"Developing in house solutions vs. 3rd party?"
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"Developing in house solutions vs. 3rd party?"

By Robert D. Budman, MD MBA CDI-P, CMIO, Piedmont Healthcare

Robert D. Budman, MD MBA CDI-P, CMIO, Piedmont Healthcare

All too often leaders in various roles want to implement new software programs for a wide range of uses. This could be anywhere from new clinical workflows all the way up to complex reporting and analytics solutions. The question often comes up do we already have this capability or can we build it? Alternatively, vendors present their wares or an executive or manager may have seen something at a tradeshow that might solve the problem. Then the challenge becomes whether or not we have the time, budget, people and resources to create something worthwhile ourselves or to partner with the outside entity/vendor to do the implementation.

It should come as no surprise in the field of healthcare IT that the complexities and variables are many and may include culture, leadership, risk appetite, and return on investment not to mention talent pool within an organization. I generally see the risk conundrum as a top concern. Either leadership is not willing to take a chance or crippled by fear related to cybersecurity particularly in today's IT landscape where the threats are global and can be costly. Review the opportunity and weigh the risk, then make a decision. A second limitation to execution is the ability to prioritize projects. I believe good leadership and governance can elevate the needs of the right projects to complete them. Finally, depending on the people and talent available the choice must be made whether to do it “in-house" or use the outside solution figuring what will get you there in a reasonable timeframe, a good cost: benefit ratio, and the quality of result desired.

"Regardless of source, a new technology from within or from outside when deemed successful can have many positive returns on an organization besides just its intended purpose"

Of course, when it comes to outside solutions we must do our due diligence. That includes many checkboxes, for example, kicking the tires with a good demo, talking to outside customers and their experiences, looking over industry reviews and technical reports, and careful review of contracts from both a financial and legal perspective. It's known to many of us that vaporware, overpromising and under delivering, and failure to meet objectives can and does happen. Once the right stakeholders complete the review and the approval process ensues with a big thumbs up then the next stage begins. That is the build out of the project timeline and the project team members to carry out the work.

When milestones are met and testing is successful then it's time for the rubber to meet the road. The rollout of the end result. Depending on another set of factors like the criticality of the need, risk to the business or customers, and effects on other systems the final product, whether developed in-house or from an outside vendor, the solution can be deployed in a controlled or piloted or sequestered fashion versus enterprise wide. Everyone has expectations but it's wise to have some sort of measurement or surveillance of the new and shiny tool. And don't forget the ever present need for mitigation strategies, support, backup, and the ability to occasionally fully back out a new IT product if need be.

Regardless of source, a new technology from within or from outside when deemed successful can have many positive returns on an organization besides just its intended purpose. From within it may develop new talents and skills for your teams, and from outside vendors it may develop new partnerships and trust and opportunities for your organization to grow and succeed. As echoed by some leading healthcare CEOs at a recent conference, "be willing to take well vetted risks or risk stifling your progress." 

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