This first study of professional services, focusing on provider-based acute care clinical and financial implementations, is KLAS's inaugural event and launch into performance monitoring of healthcare professional services.

Automation in healthcare is viewed as an integral component to many provider quality and safety initiatives. In addition, many clinical and financial systems are either being upgraded or replaced with the latest technology has to offer. Today, given the importance and complexity of and emphasis placed on workflow, third-party resources are often sought to lead or play a principal role in such projects, which is the focus of this study.

Professional services are broken down into eight market segments: implementation (principal, implementation); supportive; planning and assessment; vendor selection; technical consulting; full or CIO IT outsourcing; department outsourcing; staff augmentation. This study focuses on the "I"Implementation – Principal" and those Professional Services Firms (PSFs) that played a principal role in either clinical or financial system implementations within the last 24 months.

To qualify, a project must either be a one-time project completed in the last 24 months or an ongoing project that has completed a measurable portion (major module live) of an implementation project. This segment includes projects in which the PSF played a pivotal role in or led the implementation efforts for one or more major applications. This segment also includes net new implementations and major upgrades (e.g., upgrade from version 7.x to 8.x). A pivotal role is defined as supplying key resources that provide intellectual capital critical to the success of the project. A lead role is defined as responsibility for the overall success of the project (which may include project management and other key resources). To be included in this segment, the PSF will have completed a major measurable portion of the implementation project.

Six clinical PSFs (Capgemini, Cerner, CTG, Eclipsys, First Consulting, Healthlink) and eight financial PSFs (Capgemini, First Consulting Group, Healthlink, ISH, Lawson, PeopleSoft, Rapidigm, Superior) qualified for this study. Performance measurements of the KLAS 13 professional service indicators, special questions, client win/loss and pricing provide the basis of the provider experience. Vendor/firm overviews with information regarding professional services delivery history, move forward strategy, market perception/competition/trend, partnering strategy and executive commentary round out the vendor/firm view. Metrics involve comparing one to another clinically or financially and to the overall average of all professional services implementation vendors/firms/
organizations.

Putting Client Comments Into Perspective

In support of this effort, a new KLAS Professional Services Evaluation was designed with the assistance of and representation from professional services firms, software vendors offering professional services and KLAS's own advisory board. The evaluation uses 13 criteria to rate the overall performance of the professional services delivered. The first 12 criteria were rated using a scale of 1–9 (1=poor; 9=excellent) and the thirteenth criterion was a yes/no question with its score reported as the percent yes responses.

Performance Indicator Evaluation Criteria

1. worth the effort (criteria 1–12 given ratings of 1–9)
   
2. lived up to expectations
   
3. achieved objectives
   
4. Would you buy the services again?
   
5. SLA process, terms and conditions
   
6. services delivered per contract
   
7. overall satisfaction rating
   
8. met contracted time frame
   
9. professional, well-trained staff
   
10. proactive staff
    
11. impact on your personal job performance
    
12. would you recommend the services to a friend/peer?
    
13. ranked client's best/one of best consultant experiences (answer is a "yes" or "no"; score reported is the percent "yes" responses)

Overall, KLAS interviewed 159 survey participants. A minimum of six unique clinical information system (CIS) implementation projects or six unique financial implementation projects were required per PSF (see Figures 1 and 2). Note: KLAS originally targeted a minimum of 10, but the survey data did not support that level of qualifying activity.

Study Summary

Healthlink leads a rather strong field of clinical implementation vendors with a score of 90.8, followed by CTG, First Consulting Group, Cerner and Capgemini with scores in the 80s. Rapidigm leads the financial implementation group with a score of 89.5, followed by two other firms, Healthlink and Superior, scoring in the 80s (see Figure 3).

