Imagine that you want a boat. You tell someone to build or buy you a boat, and tell them to send you a bill. What would you get? A kayak? A windsurfer? A boat for waterskiing? A sailboat. A party boat? A cruise ship? A submarine? A battleship or destroyer? You probably would not get what you want. Very likely you would end up with something expensive - that you cannot use.
Before you build or buy a boat, you need a defined goal and a process:
The same applies in medicine. If you are the leaders of a medical institution and want an electronic health record, you cannot simply pay someone to write it or buy it. You need to start by asking the users to define what it is do and how it is to do it.