Writing of Request for Proposal and Tenders, lessons and experienced learned from a purchaser and vendor perspective

Richard TurnerServices Manager and Programme Director

Health Care Information Solutions Europe, Middle East, Africa, Russia, & Indian Sub-Continent,

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Abstract

We will review the key questions and common omissions in the construction of RFP and tender documentation and how to get the best answers from potential suppliers that meet the justifications for Radiology Information Technology investment cases. In particular we will cover the need for specific and measurable benefit identification and why this benefits specification can ensure vendor responses will answer the organization questions and needs during procurement, through the deployment to realization.

AT A GLANCE

� Questions and omissions from RFP’s

� Getting the best answers from suppliers

� Specifics and measurable benefits

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Background

• A successful RIS/PACS implementation starts with a well written RFP/tender understanding the change and benefits sought.

• The justification from the start has to be based on the benefits defined by the organisation rather than the technology itself.

• More often than not one or two people in the Radiology department are tasked with writing a RIS/PACS tender/RFP.

• If the proposal document solution is normally a copy and paste from past tenders (written by people in the same situation!).

• The result is a document with multiple inconsistencies when it should be defined by the Business Case which then should develop the project delivery and a benefits realization plan!

AT A GLANCE

� A well written RFP provides sufficient information to allow vendors to configure the solution without the need for multiple requests for clarification or for the vendor to supply multiple solutions / options

� The RFP has to Reflect the Justification and reflect a Benefits Realisation plan

Creating an RFP Team

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Reasons

• RIS/PACS procurement is a Business development and change Project

• RIS/PACS is not only an IT project, or a Radiology project, it involves:

• ALL areas of the hospital that previously created & used film

• Any departments responsible for new methods of distributing image / study data

• Departments responsible for hospital operation and capital expenditure

IT

Biomedical

Management

Clinicians

Vendors

Radiology

AT A GLANCE

� This person is the senior user

� Represents all users thought procurement

� Will be part of the project board in implementation

� Responsible for the business benefits

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Manage the Change

• Use the RFP creation process as the first step in Change Management, remember…

• Has to have a Senior User which will be owner of benefits during and after the Project

• Have a Champion as everyone hates change

• RIS/PACS involves Everyone!

• Break people in gently

• Indentify a Champion

• Explain the concept

• Demonstrate the benefits

• Involve representatives from all departments

• Understand their viewing needs

• Incorporate these into the RFP

AT A GLANCE

� A user who owns the Benefits plan

� Work streams that engage and keep involvement

� Have a Champion

Defining Objectives

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Objectives

• Clearly define The outline business case of the Reason why the Hospital wants to implement RIS/PACS, be specific (measurable) and prioritize

• The case will develop in a full Business Case for the project later

Improve Efficiency

ensure all reports read Within 5 days

Reduce Film Costs by 80% in year 1

Improve CommunicationAllowing data sharing in year 1

Tools to handle new studies to improve diagnosis and reduce

bed stay by 10% by end of year 1

Improve Patient Care reducing appointment wait by 20%

Note: Remember the benefits are those that the RFP and subsequent project should deliver, expressed in measurable terms against the situation as it exists prior to the project. Benefits should be both qualitative and quantitative

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Objectives

Also be clear on the dis-benefits which could include

• Training of staff and Time demand clashes and availability

• IT support staffing needs to manage the solution

• Increased network loads and impacts

• Workflow disruption during the change

• Staff role changes and impacts

• User acceptance

Note: Remember Dis-Benefits are outcomes perceived as negative by one or more stakeholders. Dis-benefits are an actual consequences of an activity

AT A GLANCE

� Benefits that are measurable but can be Qualitative and Quantative.

� Dis-Benefits by the change

Business Benefits

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Define your Business Benefits

For example you should have a clear Project Product Description which is the description of what you want to achieve for example:

‘10 year digital storage of all radiology images allowing the sharing data and electronic reporting across all campuses interfacing to the existing HIS systems’.

Then the RFP should have:

• The reasons which explains how the RFP and subsequent project will enable the achievement of organization strategies and objectives

• The RFP and Business Case must be aligned with the benefit objectives and be clearly identified and justified

• It should be clear how the benefits will be realized and what will define a successful outcome

• The Business Case should include operations and maintenance costs and risks, as well as future project costs and risks

• The Business Case conforms to organizational accounting standards (e.g. break-even analysis and cash flow conventions)

• The major risks faced by the RFP and the Project delivery are explicitly sort and stated.

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Measure and Plan - Benefits Review Plan

A Benefits Review Plan is used to define how and when a measurement of the achievement of the RFP’s and subsequent project.

The Senior User (often the lead radiologist is accountable for this), and note both the business and benefits plans need to be developed as you enter the project should to ensure plans define any post-project benefits reviews as PACS benefits are often realized after the project closure.

Remember that after the RFP and Project deployment the expected benefits of the solution have to be checked to ensure the benefits are realized and how the solution has performed when in operational use. Each expected benefit has to be assessed for the level of its achievement and whether any additional time is needed to assess the residual benefits.

