1	Selecting Lab Portal Software – Business Needs and the RFP
2	Learning Objectives List major considerations and business needs for selecting lab portal software Outline a structured process for evaluating lab portal software Describe key elements of the RFP Define post-RFP stages for system evaluation and selection
3	Session Outline Definition of lab portal Business needs and project scope RFP structure and process Post-RFP steps
4	Lab Portal Software – Definition Web-based system for communication of laboratory test orders and results between a laboratory and its client sites “Front-end” that enables Internet-based communication with laboratory information system (LIS) host
5	Lab Portal Architecture
6	Preliminary Vendor Evaluation Sources of information CAP Today series Exhibits at Lab InfoTech and APIII meetings Professional networking Company web sites Initial criteria No./size/complexity of installations “Big picture” features such as AP, interfaces Prior experience with vendor “Hot button” issues for your site based on reasons for project
7	Define Goals and Scope for the System What types of clients do you plan to serve with the system? Clinical laboratory vs. anatomic pathology vs. both Hospitals, physician offices, other settings How many client sites do you plan to install and in what time frame? Current clients vs. new clients Do you want to provide additional services to clients? Demographic data management Point of care testing data integration Other types of orders – radiology, prescriptions
8	“Big Picture” Business Needs – Scope Assessment Clinical laboratory vs. anatomic pathology vs. both Results reporting and printing Order entry Patient demographic data management Billing/accounts receivable Technical architecture Interfaces Hosted vs. application service provider (ASP) Thin vs. thick client vs. both
9	Lab Portal Interfaces LIS-to-web portal system results-out interface necessary for result reporting Web portal system-to-LIS interface may be desirable but not necessary Web portal system-to-physician office practice management system facilitates demographic and billing data transfer but broadens scope and increases expense
10	Orders Interface Pros and Cons - Table
11	Practice Management Interface Pros and Cons - Table
12	Thin Client vs. Mixed Pros and Cons – Table
13	Request for Proposal (RFP) Main component of RFP is detailed listing of required functionality and features RFP asks vendor to specify: if specified capabilities are present corporate information pricing other attributes of system RFP responses become part of final contract
14	RFP – Considerations Process of RFP development can be valuable exercise; in practice, some consider RFPs misleading Main value of RFP is adding structure and documentation to the process and ensuring that all information is gathered Particularly useful for discerning “red flags”
15	RFP Outline Management Summary Functional scope of future system Administrative information and instructions Core functionality questions/checklists Technical architecture description Hardware and software support Implementation services Training services Pricing Vendor information
16	RFP: I. Management Summary Your goals and objectives for the system Brief overview of desired functionality Background about your site and the context in which the new system will be deployed Operations summary Technical environment
17	RFP: II. Functional Scope of Future System Narrative overview of elements desired Results reporting Order entry Dictionary maintenance and other data management Security and performance Emphasis of most important features needed Highlights of potential, specific challenges or considerations in your environment
18	RFP: III. Administrative Information and Instructions for Response Vendor commitment and conditions for bidding Confidentiality Representation of fact and inclusion of response in forthcoming contract Contact information Selection process Due dates and selection timeline Basis for evaluating vendor (criteria here need not be all-inclusive) Format for RFP response packet
19	RFP: IV. Core Functionality Checklist Choices for each item: Yes/No, beta, future, custom; ability to add comments Sections and sub-sections: Test result viewing, inquiry, and display Anatomic pathology-specific items Report printing Test order entry Order processing Demographic/insurance/billing data management Client-specific management and order sets User help Requisitions and other printed materials Compliance Data security and audit trails Management reporting
20	Result Viewing, Display, and Inquiry – Considerations Display elements Reference ranges Abnormal flags Footnotes and comments that are part of result Cumulative format Mixed numeric-textual results Antimicrobial susceptibility Coagulation panels Monoclonal protein evaluations
21	Result Viewing, Display, and Inquiry – Considerations Inquiry filters and criteria – by patient name/no., ordering MD, client site, date(s) Order status (e.g. Pending) inquiry Result handling Preliminary results Corrected results Cancellations Graphing capabilities Digital images and scanned documentation (e.g. long send-out reference laboratory reports)
22	Report Printing – Considerations Ad hoc/on-demand at client site Unattended automatic printing at client site Printing series of reports based on criteria (e.g. all reports for Dr. X for last 24 hours) Report formats and options Graphs and images
23	Test Order Entry – Considerations Test name/code lookup methods Capture of additional data required at time of order for certain tests, e.g. prenatal screens, cystic fibrosis, heavy metals Order modification, add-on, and cancellation handling Access to test reference information (e.g. on-line test directory)
