So who's really paying for lunch, anyway?

April 10, 2013
I have been a party to a number of vendor demonstrations and site visits recently, and it has led to some thought as to who benefits from these exercises.

I have been a party to a number of vendor demonstrations and site visits recently, and it has led to some thought as to who benefits from these exercises. The following are some observations from these recent experiences:

§ Vendor site visits represent a huge expense to the vendors. Guess who is paying for that expense? More than likely it is a cost of doing business that is passed along in the vendor’s markup. I wonder if anyone has taken the time to calculate the cost implications. Would you really take your staff to a fine restaurant for lunch, because that is in essence what you are doing?

§ The logistics of coordinating staff for site visits is complex, and seldom can the same staff make all the visits, resulting in an inconsistent assessment.

§ Rarely is it possible to find a site that has exactly the same configuration as the prospective customer. For example, a site looking at a new cardiology system has an Epic HIS, but the only site with a similar cardiology system configuration has a McKesson HIS. What is the value in seeing a potentially dissimilar cardiology configuration interfaced to a different HIS? More than likely, the workflow is different as well.

§ What exactly is the point of the site visit, and how prepared is the prospective customer to make the assessment? Typically, the customer gets to tour the facility, perhaps watches a procedure in process, and maybe, time permitting, gets to discuss issues with the site one-on-one. One can prepare detailed visit guides and end up not having the right people present to address all of their questions.

§ How does one compare site visits across vendors? If a prospective customer visits three competitive sites, what criteria are used to determine whether one vendor’s site was more effective at making a vendor decision than another? Could it be possible to have a bad site visit for a favored vendor, and have that influence the selection outcome?

§ Are onsite vendor demonstrations and presentations effective to a vendor selection? I recently had a vendor complain about the “vendor fair” approach to onsite demonstrations, pointing out that in that setting they really don’t get to show their strengths. Conversely, I pointed out that the advantage is the opportunity for a broader spectrum of staff to get to see all the vendors at the same time and to be able to draw comparisons between them.

§ How many prospective customers take the time to plan out an onsite demonstration in terms of what is expected to be demonstrated such that the vendor has a good idea of what to show? Are there adequate scripts prepared so that the staff gets to see a consistent demonstration across vendors, in terms of elements that are important to their practice or workflow?

Hopefully, you see where I am headed with this! The vendors are spending vast sums of money entertaining prospective customers at a number of show sites that may or may not be relevant to the customer’s needs. And that cost is being passed along.

Conversely, the prospective customer is investing a large amount of time to make the visits or attend a demonstration, and they may not be seeing anything that is relevant to their decision. So, what to do? Here is some food for thought:

§ Prospective customers should make an effort ahead of any site visits to define what their goal is for such a visit. There should be a clear documentation of visit objectives, and communication with the vendor to assure that the right staff, equipment, and interaction will be available at the site. Several vendors I have worked with will make a concerted effort to include time alone between the site and the prospective customer for a frank discussion of the vendor. Seeing an agenda ahead of the visit can help assure that the right conversations are planned.

§ Sometimes it may be more realistic to visit a site that is not considered one of the vendor’s “show sites.” A site that can honestly say things didn’t go exactly smoothly, but in the end they are satisfied may be a better gauge of that vendor’s capability.

§ Customers should also make an effort to think through the objectives of an onsite vendor demonstration or presentation. The question is what is the expectation for the staff, and what do you want them to come away with in terms of an ability to contrast one vendor from another. Having the vendors bring in workstations to demonstrate is helpful to radiologists or cardiologists in terms of understanding whether it meets their daily needs, but it may not be the most effective way for the rest of the staff to get an idea of how well the system meets their work flow expectations. Demonstrations, coupled with presentations may produce a better result.

I realize that sometimes site visits can be perceived as a “perk” for making a decision, and that saving money benefits the facility, not the individual. But, in these economic times, perhaps it’s time to step back and evaluate the gain versus the benefit. Just as Paul Levy of Beth Israel Deaconess Medical Center in Boston has gotten a lot of press recently for his innovative approach to offsetting staff reductions, I am willing to bet that any CEO will buy you lunch if you could save the facility a significant amount on a large capital purchase by passing through savings on meaningless site visits!

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