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Clinical Optimization Services 2020 Clinical Optimization Services 2020
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Clinical Optimization Services 2020
Who Can Help Pull the Right Levers to Accelerate EMR Value?

author - Warren Whitford
Warren Whitford
May 26, 2020 | Read Time: 6  minutes

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Nearly all healthcare organizations today have implemented an EMR, but many clinicians express dissatisfaction with their system’s workflows and overall usability. This often stems from gaps in training and customization, which aren’t always prioritized during the initial implementation. Regardless of the reason, these issues contribute to poor EMR adoption and clinician burnout. To solve these problems, clinical optimization services firms offer three key levers proven to help organizations realize the promised value of their EMR: (1) workflow refinement, (2) application enhancement, and (3) clinician training.

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In High-Scoring Field, Chartis Is Best in KLAS (Serving Cerner/Epic Health Systems)

Clinical optimization is one of the highest-rated services that KLAS measures. Four of the five firms in this study have overall scores above 90.0, and the fifth is rated 89.9. Chartis Group clients report the highest satisfaction overall (and the firm is the 2020 Best in KLAS winner for this segment). Nordic also stands out for consistently delivering a positive experience across clients.

breadth of clinical optimization and overall score variation


Clinical optimization projects focus on improving how clinical systems operate and are used by clinicians, and these services should result in improved patient care, ROI, and physician use and adoption.

To accomplish these goals, the firms in this report help clients activate three primary levers:

workflow refinementWorkflow Refinement
Assessing the logical flow of EMR-based processes and redesigning them as needed to improve end users’ efficiency and effectiveness; these efforts may result in recommendations for future application enhancements or training.

application enhancementApplication Enhancement
Programming EMR screens, controls, and reports within the EMR to support desired clinical workflows; these efforts may result in recommendations for further workflow refinement or training.

clinician trainingClinician Training
Educating clinicians on how to make the best use of EMR-based tools to care for patients.

Provider organizations often turn to clinical optimization firms when they lack sufficient resources or expertise internally to meet their goals in the desired time frame. Engagements are usually sparked by an event—like the implementation of a new EMR, a significant upgrade, or the decision to standardize to a single EMR platform (often after a provider organization acquisition). Many organizations use different firms for different levers.

Effects of Clinical Optimization on Clinician Experience

The chart below, based on research from the KLAS Arch Collaborative (a collective of provider organizations measuring and improving end users’ EMR experience), shows which provider-reported optimization efforts are most impactful for clinicians. This data comes from organizations who measured end-user satisfaction, implemented improvement initiatives, and then re-measured.

high-impact clinical improvement initiatives from klas arch collaborative research

workflow refinementWorkflow Refinement

Workflow refinement is the foundation of clinical optimization and the starting point for three firms in this report: Chartis Group, Impact Advisors, and Nordic. The other two measured firms, Atos and NHA, were used by respondents primarily for clinician training and application enhancement, respectively.

workflow refinement percent validated

Chartis, Nordic Clients Praise Epic Expertise and Strategic Role

quality of staff consultantsOf the three levers, workflow refinement requires the most expertise in business processes, as consultants are expected to optimize EMR workflows in a way that works well for clinicians. Consultants of all firms received compliments from customers, but Chartis Group’s staff is rated the highest. Clients say the firm’s seasoned staff and Epic expertise were key to success, and they also express appreciation for consultants’ strategic help, which took the form of candid advice, best practices, and creative problem-solving. Nordic clients say they benefit from strong expertise; many of the firm’s consultants are former Epic employees. Atos and NHA respondents are the most likely to mention knowledge gaps.

application enhancementApplication Enhancement

All firms have been validated for some application enhancement work. NHA is the only firm in this report whose interviewed clients used the firm primarily for application enhancements; clients are often small hospitals needing technical help with ancillary solutions. A significant portion of Nordic clients also engage the firm for application enhancement.

application enhancement percent validated

Impact Advisors’ Methodology Drives Satisfaction

The technical nature of application enhancement requires structure and discipline for successful execution. Compared to other firms, Impact Advisors received the most praise around engagement execution, often for bringing to bear proven methodologies that delivered fast results. The limited number of NHA respondents appreciate that experienced staff helped them establish a path forward for their clinical optimization efforts. A couple of NHA customers mentioned timeline challenges.

client feedback on engagement execution

clinician trainingClinician Training

According to KLAS’ Arch Collaborative data, clinicians who report having good training are much more likely to be satisfied with their EMR overall, yet clinician training is the least commonly used clinical optimization lever, perhaps because it yields the least quantifiable outcomes. Most respondents considered training a more minor element of their engagement. When present, training efforts involved creating a curriculum and providing traditional classroom learning. By a solid margin, Atos had the highest percentage of interviewed clients use them for clinician training.

clinician training percent validated

Atos’ Technology-Enabled Training Brings High Value

clinician training scope and money's worth

Arch Collaborative data shows effective training depends more on quality than setting or timing. Atos (formerly The Breakaway Group) offers clinical optimization services focused primarily on clinician training, including curriculum development and delivery (via several modalities). Respondents especially praise the effectiveness of Atos’ simulation software, which mimics the client’s EMR environment for educational purposes. The long-term usefulness of Atos’ tools contributes to their leading money’s worth rating.


Atos: Works with health systems of all sizes, primarily those using Cerner. Focus is clinician training, including classroom training. Key strength is their EMR-simulation tools, customized to the client’s EMR environment and effective for end users. Engagements tend to be long term as clients work through staged rollouts of EMR functionality across the organization.

Chartis Group: Works mainly with large health systems. Validated for work on Cerner and Epic EMRs. Provides services related to all three levers, but most often workflow refinement for operational readiness programs by clients migrating users to Epic. On average, engagements are short term (one year) and involve a handful of consultants.

Impact Advisors: Works with large and small organizations rolling out Epic. Validated for workflow refinement, application enhancement, and clinician training. Optimization work often preceded by implementation planning engagement. Epic expertise is valuable for defining areas of opportunity on top of Epic’s foundational systems. Optimization engagements last less than a year on average.

Navin, Haffty & Associates (NHA) (limited data): The only firm validated for clinical optimization work on MEDITECH. Most clients are standalone hospitals who need help with application enhancements and filling clinical analyst gaps. Projects tend to be specific and small, with an average of a couple of consultants over five months.

Nordic: Works mostly with large health systems, mainly those using Epic. Validated for helping clients with all three levers. More likely than other firms to be working with existing Epic users on optimization efforts unrelated to a new implementation.

author - Amanda Wind Smith
Amanda Wind Smith
author - Madison Moniz
Madison Moniz
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2023 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.