24	Test Order Entry – Considerations Duplicate order checking Standing and recurrent orders Unsolicited orders from LIS Complex panels that may require more than one tube type and transport temp. Handling of ordering physicians or tests not defined in system dictionary Client-specific order sets
25	Test Order Entry – Considerations Options for billing party and insurance carrier data management Specimen label generation Requisition printing, format, options Options for packing manifest contents and sorting, e.g. specimens sorted by transport temperature (room temp., refrig., frozen) ICD-9 code lookup capabilities Medical necessity checking and advanced beneficiary notice (ABN) printing
26	Anatomic Pathology – Considerations Report format options and capability to preserve formatting (e.g. pdf files) Capture of required information during Pap smear order entry, e.g. LMP Order entry of surgical pathology accessions with multiple specimen parts that each have specific descriptions, e.g. colon at 30 cm, 60 cm, 75 cm. Display of digital pathological images
27	Financial and Demographic Data Management – Considerations Entry, management, and updates of: Patient demographics Insurance – primary and secondary Billing party specification at order entry – client, patient, insurance Accounts receivable and billing/collection module Interfaces – billing system, clients’ practice management systems
28	RFP: V. Technical Architecture Vendor recommendations for your site Diagram that shows essential components and connectivity Configurations, options and third parties for, hardware, software, printing Maintenance tables and system dictionary updates Capacity limits Security features
29	RFP: VI.-VII. Vendor Support Interfaces Existing interfaces – types, systems, and versions Flexibility Hardware and software Installation Ongoing support Processes for bugs, enhancements, and customs Documentation
30	RFP: VIII.-IX. Implementation and Training Services Implementation Project staffing Client resource requirements Training Client resources required Users and system managers Documentation
31	RFP: X. Itemized Components of Pricing Hardware Software Application OS, database, 3^rd party Interfaces Implementation services Training Recurring maintenance fees 24 hour support Warranty Options for transaction-based or subscription-based pricing
32	RFP: XI. Vendor Information Corporate profile Company staffing Research and development commitment User groups / user input Client references and contacts
33	Evaluating RFP Responses Traditional method is numerical: Assign weighted value to each item based on importance Assign score to each answer (e.g. yes=3, beta=2) Multiply weight x score = weighted score Total the weighted scores for all answers Choose the system/vendor with highest score Numerical method may be constraining and misleading if used as sole criterion
34	Evaluating RFP Responses Alternative method is less strictly numerical: Tabulate all “non-yes” responses by no/beta/future/custom for each vendor Decide if any of the absent functionality is a “deal-breaker” requirement Determine which of the absent features are the biggest negatives for your environment Emphasize these in future evaluation of vendor Decide which vendor’s “negative” profile is best suited to your site
35	Factors to Evaluate for Lab Portals Functionality/business needs RFP Demonstration Client references – calls, site visits Technology platform Vendor as potential partner Price
36	Vendor/System Demonstrations Philosophy: demonstration is not just a 30-minute overview but rather a golden opportunity for the vendor to show in-depth how features of the system will meet your business needs. The most effective demonstrations require considerable preparation on the part of the prospective client and the vendor.
37	Vendor Demonstrations – Script Develop detailed script for vendor based on: Core aspects of order entry and result reporting More complex scenarios that are challenges in your current workflow Items from the RFP that require clarification and visualization Permit unstructured time for special features and new development Ask for printed materials related to scripted scenarios Reports Requisitions Packing manifests Labels
38	Vendor Demonstrations – Preparation Emphasize that only currently available functionality should be shown If beta or future features are shown, they must be clearly noted as such Provide to vendor examples of (anonymized) current documents such as different report types, forms, requisitions, and others that relate to the demo Prepare Internet access and have backup capabilities for vendor demo equipment (e.g. PC, projector, printer, etc.)
39	Vendor Demonstrations – Evaluation Convert script into functionality checklist and comment sheet for those attending demo Assess subjective aspects – evaluate and rate (e.g. excellent, acceptable, poor): Ease of use Aesthetics Special features not covered by RFP
40	Client Reference Calls/Site Visits Best site is one similar to you in case volume and test mix to you and whose implementation is similar to your vision LIS used, including versions and modules Interfaces – orders, results, practice management Report printing Hosted vs. ASP model
41	Client Reference Calls/Site Visits Time to install? Time to install and train at your clients’ site? Surprises? Lessons learned and things to do differently? Satisfaction with vendor?
42	Summary Determine scope of installation desired Results, orders, interfaces, technical architecture Develop RFP and evaluate responses Tell vendor about you and what you are seeking Develop core functionality checklist Determine impact of negative answers Prepare for meaningful vendor demonstrations Evaluate other factors – vendor as partner, price