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

Elekta 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.

Many 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.

Users 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.

Many 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.