detailed list of what you are being offered Recurring costs Annual licensing Number and type of software licenses Server? Specific feature bundles (if any) Processors? Professional Service hours Implementation support Initial costs System purchase Server? Connections? Processors? Professional fees Connections? Annual support 24 X 7 or business hours? Phone support Engineering support Response times 33. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:9. Send out RFP/RFQ Dont forget to weight the money The financial category should have elements that align with the major components that make up a vendor quote. Your team (or perhaps finance) can assign factor weighting to each element, for example: PricingCategory 172 173 174 175 176 177Seat License Server License Consulting Fees Support Fees Upgrade costs Training costs TOTAL FOR CATEGORYWeight 0.2000 0.2000 0.2000 0.1000 0.1000 0.2000 1.0000 When comparing value based on price, be sure you are comparing apples to apples. What type of training is the vendor offering? Is it onsite or will travel be required? What is included in support fees and consulting fees? Lesson Learned:Be careful on the factor weighting given to the financial requirements. If too much weight is given to a single element you can turn some promising vendors into losers when in fact total cost of ownership and increased business value to your organization should keep them in consideration for the final selection. 34. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:9. Send out RFP/RFQ Lets Talk to the Vendors Friends References are very important in assessing the fit with your organization. Request from the Vendors customers who are the same size/type as your organization (most important). Inclusion of one or two larger and smaller organizations can also provide some useful insights Ask for reference customers who have a similar application portfolio mix (HIS, Lab, etc.) Call each reference and arranging a time for a phone interview with some of your team. This can extend the timeline of the process a bit but references are too important to ignore. If time and distance allows, arrange a site visit with some reference customers Sit with their developers and see how they use the product. Gives a tremendous amount of additional insight into how the vendors product behaves in the real world. Be prepared to compromise on finding a reference of the same size or type as your organization for each vendor that is reasonably close. It is worth taking a site visit to a dissimilar organization if it is your only option to seeing the product running in a production environment. Lesson LearnedDon't collect or spend time contacting references until the field is narrowed down to 3 or less vendors as it is time consuming to schedule the interviews. 35. THE PROVEN APPROACH MAKING A DECISION 36. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:9. Send out RFP/RFQ So Whats All This Really Going to Cost? The calculations only start with each vendors RFP/RFQ response. Hardware purchase and installation These will vary depending on vendor system requirements and the scope and scale of the interfaces in your organization. Typical items include: Servers (blade, rack mount, or virtual) Data Center rack space Storage (SAN or on board RAID) Network or Server Rack appliances Data center or server engineer hours Development and Implementation Labor costs are less precise to calculate than hardware and installation. The costs fall into three buckets: Contract Legacy system developers to fill in while your team ramps up on the new platform New Platform developers to increase velocity of migration effort May be provided by vendor or 3rd party Consulting Services from Software Vendor Lesson LearnedThe differences in labor costs between vendors can be dramatic and can easily change the value propositions from each. Be sure to take the time to look at availability of labor and size of learning curve for the technology being used by the vendor. To ignore this can be a costly mistake. 37. Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerJohn Traeger ([email protected])The 13 step process:10. Score RFP/RFQ including financial component May I Have The Envelope Please?Vendor 2Vendor 3Vendor 4Vendor 5Weighted scoreWeighted scoreWeighted scoreWeighted scoreFUNCTIONALITYFactor WeightingVendor 1Weighted score The totals for each vendor are rolled up into a summary worksheet that reveals who is highest and lowest in each of the categories, including financial.Engine Development Environment and Tools1.000.4520.4170.4270.4270.427Engine Support1.000.7230.7310.7230.7230.723Data Migration/ Conversion from old system1.000.4850.4850.4850.4850.485Training1.000.5600.5600.5950.5600.560Server Configuration1.000.4700.4700.4700.6800.470High Availability - Disaster Recovery1.000.3400.3400.3400.3400.440Software Capacity1.000.1900.1900.1900.1900.190Network1.000.6300.6300.6300.6300.630Database1.000.4700.4700.4700.4700.470Desktop Client and User Devices1.000.4700.4700.4700.4700.470Web Enabled Standards1.000.6330.6330.6330.6330.633Remote Access1.000.7300.7300.7300.7300.730Customer/Vendor Support1.000.3630.3630.3630.3630.363Security/HIPAA1.000.5000.5000.5000.5000.500Business1.000.5170.5170.5170.5170.517Pricing1.000.4400.4400.4400.4400.440Hardware Costs1.000.5400.5400.5800.4900.610RECOMMENDATION TOTALS17.008.5138.4858.5638.6488.658KEY Lowest HighestLesson Learned:Remember to keep vigilant of personal and institutional biases when doing the final scoring. 38. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:11. Select Vendor Finding the pick of the litter For the highest and lowest scorer in each group, write up a couple of sentences describing why that vendor is great or not. The score totals represent the cumulative evaluation of all of the elements and the sum of the functionality group totals. It should be pretty obvious who the winners are and who is out. The relative importance of some functionality groups over others is key to pay attention to. For example, a vendor with a higher total score may still not be the right choice if the business and pricing are most important and that vendor fell behind in those two categories. If after all of the above it remains too close to call between two vendors, fall back on vendors cultural fit with your organization 39. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:12. Negotiate the final details and obtain final signatures Taking it the last mile Once the final selection has been made, its time to announce the decision to stakeholders within your organization. Schedule time to review the results in detail with each of the stakeholders who helped with requirements. Be sure to obtain executive approval and leverage this for broader communication within the organization. For each of the major groups impacted get onto the agenda for their next regularly scheduled team meeting and review both the process used, findings and final selection.Lesson Learned:Be sure to share the process used to reach the decision and include testimonials from the stakeholders that participated.Lesson Learned:Final contract negotiations and Legal review always takes longer and is more complex than you think it should be. Be patient and dont let it derail the selection in the last mile. 40. John Traeger ([email protected])Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified PartnerThe 13 step process:13. Socialize the selection in your organization Avoid Getting Lost in the Noise At most organizations there are competing priorities for IT resources, even in calmer times. In our current era of ARRA, HIPAA, business consolidations and transformations it is harder than ever to retain the commitment from leadership to provide the resources needed to follow through on implementing a new interface engine. Draft a compelling scope document You need to drive home the importance of the new interface engine deployment. Be sure to highlight the dependencies all of the other major IT and business initiatives have on a reliable, agile interface engine for success. Keep the project visible and stakeholders informed Make sure the project is visible with consistent status updates. Get an early win on an initial project.Lesson Learned:It is critical to get out of the gate early and deliver an initial success. Both internal customers and the vendor will be disappointed if there isnt early results to create momentum. 41. APPENDIX 42. RFI Requirement/Questions Engine Development Environment and Tools Engine Development Environment and Tools1 2Briefly describe the usability of the developer GUI. Does the application provide for any standard interfaces, libraries, templates, or routines?3Is there an internal HL7 library in the application? How often do customers receive updates?4 5 6What languages are available for scripting? What other vendors have plug-ins to your application?How many and what type of user defined fields are available? (memo, free text, table driven, date, etc.)7 8When and how (what UI) is "Hand Coding" performed?Does the system provide the ability to test message translations, filters, and routes?9 10 11What is the recommended set up for dev./test/production environments?13 14 15 16 17How do you promote code from one environment to another?18 19 20 [email protected] is the development environment? Local, shared server or other?12John TraegerDoes the application provide interface version control?What are the troubleshooting capabilities?21What happens when automated error recovery fails?Does the application have any imposed development processes?Do you provide a simple solution to FTP? Please describe. Does the application have any batch processing functionality? Does the application have any file parsing functionality? What other EDI formats does the system support? Is there a library for them?What are the de-bugging capabilities? Describe the automation and scheduling component of the application. Last modified: 16 September 2013 2013 OTB Solutions. All rights reserved.42 43. RFI Requirement/Questions Engine SupportEngine Support 22 23 24Is there monitoring in the application? Please describe. Does your system have connection alerting? Please describe.Can your system send emails? Can your system interface with Active Directory distribution lists?25What analytics/metrics can be produced from the system? Is there a "dashboard"view of this? Please describe.26 27What is the upgrade process?28How often are new major versions of your product released? Minor ones?29When was the software first developed and installed? When was the last majorDo upgrades require down time and if so what is the typical duration?release or upgrade?30When is the next