Follow the Money

I've been involved in countless projects over the years involving millions of dollars and companies of all sizes in many verticals - as a vendor, as a buyer, and as a consultant. Rarely have I encountered a vendor, who truly knew how the client was evaluating the options. Sure, sometimes that is intentional. Probably more often, it's because he/she never asked. Customers too, are naive about how decisions work within their vendor's world. What can be negotiated? What is sacred? The result is often a contentious contract dialog that ends up with hurt feelings and bruised egos on both sides. Not a great way to enter into a relationship.
Let's make it even more real. Many client and vendor teams don't really know how or why decisions are made in their own organizations. Who seeks to benefit from the decision one way or another? Who takes on more responsibility? What politics and relationship dynamics are in play?
One more progression. If it's commonplace that neither the vendor nor client representatives really understand the decision-making process, they certainly aren't following the budget choices that created the opportunity in the first place.
Allow me to help - very succinctly. Follow the money. I know it's basic, but it's true. The entity reaping the benefit - will almost always (read should) pay the bill. Is there any mystery here? Is this some great and wise truth - of course not.
And yet... many Washington are ignoring this. Yes - I could go a hundred ways from here but I will restrain - and focus on just one.
President Obama plans to make electronic health records a priority in his first term. He plans to invest upward of $10B per year for 5 years. If it's anything like every other initiative out of Washington - that number is just the ante. More importantly who will get the money? How will the money flow thru the marketplace? It's like these so-called Stimulus bills Congress is passing. Has that money actually been used to impact individual taxpayers - or just pay bonuses and refill the coffers? (Sorry, I digress)
EMR/EHR - who is the beneficiary? Who is paying for it? To whom is the money going? Is there any tracking to show that the funding actually went where it was supposed to? How and when are the returns expected?
Don't get me wrong - I am a huge advocate for getting healthcare into the information age. But there are many questions, and I worry that those providing answers have an agenda. Privacy issues aside - the money trail here needs to be closely monitored or we'll have another Fannie and Freddie crisis.