Vendors, take note: If you don’t deliver, you’re out.
With CIOs facing mounting pressures, the relationship with their core vendor is becoming increasingly critical. And although most are generally satisfied, they’re willing to make some noise — or even walk — if things go south, according to the April healthsystemCIO.com Snap Survey, which found that 69 percent of CIOs have a “very good” relationship with their core vendor, and 63 percent find their vendor to be “very responsive.”
But while most CIOs are getting what they need, it doesn’t always happen right away — or without a little nudging. “Much of the time, our core vendor is very responsive,” noted one respondent. However, “in some instances, we have to push hard or wait longer than we’d like to get attention or to get in touch with the right people there who can make things happen.”
With CIOs fighting for every budgetary dollar, waiting around simply isn’t an option. In the survey, 96 percent said they are willing to elevate an issue that wasn’t being addressed to the vendor’s senior management team. And although most CIOs try to follow the chain of command and avoid “crying wolf,” they won’t hesitate to go straight to the top when facing time constraints or a lack of responsiveness. “We do not like to play this card unless absolutely needed,” one respondent stated.
When it is necessary to elevate an issue, CIOs believe it’s important to be direct, but fair. “Leave the emotion at home and state the issues clearly and factually,” said one respondent. “If the vendor begins to feel that you are venting unfairly, you will not get the desired response.” At the same time, CIOs need to be firm, particularly when a vendor fails to right the ship. “You need to make sure they know that 1) you are serious, and 2) you do have alternatives that are viable. Never back yourself into a corner where you are at the mercy of a single vendor,” said one CIO.
Another remarked that to expect the relationship to thrive at all times is unrealistic and could damage any partnership. “Not every vendor will be able to deliver on what was contracted and/or promised during the sales cycle. There will also be changes in the market that some of the vendors don’t foresee or can control.”
Interestingly, when CIOs were asked to offer advice on maintaining a successful vendor relationship, accountability and managing expectations were cited often, but what it really all comes down to, according to the respondents, is communication. “Be direct and transparent about your vision,” stated one respondent, while another urged “open, honest communication from everyone.”
(SnapSurveys are answered by the healthsystemCIO.com CIO Advisory Panel. To go directly to a full-size version of any individual chart, click on that chart.)
1. How would you rate the overall experience you’ve had with your core vendor?
Very good (there have been more ups than downs)
- They are growing fast, so we’re seeing more downs lately.
- One of the reasons we picked our core HIS/EMR vendor was their reputation for excellence in implementation and service. Our real-world experience with the vendor has been consistent with their reputation.
- More ‘good’ than ‘very good,’ but I do not think it is only ‘fair.’
Fair (equal share of ups and downs)
- The pace of change has strapped vendors, who are trying to keep up with Meaningful Use and with ICD-10. Their performance has been less than stellar due to the volume of change and the frantic pace to keep up.
- Meditech — really good, eCW — only OK, Merge — only OK.
- I think it really depends upon the quality of people you have the opportunity to work with and the value that they believe your relationship can bring to the table.
- The vendor is still very siloed and I find that only parts of the company are well represented.
Poor (more negative than positive)
- Don’t keep promises. Lack transparency. The field staff is at the mercy of Central office. Senior leadership is out of tune with what is happening with clients.
2. How responsive has your vendor been when you’ve reported issues that needed to be addressed?
Very responsive
- They are acknowledging, but it is also a reality that they are “flat out” and can only move so fast.
- Our vendor has been responsive on items that meet the regulatory requirements we are facing. Items that fall outside of those have been more difficult to negotiate.
- Much of the time, our core vendor is very responsive. In some instances, we have to push hard or wait longer than we’d like to get attention or to get in touch with the right people there who can make things happen. Typically, when we get an audience with the right people there, we receive the assistance needed to resolve any issue.
- I’ve really not had a problem; however, sometimes the answers I get back really don’t fit, but there are internal items that I don’t have knowledge of.
Somewhat responsive
- At times we have really struggled with getting issues resolved, especially with issues like CCDs and bolt-on solutions.
- Again, it depends on the module and issue. On the clinical side I get an OK response, but on the PACS side, it is a complete disconnect.
- The ability to respond seems to be affected by the demands from MU 2 and ICD-10, in addition to normal workloads. Too many projects and too few resources
Not responsive
3. Have you ever had to — or would you be willing to — elevate an issue that wasn’t being addressed to the vendor’s senior management team?
