ONC to healthcare managers: Be prepared when negotiating EHR contracts

Negotiating contracts with electronic healthcare record vendors is no small feat, but according to new recommendations by the Office of the National Coordinator for Health Information Technology, it's better to go in prepared.

Standard form EHR contracts can be a bit tricky to negotiate, according to ONC. The terms are generally prepared by the vendor, which leaves the provider with little room to negotiate at all -- sometimes resulting in a "take it or leave it" situation, the federal agency said.

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The ONC released the guidelines to coincide with National Health IT week.

An organization's ability to negotiate any changes to the standard form contract depends on several factors. The size of the practice or organization, and how important it is to the EHR vendor, is important. The vendor's market share and the amount being spent on the acquisition factor in heavily as well.

ONC's advice is to ask an EHR vendor about its contracting policies early on in the process, before the business actually settles on a vendor. There's nothing wrong with signing a standard form contract, but any business doing so should understand the nature of the rights and obligations to which they're agreeing, the ONC said.

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If the EHR vendor is open to negotiating contract terms, an organization's negotiating leverage is likely to depend on a number of factors, the group said. The company's circumstances and available resources; standard and alternative contract terms; negotiating skill; and state law all factor into it.

Before negotiating terms of the EHR contract, ONC recommends that any group and its acquisition team should prepare a list of issues -- or even a negotiation matrix -- that documents each of its initial positions, and fallback positions, for each issue arising in the contract. And depending on resources and time, it may be best to conduct parallel negotiations with multiple vendors, rather than labeling one as the "vendor of choice."

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Legal advice is paramount, ONC said, but so is seeking input from a technical advisor. This could minimize problems during and after the EHR "go-live" period, and could help an organization anticipate its future needs, whether they be customizations or additional technology from other vendors that could complement the core system.

Technical advice can also help a business design options to ensure that patient information can be shifted to new technology if the current tech becomes outdated -- or if it's simply necessary to change vendors.

Twitter: @JELagasse