Metropolitan, Regional and State Alliance General Hospital

Infection Control System Vendor Selection

ICS Committee: Amanda Banks, Cara Fowler, Ash Goel, Lee Kauffman, John Wong

Agenda
Recap of Hospital Infection Control System Goals Roles and Responsibilities Political Environment & Changes Change Management Budget Estimates Vendor Selection Process Vendor Comparison & Analysis Vendor Size Cost Comparison Acceptance Testing Executive Summary

Introduction for Vendor Selection MRSA General Primary Goals for ICS Implementation Have system implemented and operational in 1 year Evidence of improved patient care with measurable outcomes
LOS Complication Rates Mortality

Decrease HAIs by 50% within 1 year of implementation

Roles & Responsibilities

Roles Responsibilities
Analyzed responses from RFP related to their expertise Infection Control System Contacted references Selection Team Participated in the vendors live demos Submitted scorecard Each individual was responsible for their specic expertise Responsible to analyze and select a vendor: CNO support nursing/operational work ows Bed management Expedites medical care/Communication to physicians/overall system improvement System reports Better communication and bed management Budget/nancial limitations Investigated vendors nancial stability Provided a business case for the need of an IC system Analyzed interoperability current and future systems Analyzed technical support and installation process Analyzed its functional/technical capabilities Sought any HIPAA, state, and federal violations within the system Investigated if vendor had any pending/active litigation Reviewed and analyzed potential risks within the system

CMO ICM CFO

CIO

Legal/Risk Management Team

Political Environment & Changes

Several Changes in project leadership which caused several changes in direction Resulting in a system driven to meet technical, clinical, and financial requirements

CIO

CMO

CIO

CMO

CFO

Change Management
Use of Agile Project Management Approach Setup Mutual Agreement For Change Management With Vendor All functional and process changes review by change control board All changes that require extra charges must be approved by top management

Prelim Budget Estimates

Category Initial Cost 5 year Cost (Includes initial costs)

Total Project Costs (20 user $686,000 license, local hosting) excluding internal resource costs

$1,176,000

Total Project Costs (20 user $496,000 license, remote hosting) excluding internal resource costs

$1,013,000

Top Two Vendors Selected

&

Live Demo- Use Case Scenario

PCR returns positive for a suspected case Vancomycin-resistant Enterococci (VRE) (high rate false positive). Expectations of system: 1. Flag order and notication 2. Identify the location of the patient. 3. Alerts sent to EMR. 4. CDSS should recommend culture. 5. CDSS suggests isolation procedure 6. CDSS presents treatment options.

Scoring Matrix
Process Categories Category Tech Requirements Clinical Requirements Financial Requirements Organizational Requirements Vendor Partnership Weight 25% 25% 15% 20% 15%

5 Categories dened
ICS project team interviewed stakeholders

CIO, CMO, CNO, CFO, Chief Surgeon, Chief Surgical Nurse, PM Office, QA Office, Legal Counsel

Multiple specic requirements established in each Specic weight assigned to each

Category Score Card

Evaluation Team: Financial Team Category: Financial Requirements

CareFusion Vecna

Maximum Score: 38 Hardware Local Hosting Solution is within budget Remote Hosting Initial Costs are less Workstations Costs are less Data Migration Costs are less Interfaces expenses Software Costs Concurrent User License costs within budget Enterprise License available Cloud Computing available Software Maintenance Costs within budget Warranties 1 year warranty Warranty begins at (UAT 2, Install 1, All other 0) Telephone support included in warranty period Option to extend beyond initial term Total Score* (Total score reective of criteria not expressed on this example)
Comments:

2 2 1 2 2 2 2 2 2 2 2 2 2 36
Scale Met Fully Met Part Not Met 2 1 0

2 2 2 2 0 2 2 1 2 2 1 0 1 29

Evaluation Matrix
Total Score Matrix Technic al Require ments
40 25% Actual 39

Clinica l Requir ement s

44 25% 39

Financi al Requir ement s

38 15% 36

Maximum Points Weight Score CareFusion

Organi Vendo Total zation r Score al Partne Requir rship ement 28 30 180 s
20% 28 15% 27 169

