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Oncology 2020 Oncology 2020
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Oncology 2020
A Comprehensive Look at Medical Oncology and Radiation Therapy Solutions

author - Monique Rasband
Monique Rasband
September 29, 2020 | Read Time: 7  minutes

An estimated 1.8 million new cancer cases will be diagnosed in the United States in 2020. In order to treat cancer at these volumes and achieve the best outcomes for patients, healthcare organizations—including comprehensive cancer centers, community oncology practices, and oncology facilities associated with acute care hospitals—need oncology software and equipment with up-to-date functionality, strong integration, and good vendor support. With the goal of helping healthcare organizations understand their options, this report provides a comprehensive look at the oncology IT market, examining customer satisfaction with medical oncology software, radiation oncology software, radiation therapy equipment, and treatment planning software.
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Oncology Vendor Landscape

Despite the availability of oncology solutions from broad healthcare vendors (e.g., Cerner and Epic), oncology is one of the few HIT areas where best-of-breed vendors still maintain a strong foothold. Some of these best-of-breed vendors deliver comprehensive oncology portfolios, while others focus on a niche area.

oncology vendor landscape


Elekta Leads in Medical Oncology Functionality and Integration, Followed by Epic

integration vs functionalityElekta MOSAIQ’s good product quality and tight integration with radiation oncology software (both Elekta’s and Varian’s) have persuaded many customers to keep MOSAIQ despite pressure to switch to the oncology solution from their inpatient EMR vendor, either Allscripts, Cerner, Epic, or MEDITECH.

Of these inpatient EMR vendors, only Cerner and Epic have seen significant adoption. Epic Beacon customers report above-average integration satisfaction, though they are specifically rating integration with the Epic suite; integration with non-Epic systems is more of a challenge. Multiple customers, mostly those associated with acute care hospitals, say the Epic-to-Epic integration enables them to reduce duplicate charting and maintain a single patient record for cancer patients; a handful of other customers, mostly comprehensive cancer centers, report workarounds or manual entry for recording radiation oncology data. Overall, the Epic oncology solution does what customers need it to, but functionality gaps remain, and customers report growing frustration with the slow pace of development. Gaps exist for Cerner customers as well. While they wish development were faster, they feel Cerner is listening, and multiple customers highlighted the monthly calls in which Cerner facilitates customer feedback and enhancement requests.

Flatiron customers describe the technology as solid, reliable, and easy to use, and they appreciate Flatiron’s oncology-specific expertise, which is evident in the product development and support. Several customers mention communication challenges around enhancement requests, upgrades, and delayed support responses. Customers who report involvement from an account manager describe a more positive support experience.

McKesson Does Well with Training; Varian, Epic, and Cerner Customers Struggle with Workflows

operations metricsMany McKesson customers say the vendor’s frontline support personnel are responsive and willing to provide extra training or walk through issues on a call; one customer also highlighted the system’s built-in tutorials. Past the tier-one support, customers often encounter delayed responses. In general, Generation 2 customers are the most satisfied McKesson customers overall.

Functionality challenges such as overly manual report workflows and poor workflows on the administrative side (e.g., registration and scheduling) are the root of Varian’s lower ease-of-use score. Additionally, some customers describe the technology as old; while radiation oncology updates have been made, customers do not feel medical oncology has been a development priority.

Cerner and Epic customers say there are often multiple ways to complete the same task, making their solutions harder to use and train on. Both customer groups would like fewer clicks and greater simplicity. In addition, multiple Epic customers report receiving little support or oncology expertise from Epic during implementation and caution potential customers to be prepared for a significant up-front effort customizing Beacon to meet their needs.


Culture, Value the Biggest Differentiators, with Elekta Ahead of Varian in Both

customer experience pillars

Due to the highly regulated nature of radiation oncology, only the two comprehensive oncology vendors—Elekta and Varian—offer software in this area. Though the vendors’ overall scores for radiation oncology are quite similar, there are important differences when it comes to culture and value. Elekta customers highlight the proactive nature of their vendor’s support and say that personnel are also responsive to issues and good at closing the loop. Customers rarely feel nickel-and-dimed by Elekta; the few issues mentioned had to do with charges for reports.

