University of Victoria Health Information Science Program IT/IM Procurement

1. University of Victoria Health Information Science Program IT/IM Procurement Peter DurrantExecutive Director – Health & Government Practice Victoria Location Manager June 22, 2009

2. Agenda • KTC Health Practice • Procurement Context • Procurement Models • Summary & Issues

3. KT Health Practice • KT Health Practice focused on HA & MoH issues • Many senior level, decision maker client relationships • Have 45+ consultants active; network of 100+ and growing • Offices in Vancouver & Victoria • Wide range of services in both Management and IT/IM consulting • Gold Certified Partner with Microsoft • Partnering with CIS, EMR, SI and Clinical Advisory firms

4. Health Practice Teams The KTC Health Practice has created dedicated teams in five main serviceareas to address the complex challenges facing managers in the health system

5. Health Practice Services We provide a wide range, high quality services in both Management and IT consulting at different levels ranging from local, regional, provincial to national.

6. Procurement Context Most Health Sector IM/IT projects are publicly tendered Hundreds of health sector market procurements each year RFP’s focused on the Health Authority and MoH IM/IT agenda and eHealth issues Many different kinds of market procurements Health organizations are being asked to do more with less – more procurements There is an art and a science to responding successfully

7. Procurement Context - Continued eProcurement is starting – still long lead time BC Bid permits electronic submission Timelines for review can be very lengthy – proposed resources may be unavailable Significant effort required to respond effectively Need to determine if it’s a real opportunity or ‘wired’ Who you know vs what you know syndrome FAA drives procurement policy in public sector Common sense & business strategy drives procurement activity in private sector

8. Procurement Models Request For Proposal (RFP) Joint Solution Request For Proposal (JSRFP) Request For Quotation (RFQ) Invitation To Quote (ITQ) Pre-Qualification Vendor of Record/Preferred Vendor Direct Award

9. RFP Dominant procurement vehicle in BC Public Sector Response typically articulates business solution, resources and rates against stated client business requirements and term Bread and butter of BC Health consulting businesses T&M or Fixed Price Large firms have RFP specialists & Coordinators Consultants not engaged on billable work typically assigned to RFP responses Need inside intelligence – can’t rely on outcome

10. JSRFP Relatively new model Best suited for large scale & complex projects Solution requirements unknown by client Requires significant investment by respondents Only appropriate for large SI’s etc Result in 7 to 10 year deals $300 million plus (HBO, Payroll, Rev Management, eHealth, Data Centre etc) ASD managed - line Ministries are customers Track record is mixed

11. RFQ/ITQ Request for quotation typically specific requirement Resource based Relatively Short Fixed Term Price is very important in weighting ITQ even more specific Smaller budget, shorter term, specific requirement Shorter turnaround time than RFP Vendor usually needs to be aware of it before it hits street to be successful

12. Pre-Qualification Customer organizations trying to develop a list of qualified consultants for a period of time Term is usually for 1-3 years Consultant lists by specialty category – BA, PM etc Consultants submit resumes and rates citing experience and qualifications Once pre-qual list established - easy to draw from Increasing trend in BC & Alberta Gov’t Ministries Advantageous to independent consultants & small firms

13. Vendor of Record/Preferred Vendor Similar to RFP but result is Down Selection to 3 Once Down Selected deemed Preferred Compete with other Preferred’s for future business Specialty usually emerges across the 3 Preferred’s Easy process once Preferreds established CR is short and turnaround is fast Increasing trend in HA’s to use this method for IM/IT project work Need inside position to be successful once started

14. Direct Award Small, focussed, immediate term $25,000 (signing level in client organization) Useful for quick and specialized projects Client needs something asap from consultant with unique skill Sometimes difficult to obtain approval Not used frequently Difficult to extend or renew Can lead to problems if abused (eHealth Ontario)

15. Summary & Issues Public sector/health industry consulting work typically awarded based on public tender process (FAA) RFP is most common procurement vehicle for projects & initiatives JSRFP used for large complex deals where requirements need development – significant investment and effort required on both client and vendors part Very competitive landscape for contracts in health sector $millions$ tendered in health sector each year in BC Pre-Qual lists are becoming popular for small projects

16. Summary & Issues - Continued Many tenders released mid –summer Lengthy turnaround time – few staff to review Panels of reviewers not necessarily close to business Focus on cost reduces benefit of value add of business/industry experience It’s a crap shoot, outcome cannot be predicted Very difficult to plan for resources & investments High level of audit activity eHealth Ontario – Direct award issues

17. Summary & Issues - eHealth Ontario – Headlines! • “Ont. health agency scrutinized for contract tendering practices” • 'Taxpayers are really getting ripped off': PC leader • “Personal ties exposed in eHealth's untendered contracts” • “Several ties between Courtyard exec, eHealth board” • “Close ties - Questions are also being raised about a further $1 million in apparently untendered contracts awarded in the early months of the agency's transition to Courtyard Group, on top of the single $915,160 deal”.

18. Thank You!

19. Health Clients • Interior Health Authority • Maximus Health BC • Pacific Blue Cross • Provincial Health Services Authority • Source Medical Solutions • Vancouver Coastal Health Authority • Vancouver Island Health Authority • WorkSafe BC • Alberta Medical Association • BC Cancer Agency • BC Centre for Disease Control • BC Medical Association • BC Ministry of Health • Center for Child Development • Community Living BC • Fraser Health Authority • Health South

20. Partnership

21. Project Examples • Fraser Health Emergency Room System Rollout & Workflow • Electronic Master Patient Index Project • Medical Image and Information Management System • Regional Cardiac Images Library Solution • Cardiology Lab System Upgrade and Enhancement • Clinical Systems Integration • Primary Care IT Strategy • Community Health Records Implementation • Patient Safety (Patient Safety & Learning System) • PIA’s for eHealth, VIHA, PHSA & IH • Strategic Advisory Services – eHealth Privacy, Program Management, PD PLIS • BCCA CMG Website & Protocol Management