Performance Measurements

Today, the PSFs for clinical implementations outscore the PSFs for financial implementations, with a collective higher average score of 83.7 as compared to 72.5, an 11-point difference. Similar differences (higher clinical, lower financial) are also observed in the three firms that qualified for both categories: Capgemini, First Consulting Group, Healthlink. The difference in scoring, however, varies widely. Healthlink's variance (clinical to financial) is 9.3; Capgemini's is 14.4; First Consulting Group's is 20.3.
When looking across all implementations measured, clinical and financial:

• highest overall score: 90.8, Healthlink (clinical); range of scoring 65.9–90.8

Figure 3
PSF	Overall PSF Score	Avg of 12 Performance Indicators	% Yes Best/ One of Best Experiences	Percentage of Positive Comments
Clinical Implementation
Capgemini	81.6	7.3	88%	61%
Cerner	82.1	7.4	80%	50%
CTG	87.7	7.8	100%	71%
Eclipsys	68.4	6.2	63%	44%
First Consulting Group	86.2	7.7	94%	61%
Healthlink	90.8	8.1	100%	79%
Clinical Average	83.7	7.5	88%	61%
Financial Implementation
Capgemini	67.2	6.1	60%	56%
First Consulting Group	65.9	6.1	43%	60%
Healthlink	81.5	7.3	86%	77%
ISH	71.2	6.5	59%	45%
Lawson	72.5	6.6	63%	48%
PeopleSoft	70.5	6.5	50%	54%
Rapidigm	89.5	8.1	83%	74%
Superior	80.6	7.3	75%	54%
Financial Average	72.5	6.6	63%	56%
Overall Professional Services Average	79.7	7.2	76%	62%

Why Professional Services Vendors/Firms are Typically Selected or Not Selected

Analysis of client win/loss commentary provides insight into the selection process and the reasons why a PSF is or is not selected. The percentages reported are taken from the overall commentary and the supporting commentary under each vendor/firm section. The percentages may not add up to 100% because of multiple comments from the same respondent (see Figures 4 and 5).

• Collectively, skills (whether clinical expertise or financial knowledge/experience) are the top reason why PSFs are or are not selected for implementations.
  
• Individually, on the clinical side, the top three reasons for selection/non-selection are: (1) clinical expertise; (2) prior relationship; (3) same software company.
  
• Individually, on the financial side, the top three reasons for selection/non-selection are: (1) experience/knowledge; (2) cost; (3) prior relationship.
  
• Differences: same software company plays much more of a role in clinical versus financial PSF selection; cost plays much more of a role in financial versus clinical PSF selection.
  
• Individual PSF selection/non-selection reasons vary; delineations are highlighted in red in Figures 4 and 5.

Figure 4: Clinical implementation – why PSFs are typically selected
	Capgemini	Cerner	CTG	Eclipsys	FCG	Healthlink
Prior Relationship	25%	8%	43%	20%	58%	29%
Sales Presentation	13%	0%	0%	0%	8%	0%
Cost	13%	0%	14%	0%	25%	14%
Clinical Expertise	13%	17%	57%	0%	33%	57%
Methodology/Processes	38%	8%	14%	0%	0%	0%
Recommended by Software Vendor	25%	0%	0%	0%	0%	0%
Reputation/References	13%	8%	14%	0%	17%	14%
Same Software Company	0%	75%	0%	80%	0%	0%

0%

Figure 5: Financial implementation – why PSFs are typically selected
	Capge- mini	FCG	Health- link	ISH	Lawson	People- Soft	Rapi- digm	Super- ior
Prior Relationship	60%	60%	33%	14%	0%	0%	14%	33
Sales Presentation	20%	20%	17%	7%	14%	0%	14%	11%
Cost	40%	0%	33%	29%	14%	0%	57%	11%
Experience/ Knowledge	40%	60%	33%	50%	50%	43%	86%	67
Methodology/ Processes	0%	0%	17%	14%	0%	14%	14%	11%
Recommended by Software Vendor	20%	20%	0%	0%	0%	0%	0%	0%
Reputation/ References	20%	0%	17%	29%	7%	0%	0%	0%
Same Software Company	0%	0%	0%	0%	57%	57%	0%

Offer to Canadian Healthcare Facilities

Many Canadian Healthcare facilities and organizations use vendors who supply solutions unique to Canada. KLAS – the organization rating IT vendors in this and subsequent issues of ElectronicHealthcare – is willing to gather confidential and candid data from Canadian healthcare executives and provide access to the results to all the data contributors. The vehicle that will be used is the Web-based KLAS vendor evaluation form found at www.healthcomputing.com under "rate your vendor" button. If you have comments, suggestions or questions about this vendor-rating feature, please e-mail editors@longwoods.com.

Comments

Be the first to comment on this!