major software upgrade planned for this system? Briefly, what will be new?31 32 33How are patches delivered? Does the application allow for logging of outbound messages? What are the data retention capabilities and recommendations for maintaining history on-line?34What is the process for resending messages both single and batches?35Does the application use standard Windows or UNIX commands?36What system performance monitoring and optimization tools are included with the application?John Traeger [email protected] modified: 16 September 2013 2013 OTB Solutions. All rights reserved.43 44. RFI Requirement/Questions Data Migration/Conversion from old system Training Data Migration/ Conversion from old system 37 38Do you provide a data conversion service?39What format do you require of the data to be converted?40Will initial training be performed at our offices or at your facilities? (include costs).41How many of your staff will conduct initial training? What are their qualifications andCan you convert our existing parameters, maps and configurations?Trainingexperience?42How much time should we budget for training each user? Please list bydifferentuser roles.43 44What is your approach to training users? Describe briefly. What training materials (e.g. manuals, video tapes, CD-ROM, multi-media, online) are provided?45Do you offer ongoing training classes? What is the typical cost per day or class?46Where is your nearest training facility? What resources are available?47Is there an organized national user group? Is there a regional user group in our area? How often and where are meetings?48What documentation (i.e. user, operations, technical) is supplied with your system?49How often is documentation updated? Will you contractually guarantee documentation to be current with new software releases?50 John Traeger [email protected] users customize on-line help screens and other documentation?Last modified: 16 September 2013 2013 OTB Solutions. All rights reserved.44 45. RFI Requirement/Questions Server Configuration High Availability - Disaster Recovery Server Configuration 51Briefly describe the system architecture (e.g. network, centralized, open systems, PC based, LAN, etc.).52Briefly describe the processor, memory, and disk capacity requirements for the file servers used in the system architecture for a deployment of your system at a facility of our size.53Are there any Server monitoring tools available such as BMC Patrol?54Does your application support running on Virtual Server environments?55 56Does your application support drives running on SAN?57What safeguards (e.g. fault tolerance, hardware redundancy) are included thatIf there is a database server is it required to reside on the application server?High Availability Disaster Recovery eliminate unplanned downtime?58Describe your disaster recovery - quick restore capabilities and procedures.59Does your system provide the ability to configure a high availability environment? (for example: RAC, clustering, fail over server, HACMP scripts) Please describe andinclude architectural diagram with the HA configuration.John Traeger [email protected] modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner45 46. RFI Requirement/Questions Software Capacity Network Software Capacity 60What is the maximum number of Developers that can be supported?61What is the maximum number of monitor users can be supported?62 63 64What is the maximum messages per day? What is the maximum number of connections? Does your application have capacity to run the following scenario on a single instance without queues backing up? > At or near maximum number of connections on your engine > At least one interface of these that sends 1.2 million messages/day with peaks of 100 messages/sec65Please provide performance metrics from "typical" implementations for small, medium and large organizationsNetwork 66Are there any network requirements integral to the engine (in the data center or on a rack)?67If your solution for our organization requires a multiple server architecture, please diagram the details of all protocols, ports and flows between servers (For example, separate database server, configuration server, web server and the connections between them within the data center).68Please specify any other data center or rack based network requirements for the engine to operate at peak performance and capacity (this refers to between engine components).69Please describe and assess DNS requirements and DNS records that are required for the system.John Traeger [email protected] modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner46 47. RFI Requirement/Questions DatabaseDatabase 70 Does the application use a database platform and if so what version?71 Does your system provide ability to back-up database changes throughout the day with no user interruption?72 Describe your database disaster recovery - quick restore capabilities and procedures. 73 What operating system will the database server use? 74 For High Availability; does the DB use Oracle RAC, Standby Database, or SQL Replication? 