Yes
- I think that is part of the reason that this works. We know the senior management team and they know us. They know if something is being escalated, it is big.
- I am in contact with the vendor’s senior management team(s) and do reach out when necessary. I try to avoid “crying wolf” and escalate only when I need to. Also, make sure you are being direct and appropriate. Leave the emotion at home and state the issues clearly and factually. If the vendor begins to feel that you are venting unfairly, you will not get the desired response.
- Have to do it all the time.
- Part of successful vendor management is having the visibility with the senior management team of your vendor. I am typically “on the ground” at the vendor headquarters 2-3 times a year.
- There have been occasions where I’ve needed to elevate critical issues to vendors’ CEOs. This doesn’t happen often because the large majority of the time their teams deliver as expected. But when it’s crunch time and the team isn’t on target, I never hesitate to ask their executives to step in and help.
- We have, on numerous occasions over the past 9 years. We do not like to play this card unless absolutely needed. In a perfect relationship the vendor senior management would be informed at the right level of detail so that they step in and contact us prior to us getting them involved — isn’t that what real customer service and relationship about?
- I’ve done this on several occasions; however, I always allow the folks in the chain of responsibility to get a shot before I step over them.
- I find that I get a quick response, but it’s more excuses then resolution.
- Meditech encourages task escalation and we use this judiciously. This process is effective.
No
- Came close a couple of times, but they were resolved.
- I’m not sure.
4. Have you ever had an experience that caused you to sever ties with your vendor? (If you answer ‘yes,’ please explain.)
Yes
- Previous core vendor’s inability to deliver reliably caused us to change to a new system.
- ‘Past life’ chronic under-performance to mutually defined metrics of success… it’s best you take action prior to your organization taking action — on you.
- Failure to deliver on product roadmap and commitments.
- Not with a primary vendor. I am in the process of severing ties with a secondary vendor for an add-on module. They tripled the price of the solution 6 months after the last quote. There were no substantial changes to the system and they refused to budge in pricing, even though we have been a customer for 15 years. I am replacing their entire system with a competitor for slightly more than the inflated cost of the add-on.
- Yes, it was with a company we were using for a complete network upgrade. It was a two-year project. As time went on, many of the employees we trusted left the company and the replacements did not have the same skills, nor did they respond as quickly.
- We had a series of negative experiences with our core PBX/telecommunications services vendor which caused us to sever ties. Their performance was terrible, and despite our efforts to work with them and their attempts to work with us, it didn’t get better. We realized our best strategy was to make a change and we negotiated a termination in order to make way for a replacement vendor.
- I think you’ll find that everyone has these types of stories, or at least should. Not every vendor will be able to deliver on what was contracted and/or promised during the sales cycle. There will also be changes in the market that some of the vendors don’t foresee or can control.
- Right now I am doing that with Siemens PACS because the product has not worked well since we installed 24 months ago. I have raised the issue to the top, and all I hear is excuses. I am starting the RFP process to replace. In the past I have replaced an entire EMR because the company was just not focused on providing tools that worked well in clinical setting.
No
- I’ve had to threaten, but no vendor wants to lose a relationship. You need to make sure they know that 1) you are serious, and 2) you do have alternatives that are viable. Never back yourself into a corner where you are at the mercy of a single vendor.
- When it is your EMR vendor, severing ties is not easy, and the EMR vendor knows that.
5. What’s the one piece of advice you would offer to other CIOs for maintaining a successful vendor relationship?
- Routine contact.
- Get the facts straight before you escalate.
- Communicate, communicate, communicate.
- Forgive when things are made right.
- Put yourself in their shoes and ask them to do the same.
- Develop written relationship documents.
- Form a partnership beyond money and service.
- Communications is key so that both parties understand each other.
- Pick your battles.
- Crisp and concise conveyance of expectations.
- Establish strong accountability on both parties.
- Be direct and transparent about your vision.
- You are responsible for your vendor relationship.
- Go into it as you would a partnership.
- Be firm but fair.
- It is about the relationship.
- Involvement — attend user meetings.
- Treat your vendors as you would your own staff.
- Keep your execs informed prior to escalating.
- Open, honest communication from everyone.
- Be kind but direct; hold them accountable.
- You have to establish vendor accountability.
- Understanding motivations and missions.
- Hold them accountable.
- It’s a marriage — good and bad.
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