For Varian customers, poorly managed upgrades that require significant time from customers leave some organizations feeling that Varian doesn’t keep their promises, and this problem is sometimes exacerbated by slow or unresponsive support. Multiple customers feel nickel-and-dimed by charges for upgrades or enhancements, reducing their overall perceptions of value. Varian does score slightly higher than Elekta in the customer experience pillar of loyalty. This is a result of Varian customers being slightly more optimistic about improvements Varian will implement to overcome current struggles; Elekta customers predict their satisfaction will stay constant.

The Value of a Comprehensive Oncology Vendor
Organizations who choose comprehensive oncology vendors Elekta or Varian often highlight the benefits of having a vendor who offers a full oncology portfolio, strong integration, and oncology-specific expertise.

Varian customer: “It is nice to have one vendor who deeply understands oncology inside and out.” —COO

Elekta customer: “Elekta does a good job of being a source of comprehensive oncology information.” —Director of oncology


Elekta Delivers High Value and Relationships; Accuray Trails the Market

relationship vs valueUsers of Elekta’s equipment—both the Leksell Gamma Knife Icon and Versa HD—are enthusiastic about the experience, with no interviewed customers reporting an overall score of less than 80 (out of 100). Leksell Gamma Knife Icon customers highlight the benefits of having high-quality equipment specifically for treating the head and neck and praise the knowledge level of Elekta’s employees. A handful of customers mention the cost as a negative, but most acknowledge it is worth the investment. Many Versa HD customers say their ability to quickly and accurately treat patients has enabled them to increase their patient load. Multiple Versa HD customers feel their support person is invested in their facility and willing to put in extra effort.

In a segment where customers rarely switch vendors, Accuray is the only equipment vendor to have some customers report that the solution is not part of their long-term plans, due largely to perceptions of decreased value. CyberKnife customers feel that while the equipment is good, Accuray has lost their edge and is no longer the technology leader. TomoTherapy users describe their equipment as solid and reliable, though multiple customers emphasize that they would not recommend it as a standalone piece of equipment because of its lower throughput compared to linear accelerators. Across both products, customer feedback regarding Accuray’s support is inconsistent from organization to organization—some say the support is good when they get it but is spread thin and slow to fix or replace parts; others describe the personnel as responsive and quick to come on-site when needed.

Varian TrueBeam users report mostly positive feedback about their equipment, and some customers say relationships have improved. Varian customers are more likely than Elekta customers to report nickel-and-diming, bringing down perceptions of value.


Over Half of Philips Customers Don’t Plan to Stay

customer loyaltyMany interviewed Philips Pinnacle customers have a long history with the solution and feel they can operate it easily, yet over half have contracted to switch to another vendor or are in the process of phasing out Pinnacle. These customers consistently report a lack of development from Philips, and some say Philips has a track record of not keeping their development promises. For these customers, positive reports about current upgrades and future development plans are too little too late. Varian customers, who have reported high satisfaction for years, praise the integration between Eclipse and the rest of Varian’s oncology suite, and clinicians describe the solution as easy to learn and use. Interviewed customers mention some small things they feel could be improved, but they say the system has few bugs, and all plan to keep the solution long term.

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared online in real time so that other providers and IT professionals can benefit from their peers’ experiences. To enable readers to more quickly understand high-level differences in vendor performance and give better context as to how each product compares to other offerings in the market, KLAS has organized the questions from the standard evaluation into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.

customer experience pillars

The data in this report was collected over the last 12 months; the number of unique responding organizations for each oncology solution included in this report is given in the tables below.

comprehensive oncology offerings niche oncology solutions oncology solutions from broad healthcare vendors

What Does "Limited Data" Mean?

Some products are used in only a small number of facilities, some vendors are resistant to providing client lists, and some respondents choose not to answer particular questions. Thus a vendor’s sample size may vary from question to question and may not reach KLAS’ required threshold of 15 unique respondents. When a vendor’s sample size for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

Overall scores are measured on a 100-point scale and represent the weighted average of several yes/no questions as well as other questions scored on a 9-point scale.

Product Designations Used in This Report

  • Mostly Community Oncology [CO]: Product for which the majority of responding organizations are not directly owned by an acute care organization (e.g., outpatient oncology and comprehensive cancer centers).
author - Jess Wallace-Simpson
Jess Wallace-Simpson
author - Robert Ellis
Project Manager
Robert Ellis
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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. © 2024 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.