Interview 1 Chief Technology Officer (CTO): The types of negotiations undertaken by a chief technology officer encompass discussion with vendors prior to implementing electronic health record systems within health care organizations. It is important to negotiate because there are numerous irregularities occurring within the electronic health record systems across the country and world. Physicians and nurses have to contend that they are experiencing incomplete or delayed patient information; receiving incorrect orders from physicians; undergoing difficulties tracking laboratory and radiology orders. There are also frequent errors recording patient vitals. Ultimately, these difficulties can be summarized as medication errors, misplaced lab results and delays in updating patient charts. Precisely, these critical incidences are surmounting being directly associated with incorrectly medicated patients. Further investigations show where vendor’s inappropriate implementation practices have influenced these in consistencies. Therefore, negotiating with vendors for the best possible software as well as soliciting their integrity to be honest in building systems that work is imperative. Technology analyst Quinn (2003) argues in his article ‘the role of information management in clinical transformation’ that five performance criteria are essential to successful management of electronic health record system. They encompass reliability; response time; accessibility; flexibility and security/privacy (Quinn, 2003).
Interview 1 Chief Technology Officer (CTO): Based on these dysfunctions within electronic health record systems as chief technology it is important to first negotiate with vendors. Really, since electronic health records technology is still in its creative stages even vendors cannot guarantee a favorable response time rate for users although when thoroughly researched before system implementation. The only solution advance for this issue is putting pressure on vendors through articulate negotiations prior to the implementation process to offer the best response time techniques in he programs.
Vendors often contract other information technology vendors to build access devices into the system. On many occasions these hardware constructions prove incompatible and create numerous problems within databases. As such, during the negotiations it is wise to gather all the vendors involved in building the software for the system and insist through contractual agreements improve their software quality to address inefficiencies contained in the system. Next, phase of negotiations is with vendor staff to train nursing staff about techniques used for accessing the system efficiently while vendors contract to conduct regular update. The of these purpose is improving electronic health care vendor image as efforts to establish effective systems are made.
Interview 1 Chief Technology Officer (CTO): Challenges Technology Officers face in negotiating with IT vendors are numerous. Significantly, many of them do not want to deliver honesty in their transactions. At the onset of this mandate that health care organizations implement electronic records in their organizations vendors many providers were exploited financially. As such, a major portion of the negotiations centered on providers receiving their money’s worth from them.
For example, in 2002, the initial startup costs were negotiated at approximately $50,000–70,000 per physician in a 3-physician practice. Subsequently, while costs have been greatly reduced due to more organizations adapting the system, still some vendors insist is charging providers a fortune. As such, during negotiations reviewing present market value of the commodity applying a 2011 survey approximate $32,000 cost per physician in a 5-physician practice for the first 60 days, it is hardly likely that a chief technology officer will settle for any price above that rate. Profound negotiation strategies are always necessary and still pose challenges because with five years electronic health record recovery cost should be as much as $86,000 (Quinn, 2003).
Interview 1 Chief Technology Officer (CTO):- Successful negotiations depend on the expert’s ability to arrive at a compromise that is beneficial to the vendor as well as my organization. Certainly, it encompasses applying all the negotiation techniques available in creating this ultimatum. The truth is that most experts do not take a negotiation class before beginning this process. Therefore, to a great extent success depends on the expert’s experience in conducting successful negotiation ventures. One element in this process that the expert has to always keep in mind is who is making the negotiations because the vendor could many times get away with the lead in the process and be the negotiator instead (Principles and Tactics of Negotiation, 2013). Interview 1 Chief Technology Officer (CTO):- In response to how do I select vendors for negotiations. It is a screening process. There is a registry of information technology vendors. As negotiators it is important to read about the credibility of vendors and design a profile of what is expected of them. A sample of vendors who have produced efficient electronic health record systems will be invited for negotiations. Another strategy in selecting probable vendors for negotiations invitations is by asking other health care organization to recommend credible vendors.
Interview 1 Chief Technology Officer (CTO):- What leads you to select one vendor above the other during negotiations. Certainly, when a vendors keeps saying yes to all my proposals I take that to mean that either he/she is not professional enough to make objections or is saying so to p[lease me but in the end will not deliver quality. My experience has taught me never to contract a vendor who agrees to everything the negotiator request. It indicates that he/she is prepared to deliver none of it and often it relationships ends up in litigation. Therefore, experience and instinct guides me into making decisions about vendors teaches.
