KLAS: Specialist consultants best vendors at IT implementation
 |
Healthcare providers reported contracting out implementation work to 30 companies, from smaller boutique firms to the software vendors themselves, according to the report, titled "Clinical Implementation Services: High in Demand But More Specialized in Need." Every vendor except for Epic was outperformed by third party specialists, the Orem, Utah, market researcher reported.
“There are pieces to the build that only the vendor can do,” Lorin Bird, KLAS’ strategic operations manager, said in an interview. “You have to use the vendor for at least a portion of the build, but when you get beyond the technical nature and into … services such as [return on investment], benefits analysis, defining pre- and post-go-live metrics and goals, process redesign—those types of add-on services are the consultant firms’ bread and butter.”
Most firms now typically specialize in work for only one or two software vendors because of the growing need for vendor-specific know-how. “There are so many requests for implementation of new modules, for physician documentation or for computerized physician order entry systems. There are RFPs [requests for proposals] out there for a burgeoning number of hospitals under 300 beds. Our research last year around clinical information systems/EMRs showed that under 300 beds is where all the activity is.
“Even though it’s a lower cost per install, there are a lot of installs,” Bird said.
“There are more projects, and they’re smaller, more specialized in need: ICD-10, accountable care organizations, health information exchanges, business intelligence … [and] there’s a lot of providers who need assistance.” But unlike several years ago, “they don’t want you to come in and run the whole show, then take with you all that knowledge. They want you to come in and augment the knowledge they have already gained over the last few years in working with these EMRs,” he explained.
The report categorizes vendors/firms by role filled for providers—either principal or supportive. In the first category, Deloitte earned the highest score among third-party firms, at 88.8 out of 100 points, while Epic took first among vendor-only implementations, at 92.3. In a supportive capacity, IHS was the highest rated third-party firm (96.5) and Siemens Healthcare was the top vendor (78.7). The report also rates 13 other firms/vendors.
“Our history and trends show consultants outperform vendors, and it’s a much bigger gap now than in the past. When we query our database across all services and all products over the last five years, the gap has widened significantly,” Bird said. “Consultants are getting higher performance scores ... while technology companies’ scores are getting lower.”
IT vendor market consolidation has not led to a commensurate decrease in consultant firms, according to Bird. "We conducted a study in 2009 [around] almost all of our data on consulting services. It was fascinating to see that we were exiting a period in 2008-2009 when there was lots of consolidation: Systems integrators buying consulting firms, consulting firms buying other consulting firms. But instead of resulting in fewer consulting firms, it resulted in more, because when a systems integrator buys a consultant, all you’re buying is intellectual capital. Then the intellectual capital departs and starts its own consulting firm,” he explained.
“Instead of consolidation of intellectual capital among a few firms, you have smaller firms focused around one or two specific vendors.”
The upshot for clinical IT leaders? “It might not be a bad idea for providers to at least [conduct a request for proposal] with a consulting firm and compare it against vendor’s services or pricing to know all of your options,” Bird said.