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Implementation Benchmarks 2023 Implementation Benchmarks 2023
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Implementation Benchmarks 2023
Common Implementation Challenges for Provider Organizations

author - Ryan Oliver
Ryan Oliver
author - Alex McIntosh
Alex McIntosh
author - Andy Paulsen
Andy Paulsen
April 12, 2023 | Read Time: 6  minutes

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The success or failure of an implementation can significantly affect provider organizations’ ongoing product and job satisfaction—data from KLAS’ “The Power of Strong Implementations” shows that about half of all respondents say their implementations had room for improvement and that negative feelings about the new solution can linger for up to a year after go-live. Provider organizations also state these challenges are worsened by the fact that they often underestimate the time and effort needed to successfully implement a solution. Vendors have to balance meeting customer needs and setting best-practice standards, and provider organizations need to both receive consistent vendor guidance and proactively take project ownership. For this Landmark Insights report, KLAS talked to 180 respondents from 113 unique provider organizations who are implementing or recently implemented a solution about common difficulties that occur throughout the process.

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Note: This Landmark Insights report is focused on pitfalls that can occur during implementation. KLAS plans to publish a follow-up report focusing on implementation best practices for provider organizations.

The Power of Strong Implementations

The charts below come from KLAS’ “The Power of Strong Implementations” white paper. Data for this white paper came from KLAS’ standard data across a broad set of IT solutions.

almost half of implementations need improvement
lingering effects of poor implementations

Misaligned Expectations Can Lower Satisfaction throughout Implementation Process

As an implementation progresses, misaligned expectations between the provider organization and the vendor can frequently lead to problems as well as lower provider satisfaction. Because vendors are still securing a bid when explaining the required investment to the customer, provider organizations planning to implement cannot always take the expectations vendors set at face value. Respondent feedback indicates that going into a project, provider organizations almost always underestimate the time and effort implementation requires; they also often feel that vendors undersell the time needed for implementation in order to win the contract. Some report that established timelines are unrealistic or too rigid when unexpected delays occur, causing their organizations to have to add extra resources, postpone implementation (and risk exceeding their budget), or shorten another project phase (e.g., training) to stay on schedule.

The training phase can have a major positive impact on implementations, but it can also present challenges. Reasons for dissatisfaction with training include respondent organizations underestimating their product’s learning curve or the time required to train. Organizations are also sometimes insufficiently staffed and don’t fully understand the work an implementation will add to employees’ daily responsibilities. Since the COVID-19 pandemic began, many have struggled to handle the patient load, and adding or replacing major software programs adds further strain to an already burdened workforce.

implementation benchmarks overall satisfaction with vendors implementation services by project status
top implementation challenges

Provider Organizations Feel Most Implementation Challenges Could Be Prevented with Better Preparation and Training from Vendor

When asked what could have prevented implementation challenges, interviewed provider organizations most often mention better preparation from their vendor. Most staff members are not familiar with the implementation process, and the discrepancy between how a project is sold and what happens during the implementation decreases satisfaction. Vendors need to be more up front and detailed about the extensive workflow required for projects. Respondents want more vendor guidance when preparing for projects, as they worry their vendor merely caters to their desires instead of telling them what they need and how to address issues. They also note vendors’ on-site staff are sometimes undertrained and unfamiliar with their organization’s unique needs. Multiple respondents wish their vendor had taken time to understand their operations before planning and designing the implementation; during the configuration and building phase, these respondents discovered knowledge gaps, which led to a lowered sense of confidence in the vendor as well as lowered satisfaction.

overall satisfaction with implementation by project phase
ways implementation challenges could be prevented

Satisfied Provider Organizations Implement Change Management Plans before Training Begins; Unsatisfied Provider Organizations Cite Insufficient Vendor Guidance

Working with one or two vendor teams during implementation can quickly lead to a chaotic operation if project roles, responsibilities, and milestones are not clearly defined and understood by all stakeholders. Interviewed provider organizations often express frustration about unclear expectations, progress, and communication channels. While the provider leadership team is responsible for establishing and administering a change management plan, the strength of that plan—and consequently the success of the implementation—highly correlates with how involved the vendor is. Most vendors suggest best practices for developing an implementation plan, but provider organizations want their vendor to be a partner who will actively help create a plan that best meets their organization’s needs. Respondents who developed strong change management plans early on not only report higher satisfaction with their vendor at the end of the project but also feel more ownership over post-go-live projects (e.g., increasing user adoption). In contrast, dissatisfied respondents report feeling disconnected with their vendor and uncertain about the project road map, leading them to have significantly less confidence in their own team’s ability to complete the project on time and within budget. These respondents also more often note missing functionality or debilitating system bugs and focus less on maximizing the use of their investment.

top implementation challenges satisfied customers
top implementation challenges dissatisfied customers

Change Management & Training Are Common Implementation Struggles; ERP Implementations Most Challenging Project Type

Executing change management well is a common challenge for provider organizations implementing solutions and is one of the areas of lowest satisfaction in this sample. Even the most satisfied respondents report struggling to help end users and other employees adopt new processes post-go-live. Interviewed organizations say that insufficient training in change management plans can contribute to low adoption rates, as users can’t fully engage with the new solution unless they feel comfortable with it. Provider organizations sometimes try to save costs by choosing less-involved training plans; however, knowing how much training staff members will realistically need before the transition is paramount for a successful go-live. Respondents that invest in longer, more in-depth training from the beginning are more likely to have higher adoption rates.

Across different projects, ERP implementations are generally more difficult and consistently score lower than other implementation types. Additionally, when implementing multiple types of solutions at once, respondents report that staffing and vendor resources are often prioritized for EMR projects instead of ERP projects, leading to lower satisfaction. Respondents who implemented an ERP solution alongside other implementation projects also feel that change management was more difficult for their ERP solution.

implementation project expectations
change management well executed by implementation type

landmark insightsKLAS’ new Landmark Insights initiative focuses on helping organizations successfully navigate large HIT implementations. At strategic points in the implementation process, KLAS conducts in-depth interviews with health system stakeholders in multiple departments, vendor implementation leaders, and third-party implementation resources. Data from these interviews is analyzed to identify any stakeholder misalignment and to detect problems early so they can be addressed before the go-live. To learn more about how to participate in this initiative, visit the KLAS website or contact the Landmark Insights team at

About This Report

This Landmark Insights report is the result of a study where healthcare organizations shared their experiences and satisfaction throughout the different stages of the implementation process. To gather these perspectives, KLAS used a supplemental evaluation to interview 180 respondents from 113 unique healthcare organizations that are implementing or recently implemented a HIT solution. Data was collected between October 2022 and December 2022.

This report also draws on KLAS’ standard data across a broad set of IT solutions to explain industry-wide trends around implementations and the subsequent customer experience. Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. KLAS’ standard quantitative evaluation for healthcare software is composed of 16 numeric ratings questions and 4 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value. Additional insights on specific solutions can be found on the KLAS website.

customer experience pillars software
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author - Natalie Hopkins
Natalie Hopkins
author - Madison Moniz
Madison Moniz
author - Joel Sanchez
Project Manager
Joel Sanchez
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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.