Hey Reader,

When Profits Trump Patients: A Healthcare Integration Expert's Warning After Three Decades in the Field

The Erosion of Healthcare's Mission

In my three decades as a healthcare systems integrator, I've witnessed a disturbing transformation in how corporate America approaches healthcare. What began as a mission-driven industry focused on providing solutions that improve patient care has increasingly become a profit-driven machine that prioritizes investor returns over clinical outcomes.

The Modern Integration Crisis: When Solution Providers Become the Problem

The Profit-Over-Problem Paradigm

Today's healthcare integration landscape mirrors the destructive patterns that brought down a major health system in New England. Vendors increasingly approach hospitals with predetermined solutions designed to maximize their revenue rather than solve actual clinical workflow problems.

The fundamental shift I've observed is troubling:

💰 Revenue-Driven Implementation: Vendors arrive with predetermined technology stacks. They ask "How do we sell our platform?" instead of "What does this hospital actually need?"

📊 Contract Metrics Over Patient Outcomes: Vendors measure success by implementation timelines and user adoption rates, not improvements in patient care or operational efficiency.

⏰ Short-Term Profit Focus: Integration firms optimize for contract renewals rather than sustainable long-term operations.

💼 Sophisticated Financial Engineering: Technology leasing exemplifies how vendors use complex financial structures to increase profits, maintain control, and reduce hospital flexibility.

Watch for these red flags when evaluating integration partnerships:

📈 Scope Creep Without Value Assessment: Projects that continuously expand beyond original requirements mirror the acquisition-heavy growth strategies that have bankrupted multiple health systems. Each additional module generates vendor revenue while straining hospital budgets and staff capacity.

🚀 Implementation Over Optimization: Vendors focused on rapid deployment to secure payment milestones sacrifice proper workflow analysis—prioritizing financial extraction over operational investment.

🏦 Financing-Driven Decision Making: Vendors promote leasing because it accelerates revenue recognition, creates recurring revenue streams, and locks hospitals into longer relationships. Hospitals accept these arrangements without recognizing the devastating long-term financial burden.

🎯 Predatory Sales Tactics: Vendors employ aggressive techniques to secure bookings, often demanding Letters of Intent before hospitals are ready to purchase. This benefits solution providers while leaving hospitals vulnerable to suboptimal decisions.

🛡️ Protect Your Organization by Asking Yourself These 5 Essential Questions

1. Do I Really Understand What Problem I'm Solving?

• Have I conducted a thorough workflow assessment with my clinical teams before talking to any vendors?
• Can I articulate the specific clinical problem in one sentence?
• Do I have baseline metrics to measure improvement against?
• Am I looking for a solution to a real problem, or am I being sold a problem to fit their solution?

🚩 Red Flag: If the vendor is defining your problems for you

2. Am I Financially Protected or Walking Into a Trap?

• What is the TRUE total cost over 5-10 years, including all hidden fees and escalations?
• Can I exit this contract without devastating financial penalties?
• Will I own my data and workflows if I need to leave?
• Am I being pressured into leasing because it "looks cheaper" upfront?

🚩 Red Flag: Complex financial arrangements you don't fully understand

3. Will This Vendor Actually Be Held Accountable for Results?

• Are success metrics tied to patient outcomes and operational improvements, or just software deployment?
• What specific consequences does the vendor face if they fail to deliver promised results?
• Will they invest their own resources in change management and staff training?
• Who controls the project scope—me or them?

🚩 Red Flag: Payment milestones based on installation, not performance

4. Do They Really Understand Healthcare, or Are They Just Good at Sales?

• Have they successfully implemented similar solutions in hospitals like mine?
• Can they speak intelligently about my specific clinical workflows without reading from a script?
• Are their references from comparable healthcare environments, not cherry-picked success stories?
• Is healthcare their primary business, or are they trying to expand from other industries?

🚩 Red Flag: "We work with all industries" or generic business-speak instead of healthcare expertise

5. Am I Being Manipulated by High-Pressure Sales Tactics?

• Are they creating artificial urgency to force a quick decision?
• Do they refuse to provide the specific references I request?
• Are my clinical teams expressing concerns about workflow disruption that I'm ignoring?
• Do their promises sound too good to be true compared to industry norms?

🚩 Red Flag: Any pressure to sign before you're fully confident in your decision

🎯 The Ultimate Test

Can you confidently answer "YES" to this question?

"Will this decision truly improve patient care while protecting my organization's long-term financial and operational independence?"

If you can't answer that with absolute certainty, don't sign anything.

💡 Remember

Your mission is patient care. Your vendor's mission is profit.

These don't have to be mutually exclusive, but never assume they're automatically aligned.

What integration challenges is your organization facing? Share your experiences and questions—I respond to every email. bryan@whywherematters.com

Until next week,

Bryan Small ​Healthcare Technology Consulting ​​​