The witch report_2018_annual_review

© 2019 Damo Consulting Inc.
The WITCH Report:
2018 Annual Review
A review of the financial and market
performance of global technology firms in
healthcare

About the report
This report is a summary of the financial and market performance of major global technology consulting firms, specifically in the healthcare segment. The
focus of the report is on M&A activities, customer wins, partnerships, new product initiatives and leadership announcements. The report is based entirely on
publicly available information about the companies covered. For consistency, timelines are referred to in calendar quarters, though the fiscal year periods
are different for the companies covered here.
2© 2019 Damo Consulting Inc.

Despite a slow Q4, the outlook for technology services in healthcare remains strong
Most firms had a soft Q4 in 2018, with HLS business growth
dropping below overall company growth. HCL continued
to be an exception, growing at an impressive 18.56% on a
YoY basis, the highest in its peer group. We believe Wipro’s
struggles with the HPS acquisition may be bottoming out
and the HLS business could be headed for a breakout year in
2019.
The HLS business of all companies covered in this report contains a mixture
of offerings, from infrastructure and applications services to business process
services and in a couple of cases, IP and platform-based services. In terms of
segment-wise performance, we estimate that most of the business for the
WITCH companies comes from the payer and pharma segments. The provider
segment has long been a challenge for global IT consulting firms for a variety
of reasons. We believe there are emerging opportunities in the provider space
from digital transformation initiatives and cost reduction pressures leading to IT
operations outsourcing.
There was significant M&A in 2018. Large transactions include Atos’ acquisition
of Syntel for $3.2 billion, HCL’s acquisition of a portfolio of IBM’s IP assets for
$1.8 billion, and DXC’s acquisition of Luxoft for $2 billion. DXC made a string of
acquisitions over the year including Molina’s Medicaid Solutions (MMS) for $220
million earlier in the year. Cognizant continued to be active, acquiring Bolder
Healthcare and Softvision LLC during the year.
In the past couple of years, many India-heritage firms have set up operations
centers and innovation hubs across the U.S. The drivers for this trend include
the need to be closer to customers with local talent, the need to tap into scarce
skills such as design thinking which are important for digital transformation
programs, and building the next level of scale which is increasingly difficult in
the highly saturated overseas talent market. We have included an interactive
map in this report indicating the build-out of innovation hubs and centers
across the U.S. by firms covered in this report.
A couple of firms covered in this report had a challenging year. Cognizant had
a significant ramp down in a major contract, and IBM struggled with negative
media coverage for its Watson Health platform and business.
There were leadership changes in several companies, including Cognizant,
Wipro, Infosys, and IBM Watson Health.
Our view is that the demand outlook for healthcare remains strong and broad-
based. Digital transformation programs are taking hold in the larger enterprises
in each sub-segment of healthcare. Most firms in this report are deriving their
revenues currently from the payer and pharma segments, leaving a huge
untapped opportunity in the provider space. As providers start to embrace
outsourcing and invest more in digital transformation, global IT consulting firms
will see a significant growth opportunity.
As many of you know, we have been publishing the WITCH report since 2015,
and till now we have based the report entirely on publicly available information.
This year, we received briefings from companies covered in the report which
enabled us to refine our commentary and address the emerging trends for
technology services in healthcare. We believe the content in our report has
been significantly enriched by our interactions and would like to thank the firms
for their time and effort.
This year, we are adding a bonus section to this report. You can find download
details at the end of this report.
As always, I hope you find the report useful and informative. I would love to
hear from you.

Paddy Padmanabhan, CEO, Damo Consulting Inc.
paddy@damoconsulting.net
April 02, 2019

Table of contents
8
14
19
23
29
34
40
42
44
46
49
Wipro
IBM
The WITCH group: Healthcare financials
Infosys
TCS
Cognizant
HCL
Financial and market performance: Select global consulting firms
Accenture
Atos
Capgemini
DXC Technology
NTT DATA

Glossary of terms used in this report
OM: Operating margin
QoQ: Quarter on quarter
YoY: Year on year
$: USD
HLS: Healthcare and Life Sciences
CTS: Cognizant Technology Solutions
TCS: Tata Consultancy Services

