EHR Vendor Selection Process

Affordable EHRs for Priority Primary Care Providers

The Office of the National Coordinator for Health Information (ONC) requires every Regional Extension Center (REC) to negotiate discounted group rates for priority primary care providers (PPCPs) on at least two electronic health records (EHR). CIT designed and implemented a process designed to vet the more than 200 ambulatory EHR solutions currently available in the USA. At the end of this process, CIT recommended a small number of vendors as Virginia Health IT (VHIT)’s “Solution Partners."

The vendor selection process began in February 2010 and consisted of five stages:

Stage 1: Preliminary Vendor Screening Process

Stage 2: In-Depth Vendor Screening Process

Stage 3: Short List Development

Stage 4: RFQ, Demonstration, and Vendor Selection

Stage 5: Negotiations and Agreement Executions




Stage 1: Preliminary Vendor Screening Process

Stage 1 criteria vetted functionality by requiring that EHRs have Certification Commission Healthcare Information Technology (CCHIT) ambulatory certification. Of the 200-plus EHR solutions researched by CIT, only the 77 vendors with products meeting this criterion were allowed to continue to Stage 2 of the process.

Stage 2: In-Depth Vendor Screening

Stage 2 criteria were based on the Meaningful Use (MU) Interim Final Rule, which contained specifications that go beyond those addressed by basic CCHIT certification types. CIT determined that Virginia PPCPs are best served by EHRs that held at least one of the following CCHIT ambulatory certifications:

  • Fully CCHIT 2008
  • Preliminary ARRA
  • Pre-market 2011 CCHIT

CIT determined these more recent certification levels represented vendor commitments to achieving the requirements of the MU Final Rule, which had not yet been released. At the time of evaluation, there were 65 vendors with products meeting Stage 2 criteria.

Stage 3: Short List Development

VHIT has led the way among RECs by pursuing only Application Service Provider (ASP) or Software as a Service (SaaS) solutions. This approach was based on CIT’s recommendation that ASP and SaaS EHRs have lower hardware and maintenance costs for providers and shorter implementation times. The 65 remaining vendors were contacted by phone or e-mail to determine if they met all of the following criteria:

  • SaaS or ASP solution
  • Solution maturity of three or more years
  • At least 300 physicians using the system at a minimum level of e-prescribing
  • An integrated and internally developed practice management system
  • A patient portal system

At the time of evaluation, nine EHR vendors offered products meeting Stage 3 criteria.

Stage 4: Request for Quote (RFQ), Demonstrations, and Vendor Selection

In March 2010, the nine EHR vendors with products meeting Stage 1, Stage 2, and Stage 3 screening criteria were sent an RFQ consisting of 12 sections, including: functionality; privacy and security; meaningful use; implementation, support, and service; technology, standards, and integration; and pricing. These vendors were required to submit a letter of intent to respond to the RFQ and to respond by April 2010.

CIT technical experts evaluated the RFQs using the Acquisition Center of Excellence (ACE) model, in which each expert graded all of the responses to section(s) that corresponded to his expertise. This process ensured the same evaluation standards would be applied across all RFQ submissions.

RFQ scores were aggregated and weighted based on a scoring algorithm to determine which vendors would be invited to demonstrate their products to VHIT and the VHIT Physician Advisory Committee (PAC). The PAC consisted of PPCPs from across the state. It was established by VHIT to provide:

  • Expertise on usability issues with a focus on PCP clinical encounters
  • Insight into the limited adoption of electronic health records by PCPs as well as their practice requirements
  • Personal experiences using/evaluating EHR products
  • Recommendations for necessary functionalities of the various products
  • Recommendations for questions to include in the RFQ
  • Comments about the products under consideration

Based on the results of the RFQ, six vendors were invited to conduct product demonstrations for VHIT and the PAC. Demonstrations were conducted online and were captured for later viewing. After the demonstrations concluded and feedback was collected, CIT performed due diligence on each vendor, which included:

  • Interviews of 10 references (submitted in the RFQ)
  • Corporate financial analysis
  • A two-hour conference call to review the vendor’s implementation process and timeline

At the end of Stage 4, four vendors were invited to enter into contract negotiations.

Stage 5: Negotiations and Agreement Executions

Four vendors entered into individual face-to-face meetings and contract negotiations with VHIT beginning in June 2010. During negotiations, vendors were presented with a clear description of VHIT’s operating requirements, goals, and the need for both significant PPCP discounts and all-inclusive pricing that incorporates “extras,” including training and technical support. 

VHIT’s vendor selection process is closed and we are expecting to offer EHR solutions from three or four solution partners once final agreements are executed.


As part of VHIT's Vendor Selection Disclosure, CIT will accept any questions related to our selection process. Questions were accepted until December 31, 2010. All questions and their answers will be posted on this web forum. Questions and their responses will be posted on the VHIT Selection Disclosure page by January 31, 2011. Questions and their responses will be available until February 28, 2011