ElectronicHealthcare 3(3) January 2005 : 111-114

The HIT Report from KLAS: Professional Services 2004; Provider-Based Professional Clinical and Financial Implementation Services 2004


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/

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%
Figure 5: Financial implementation – why PSFs are typically selected
FCG Health-
ISH Lawson People-
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%
40% 60% 33% 50% 50% 43% 86% 67
0% 0% 17% 14% 0% 14% 14% 11%
by Software
20% 20% 0% 0% 0% 0% 0% 0%
20% 0% 17% 29% 7% 0% 0% 0%
Same Software
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.

About the Author(s)

About KLAS
KLAS, founded in 1996, is the only research and consulting firm specializing in monitoring and reporting the performance of healthcare information technology (HIT) vendors and products. Our senior management staff and advisory board average 25 years of healthcare information technology experience.

KLAS, in concert with thousands of Healthcare Executives, CIO's, Directors, Managers and Clinicians has created a dynamic database of information about the performance of HIT vendors. The KLAS database represents the opinions of healthcare executives, managers and clinicians from over 4,500 healthcare facilities and more than 500 different products. The information is continually refreshed with new performance evaluations and interviews daily. The KLAS database is dynamically and effectively used by:
  • healthcare organizations to align expectations with a vendor's actual performance, assist in strategic planning and contract negotiations and to validate decision processes;
  • vendors to monitor their performance in comparison with competitors;
  • consultants for current performance information on a specific company or product;
  • healthcare investment firms to evaluate publicly traded HIT company performance and trends or the competition for a new entrant.


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