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Thomas Memorial also settled on a communications process before beginning its vendor evaluation, which included site visits and third-party ratings, from the technology assessment company KLAS. Lucas served as the communication hub between the aspiring software suppliers and the hospital. "We wanted to make sure the vendors were all getting the same story and hearing the same expectations," he explains.

The communications protocol preempted vendor shenanigans, as well. "One vendor felt like they were not hitting it off with the selection committee, so they did an end-around and tried to go to our radiologists directly," he recalls. "The physicians pushed the company right back to the selection committee." That detour, by itself, did not disqualify the vendor, but added to a growing list of reasons why it would not be a good cultural fit, Lucas says.

The site visits also proved fruitful. Even though the sites were ostensibly showcase installations for the vendors, some of them revealed flawed relationships. Lucas recalls one site, for example, that had a "worn contract, because the vendor was constantly telling them if something is not in writing, we're not doing it unless you pay for it. That is fairly concerning. We had little experience, so it would have been easy to give us what looked like a good contract only to find out the company was going to nickel and dime us to death for the life of the system."

By year's end, Thomas Memorial had deployed the lion's share of its picture-archiving system, looking to add a voice-recognition component for physician dictation in the final stage.

2. Keep the salesmanship at bay

Catholic Healthcare West has a considerable stake in IT these days. The San Francisco-based health system is investing more than $600 million over the next seven years in its "CareConnect" initiative. The program hinges on a combined EMR system and computerized physician order entry application. Moreover, CHW is looking to standardize its clinical processes and treatment approach across all of its 41 hospitals. Because CHW's empire spans California, Nevada and Arizona, it must lean heavily on its vendor partners to make the deployment as smooth as possible. Thirteen of its hospitals will be deploying a new suite of integrated applications from Cerner, while the remaining hospitals will be upgrading their existing information systems from Meditech.

"CareConnect is all about improving quality and service," says Dan Ferguson, MD, vice president of medical operations. "We are using the technology to support that." The fact that two major vendors are involved makes collaboration even more critical to the massive project, says Benjamin R. Williams, chief information officer. Overseeing the project is a 10-member executive accountability group, which includes CHW executive staff plus representatives from Cerner, Meditech, and Perot, CHW's outsourcing partner for IT staff. The executive group oversees a number of regional implementation teams that span some 150 staff, vendor representatives among them.

Order-set creation is driven by a physician advisory group, which includes a CHW physician informaticist and a full-time physician executive from Cerner to spearhead the order-set design effort. "We also have nurses and pharmacists from Cerner helping us," Ferguson says. Meditech staff are in the mix, as well; the hospitals using its software will be adopting the same order sets. "It is a huge challenge bringing together vendors that may not normally work together," Williams says.