75 Can the Database be placed on a SAN? 76 Are there database monitoring tools such BMC Patrol available for the Database? If so, are there DB monitoring scripts for your product to run on the tool available?77 Does your application support direct links to SQL , ODBC, OCI, OLEDB? Which and are there limits or restriction?78 Does the database require a dedicated server or can it be part of a shared server? What is recommended?79 Do you offer an API (Application Programming Interface) toolkit that will allow other Windows applications to connect to your database?80 Can other Windows programs query your data and obtain access to records and fields? 81 Does your system provide any preventive maintenance tools or utilities to identify database integrity errors, perform clean-up, re-organize the database, etc.?82 Does the database include any functions that are designed to ensure integrity and faulttolerance in a network environment? Please describe.83 Will you provide a complete database dictionary that defines the contents and links for each record and field, and allow access to the database from other Windows applications?84 Do you have access to all data fields? 85 If your dB is NOT one that our organization DB team supports then: Who will provide support? What is the contact process for requesting support? When hours is support available?86 What is the recommended database backup schedule (hourly, nightly, weekly, etc.)? How will the database be backed up (backup application or system)?John Traeger [email protected] will it be backed up (tape, disk, file systems, etc.)?87 How will the backups be encrypted?Last modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner47 48. RFI Requirement/Questions Desktop Client and User DevicesDesktop Client and User Devices 88What type of client access is used for development? (Browser, Citrix, terminal emulator, fat client)89Most desktops do not use static IP address, instead configured using DHCP. Will your application have any issues with this configuration?90Please provide the developer desktop specifications and requirements. Include OS, Service Pack level, supported browser types and versions, Processor Speed, Disk Space, and RAM91 92If a client is used on the desktop, can it be pushed using SMS? Are there any desktop software requirements such as Flash player, .NET, active X, etc.?93Does the application store any patient data in memory or cache on the desktop when used remotely?John Traeger [email protected] modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner48 49. RFI Requirement/Questions Remote AccessRemote Access 112Do you (the vendor) currently support any other systems in our network?113What methods can be used for vendor access? (Land to Land IPSec VPN Tunnel, SSL VPN, IPSec VPN, Citrix, other)114What servers will the vendor need to have access to? Will there be a need to access any workstation?115What are the protocols and UDP/TCP port numbers the vendor needs to access the application/servers from the remote vendor client devices?John Traeger [email protected] modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner49 50. RFI Requirement/Questions Customer/Vendor Support Customer/Vendor Support 116Where is the nearest software support office to our location? How many technical staff? How many programmers?117Is telephone software support available 24 hours per day and 7 days per week? Are support staff in office at all times or on-call from home?118Is your support department fully staffed 8 a.m. to 5 p.m. for customers in all time zones (e.g. EST to PST)?119Do you have an 800 toll free support number? Do you bill telephone charges to customers?120Is telephone support time included in the support fees or do you charge on a per call or hourly basis?121Do you have a guaranteed response time for answering customer problem calls? If yes, what is it?122How and when are known software problems (e.g. bugs, errors) resolved? Do you publish a list of known problems?123What is the SLA (Service Level Agreement) for software problems acknowledged by your company? What time frame for resolution for each level of severity can we expect?124Does your company assume responsibility for any aspects of software implementation?125Does your company provide custom programming support? If so, at what rate?126What is maximum delivery time for custom programming jobs? Will you guarantee this in the contract?127 128Is support available on weekends and all holidays? What customer/client roles (i.e., managers, supervisors, users, IS/IT, etc.) are typically involved in the Core and/or User Group for this product?John Traeger [email protected] are the processes and estimated time commitments (i.e., hours per month or per week) involved for the customer representatives on the Core and/or User September 2013 Last modified:16 Group? 