☰ CCIO handbook contents

Chapter 6


Being an expert customer: how to build valuable relationships with your suppliers

Dr Johan Waktare, consultant cardiologist and clinical lead for IT, Liverpool Heart and Chest Hospital NHS Foundation Trust.

What is an “expert customer”? One who gets a good deal? One who doesn’t get duped? I would say these are givens, but if they are your sole strategy as a chief clinical information officer then you will struggle to get the best from your relationship with your suppliers.

The most valuable relationships with suppliers are partnerships rather than a customer/vendor setup. Of course, you must never lose sight of the fact that suppliers are a commercial enterprise, and that side of the relationship needs to be appropriately handled.

However, a high quality supplier in the healthcare field will share a passion for improving the quality of healthcare for the ultimate users of their wares - the patients.

If you want to be an expert customer, then realising your responsibilities in the relationship is vital. You aren’t actually a customer; your organisation is the commercial vendor’s partner just as much as they are yours. It is your organisation that has an accountability to deliver patient benefit and financial return on investment, not the vendor.

This chapter explores how to select a supplier with which you can build this kind of relationship, and how such a relationship is constructed.

Identifying potential suppliers and “visioning”

The first step is to identify potential suppliers. The procurement phase is a very formal one, bound by tight rules, codes and laws. But before entering that is a much freer period of examining the market. Indeed, scanning the market should be a continuous process – if you don’t have a continuous horizon-scanning approach, you will not know what benefits you are not planning on realising.

Sources of “intel” include, but are not restricted to:

After gaining some initial intelligence, then seeing the products in use is invaluable. There is nothing to prevent reference site visits during this phase, whether they are supported by a potential future supplier or brokered by yourself.

Bear in mind that “gathering intel” about potential suppliers is only part of what you are doing in this phase. It is as much about shaping your vision and increasing your insight into the possibilities of what IT-enabled healthcare holds.

You can only implement what already exists or can be developed out of what is available, and you are not an expert on that until you have gained the knowledge.

Getting the right contract, putting it in a drawer and not taking it out again

Your relationship with the supplier partner will inevitably be based upon a formal contract, and it is vital to get that right. How you get to that contract is very variable and will typically be driven significantly by processes external to your role as CCIO. These typically fall into either an OJEU tender or a framework-based procurement.

The EPR in my trust was procured via a QJEU tendering process, which is a drawn out, labour intensive and high risk procedure. Early on, the trust or other organisation going out to tender has to specify in great detail the expected functionality that it is contracting for; at a time when it may be relatively naïve about how such functionality would work best.

Treating this work with the respect it deserves is key, and having done your market surveillance, intelligence gathering and visioning well is central to doing that. The other key factor is approaching your specification in the right manner, which is underpinned by three priorities:

Are they the right supplier for you, and are you right for them?

Every organisation has a culture, and it is notoriously the most challenging thing to change about an organisation. Ensuring that you are culturally aligned to your supplier in terms of approach and values is therefore critical.

Some suppliers have a strong culture of getting you to adopt their workflows, which are based upon years of research, experience and hard fought learning.

While this is in some ways proscriptive, it has important advantages: you have less accountability for getting the design right; the workflow is tried, tested and proven; and almost as a byproduct you have delivered uniformity of process throughout your organisation.

The other extreme is the laissez faire approach of the supplier having a system that is fully adaptable to your requirements. That is obviously great and a huge advantage, until you realise that you don’t really know what your requirements are for optimal, electronically-based workflows.

Each of these extremes has advantages and disadvantages, and neither is intrinsically superior. The point is to try to find a supplier who fits to your organisation’s approach and requirements.

Bear in mind that the best approach may also depend on the solution you are implementing. You may wish to be able to design and customise your core systems heavily, but when looking at a specific task your needs may be best met by procuring an “off-the-shelf” solution that requires minimal input or maintenance from you.

One useful method of evaluating a supplier is to look at the organisations in which their solution has been deployed well. Were the culture and requirements of this organisation similar to your own?

Remember that you are looking to be a partner to your supplier. Do they share that aspiration, or are you just a potential revenue stream?

