When Cindy Miller, office manager for Lynn Eye Medical Group in Thousand Oaks, Calif., had to pick a practice management system, she did what most small medical practices do. She invited the two vendors she most respected to visit the practice. Then, she visited a few other practices that were using the vendors' systems. In the end, she chose Prime Clinical Systems because she liked the company's orientation to customer service.

It's not unusual for medical practices to make momentous technology decisions based on product demonstrations by just one or two companies. But as the software market grows — and mergers and new players add to the countless companies eager to win physician dollars — picking the right software gets more complicated. That's why a small but growing number of physicians are turning to a more sophisticated selection tool used widely in other industries: the request for proposal or RFP. In the RFP process, the practice sends a detailed list of what it requires to vendors who are asked to respond with their solutions and prices.

This somewhat formal approach has supporters and detractors, but all agree that to make an RFP — or any other selection process — work well, customers must first clearly define what they need. A productive selection process aims to fulfill the practice's needs, not just find a generically good product.

"It's not typical of a physician office to use an RFP process," says Simon Lee, vice president of marketing for Prime Clinical Systems. "It is a disadvantage if they don't use [an RFP], but it's also a disadvantage if they use ... the wrong one."

The RFP advantage

Hardy North, senior marketing manager in healthcare for Dell and a former hospital administrator, is a strong advocate for the RFP process.

"People who avoid the RFP process are people who either don't know about it ... or they are afraid they don't have the expertise to put one together. ... [RFPs] help you get better solutions at better prices. If nothing else, it empowers you as a consumer. You always want to have your vendors in a competitive situation," he explains.

Indeed, a well-written RFP can make it easier for you to compare vendors on your terms. That's a lot easier than trying to compare vendors based on each company's marketing materials. "Ninety percent of vendors don't want RFPs because they introduce competition," North says.

He suggests pushing the contest further: once you narrow the field to two or three vendors, invite dealers to your practice to present their solutions in front of each other. "You'll find out real quick who wants to work with you and who doesn't," he says.

Getting to the RFP

Don't know where to start? Grabbing a generic RFP online and customizing to your needs it is a good way to start sorting through vendors, North says. Search the Web for "RFP" and you'll find many suggested outlines.

Or consider hiring a consultant to help you write an RFP and make your final selection. North estimates it can cost $2,000 to $3,000 for these services, but that cost will seem negligible compared to an investment of $50,000 or more in software.

When he helped Texas Sport Medicine and Orthopedic Group in Houston select an EMR, consultant Bill Hayes encouraged the physicians to use an RFP instead of taking the less formal route that the group was used to.

"They hadn't been through a review like this. It was more like, 'I heard someone is doing well with a certain vendor ... and we ought to get them.' That's how they had made decisions on previous vendors," Hayes says. He insists that the real issue isn't whether to use an RFP, it's putting in the work ahead of time to identify the deficiencies in your practice that you want to the new software resolve.

"In going through this drill, you have to understand where your deficiencies are and what you are trying to do. And that has to be reflected in what you are asking these vendors," Hayes says.