How to choose an HIS in 2026
Twelve questions to evaluate hospital systems without falling for empty demos or sales promises.
Replacing the information system of an IPS (instituciones prestadoras de salud, Colombia’s healthcare provider institutions) is a decision you make once every eight or ten years. It gets signed in three months and you live with it for the following decade. Yet most selection processes are settled by watching two or three sales demos and comparing price proposals in a spreadsheet.
The problem is not a lack of rigor. It is that demos are designed to answer easy questions. This is a list of the hard ones.
Before you watch a single demo
1. What problem are you solving?
It sounds obvious, and it is almost never written down. “We need a new system” is not a problem; it is a proposed solution. Problems look like this: “18% of our billing gets claim objections (glosas) and we do not know why,” or “we have seven systems and the team types the same data four times.” If you cannot name two or three problems with that precision, no demo will help you, because you will not know what to look at.
2. Who will actually use it?
Management buys the system, but the people who use it are the admissions assistants at 6 a.m., the doctors between one patient and the next, and the billing team closing the month. Any evaluation that does not include those three people is measuring what does not matter.
3. What happens if this goes wrong?
Be clear on the rollback plan before you sign. If the implementation fails six months in, can you go back? Do you have your data? In what format?
During the evaluation
4. Ask for a demo with your data, not the vendor’s.
This request alone separates serious vendors from the rest. Send twenty real, anonymized records and ask to see the workflow with them loaded: a contract with an EPS (entidades promotoras de salud, Colombia’s health insurers), your fee schedule, three typical clinical records. Generic demos are built on perfect cases that do not exist in your operation.
5. Have a real user complete a real task.
Do not watch the salesperson run the system; they have been doing it for two years. Sit down with your admissions assistant and ask them to register an emergency department patient. Time it. Count the clicks. Watch where they stop to ask.
6. Ask about the ugliest workflow you have.
Every system handles the ideal case well. What sets a good one apart is how it handles the patient with no ID document, the invoice voided after it was filed, the transfer between sites in the middle of an inpatient stay, or the medication returned to the pharmacy. Bring your three worst cases to the demo.
7. What happens when the internet goes down?
In Colombia this is not hypothetical. Ask specifically which modules keep working offline, how they sync afterward, and what happens if two sites edit the same record while they are disconnected. If the answer is vague, assume it does not work.
8. Ask to see the objections module in detail.
For most IPS, cash flow is decided here. You want to see how an objection is recorded, how the response is tracked, which reports come out without anyone building them by hand, and whether the system tells you why you get objections in aggregate, not only case by case.
About the vendor, not the software
9. Talk to a customer who left.
Any vendor will give you three happy references. Ask for the name of an IPS that stopped using the system and call it. If the vendor refuses, you have already learned something. If it agrees, you will learn more on that call than in all the demos combined.
10. Who does the implementation?
The sales team and the implementation team often have nothing in common. Ask how many people they assign, whether they are in-house or subcontracted, how many projects they run in parallel and who your counterpart is when something fails at 11 p.m. on a Sunday.
11. How are regulatory updates handled?
In Colombian healthcare, regulations change every year. You need to know whether regulatory changes come as part of the service or are quoted as custom development. The difference between those two answers, projected over ten years, is often larger than the license price.
12. Ask for the contract before you decide.
Not the sales proposal: the contract. Look specifically for the data ownership clause, the SLA with real penalties, the termination conditions and what happens to your information if the vendor disappears. A good product with a bad contract is still a bad deal.
A note on price
The license cost is the visible part and is usually the smallest. The real cost includes implementation, historical data migration, your team’s hours during the transition, the productivity curve of the first months, integrations with what you already have, and the custom development that will come up.
When you compare vendors, compare that number over three years. Differences in monthly license fees tend to disappear next to an implementation that runs six months over.
What you are really buying
An HIS is not a product you install. It is a decade-long relationship with a company that will touch every process in your institution. The final question, after the twelve above, is simple: “Do I want to work with these people for the next ten years?”
If the answer is not a clear yes, the rest of the evaluation matters less than you think.
