Experts in Hospital Information Systems and Services: Healthcare Management Systems, Inc.

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	Let Us Help Would you like more information about a specific HMS Solution or Service? Request more information... Ready to take the next step? Our eRFP will help make the decision process easier. Submit an eRFP...

eRFP
Welcome to the first step in the HMS RFP process. Once you have submitted your eRFP, one of our associates will contact you to confirm your request and ensure that we provide you with information specific to your facility's needs.

Required fields in bold

First Name:

Last Name:

Title:

Facility:

Is your facility associated with a corporate?
Yes No
If yes, corporate name:

Address 1:

Address 2:

City:

State:

Region (If not in US):

Zip Code:

Phone:

Ext.

Fax:

E-mail:

Type of facility:

	Critical Access		Acute Care
	Psychiatric		Long Term Care
	Outpatient		Other

Number of beds:

	Under 50		151-200
	50-100		201-250
	101-150		251+

Who is your current hospital information system provider:

	HMS		CPSI
	Dairyland		Siemens
	Cerner		Keane
	McKesson		Meditech
	Quadramed		Ecilpsys
	Other

Name of current system(s):

What is your current operating system?:

Are you planning to replace your current hospital information system?

	within 6 months		2-3 years
	7-12 months		3+ years
	1-2 years		not considering a change

Have you viewed a Healthcare Management Systems, Inc. solution demonstration?

	No		within the last 6-12 months
	within the last 3 months		within the last 12+ months
	within the last 3-6 months

Please check the solutions you are interested in:

Financial Solutions
	Executive View	Fixed Assets	Admissions/Registrations
	Patient Accounting	Time and Attendance	Medical Necessity
	Accounts Payable	Materials Management	Health Information Management
	Payroll/Human Resources	Patient Scheduling	Contract Management
	General Ledger	Outreach Scheduling	Electronic Remittance & Billing
	DRG/APC Case Mix	Eligibility

Clinical Solutions
	Clinical View	HMS PACS	Electronic Medication Administration Record
	Patient Care Documentation	Order Communications	Surgery Management
	Transcription	Laboratory	Reference Laboratory
	Radiology	Pharmacy	Blood Administration
	Microbiology	Quality Improvement/Risk Management	Mammography

Enabling Technologies
	Scanning	eForms (Electronic Forms)	Wireless Technology
	Pen Tablets	Touch Screen Technology	Mobile Carts
	Bar Coding

Specialty Solutions
	Provider Based Clinics	Home Health	Long Term Acute Care
	Rehabilitation	Behavioral Health	eHealth/Desktop ASP (ASP hosting solutions)
	Long Term Care	Referral Tracking and Intake Management

Please describe, in detail, your facility’s initiatives as related to the solutions you checked above:

	Registered Services Login to your account:

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	Quotes “"We never thought of looking at anyone else but HMS," Brinkley says. "We knew that it would meet our needs and provide us with the integration that we wanted."” Terry Brinkley Paris Community Hospital



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