EHR Contracts: How To Get the Vendor Support You Deserve

As I thought about this series of Electronic Health Records and Electronic Medical Records contracts mini articles, I kept coming back to one of the top questions posed by frustrated providers and administrators attending my seminars and workshops… “How can we guarantee we’ll get timely vendor support when we need it?”

For some reason, Murphy’s Law (“Anything that can go wrong, will go wrong”), seems to always kick in after the system is installed, the final payment is tendered, and the practice is now dependent on the new technology. After all, you’re paying a substantial percentage of your license fee every year for your support and maintenance “rights.”

But still, in most cases, the onus is on you to protect your own interests. I have infrequently run across a vendor that voluntarily offers to penalize themselves for poor support or that guarantees and commits to exactly how you will be taken care of. You need to become the “squeaky wheel” when you need support and a “squeaky wheel” gets better traction if you have contractual “teeth” backing you up. Thus, the concept of support clauses in your contracts or separate Service Level Agreements (SLA’s)…

These agreements outline various areas of vendor accountability in which the vendor is willing to make a commitment to service and support with associated penalties. I’ve worked with IT contracts for almost 30 years and for some reason many EHR and EMR vendor contracts have had very “lightweight” or weak contractual clauses when it comes to customer support assurances and guarantees. Some important areas to be aware of include the following.

Hours of support

Don’t just accept such terms as support during “standard business hours”. You need to have a specified range of hours. And make sure the hours are satisfactory based on local time. I’ve seen support clauses where an East Coast Vendor specifies 8-6 EST and the client is on the West coast. That would put the ending of a normal support day at 3pm PST. Remember, any issues that are resolved outside of normal business hours typically have an additional charge.

Problem Escalation

Whether it be your phone company or bank, have you ever gotten frustrated by the lack of knowledge or problem resolution by the immediate support person, and have asked to speak to the “manager”. This is what I’m talking about. In the case of your EHR contract make sure that the levels of escalation are specified ahead of time. These are your rights. This can also include asking that the vendor’s support person come on site if the issue can’t be resolved by the normal means in a reasonable timeframe.

Response and Resolution Times

How long does it take a vendor to respond to you when you have a problem? How long will it take to actually fix the problem? If your system is completely down or if this is an issue that affects patient care, will you be expected to wait 24 hours or will you get taken care of immediately. Be aware that different functions of the system might warrant different response times. For example, clinical documentation problems might need immediate attention, while a problem with a patient education module might not be as urgent. Get a commitment as to how long the vendor will guarantee a response to you. This includes associated financial penalties if they fail to meet their commitments. That’s a powerful “squeaky wheel”!

Upgrading to New Versions

What about new releases of your software as time goes on? By paying your support and maintenance fee you certainly have the right to receive new releases free of charge. But, I’ve seen contracts where a vendor has the right to expect you to upgrade in a short timeframe or support will be reduced or even dropped until you are compliant with the new system. From a vendor’s perspective, this is great because they would only need to support the newest version. However, you might not want to install the newest version right away, as the time to test and install a new version is not trivial and can possibly impact your internal resources and the operation of your practice. Also, many times, new releases can have some initial kinks. You should always expect that, at the very least, a vendor will support the previous version(s) for a reasonable amount of time.

There are more concepts to address in an acceptable Support clause or Service level Agreement, but hopefully the above tips will help get you thinking and pave the way to greater comfort in this area. Remember, you can choose the right vendor and get a great deal, but the key to your ultimate success is in holding your vendor accountable for the service and support you expect and deserve.

Michael Uretz has been involved with all aspects of technology selection, negotiation, and acquisition for almost 30 years. He presently serves as Executive Director of The EHR Group, a consultancy dedicated to providing guidance to healthcare organizations as they navigate through Electronic Health Record selection, contract negotiation, and project implementation.

Michael is considered one of the leading authorities on EHR Selection and Contract Negotiation. He is frequently asked to conduct EHR Vendor Selection and Contract negotiation seminars and workshops on both the state and national level and is the author of the CD “How to Survive Your EHR Contract.”

He can be reached at (425) 434-7102 or mikeu@ehrgroup.com.