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July 9, 2008 Readers Write 8 Comments

First-Hand KLAS Experience
By Jazzbo Depew

I work for a vendor. We crush everyone in our KLAS category, but we’re not happy with KLAS.

I firmly believe that they don’t cheat with their scores or comments. Some of their vendors might try really hard to get folks to fill out surveys, but KLAS tracks down every user they can and stops using them if they’ve milked that cow too much.

We are one of those "obscure" companies that gets the good scores. Why is ‘Spence Holmes’ surprised that agile, targeted companies will score better than the generic behemoths? Does it have to be a cheating conspiracy? Could it simply be that software written and supported for a specific speciality or service will make its users happier than those that aren’t? 

If the survey for KLAS is biased, the implication must be that my company has somehow cheated. As the KLAS contact, I assure you that I haven’t. We’re too small and have too little money, believe me.

But I do think KLAS is biased in another way – the opposite of what Holmes implies.

We got a call out of the blue one day saying, "Hey, we’re from KLAS and we’re going to start finding your clients whether you like it or not. You can help by giving us your client list." We waited the three months they told us it would take to get listed. Nothing. So, we called. "Well," they said, "when we see scores that are so out-of-line with the norm, we need more data." Huh? Good or bad? They wouldn’t tell us. 

So, we mentioned the survey to our clients. Eventually, after something like 12 months, we got listed. However, we had a BIG ASTERISK next to our name and were put among the other software vendors as "Component, Updated, or Replacement" software or something like that.

Why?  Because our scores were so good and we are a small specialty company. It’s that simple. They don’t want us listed next to our much larger competitors. Our specialist prospects will be misled to think the "Best in KLAS" folks are better for them than we are. I’ve been fighting with them about this for three years. We even see some well known vendors claiming to have the highest scores in more of the ~30 categories than anyone else – which is patently false – but because they are one of the big fish, they don’t have to pay attention to us.

So, some KLAS stories:

When our scores first came out, I was reading the comments section. One of our clients said something about us that isn’t true, but made us look better than we are ("they won’t hire anyone who hasn’t worked for three years already," when, in fact, we hire college kids every chance we get). I called them up to fix it and once the person on the phone said, "Wait, you’re the vendor?" she all but hung up on me. "We don’t talk to the vendors, period." Given that I wasn’t complaining about the bad comments, I was impressed.

We know our clients really well. When it’s a bad one (we have so few), I know EXACTLY who it is. And I can tell you that the comments are VERY real and are the GOLDMINE for KLAS users. We read them religiously and use them to direct our efforts. I could write you another five pages (I’ll spare you) about my efforts to get KLAS to understand their real value. My impression was that they are a nice little company with a family atmosphere and not the greatest sense of business.

We’ve had a number of clients tell us, "Oh, KLAS called me!" whose names we never provided and who hadn’t contacted KLAS. KLAS reads through web sites, checks out newsletters, and asks customers about other customers.

KLAS specifically reported to us more than once that our "degrees of confidence" were about to slip because they had been getting data from our same customers for almost too long. If some new customers didn’t report, we’d lose a checkmark or two.  Whether this is lip service or not, I’ll never know, but the information was delivered in a manner that I believed. We did what we always do: sent out a customer-wide e-mail saying, "Don’t forget to fill out your KLAS survey. P.S. Give us a good score or we cut off your support." [Kidding about that last part.]

KLAS made a BIG DEAL about needing a proper sample size. Ours represents a FAR greater section of our clients than from the big vendors. In fact, during the first discussion I had with them, it was clear that there was a BIG vendor bias, not the other way around. KLAS can’t have the little guys winning all the awards and driving the hospitals away from the GEs, etc. Plus, what kind of blackmail would I have to use to get KLAS to give us those scores? They hate me there – I call to complain all the time about our lack of recognition. They’d love nothing more than to have us be average.

There is probably a correlation between being publicly traded and scores. This is largely a service industry and being beholden to two masters (shareholders vs. customers) doesn’t work, as we know.

