Implementation Benchmarks 2023
Common Implementation Challenges for Provider Organizations

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.

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.

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.

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

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.

KLAS’ 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 landmark@klasresearch.com.

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.