BOB vs. SIS (Best of Breed vs. Single-vendor Integrated Solution)

3 important points when considering a single vendor for both EHR and RCM.

Sure, it sounds easier, maybe cheaper, to buy both clinical (EHR) and revenue cycle management (RCM) applications from one single vendor.  First, some vendors “require it”, holding a prospective client hostage to their EHR choice.  Or you may believe you can “leverage” your buying power, get more bang for the buck, simplify your decision process, simplify support, etc.  So, why does this logic not apply to ERP, or many other large applications?  Here are three important points to consider:

  1. Penny wise and pound foolish or Is it better to hire multiple RCM consultants rather than one good interface person?Of course, the single vendor approach could make sense if EHR & RCM were the only two, vendor-provided, applications in your facility.  However, considering you likely have 100 or more vendors in place, each with their own interface and separate agreement, is it really that helpful to go from 100 to 99 vendors – especially for two of the most important application domains you have in your hospital?

    Take RCM for example, when the RCM solution provided by your “best choice” EHR vendor is NOT the “best RCM choice” for your hospital, will have settled for a less capable RCM solution.  You can make any RCM work, but a less capable RCM solution translates to lost time to value and additional costs to hire enough people to make it work for your facility.  Ask yourself, are you considering settling for a less capable RCM solution to avoid a few interfaces?  Yes, a few interfaces.  And, is it really better to hire a team of RCM consultants rather than one good interface person?

  2. Smoke and mirrors or What are you giving up now and for the future?What are you giving up when you conform to the idea of single-vendor at the onset of system selection and negotiation – or in the single-vendor case – lack of negotiation.  Continuing with the RCM example, the result is finance, a significant segment of your organization, is tied to a single-vendor selected by the Clinical staff, and the financial folks are asked to “make it work”.  You can always make the decision to choose the single-vendor’s RCM, but it isn’t really a decision if you don’t consider other options.

    In considering other options, you may find that the best RCM solution for your hospital is offered by a different vendor.  During the selection process and negotiation is when you have the optimum leverage with the EHR vendor to ensure your organization can properly integrate ANY RCM solution with their EHR.  Does the EHR vendor you are considering restrict which “best of breed” solutions you can integrate?  You’ll discover that some vendors will hold you hostage by restricting interfaces, or services that would allow another RCM solution to be used.  If you do choose a single-vendor today, what happens down the road when you wish to replace a component of the single-vendor solution with a “best of breed” solution?  Will the vendor provide what is required for the integration?

  3. To be or not to be or Will your RCM choice breathe life into your hospital or will it result in high denials, A/R days and lost reimbursement that stifle growth?RCM is critical to maintaining the financial performance of your hospital and to be able to deliver quality care, finance expansion, executive bonus plans, to name a few.  Too many hospitals seem to “assume” any RCM will do – that is until denials reach the millions of dollars, days in A/R creep into the 50s or 60s, and revenue is impacted.  Simply put, there is too much at stake, your hospital must have the best possible RCM solution available, no matter the vendor.  Cash is king and the “oxygen” that allows the hospital to provide services.