When healthcare organizations look to implement a provider lifecycle management (PLM) system, they face a critical decision: should they build a custom solution from scratch or invest in a specialized solution from a vendor?
A truly comprehensive PLM system—covering provider onboarding, credentialing workflows, contracting with fee schedules, claims activation, ongoing provider data management, and provider directory—is rare and invaluable. Managing these functions with separate systems is not only cumbersome but also creates inefficiencies. Each approach—build or buy—has its unique set of benefits and challenges. In this post, we’ll explore the nuances of both options to help you make an informed decision for your organization.
The Build Approach: Crafting a Custom PLM Solution
At first glance, building a custom PLM system on a platform that has a basic underlying data model for provider data can seem like the perfect solution. After all, who knows your organization’s needs better than you do? But before you jump onto the build bandwagon, consider these questions:
- Do you have a crystal-clear vision of what you want to achieve? A clear understanding of project goals is essential. Organizations must define what the custom build aims to accomplish and align these objectives with business and IT stakeholders’ expectations.
- Are the right technical resources available in-house or easily contractable? The technical expertise required for a custom build is substantial. Whether utilizing in-house talent or outsourcing to specialized firms, managing resources and project timelines becomes critical.
Let’s take a closer look at the vision aspect. Custom technology solutions are, by nature, self-contained, shaped by internal business and IT stakeholders. Even with consultants guiding business process optimization or technology blueprinting, the guidance remains limited to what the organization believes it needs. Conflicting user priorities and broader change management challenges can further complicate matters, potentially dooming the project before a single line of code is written.
From Ideation to Execution: The Challenges of Building
Once the initial planning is complete, the focus shifts to building the solution. Depending on your chosen platform, the level of effort required can vary significantly. You’ll need to decide whether to allocate your own resources—who may already be stretched thin across multiple projects—or hire an external firm for the build. Either option introduces risks.
Arguably, the biggest long-term risk isn’t delayed project rollouts, unfulfilled “nice-to-have” features, or cost overruns. Instead, it’s the fact that a custom-built system will only evolve based on internal needs, further entrenching the organization in a self-contained technology that’s dependent on internal IT or an outsourced development team for maintenance.
Here are some hidden challenges of building on a general technology platform that you’ll want to consider:
- Development Time and Complexity: Creating a comprehensive PLM system with robust integrations requires extensive custom development. The process can take months or even years to gather detailed requirements and educate the implementation team and/or in-house staff on the general use case, as well as the unique nuances of your organization.
- Specialized Expertise Requirements (and Gaps): Building from scratch requires developers who possess both platform-specific skills and healthcare industry expertise—particularly in provider lifecycle management use cases. Such expertise is rare and costly, and in most instances this may be the first time your team is tackling a PLM build, which adds to the complexity.
- Ongoing Maintenance Demands: Custom solutions need constant updates to stay current with changing regulations and industry shifts. Your team may lack experience in healthcare-specific use cases or understanding how future regulatory requirements could impact the overall design, limiting the solution’s scalability and long-term value.
The Buy Approach: Leveraging Purpose-Built SaaS Solutions
Just as custom-built technology can be ideal in some scenarios, purchasing purpose-built SaaS technology from a third-party vendor is often the better choice—especially when considering complexity and scalability. As both a system integrator for one of the top technology platforms and an ISV partner offering specific pre-built provider lifecycle management applications, Virsys12 has a unique perspective on the topic.
For most healthcare organizations, a specialized, ready-to-use solution like V12 Network offers compelling advantages:
- Experienced Implementation Team: Does the PLM vendor have experience deploying solutions that adhere to industry best practices? Can they create configurable processes for provider network management while understanding the nuances of your business?
- Comprehensive Functionality: Leading PLM systems offer a variety of workflows, including provider data management, credentialing, contract management, and more. Make sure the solution supports the processes your organization needs.
- Integration Capabilities: Seamless integration is critical. Pre-built interfaces and API accessibility should be prioritized when evaluating PLM applications.
- Analytics and Reporting: Does the solution provide specialized analytics and reporting for different user roles and workflows? A strong PLM system should offer healthcare-specific KPIs that support decision-making.
- Lower Total Cost of Ownership: While SaaS products come with ongoing subscription costs, their total cost of ownership is often lower compared to maintaining a custom-built solution over time.
- Scalability: SaaS products are designed to grow with your organization, taking development costs off the table and eliminating the need for major overhauls as your provider network expands.
Conclusion
In the world of Provider Lifecycle Management, the build vs. buy decision isn’t just about technology – it’s about strategic advantage. While building custom solutions can work in specific scenarios, for most healthcare organizations, the specialized capabilities, cost-effectiveness, and rapid implementation of solutions like V12 Network make them the smarter choice.
Remember, in today’s fast-paced healthcare environment, it’s not just about having a PLM system – it’s about having the right one that can evolve with your needs and keep you ahead of the curve.
To learn more about how Virsys12 can help your healthcare organization with enterprise provider data management efforts, please contact us today or watch a product demo.