ED Software Seen First-Hand
By Lukas

[From Mr. HIStalk: I removed the vendor’s name from this writeup because I can’t verify the source or its accuracy, but it was claimed to be one of the biggest ones and it’s not Cerner, Epic, Eclipsys, or Siemens.]

During a busy couple of weeks taking parents and going myself to the local ER, I got very close to watching the ED system in action and had the opportunity to talk with my nursing and physician colleagues about what they thought of the [vendor] ED system.

The most common answer was that it was cumbersome and didn’t provide the level of documentation needed in the ED. All of the treatment rooms in the ED were equipped with wall mounted PCs, but in the four visits, no one even turned on the PCs in the treatment rooms.

What’s even more scary, when one of my parents was admitted and the information in the ED was supposedly sent to the inpatient system, the medication records were a mess. Doses were wrong, medications missing, assessments didn’t move to the inpatient system. The nurses were not happy since they are spending time on the floor updating the inpatient system with the correct information.

None of the nurses or physicians in the ED were involved in making the system selection. The nurses on the floor want to go back to manual charting.

This hospital invested heavily in COWs, but they are currently in storage. They are also cumbersome and not much help.

The PACS Designer’s Web Software Review – Adobe Acrobat.com
By The PACS Designer

Adobe has launched a new website called Acrobat.com to provide new collaborative features for Internet users. The features are:

(1) Adobe Buzzword® – online word processor
(2) Adobe® ConnectNow – web meeting platform
(3) Create PDF – convert up to five documents to PDFs for e-mailing
(4) Share – work online with others, sharing large files without  e-mailing
(5) MyFiles – ability to store up to 5 gigabytes of files for sharing with others

You can use Acrobat.com to create and share documents, communicate in real time, and simplify working with others.

The First Real Web-Based Word Processor, Adobe Buzzword®, is a key feature of the new Acrobat.com website. Adobe has promised to keep adding new features into the future as users get more experience using their new site.

Create PDF is something new that Adobe has decided to give us in an online format. Since TPD has been posting about the new PDF/H for healthcare it would be good for HIStalkers to try to record their medical information securely in a PHR on their hard drive or USB drive and then using Acrobat.com Share to e-mail their PHR as a PDF/H. Adobe is permitting up to five different PDFs for free.

Adobe Acrobat.com is a nice addition to the Adobe portfolio of products and should attract new users with its free online word processor, Create PDF capability, and its sharing function.

TPD Usefulness Rating:  9.


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Currently there are "8 comments" on this Article:

  1. Dear Jazzbo Depew,
    I have to take issue with your opinion of KLAS. I have been dealing with KLAS since it started. In my opinion, they have stayed true to their mission and delivered value to their clients. The “big vendors” you referenced all started out as small vendors and were smart enough to use KLAS to their advantage.
    The Sausage King of Chicago

  2. “[From Mr. HIStalk: I removed the vendor’s name from this writeup because I can’t verify the source or its accuracy, but it was claimed to be one of the biggest ones and it’s not Cerner, Epic, Eclipsys, or Siemens.] “

    If you couldn’t verify the source or accuracy, how do you know it wasn’t one of those vendors?

    [From Mr. HIStalk: the user gave the vendor’s name and seemed to be a credible, but had generic e-mail and IP addresses. So, I’m reluctant to run the vendor even though he gave it.]

  3. I don’t know why nobody has said this, but here goes…
    KLAS is a game we in healthcare play to feel good. Vendor’s feel good getting high scores, and CIOs get to tell their CEOs what a great decision they made!

    The basic problem with KLAS, and Dorenfest before them, and even HIMSS Analytics today is that all these supposed independent survey outfits take on paid projects and sell other information /services to the vendors they score. Can you spell ‘conflct of interst’ ??
    I know because in my sordid past I was a vendor and I signed the checks.

    I wouldn’t put much weight on their scorings unless they publish a list of revenue by vendor with the scores. In the meantime I’ll sit back and wait for the firms to tell me I am wrong and that they never get $$ from vendors, or that getting $$ from the companies you score is not a conflict…and I’ll feel good!

  4. I’d like to respond to the two KLAS comments. This is “Jazzbo Depew” (gosh, I should have requested a name…like Race Bannon or Harry Flashman).