Also remember the need to identify any unexpected side-effects, either beneficial or adverse.

If the project is part of a programme, the Benefits Review Plan may be contained within the programme’s benefits realization plan and executed at the programme level.

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Key elements in the defining The business case and benefits plans -Workflow

Define your current workflow from Clinician Requests to Results Distribution

• Identify inefficient areas and areas and goals for performance

Redefine your workflow (with RIS/PACS) to eliminate inefficient areas to maximize efficiency

• Include in the RFP & push vendors to comply

Consider the complete Hospital Workflow, not only Radiology

• Typically there will be a Hospital body already dealing with the HIS Workflow, you need to ensure that the proposed Radiology Workflow can synchronize with the Hospital Workflow, this will also help to define the integration required HIS/RIS

AT A GLANCE

� Current state

� Future State

� Enterprise impact

Radiology InformationManagement

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Clinical Lifecycle Management

• Storage Requirements

• On-line / Cache

• HDD - Immediate availability of data

• Number of Years required

• IT to advise on preferred hardware / configuration

• Near-line

• CAS / Jukebox / Library

• Number of Years required

• IT to advise on preferred hardware / configuration

• Off-line

• Disaster recovery

• IT to advise on preferred media type

• Cloud Based services

• Platform as a Service

• Software as a Service

• Exam type

• Duration of location on tiered storage per exam type

AT A GLANCE

� Local Storage

� Archiving Plans

� Lifecycle of Clinical Data

� Options of Cloud Based services

IT Information

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IT Information

• Network

• Radiology and Hospital LAN

• Specific IT requirements

• Security and Licensing Protocols

• HIS and other applications integrate to

– Integration HIS to PACS with Clinicians single login to both applications

– Access to PACS from within HIS

• Personnel

• Availability to provide IT Administration and support

• Accurate numbers of concurrent users

• Server Room

• Location, Radiology or IT? Space availability in IT Server Room

• Preferred Hardware Vendor

• Generic Management

AT A GLANCE

� LAN and WAN

� Security protocols

� Administration

� Server room environments

� Any vendor preferences

� Clear definition based on required Workflow as to the level of Integration required

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Data Migration

• Existing PACS solution or Modality storage

• Data details

GB / TB and Number of studies

Image format eg DICOM or other

• Type of Storage

• Manufacturer

• Model

• Existing PACS provider / Modality Storage provider

• Is there a legacy RIS with Data

• How and what will be moved

• Cutover management

AT A GLANCE

� Time to migrate

� Validation of data being moved

� Engagement of existing vendors

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Uptime & Redundancy

Define the level of uptime and redundancy required & the commercial ramifications

• Uptime

• Core Vs Non Core components (eg a workstation should not be considered core)

• 98.5%, 99.87%, 99.95%

• Single Servers Vs Clustered Servers

• Active : Active, Active : Passive

• Disaster Recovery

• Manual

• Automated

• Cost implications

• An extra 1% uptime = 3 x Server / Storage $

Training

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Training

• Training is yet another critical element that if neglected can result in rejection of the solution by Users

• Vendors ‘tend’ to adopt a one on one approach to training with Radiologists and either a ‘Train the Trainer’ or ‘Key User’approach with other Users i.e. Referring Doctors

• Assess your own requirements and state them clearly

• Do all Users have basic PC skills (mouse, keyboard etc)?

• Does the hospital have staff competent to become ‘Key Users’?

• Does the hospital have facilities to provide a training environment?

• What happens when new staff are employed, who will train them?

Service & Warranty

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Service & Warranty

• Detailing the hospitals requirement, ties in closely with uptime and update/upgrade.

• Understanding the commercial implications of different levels of service support that vendors can offer

• Vendor ‘standard’ package for software

• System & IT Admin Training for Hospital Staff

• Admin monitoring tools

• Level 1 support, Distributor Engineers

• Level 2 support, Remote dial in from Vendor Engineers

• Vendor ‘standard’ package for hardware

• What upgrades include

• On Site Engineer, useful if the hospital doesn’t have personnel with the appropriate skills, but otherwise expensive

• Proactive 24 x 7 support

• Hardware upgrades

• Duration of the initial warranty

• What happens when this expires?

Time Lines

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Time Lines

• Tender Response

• Providing reasonable response time for tender submission to allow customized configurations

• Post Tender Activities

• Defined activities and timelines post tender

• Site Visits

• Demonstrations

• Contract time

• Implementation

• Project Methods

• Required timelines

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Summary

• Create a Hospital PACS RFP Team

• Understand the needs of all departments ( and include them in the RFP)

• Define Business case and benefits redesign Workflow accordingly

• Consider training, service as key success factors, don’t leave them as an afterthought

• Provide as much information as possible

• Allow vendors sufficient time to respond

• Have a benefits realisation and assurance process

Extra time spent on RFP preparation saves

huge amounts of time and money