Maximising the value of your supplier relationship

As has been stressed, the key to success is to not be a customer but be a partner, with shared objectives, goals and values. This is a commercial relationship, but having strong personal relationships that underpin that is not “inappropriate” – it is a key feature of your partnership.

Not everything will always go right, and there is no issue in a strong partnership of holding each other to account. The requirement is to do that in a constructive manner, and to work in partnership to resolve matters.

A “customer plus”

Finally, consider the value that you deliver to your supplier partner. Could your relationship be strengthened by becoming a ‘customer plus’? And could you derive benefits from such a setup?

Being a ‘customer plus’ takes two principal forms:

Conclusion

Building a strong and successful relationship to commercial suppliers is a key component of the CCIO role. The CCIO acts as a bridge between parties - in this case the supplier and the healthcare organisation - to deliver value from relationships.

Technically one might be a “customer”, but a truly successful delivery of this aspect of the CCIO role would be“strategic partner and liaison”.

About the author: Dr Johan Waktare is consultant cardiologist at Liverpool Heart and Chest Hospital NHS Foundation Trust.
He has been the organisation’s clinical lead for IT for the past ten years, and has been closely involved in the implementation of an electronic patient record, which went live in 2013.

The supplier’s view: Dr Jenny Dean, medical director of Harris Healthcare, EMEA

Our experience is that informed customers make better procurement decisions to meet their specific needs, through successful, timely and cost effective implementations.

The better the partnership between the health organisation and their IT supplier, the greater the chance of the procurement and implementation being a success.

Working together ensures that the specific requirements of the organisation and users are clearly understood and addressed through configuration, design, development, implementation support. Contrary to the opinion of some sceptics, industry suppliers want their solutions to make a difference and to be successfully implemented as much as the organisations that buy them.

This is a crucial area for CCIOs to be leaders in and below is a list of simple do’s and don’ts to help towards becoming an expert customer.

Do:

☑ Understand the problem you are trying to solve.

☑ Be clear on what you want the specific solution to do in order to meet your strategic goals.

☑ Be able to explain in a clear way what is needed. The CCIO is ideally placed as a translator between all stakeholders including clinical users, managers (business case), IT departments and suppliers.

☑ Make sure the solution does or can meet your needs. It helps to understand what you need now and what you would need later, ensuring that the solution you purchase can develop for your future needs. Work in partnership with suppliers to ensure your procurement meets your needs now and will develop for your needs in the future.

☑ Have a coherent IT strategy for where you want to be, based on the ultimate goal of what you are trying to achieve, and facilitated by the IT in the short, medium and long term.

☑ Ensure you have broad buy-in on the solution being procured, with clarity on how it helps to achieve a strategic goal. Involve all stakeholders: clinical users; management for business case approval; IT team; external stakeholders and patients as and where appropriate.

☑ Measure the baseline of what you want to improve so that you understand the need and problem to be solved; ensure that the solution will address those needs and demonstrate achievement of the goal by later comparison to the baseline.

☑ Be aspirational for what you want from your IT solutions, but maintain realism and pragmatism in this complex and evolutionary field.

Don't

☒ Don’t buy the first solution that you see or be dazzled by the nice to have features not specifically relevant to your needs, especially where your core requirements are otherwise not met by the solution.

☒ Don’t wait for perfection. Healthcare and in particular healthcare IT is complex, evolutionary and in constant technological development. But do make sure that your needs are met.

☒ Don’t assume that there is a single best way to do things. Learn what has worked or what challenges were experienced elsewhere, but then make your own decisions based on your own unique organisational circumstances.

☒ Don’t base your IT strategy and procurement decisions on the technology itself as the end goal. Technology is a facilitator for transformational change, not the solution in its own right.

☒ Don’t drive ‘pet projects’. The solution should clearly fit within the overall IT strategy that meets an organisational objective, not an individual or single department’s desires.

About the author: Jenny Dean is the medical director for Harris Healthcare in Europe, the Middle East and Africa.
Previously, she was the founding executive director for the Centre for Health Leadership and Enterprise at Cambridge’s Judge Business School.
She also has ten years’ experience as an NHS doctor, specialising in anaesthesia.

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