Being proactive with vendors helps healthcare improve IT

Madison, Wis. — Moving past the balkanization of information technology in healthcare will take working proactively with vendors, said presenters at the Digital Healthcare Conference 2006. And vendors aren't necessarily reluctant to be pushed around a bit by informed customers.

Providers are facing that common IT problem: buy or build? After peering out at a patchwork of vendors and systems with challenges agreeing to standards, many institutions develop their own internal healthcare IT tools, further balkanizing IT.

"Our need to build tools is probably greater than our collective capacity to do it, and if we all build our own tools, we're going to be reducing that capacity," said Dr. William Yasnoff, a healthcare IT consultant who runs NHII Advisors.

But Dr. John Melski, clinical informatics director at Marshfield Clinic, said liability and intellectual property issues stand in the way of providers sharing tools developed in house. "All of these institutions, including the Marshfield Clinic, are reinventing the same wheel again and again" and will do so until the legal aspects of sharing are ironed out, he said.

"I don't roll my own software," said Gary Wendt, vice chair of informatics at the University of Wisconsin-Madison. "I don't think it does anybody any good. But we went and got the vendors to build software that follows standards." Vendors can benefit too, he said, because they end up with software they can sell elsewhere that meets standards needs: "I don't expect vendors to develop a one-off that works at the University of Wisconsin and nowhere else." That kind of vendor relationship requires a proactive customer. And it's customers like that, who will not just pick among existing systems but push vendors to implement better systems, that excite people like panelist Jim Prekop, CEO of TeraMedica.

It's not enough to ask vendors to all work together and solve the problems of interoperability facing an institution, Prekop said. The organization needs to develop a strategy and call the shots.

That means holding vendors accountable for providing data in standard ways that can be used elsewhere. Standardizing on software systems doesn't always work, Prekop said, because needs differ between users and change over time, so it's better to have the data "liberated," not in a proprietary form, so it can be used by whatever systems are brought into use.

"Without a strategy, you're relying on a vendor," he said. "And being one, that's a very dangerous strategy for your long-term growth."