The trials and tribulations of a middle-aged PACS consultant,
father, and garage sale junkie as he engages in his
never-ending search for sanity in an insane world.

Monday, March 28, 2011

You Can't Fix Stupid

I was on a conference call the other day with a client who hired me to evaluate their marginally performing PACS and RIS and to look at options for replacement as well as options relating to a VNA. My first step before initiating vendor divorce proceedings is to always to see if this marriage can be saved, so I went to the vendor and asked if we could have someone come and look at the systems. The answer I got was:

“Support will complete an analysis of (the client’s) current stability issues to include looking at the database and a possible re-org if needed or required. We will provide a summary of findings on Tuesday's ...conference call with (the client). We will then prepare to send someone onsite relative to our findings. Resources are aware of the possibility of onsite time, but we first need to know and understand the issues at hand. “

Huh? Understand the issues at hand? What has my client been documenting for the past several years? What kind of ‘splainin’ do you need there, Lucy? Again keep in mind that the problems they have had have been documented out the ying yang and evaluated, masticated, desecrated, flatulated and every other “-ated” including probably masturbated to for months, if not years, so my response to the vendor was:

While I appreciate the efforts taken here I have a hard time understanding why it will take so long to schedule someone to come on site… (My client) have been documenting the problems….since day one and have been paying (a whole lotta money) per month in service for that privilege. Is it too much to ask to send someone on site NOW instead of waiting until your "resources" "know and understand the issues at hand" and delay this further with yet more calls and more discussions? Quite frankly if (you, the vendor) doesn't understand the issues at hand by now- after all the documentation provided by (my client) to (the vendor) over the past several years- talking about it further isn't going to do anything but delay this further. From my discussions with (my client) as well further delays and excuses are not what they want or need further nor is it what they are willing to accept.
I will be suggesting to my client that all further service payments be placed in escrow until the problems they have experienced have at the very least been addressed if not properly fixed by (the vendor). Paying (a whole lotta money) per month for service to experience the type of problems they have had is simple unacceptable. This has gone on for way too long and has been very well documented as well. I have at least two trees work of documentation here- I'm sure, or at least hope- you have the same there. I would respectfully request you have your service department provide copies of all the records and documentation that (my client) has provided (the vendor) over the past several years to the stated resources, have them review this, and then set up a time to make at least a two day on-site visit ASAP. Decisions need to be made by (my client) ASAP whether to stick with (the vendor) or look for a replacement source for their RIS, PACS, (and other clinical information systems). Merely talking about it will NOT get the job done. They need someone on site NOW.
Until such time as you can provide us with a time and date for someone to come on site and discuss this I feel that the calls (with executive management on the future of our relationship)….. to provide us with a summary of findings and ...to discuss product and business related issues will not be necessary. That said, I will defer this to my client to have the final say in this.”

Lo and behold late that same day we get notification that someone from the vendor’s service department would be out to my client's site within a week. When he did come out he found a number of issues that had could only be dealt at the vendor service level, not by the client’s IT department or PACS Systems Administrator. That was good. The changes to the system were made and the system performed better and was much more stable.

“Can you look at our RIS and other systems too?” we asked him. "I’m sorry, I only can address PACS.” Now I learned long ago to never shoot the messenger, having been the messenger way too many times myself, plus he was much too nice a guy and did fix the problems he came to fix so….we thanked him and went back to the well.

“We greatly appreciate.(your rep’s) visit last week and his ability to work closely with (my clients) staff to understand and improve the PACS performance. From what I understand (your rep) made some changes….that resulted in much improved system performance and stability. That is a great start. There still remain several issues that need to be addressed so we all look forward to reviewing a copy of (your rep's report) and the plan(s) of action that will be outlined as well as the associated timeline(s) to address these issues from (the vendors) support organization.
As (your rep) was only able to address the PACS, (you, the vendor) needs to set up a time to send someone else out to address the ongoing RIS and (other) issues as well. Optimally this can be one person but nominally two can come out as well, so let us know when this can be set up so we can have the right people from (my client) available.”

Their answer:

“On Friday, we can also discuss the need for additional support to address any RIS and (other) related issues and concerns. “

I love it. Let’s talk some more. So back I come again with this statement:

“One of the first priorities that needs to be addressed is getting someone on-site to (my client) to handle the RIS and (other) issues next as has already been done with (your rep) and the PACS. We will need a date and person(s) for that addressed ASAP.”

Their answer:

“We will discuss additional onsite needs tomorrow on our call.”

I love it again. Let’s talk some more…and more and more So back I come again with this more direct statement that left little room for interpretive error:

“It's fine to discuss this all tomorrow- just know there is an expectation on the part of (my client) that an on-site visit to address the RIS and (other) issues will be made. Just as with PACS, attempts to fix issues with these systems remotely to date have been unsuccessful so (my client) feels an on-site visit is dictated for these systems as well.”

I followed this up with yet another e-mail reiterating the same thing so there were absolutely no Cool Hand Luke moments. The vendor knew our expectations so….let's fast forward to the conference call. There were at least seven people from the vendor side on the call (that we knew of) including four stuffed suits pulling in six figure salaries, five from my client, and me. Lotsa lotsa bodies.

So we start out recapping what the rep did to fix the problems with the PACS. So far so good. Then we move on to the RIS. I ask “When can we have someone on site to review the RIS (and other) problems? “ No answer. I ask the same question again. No answer. A third time. Again, silence. By now I am waiting for the cock to crow like it did with Peter’s denial of Christ, yet the more I asked the more we were met with silence. Can someone- ANYONE- please tell me that you will have a warm body out here within the next 3 weeks? Silence. Madness. Now in Mark 14:67-72 it says the cock crowed each time after Peter’s denial but in Matthew, Luke, and John it said it crowed only after the third time. I would have been happy if it crowed after any time but the while there were a lot of vendor cocks on the call, not a single one dared crow at all. Finally the regional rep spoke up and said “We’ll get back to you by the end of the day with a decision.“ OK, that’s some progress, I thought. And low and behold, 25 minutes before the end of the work day, we get this very detailed e-mail:

We will send someone onsite to (the client site) before 4/15 and are targeting 4/11 and 4/12 specifically. We will be back in touch with further details.
Have a nice weekend!

THAT is what took seven people including four "management types" an entire day to get back to us on- that “someone” will be on-site? No wonder why this company is so "challenged" in the marketplace. They suffer from analysis paralysis with no one there making ANY decision let alone an executive decision. Without going into details this is a seven figure install and the customer has nearly paid as much again in service as they have for the system in the 5 years or so they have had it. That said is asking the vendor to spend $1,000, or even $2,000, to send “someone” out to assess a problem with one of the systems really too much to ask? Not in my book or in most companies books either but obviously it is in this companies book. Hell if this were a larGE-er company there would be 6 people on site- 4 watching the one person doing all the work and the other taking notes to insure that Sick Sigma is being followed properly.

Knowing that “someone” would be finally coming here’s what I wrote back:

We would prefer (the rep we know) to be (the vendors) on site person if/as possible given he has both a positive existing relationship with (my client) and knows many of the problems they have faced intimately, but in his absence "someone" else will do...I'm also sure (my clients administrator) will also make sure all the parties at (my client) are made aware of these tentative dates and will have them free up their schedules accordingly.
Have a great weekend!!

Do we really need to go through all this? No. Does the vendor really care about losing this account? No. Can the vendor afford to lose this high visibility account? No. Can you fix stupid? No.

To be continued…..

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