    First poster: I don’t know at what point Medical Manager, Mysis, Epic, Cerner, etc. were “small vendors” in the KLAS lifetime. Cerner, et al, make individual sales that are multiples of our annual business. If there weren’t a focus on the larger players, then, how do you explain the absence of a handful of vendors from the “Best In KLAS” awards who, even though they have higher scores than other vendors, aren’t allowed to win?

    I am sympathetic to their position, but they have had the time to manage this problem and haven’t done much. They should have realized, a while ago, that tracking provider speciality (for example) is a big deal. The needs of individual specialities vary enough that they shouldn’t be lumped together.

    As for the second vendor: I simply call foul. We learned about our KLAS scores long before we paid them a dime and the dime(s) we pay them are simply to access the detailed. Nothing more. It was another vendor who called us to say, “Hey, great scores!” That’s when we really got interested. We are _so small_ that the income they receive from us can’t be worth the constant grief we give them about not being listed with our competitors or winning any awards. If people are interested, I’ll post EXACTLY what we pay and what we get (I don’t think there’s anything in our agreement that says we can’t). We are a thorn in their side, not an underwriter who benefits as a result.

    I’ve been approached by other review services to pay for scores (directly and indirectly), so I think I’d know the difference.

    To make this clear: they published our good scores without interacting with us, really, and then get a pittance from us because we like the data.

    To make another point clear: I *like* the KLAS folks and I think their service is quite valuable. It’s quite distinctive from many of the other reports because it is so user-driven. We actually complained to them last year because it was clear (based on our subjective info) that one of our big competitors was getting higher scores for its PMS than it deserved (the EHR isn’t bad, but the PMS is clearly sub-par). We posited that the docs were filling out the scores too often and transferring their view of the EHR onto the PMS…and KLAS concurred in our conversations and explained that they were implementing new interview and ata guidelines to make this distinction. Since then, there has been a noted decline, last I checked, in the vendor’s PMS scores.

    Meanwhile, folks can complain all they want about the “scores” but those customer comments are REAL and are incredibly helpful. Worth the price of what we pay, alone.

  5. I agree with Abe in his statement that KLAS has stayed true to their mission. I have known many of these fine individuals since before KLAS was even formed and can tell you that their personal values would not permit them to state one thing, i.e. their mssion to provide unbiased information and then deliver something skewed on a vendor’s behalf.

    Sure they provide customized services to vendors for a fee. These are the vendors that are smart enough to realize that many of us use this information to make informed decisions and they are looking to drill down deeper to improve their own performance. It’s not a game, but good business acumen.

    I also think it only makes sense that smaller, specialized vendors will receive higher KLAS scores. They HAVE to provide a higher level of functionality and service in a specific area or we simply wouldn’t consider them over our primary HIS vendor.

    I will continue to use their scorings and customized reports as I have for many years.. They haven’t steered me wrong yet.

  6. “[From Mr. HIStalk: the user gave the vendor’s name and seemed to be a credible, but had generic e-mail and IP addresses. So, I’m reluctant to run the vendor even though he gave it.]”

    Was there any reason why the 4 vendors you listed were cleared of the inverified claims, or did you pick them at random?

    [From Mr. HIStalk] I picked the four obvious possibilities that it wasn’t, leaving one major one. And no, it wasn’t Meditech, either. It’s probably not worth a lot of thinking either way since it’s just an observation from someone that was interesting.

  7. Two responses:
    1. I really like to reading the comments of the small vendor responding to his KLAS realities- it read very honestly and I could read fairness between the lines.
    2. I really wish Mr. HIStalk would have included the ED vendor’s name, it seems to me that naming names is what he is all about. A generic statement about a bad ED EMR might be doing more harm, in an utilitarian sense, then providing the name with a disclaimer.

  8. RE: ED Software Seen First-Hand “From Mr. HIStalk: I removed the vendor’s name from this writeup because I can’t verify the source or its accuracy, but it was claimed to be one of the biggest ones and it’s not Cerner, Epic, Eclipsys, or Siemens.”

    Based on the description of the precise integration between applications and ease of use, do I smell something bad? Oh! that must be McKesson?

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