Improve Your Medical Practice Vendor Relationship

Practice administrator Raquel Garcia de Acosta has worked with dozens of vendors - from small ones to large ones, from laboratory vendors to, most recently, an EHR vendor. "If I had to pick my favorite vendor, the EHR vendor would be it, and it's because of their commitment to customer service," says Garcia de Acosta, who works in a solo family practice in Lake Hopatcong, N.J. "They have been very focused on making sure that their customer is well taken care of, but they've also listened to some of the suggestions we've had and taken them as suggestions that they've incorporated into the software. I think there's nothing better than when you stress a point to someone that something could possibly be done a little bit differently, and that person listens to you and incorporates it."

The easy partnership Garcia de Acosta enjoys with her Hello Health EHR vendor is the type of relationship that, unfortunately, not all practices share with their vendors. And when that healthy relationship is lacking, it's a problem that can lead to timeline delays, poor product utilization, and even failed implementations.

Whether you're going through the vendor selection process, or you already have a longstanding relationship with a vendor, here are some tips for how to experience the type of healthy vendor relationship that Garcia de Acosta's practice is enjoying.

Streamline communication

Miscommunication can be a major source of problems when interacting with vendors. That's why it's critical to have a solid one-on-one communication channel between the practice and vendor, says health IT consultant Bruce Kleaveland. "Many individuals within a practice may have various different issues with a particular vendor," he says. "It's really more effective for [the practice] to channel those issues to a single person who then can communicate it with the vendor so that the vendor isn't getting 15 calls, from 15 different people, with 15 different issues, expressed in 15 different ways."

It's also crucial for the vendor to assign a responsive and reliable point person to work with the practice. Just as important, that individual should have a solid background working with that vendor (try to avoid new hires), and he should be familiar with your specialty, says Laurie O'Brien, vice president of implementation for Physicians EHR, a Raleigh, N.C.-based consulting firm. If you have been assigned a point of contact that lacks the proper experience, ask to have a different person added to your account, she says, noting that an unseasoned point person is one of the most detrimental problems practices face.

Balance responsibilities

Ever have a coworker leave all the heavy lifting to you? It causes serious tension. That's why it's critical to ensure your practice is fulfilling its implementation and project management responsibilities. "It varies depending on what's being implemented, but generally my recommendation is that the practice is very involved in understanding what's happening with the implementation - what their roles and responsibilities are versus the vendor's roles - so that they aren't simply leaving it to the vendor to do everything ...," says Kleaveland.

At the same time, ensure your vendor is fulfilling its responsibilities. "It's really easy for them to be coming from a playbook and not necessarily coordinate internally because they're on multiple projects working with multiple clients," says Laura Jantos, principal at ECG Management Consultants, a Seattle-based healthcare consulting firm. "You've got to be able to understand their work plan well enough to be able to probe and make sure that they're really managing their folks and that their folks are all aligned."

Follow a schedule

In large-scale vendor projects, there's likely to be changes and adjustments made along the way. Be careful not to lose sight of important details (i.e., deadlines). Institute a formal timeline with the vendor and actively monitor your progress. "Review the project plan with the vendor, making sure that you're taking into consideration what the practice needs to be doing, as well as understanding what the vendor is doing and what progress they're making," says Jantos.

Also, officially document any changes that you make to the timeline and/or vendor contract, says O'Brien. "That way you have something to go back to if there is a problem," she says. "You can say, 'How did we get here? What were the decisions that led us to this?'"

Set realistic expectations

If you don't establish from the get-go what you expect of the vendor, you're bound to get disappointed and frustrated, says nonpracticing internist Karen Bell, chair of the Certification Commission for Health Information Technology. "Nothing can make a relationship go more sour than missed expectations, so when you go into this relationship it's really important to understand exactly what it is, what it entails, and what you're going to get for it," she says.

Also, make sure your vendor expectations are "reasonable," says O'Brien. For instance, many practices become frustrated when they feel their vendor inquiries are not answered promptly. "I think just having clear expectations and talking upfront about 'Hey when I e-mail you or when I call should we expect to hear back that day, or is it 24 hours?'" is helpful, she says.

Plan ahead

Regardless of how healthy your relationship with your vendor is, issues are bound to crop up. The important thing is whether you can solve them quickly.

In addition to identifying a point person at your practice, also identify a core team of staff members who will be involved in major vendor-related decisions and developments, says O'Brien. That way, when problems arise, this team can make informed decisions quickly.

Also, watch out for changes that could disrupt your vendor relationship or require you to make changes to the system you have in place; for instance, if your practice is being acquired by a hospital or if you are hiring additional physicians, says Jantos. On the vendor's side, watch out for news of financial loss, staff layoffs, or ownership changes. "If there are rumors flying around that they are going to be acquired, you are going to want to pay special attention to that," she says. "... It's probably going to be something that changes how services are being provided."

Problem solve

If your relationship with the vendor does become strained, ask for some face-to-face time, says O'Brien. "A lot of times the practice will feel better knowing that someone's there and can actually see what they're talking about." And don't let cost deter you from asking for a vendor visit. "If the relationship is going downhill, the vendor usually wants to do whatever it can to patch up that relationship, so they're usually pretty good about coming out on their own dime for a day or two," she says.

Often, it's helpful to remove the people immediately involved in the dispute from problem-oriented discussions, says Jantos. "Escalate it up the chain of command, get somebody involved ... who can be more objective about what's happening, and understand and listen to what's going on from the vendor's perspective, as well as what's going on from your perspective, and try to figure out if there's a way to close the gap," she says. Then, have a consultant or legal expert help evaluate what is reasonable and normal to expect from the vendor-practice relationship. "It can be helpful to have that third party help develop that plan with you to right whatever's gone wrong, and maybe establish new milestones or criteria that you can be more effective with," says Jantos.

Make tough decisions

Still, if the vendor remains unresponsive despite your attempts to mend the relationship, it may be time to move on, says nonpracticing internal medicine physician Jeffrey Hertzberg, president of Medformatics, Inc., a Minneapolis-based consulting firm. "It's always expensive to try and find a new vendor - you've got to go through that whole process again - but if the culture is poisoned and the productivity is down, you may very well have to move on," he says.

Prior to terminating that relationship with the vendor, however, ensure you understand what you are getting into; for instance, penalties for early termination, resources spent finding and implementing a new vendor, etc., says Jantos. "Get your legal counsel involved in helping you think that through and mitigating any of those responsibilities, and making sure that your transition is as seamless as possible."

Vendor Selection Tips

The primary way to ensure a positive vendor-practice relationship starts with your vendor selection process. Visit http://bit.ly/Vendor-Selection for 10 ways to ensure you select the right vendor for your practice.

Negotiating Vendor Contracts

Once your practice signs a contract with a vendor, it’s set in stone. For tips on how to ensure your next vendor contract includes everything necessary, listen to this podcast with Brian Beals, senior project manager at healthcare consulting firm Atlanticon: http://bit.ly/Vendor-Contracts.

Aubrey Westgate is an associate editor at Physicians Practice. She can be reached at aubrey.westgate@ubm.com.

This article originally appeared in the November/December 2012 issue of Physicians Practice.