Pulling the Trigger

PACSman: In the 25+ years I’ve been doing PACS consulting almost every client who has gone through a detailed vendor assessment process and gotten ready to sign on the dotted line has questioned their decision. They usually have to be reassured that everything will be OK and it will work out. We’ve all been there, be it in PACS or getting married. You can date or even be engaged to someone for ages, think you know everything about them (and they you), yet still wonder “Am I making the right decision?“ “Is there something better out there?” Will they be around long?” “How much support will I get?” Those and other questions are the ones that haunt you before doing and after you say I do, be it to vendor or a mate. And despite your best intentions and due diligence most of the time you make a decision largely on what amounts to a leap of faith.

Pulling the trigger on a PACS decision is a lot easier than saying “I do”… First off, if a PACS doesn’t work out, the longest you’ll have to live with it is five years, maybe six before you can install a different PACS. Courtship with the new vendor can begin a lot sooner too. Sometimes you can even install a new PACS before the ROI period as well, although with PACS there is an inverse relationship between it and marriage. The shorter the time you are together with PACS the more it ends up costing you, unlike marriage where 15 years or more typically costs you big time…. With PACS you can also elect to re-up and get the newest model PACS from the same vendor without having to deal with the baggage that comes with changing horses in mid stream (in PACS case, data migration – in a marriage they are way too numerous to list from stepchildren to emotional issues and everything in between.) Staying with the same vendor is sorta like renewing your vows, acknowledging that you are comfy with the model you’ve broken in…or that has already broken you in…

On the surface marriage seems to have a better track record than PACS although in fairness they are probably pretty equal. Roughly one out of two marriages survive while only one in four end users pick the same PACS vendor again…Of course I’d venture to say that half the marriages that do survive probably can be considered marriages in name only, while the other half those who are looking to replace their existing PACS find their existing vendor is no longer in business (or at least not in the form they originally bought them). Sorta sounds like marriage as well come to think of it- an extra 10 pounds here, a few gray hairs there, and while newer, better, faster looks better, overall it’s not bad enough to change horses in mid-stream. Besides, you already know each other’s habits and idiosyncrasies so…

So why don’t people take the Nike approach and just do it? Fear of making a mistake is the main reason. Price usually isn’t an issue even with the economy the way it is. I’ve never seen a deal be lost based on price alone. Support is crucial yet few ask questions about this and almost always routinely sign service contracts without even asking what they are getting for it as well…

I find it funny yet somewhat sad that people will make 100K, 500K or even $1M+ decisions on their own. Most want outside input, but only as it relates to what we feel are the pros and cons of a particular vendor. The funny thing is my thoughts and anyone else's really don’t matter though- only those of person(s) who is/are making the decision matters and how comfortable they are with the vendor of choice do. The role any consultant plays is to insure that what the vendors say will indeed work and meet the client’s needs and protect them contractually if it doesn’t. Every vendor can do the job or at least will say they can do the job. What protects you is two things: asking the right questions up front to get you the right answers and having an ironclad contract with the right language on the back end. You’ll never get a bad reference – that’s like seeing a bad image at RSNA – it just doesn’t happen. Bad demos? Often. Bad references? Never…But references alone don’t tell the whole story. You can have great service coverage in Peoria and terrible coverage in Pittsburgh. You also need to assess your own internal resources from a support standpoint as well.

I had a call the other day discussing vendors that a group was looking at and talking about the pros and cons of each…One deal seemed too good to be true – but in this case it wasn’t. They really liked the vendor, but being a smaller vendor there were concerns about their market longevity. The deal they were offered was sweet – one-third that of the closest competition – a system de-installed from a site that had been in operation less than 6 months – and the vendor offered them an as new full warranty with software upgrades at no charge. My answer to them – pull the trigger,

I had a friend who is in PACS sales who summed it up best – “I’d rather lose to my competitor than lose to indecision…” So true…

There are 14 days left in December – although realistically 2, and maybe 6 if we really stretch things – and deals aplenty to be had…Don’t let indecision hold you back. Just pull the trigger…

Ms. PACS: OK Quickdraw McGraw.* Not to sound like you PACSman, but do you mean, “Pull my finger”? Because it sounds like you’re blowing a lot smoke out of somewhere. You know as well as the rest of the IT guys, even if they wanted to work on a Mac, they have to buy a PC. Similarly, even if they like a small vendors solution, more than 80 percent of the time they feel compelled to go with the larger PACS company. Why? Because no one got fired for buying GE.

They will go with what is safe. As sad as it sounds, five years is a long time to last at a company if the PACS you decided to purchase turns out to really…to be a lemon. So, usually the guy who makes the final decision is less concerned about getting the best PACS available than he is about covering his own arrears.

*Source: Quick Draw McGraw and all related characters © Hanna-Barbera Productions.