Total Rank Weight ed Score

100

Weighted

24.37

22.16

14.21

20

13.5

94.24

Score Vecna Actual

27

29

29

22

20

127

Weighted

16.87

16.48

11.44

15.71

10

70.5

Vendor Analysis Summary

MedMined-CareFusion
Compatible with our current technology without having to outsource to 3rd parties Optimized for T-1 and up WAN with minimal degradation Customization with continued upgrades and support. Increased product exibility. Benchmarking ability Customer Service 24x7 Comprehensive Education Package RFID not available or planned for the future Overall initial investment more costly

QC PathFinder-Vecna
Compatible with some of our current technology, however would have to turn to 3rd party vendors for most interfaces Degradation noted in speeds under T-1 Discourages customization related to inability to upgrade product. Less product exibility. Does not support benchmarking Limited customer support hours No currently offered or planned in the future. RFID currently offered to monitor/detect personal hygiene Less expensive of the 2 vendors

CareFusions MedMined Selection Met our clinical, technical, nancial, organizational, vendor partnership requirements Technical Interfaces with MedHost (ED EMR) and other major systems Limited use of third party vendors Toolkit facilitates upgrades

MedMined Selection Clinical Clinical education tools within system Able to include local policies to improve work ows Better Decision Support
data mine capabilities within microbiology use of clinical standards for SSI expedited care/facilitate bed management

Easy system, better customer service Support services-benchmarking, customized reports, direct reporting to national

MedMined Selection Organizational Detailed project plan Quick response time for problem resolution Cultural t Financial Met contract and warranty requirements CareFusion-well run company 3rd Party software source code escrow

Why Vecnas QC PathFinder Was Not Selected Inferior clinical support Limitations with data integration Limited reporting capabilities E-mail communication Inadequate cultural t

Vendor Size
All other factors being equal the hospital prefers to select market leaders. We examine: Stability Organizational size and longevity Financial performance Established client base. Software Escrow Vendors having less than $100,000,000 in annual revenue. Third party escrow agreement only.

Cost Comparison
Costs Hardware Local Hosting Remote/Cloud Interfaces (5) Software Local Hosted Solution Concurrent User (20) Enterprise Remote Hosting Concurrent User (20) Enterprise Other Features Cloud Training Material Third Party Escrow Venca 295,000 175,000 75,000 163,000 578,000 199,000 693,000 Data Center hosting At Cost No CareFusion MedMined 330,000 275,000 No cost from Standard Interfaces 267,000 810,000 328,000 885,000 Yes No Cost Yes

Cost Analysis Hardware costs comparable Software Vecna has less upfront costs. CareFusion provides
24/7 customer support Cloud Hosting Comprehensive training modules Interfaces and integration at no added cost No third party vendors needed

Selection Cost Considerations The lowest price vendor has not been selected.
The cost differential between our two nal vendors equals the cost of approximately 5 HAIs per year. We project our second place vendor will take at least one month longer to implement (our current HAI rate is 75/month). The higher price vendor has a culture which has better aligned with our organization for superior buy in (Each 1% lower HAIs equals $420,000)

User Acceptance Testing

User Acceptance Tester: Important roles in vendor selection and product acceptance UAT to test at the end of each of the 3 builds 45 days to test the system after nal deployment Vendor must correct in 20 days at no additional charges Vendor to repay all amount in 10 business days if product is not acceptable by UAT Unacceptable: < 2 sigmas (95%) infection identication, not HIPAA compliance, MTTF rate exceeds our IT threshold, etc.

Executive Summary
Purpose: To describe the process and criteria for choosing the best vendor Process: Delegates from top management evaluate vendor responses using Score card matrix Project Budget: $496K to $686K Initial Cost Result: CareFusion MedMined: Best match to our technical, clinical, nancial, and organizational requirements CareFusions culture is a better t to our company

Questions?