Interview 2 Nursing Home Administrator: – My role enables me to negotiate with a number of professionals on a daily basis. Nursing homes are not acute care facilities. However, responsibility regarding efficient patient care and safety is just as essential as acute care facilities because health care law enforcement do make nursing homes liable for negligence or malpractice. Consequently, a strong administrative structure is mandatory. Modern nursing homes administration consists of an administrator, medical director and director of nursing. Their and responsibilities are distinct yet they collaborate in enduring efficiency within the organization.
A nursing home administrator‘s role encompasses supervision of staff, planning activities and programs for the organization; developing strategies for performance improvement, monitoring progress and disturbances as well as maintaining adequate care standards in every department in the organization. In order to function effectively there must be astute leadership skills; open communication and a very businesslike approach towards management of the facility. Importantly, this position is very demanding. As such, some administrators across the country ere targeted for poor management skills. Due to the high turnover in nursing homes it is very important that administrators keep abreast with changing and current trends in the nursing home business (Townshend, Davis, & Haacker, 2003). Hence, the need for frequent negotiation is essential.
Interview 2 Nursing Home Administrator: – The people with whom I negotiate include the Director of Nursing and the Nursing Home Medical Director. In the organization the medical director role is leader and manger, but in a different capacity from the nursing home administrator. According to Medicare regulations a physician serves as medical director in skills nursing facilities. He/she is responsible for all medical care executed within the facility. Passage of the Nursing Home Reform Act of 1987, AMDA subsequently in 1991 approved roles and responsibilities for nursing home medical directors (Townsend et.al, 2003).
As such, in my capacity of Nursing Home Administrator with duties of nursing home administrator supervising staff, planning activities and programs; developing strategies for performance improvement, monitoring progress and disturbances as well as maintaining adequate care standards in every department in the organization. In order to function effectively there must be astute leadership skills; open communication and a very businesslike approach towards management of the facility through constant negotiation with others in the management level. Importantly, my position is very demanding. Consequently, some administrators across the country are targeted for poor management skills. Due to the high turnover in nursing homes it is very important that administrators keep abreast with changing and current trends in the nursing home business. Therefore, executing excellent negotiating skill is imperative.
Interview 2 Nursing Home Administrator: In my negotiations from time to challenges surface, but none which we as management cannot resolve in the interest of our patient population. For example, while we function together our roles are distinct, but important together form the organization’s success. One of the challenges is learning to disagree to agree which is a useful management negotiation strategy. The medical director who is a qualified physician has four unique functions as leader/manager within the organization. They relate significantly to professional education and clinical practice efficiency.
Alternatively, nursing home administrators’ role requires management of the entire organization’s physical structure as it relates to budget and financial stability. Subsequently, nursing director is concerned with quality of patient care from the evidence based nursing perspective. As we sit down to plan activities/care for patient based on our uniqueness often we disagree in making the best decisions, but ultimately each one has to consider his/her role on the team and calm down.
Interview 2 Nursing Home Administrator: On my team successful negotiations is determined when each member of the team respects the others professional discipline and t no one time should the medical officer try to make decisions for the hospital administrator without prior consultation and negotiation. The same is true for the nursing director and vise-versa. It is learning to co-exist with the understanding that we need each other for the organization to survive.
Interview 2 Nursing Home Administrator:- What motivates you during negotiation with other management to arrive at a consensus. In my organization quality of care is paramount to the business. While it is not an acute care facility when it comes to maintaining high quality patient intervention I will sit and the negotiation table all day until the correct decisions are made.
Interview 2 Nursing Home Administrator: – Is there any development during the negotiation that would make you recede from the negotiation table/forum. As it is now there is nothing that would cause me to walk out on negotiations with my team for the patients in my facility. However, my standard of negotiations is that it ought to be respectful and peaceful. If persons are going to become violent then it is time to escape.
- Principles and Tactics of Negotiation (2013). Additional Article Information. Journal of Oncology Practice. 2(3); 102-105
- Quinn, J. The role of information management in clinical transformation. Health Technology: Special Technology Overview, 1, 2003; 203-207 Print
- Townshend, J. Davis, W., & Haacker, R. (2003). Principles of health care administration. Publicare.