Medical Oncology 2017
A Medical Oncology Perspective

1. Epic and Cerner Gain Market Share but Fall Short for Integration, Usability, and Functionality

While clinicians acknowledge that Epic still has significant room to mature, the end-user experience is still significantly better for Epic customers than for Cerner customers. Providers are still unsure whether Cerner is fully committed to the space. Turnover on Cerner’s oncology team has led to drastic declines in communication and relationships, and customers have not seen the innovation or new technology they would like. The Cerner system’s high configurability can be a double-edged sword—lacking the ability to create efficient workflows themselves, some providers would like more out-of-the-box functionality.

Cerner and Epic customers report more difficulty than other providers when it comes to integrating their medical and radiation oncology systems, though all vendors—aside from Varian and Elekta, who have both radiation and medical oncology systems—deliver poorly there. Many Epic customers say there is no integration between Beacon and their radiation oncology systems, and those that have achieved some integration have done so through manual, self-created workarounds. Integration between Beacon and Epic EMRs is strong, but integration with other EMRs is difficult or nonexistent. Cerner customers have also struggled to get what radiation oncology integration they do have. Some note that bidirectional integration does not exist, that only PDFs are transferred over, and that Cerner is unwilling to give needed support. Cerner customers are more satisfied with core-EMR integration but still encounter difficulties.

2. Providers Hopeful yet Cautious as Varian Executes About-Face

After announcing plans in 2015 to partner with Flatiron in medical oncology, Varian says that they are now refocusing on medical oncology and will not be moving any medical oncology business to Flatiron. While some Varian customers are cautiously optimistic and note recent improvements—such as better communication and the introduction of 360 Oncology—customers in general want more new development and better relationships with Varian.

"Varian has been starting to refocus on the medical oncology side. For a period of time, it was not a focus, and at one point, they even tried to push some things onto another vendor. I think Varian realized that had been a big mistake. Varian heard the feedback from us and several others and took responsibility. . . . The biggest area that has been improved is the focus and vision for medical oncology. . . . We are very pleased with what Varian is talking about . . . for the future. In the past, they did not have this kind of energy. I think they are starting to see how things tie into the big picture of patient care." — Chief Administrative Officer

"We have seen some new functionality, and the addition of 360 Oncology will improve patient care and outcomes. It is still fairly early, but we can see this system making a difference, and we are looking forward to it." — Senior Director, Information Services

3. Optimism Spikes as Customers Observe Shift in Flatiron’s Approach

A year ago, Flatiron customers were very nervous about the future—support was already a weakness, and providers doubted Flatiron’s ability to scale to the quantity and scope of Varian’s customer base. However, with Flatiron’s plans to focus on their own customers and not take on additional Varian sites have come huge improvements in customer optimism. While execution in some metrics still varies, providers feel Flatiron is truly invested in their success, and they report considerable improvements in relationships, communication, functionality, and Flatiron’s ability to keep promises. Many providers interpret these improvements as early signs that the vendor is on their way to becoming a more proactive partner.

4. McKesson Specialty Health Viewed as Reliable Partner in Provider Success

A consistent and stable high performer, McKesson Specialty Health stands out for taking a partnership approach to customer success. In addition to delivering a highly customizable system that is geared toward medical oncology, McKesson Specialty Health also provides the guidance customers need to create efficient workflows and reduce rework. The vendor also excels at driving integration—while other vendors leave most integration responsibilities to providers, McKesson Specialty Health takes the lead in improving the integration iKnowMed has with acute care EMRs and radiation oncology systems.

5. Providers Concerned with Elekta’s Lack of Medical Oncology Innovation

Reporting a lack of innovation, Elekta’s medical oncology customers are not confident that the vendor is fully invested in medical oncology. Providers have not seen as much new development as they would like, and the customer experience is extremely varied. While some providers are satisfied, others describe the system as overly complicated and time consuming. The system’s high customizability is both a strength and a weakness since Elekta's training does not adequately enable providers to create efficient workflows or use the system effectively.