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AI Vendor Evaluation Guide for CAHs and FQHCs

Vendor Due Diligence

AI Vendor Evaluation Guide for CAHs and FQHCs

Most AI vendors build for large health systems first. When they pitch to rural facilities, they tend to use case studies that do not apply. This guide is the consolidated due-diligence framework for any AI purchase at a Critical Access Hospital or FQHC.

10
Questions every CAH or FQHC should ask before signing
5
Red flags that should disqualify a vendor from consideration
4
Steps to complete before scheduling a vendor demo

Before the First Demo

  • Document the workflow you intend to improve and the metric that will define success.
  • Confirm internal readiness using the AI Readiness Checklist.
  • Identify the EHR integration requirements your environment can actually support.
  • Set a budget ceiling and a funding source, including RHTP eligibility where applicable.

The 10 Questions

  • Has this product been deployed in a CAH or FQHC of comparable size?Ask for a reference customer at a facility under 50 beds, not an academic medical center case study.
  • What are the EHR integration requirements?Native integration, parallel workflow, or a hybrid? Confirm version compatibility and integration cost in writing.
  • What is the total cost of ownership for the first 24 months?Implementation, integration, training, support, and renewal pricing. The sticker price is rarely the total.
  • What does the contract say about data ownership and exit?Your patient data must remain yours, with a defined return format and a known retention window after termination.
  • What happens to our data and contract if you are acquired or shut down?Data portability and continuity provisions must be negotiated before signing, not after.
  • How was the model trained, and on what populations?Performance claims must be supported by data from settings comparable to yours, including patient demographics and volume.
  • What is the support model for facilities without a dedicated AI operations team?Rural support requirements differ from large-system support. Get specifics, not generalities.
  • How are model updates tested, deployed, and disclosed?You need to know how changes are validated, how you are notified, and what clinical oversight is required when the model shifts.
  • What training is included, and who delivers it?A sample training plan should be in the contract. Training must be designed for facilities without dedicated IT support.
  • What ongoing support is included, and what does it cost?Confirm support is in the base contract price and built for small-team environments.

Five Disqualifying Red Flags

  • No reference customers in facilities of comparable size or setting.
  • Refusal to sign a Business Associate Agreement before accessing PHI.
  • Performance claims without supporting documentation from comparable environments.
  • Vague or punitive termination terms, or unclear data return obligations.
  • Support models that assume a dedicated AI or data science team.