I have found that the greatest hurdle to overcome when promoting process improvement at hospitals is apathy. Many under-performing ePayables programs remain entrenched at hospitals, even when they cannot achieve above 10% enrollment of the institution's spend.
Why do hospitals put up with such poor results? In my opinion, many view ePayables as an implementation to remove from their task list--and once it has been removed, the success of the program isn't sufficiently examined.
Unfortunately, this apathy results in a loss of incremental revenue and process efficiency. If you have an ePayables program that is achieving less than 30% enrollment of spend, it is time to examine alternatives.