It turns out a lot of corporate IT has no idea how to switch vendors in case a product they use gets acquired by a company with this business model.
This always shocks me. I moved a company off of Salesforce in 45 days without a big issue. Day 1 was a bit slower but by day 2 folks were back at full speed. I've pulled off EMR migrations, ERP, accounting, etc. Moving is scary but doable.
Sometimes the execs will just pay rather than risk anything. At my last job I spent 7 months researching and building a migration plan for an app that was literally costing us customers/patients because it was so bad. Came back with a plan to move to a better system (of of 38 I researched), 6 month implementation, $800k/yr savings directly, another $400k indirectly from other tools we could cancel because the new tool would do all of that. The board ignored me and the rest of the C-suite, and went back to the vendor and signed a new agreement that INCREASED the yearly bill from $1.2m to $1.8m/yr. They completely cut me out of all the negotiations, I didn't even know it was happening, and I was the CIO. I quit, and they're now being sold at a firesale price.
The answer to what have I switched people to is at the end of this post.
One company was using SF as a patient management system because their EMR wasn't set up right. They spent 6 figures a year on SF just to communicate with patients, make and change appointments, send and receive documents, record insurance information, etc. I spend 2 months fixing the EMR and they moved everyone to that, canceled, SF, and saved $200k/yr on SF and another $250k/yr on SF consultants. For a $50m/yr business, that's a lot.
Another was using SF as a ticket system. Those folks we moved to FreshService. $180k down to $15k/yr. From my experience, ticket systems tend to be one of the most common existing applications that get duplicated inside SF. People think they have to build it in SF rather than just linking your apps. There was another company who kept SF for their CRM aspects but we moved them to an external ticket system that linked to SF and cut their SF bill from $550/yr to $270/yr.
Then there have been cases where I'm brought in while in the middle of a development project. One of my favorites was this consulting firm said they could do all these things and integrate their EMR and Salesforce and that they had done it before with their custom middleware. But every month there'd be a new change-order from them where they said certain things weren't possible, and it came with an invoice! They were CHARGING this company to reduce the scope of an approved, signed, paid contract. I jumped in and said, "we're not paying any of these change orders, you don't get to charge us to do less work. You promised all these features, you said your software ALREADY DID them. What's the problem?" Then for two months we went round and round where I was able to offer them methods to do every single feature they said wasn't possible, and then they'd invent another reason they couldn't do it. I said we're done, canceling the contract, not paying any open invoices, not paying the remainder of the invoice, and in exchange I wouldn't recommend we sue them to get back everything we paid so far. Their own lawyer agreed, and we parted ways. They had us sign a Salesforce contract before we even paid them, so we were a year into a 3 years salesforce contract and literally nothing had been built out. By this time it turns out I had a reputation in the salesforce finance department, so it didn't take a lot of arguing to get them to offer a 50% reduction in exchange for paying off the contract immediately and canceling it.
What they get moved to depends on what they actually need. 50% of the time it's not a CRM at all but a more appropriate app like an EMR, ticket system, ERP, scheduling apps, invocing solutions for existing accounting apps, etc.
The rest of the time it'll be to CRMs and marketing tools that already exist, or custom extensions/connectors to their apps or a way to link their apps and a CRM. I've moved folks to Monday, Nutshell, Hubspot (who I don't like either but they're better than SF), a dozen others.
I haven't dealt with a company yet that couldn't move to a cheaper alternative with no loss in functionality. If execs have emotional ties to SF then I can't do anything. I had one client, the sales VP shot down a conversion because he liked being able to say "we run on Salesforce!" Literally. he liked being able to brag they could afford Salesforce. I just left that one alone.
Unfortunately this is what I meant by the braggarts and resume padders. It's usually only after these people leave that the company takes a serious look at their books and then decide that they want to move away from SF.
Salesforce is the most bloated piece of any software I've ever seen, and I've seen Azure. Apples and oranges, yes, but Azure is far more navigable than Salesforce.
Once when planning to buy some property, I watched for 10 minutes as the real estate sales agent painstakingly took about 10 minutes to navigate through and book an apartment for me. Enough time for me to start second-guessing about buying the property. Had SF been faster, I would've been stuck with some really illiquid shit.
When does this end? Next year, there will be "ReFreshService" at $1K/year, so migrate again, re-train again? There is a lot be said about stability and continuity, wouldn't you say? I have no dog in the hunt, SF-wise, I've used it like 3 times in 20 years. If it continues to exist because if its predatory tactics (I've no idea) that's a different narrative.
One of my absolute favorites was, "well, our Salesforce consultant is the husband of the VP of marketing so we can't do anything that would eliminate his contract." In the end we got rid of Salesforce, him, AND the VP of marketing.
I was really surprised, because one of the two I'd worked with at three other companies, all of which had successful exits (including an inpatient healthcare provider that we ran and sold during COVID!). Something changed, and at this company he made it all about him making the calls and not just trusting his CEO and company staff. He froze out the C-suite, manipulated facts to cause a change of leadership, and in 6 months he forced the new CEO to do all these dumb ideas we'd already tried repeatedly, taking the company from being break even and close to profit to a $2m/month revenue shortfall. There were structural process issues inside the company but he just kept insisting we needed a bigger marketing spend, "marketing can fix any problem."
ah, can stop there
I can't pick one over all, it really depends on what your health care company does. I researched dozens to find one for our company, and it was one focused on behavioral health.
In general I'd say stay away from Nextgen like the plague, and avoid Netsmart too. Those are the worst I've ever seen. I could write a small book about Nextgen's failures.
My international enterprise and all our business partners moved every broadcom product we have to a competitor. On top of that, they were very aggressive and combative with their sales+cease and desist threats.
They earned enemies for life. Some of us care about business relationships. Broadcom is dead to me and anyone that will listen to me.
That's the thing: Broadcom don't. Care, bother, whatever. You are not even a blip.