How to ensure your IT services provider delivers on promises

By Michael Uretz, contributing writer

March 12, 2009 -- Geeks, propeller heads, computer nerds ... "Saturday Night Live" had Nick Burns, the computer guy who went through life abusing and taking advantage of his clients, mainly because he could. And there have been countless parodies of the noncommunicative techies who hold the technical future of an organization in their hands.

While dentistry may not be one of the early adopters of digital technology, at some point every dental office needs to contract with an IT services provider to set up the network and computer hardware, install the software, and provide ongoing technical support and related services. Whether you use a single computer in the front office for scheduling and filing claims or you have workstations in every office and operatory, finding the right IT services provider and developing a good relationship is critical.

One of the first issues you should address is who will control the relationship -- you or your IT services provider? I will tell you that, with more than 30 years of IT experience (as both a provider and purchaser), I believe it is in your best interest to level the playing field when it comes to contracting with IT services providers.

That's why I want to share some tips on how to ensure that you are on equal ground with your IT services provider from the get-go. These tips come from years of negotiating with these firms and fielding questions from practice managers and providers attending my workshops and seminars.

How do I make sure my IT services provider lives up to commitments made?

This is why negotiating and structuring protective, all-inclusive contracts and agreements are so important. It's unfortunate that we need these instruments to hold our IT services providers accountable, but you need to be certain about their commitments.

Important areas to focus on are the level of service and commitment of service. These are typically spelled out in a service level agreement (SLA). This document should detail the "rules of the road" regarding how your IT services provider is going to take care of you.

Key components of an SLA are issue response and resolution. During the honeymoon period, when IT services providers are trying to sell you their services, sales people are quick to assure you of their great support. But can your IT services provider walk the walk as well as talk the talk? Sales people will commit to taking care of you, but unless there are real consequences for your services provider, you might not be the squeaky wheel you thought you'd be! Are they going to guarantee that they will to respond to your phone calls in one hour, or 24 hours? How long does it take them to actually show up? What are they going to do when they get there? How are they going to do it? What are they willing to guarantee?

You should get answers to these questions in writing.

But even some SLAs don't go far enough. If services providers say they are going to come in an hour and they don't, and they don't call you in an hour (or whatever time period is agreed to), there have to be financial penalties. Typically, these take the form of monthly credits. The actual dollar amount of the credit isn't necessarily as important as the fact that they are now held accountable for not living up to their commitments.

Finally, a day may come when you've had enough and you want to get out of the deal completely. IT services providers like to include a termination clause that outlines their rights. But what are your rights? Spell this out in the termination clause. If they don't come up with the goods or if they don't give you good service, they should be out. For example, if they don't perform their implementation for you per the project plan you agreed to, you should be able to part ways. If they consistently don't follow the SLA for support and it's affecting your practice, you should be able to say "enough" -- without penalty.

In addition, to prepare adequately for the possibility of moving on to a different services provider with the least amount of downtime, you need to ensure that all the work your provider does for you is documented in detail. They have to provide you with evidence of everything they've done and the processes they've put in place. This way, if you need to pull the plug and transition to another company, you don't have to reinvent the wheel.

How do I prepare for managing my own IT down the line?

I'm actually working with a practice right now that is large enough to have its own IT staff, and may one day have their own IT staff, but they want to start with an outside IT services provider first. So we're making sure from day one that whatever work that contractor does for that office is being documented. Whatever the architecture is; whatever processes they put in place; how they do backups; what the hardware, software, and network configurations look like -- these are all important moving forward. Because one day this office will want to transition to its own IT person and that individual will step in and say, "OK, how does this all work?"

If the person has the documentation regarding all the work the IT services provider has done, it's much, much easier to make the transition. In a case like this, you could also ask your present IT services provider to guarantee that they will help transition whoever is taking over that role for you. This could be spelled out in a transition services clause or -- my personal favorite -- the "let's play nice" clause.

The bottom line is, to get into a relationship with an IT services company without adequate control of the situation and proper protection can be a big mistake. The future of your practice rests in part on how well you integrate the growing flood of technology today. Your expertise is taking care of patients, not managing IT. Unfortunately, some IT services companies will try to take advantage of this.

The tips provided in this article are just a few of the tools you can use to fight back and gain control of your IT destiny.

Michael Uretz, president of EHR Group, is an authority on health IT selection and contract negotiation. The EHR Group helps providers, practice managers, and administrators select health IT vendors, structure and negotiate contracts, and ensure that projects meet budget and timeline requirements. He can be reached at

Copyright © 2009


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