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner50 51. RFI Requirement/Questions Security/HIPAA Security/HIPAA 130 131Is the System capable of archiving all data? Has the system satisfied the criteria for 170.314(d)(2) Auditable events and tamper-resistance? If not, how does the system track and report on all user activity including date and time data was accessed?132Has the system satisfied the criteria for 170.314(d)(1) Authentication, access, control, and authorization? If not, how does the system handle authentication, access, control, and authorization?133 134 135What security measures are available for remote access? Are passwords encrypted? Has the system satisfied the criteria for 170.314(d)(7) End-user device encryption? If not, what method of encryption is used for patient data?136Has the system satisfied the criteria for 170.314(d)(5) Automatic log-off? If not, describe the systems auto log off capability.137Can the system provide flexible user defined roll based security? Is there any limit to the number of rolls defined?138Has the system satisfied the criteria for 170.314(d)(3) Audit report(s). If not, describe you tools/reports for HIPAA compliance/privacy requirements?139Has the system satisfied the criteria for 170.314(d)(8) Integrity? If not, how does the system ensure the integrity of the message when required?140Does your system allow easy account management? Please describe.John Traeger [email protected] modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner51 52. RFI Requirement/Questions Business Business 141How many installations of comparable size and complexity (100+ physical interface connections) do you have?142What is the number of successful installs on the current version?143What is the name and current release (e.g. version number) of the application software?144Are all software upgrade costs (e.g. custom programming, installation, training) included in support fees? If not, explain.145How are software installation fees billed (e.g. customer milestones, fixed amount, line item, hourly)?146How are monthly support fees billed (e.g. fixed amount, variable, hourly)?147Is travel time to our site billable? If so, at that rate? Briefly explain policy.148 149What is your software warranty period and what is covered? Will your company allow your code to be put in escrow for our use if your company goes out of business?150 151 152 153 154 155What percent of your business is Healthcare? Have you interfaced with [our] HIS system? Have you interfaced with [our] LIS system? What sort of training resources do you have? How many years have you been in business? To what level will your company guarantee that if the software is kept up to date with maintenance and service patches it will comply with all current and future federal and state mandates?156Is the system licensed by Enterprise license, max number of ports, specific ports used, processes or concurrent users? Is there a limit? What is the next level and associated cost?John Traeger [email protected] modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner52 53. About OTB OTB Solutions Group is a Professional Services Firm founded in 2002, which serves customers in multiple industries in the Pacific Northwest, across North America and internationally. Our primary business location is in Seattle, Washington. Our senior team members are all formerly from global consulting firms. Our core team consists of approximately 25 professionals and is augmented by a worknet of approximately 70 additional resources. OTBs client base spans a diverse range of organizations: from an international non-profit focused on global health issues, to several major multi-state healthcare networks, to manufacturing companies, enterprise software, and financial services companies. Our team members have completed significant public sector projects at both the local and state level and have been recognized as leaders in developing public/private partnerships for enabling information technology projects. We pride ourselves in thinking Outside the Box to bring our clients innovative business solutions for collaboration and process automation, enterprise content management, business intelligence and portals. Over the last 6 years, OTB has completed multiple projects valued over $1,000,000 and many more in the $500,000 to $1,000,000 range. We have never had a failed project and our client retention rate is essentially 100%. The majority of our work involves emerging technologies and state of the art business systems. OTB Solutions Group is a Microsoft Silver Partner in Portals and Collaboration and Search; and a SharePoint Deployment Planning Services (SDPS) program member. OTB Solutions Group brings an exceptional level of experience as well as world class credentials in project and program management. Our consultants have successfully managed public sector projects, which were nationally recognized as models of private/public sector partnership. We understand how to work with public sector agencies and how to create value in this environment. We routinely ask our clients why they have selected us and why they are happy with the results. Several common themes emerge from these discussions. Generally, the reasons are: We take the time to listen, and to understand the problem We are able to put together the right team with the right skills We know how to tread lightly, treating everyone with respect The people introduced at the beginning of the project will be working with you until you achieve your objectives and the project is completeWe have a verifiable track record of bringing projects in on time and on budget We know that our long term success depends on the passion we bring to our assignments, the results we achieve for our clients, and the impact we have on the organizations with which we work. We believe that you will enjoy working with our people and we are excited about the opportunity to bring our teams skills and capabilities to assist the KCHA. John Traeger [email protected] modified:16 September 2013 2013 OTB Solutions. All rights reserved. | OTB is a Microsoft Gold Certified Partner.53