Financials and related commentary

The WITCH Group: M&A and organic growth in equal measure
For four quarters ending Dec 31, 2018
7
Performance highlights
Results for
12 months
ending
Dec 31,
2018
Company
revenue
(in USD
MM)
HLS revenue
(in USD MM)
Healthcare
% of total
HLS
operating
margin
(Avg 2018)
HLS
revenue
growth
(YoY)
Company
revenue
growth
(YoY)
Wipro 8143 1087 13.34% 11.48% (5.48%) 2.39%
Infosys 11510 745 6.47% 28.62% 4.93% 7.77%
TCS 20488 1517 7.40% N.A 14.58% 10.33%
CTS 16125 4668 28.95% 30.65% 9.50% 8.88%
HCL 8392 1054 12.56% N.A 18.56% 10.18%
• Cognizant remains the dominant player in healthcare
among its peer group. However, its growth rate has
slowed in the past few quarters. Inorganic growth
from acquisitions during the year has helped maintain
overall growth rates for the year.
• HCL has shown the highest growth in HLS business
among its peers, with an impressive 18.56% growth
rate for the year. HCL’s HLS business has consistently
outgrown the rest of the company.
• Wipro’s growth continues to be impacted by the HPS
acquisition, however, its performance in the last
quarter suggests a turnaround, led by growth in the
rest of the HLS business.
• Infosys’ growth has been flat for the Insurance SBU
(which includes HLS) in the past three quarters. Among
its peer group, Infosys is the only company where
HLS is not a stand-alone SBU. The HLS business could
see upsides in 2019 from a couple of significant wins
announced during the year.
• TCS’ HLS business has seen steady low-to-mid single
digit growth during the year, supported mainly by
organic growth from the life sciences business.
4.93%
14.58%
9.50%
18.56%
2.39%
7.77%
10.33%
8.88%
10.18%
Infosys TCS CTS HCL
20.00%
15.00%
10.00%
5.00%
0.00%
-5.00%
-10.00%
-5.48%
Wipro
HLS vs overall company revenue growth % comparison
HLS revenue growth Company revenue growth

Wipro: 2018 performance and highlights (1/4)
• The company’s overall HLS revenue has
remained somewhat flat since 2015 despite
the sharp decline in revenues from the
HPS acquisition. This suggests that the rest
of the HLS business is doing well and is
compensating for the HPS decline through
above-normal growth rates.
• While HLS outgrew the rest of the company
in Q4 2018, the impact of HPS continues
to be a drag on the operating margins for
Wipro’s HLS business. The HLS operating
margin has declined to 10.25% for Q4 2018,
translating to a notional impact of $250-
$300 million (on operating profit) during
the year.
• Wipro HLS has a new leader, Bill Stith,
following the departure of Jeffrey Heenan-
Jalil in late 2018. The company has also
indicated a positive outlook for the coming
year based on major new client wins in
2018.
HPS business continues to struggle, however, the rest of the HLS business seems to be doing well
Results
for period
ending
Dec 31, 2018
Total
revenue
(in USD MM)
HLS revenue
(in USD MM)
Healthcare
% revenue
HLS
operating
margin
Healthcare %
revenue QoQ
growth
QoQ
growth
for
company
Mar 31, 2018 2062 286 13.90% 9.82% 1.70% 2.43%
Jun 30, 2018 2026 271 13.40% 11.37% (5.28%) 1.75%
Sep 30, 2018 2009 261 13.00% 14.48% (3.69%) (0.84%)
Dec 31, 2018 2046 268 13.10% 10.25% 2.68% 1.84%
Operating margins – company and HLS
Mar 31, 2018 Jun 30, 2018 Sep 30, 2018 Dec 31, 2018
5.00%
0.00%
-5.00%
-10.00%
Revenue growth over last four quarters
Healthcare % revenue QoQ growth QoQ growth for company

Signs agreement to divest Workday and Cornerstone OnDemand business, acquired through the buyout of Appirio, (a global cloud services company
acquired in 2016 for $500 million) to Alight Solutions for $110 million. The divestiture agreement will result in approximately 350 employees in Wipro’s
Workday and Cornerstone OnDemand teams moving to Alight. In July 2018, Wipro signed a $1.5 billion contract with Alight Solutions, one of the largest
ever for Wipro and for the entire industry. Alight Solutions is a provider of benefits administration and cloud-based HR and financial solutions to
1,400 clients serving 19 million employees and their 18 million family members.
Wins contract from a North American healthcare provider (name not revealed) to enable the design, development, and launch of their new
healthcare marketplace. Wipro Digital is their partner for a new brand, platform and service and bringing agility.
Appoints former IBM executive Bill Stith, who headed IBM’s healthcare and life sciences business in the U.S. as Senior Vice President and Global Head of
health strategic business unit. This follows the resignation of Jeffrey Heenan-Jalil, Wipro’s Senior Vice President and Global Head of the healthcare
business in August 2018.
Partners with Alfresco, an enterprise open source software company automating content-centric processes for digital business, to develop and run open
source based digital transformation programs for their clients worldwide. Under the partnership, the companies will launch a series of go-to-market
initiatives including a joint Predictive Service Automation solution using AI, machine learning, and a microservices-based framework, that will transform
the future of asset maintenance. Alfresco supports healthcare providers to manage patient data and automate clinical processes with platforms
including Health Content Management Platform, Clinical Process Automation, Vendor Neutral Archive, and Clinical Collaboration.
Feb 2019
Dec 2018
Nov 2018
Dec 2018

Wins a multi-year business process services engagement and chosen as a finance transformation partner by Falck, a leading supplier of ambulance
services, employee health care and roadside assistance. As part of the contract, Wipro will help transform Falck’s finance operations, increase
operational efficiency and achieve data and process consistency across its different entities around the globe.
Launches an end-to-end solution to address the issue of fraud, waste, and abuse in healthcare insurance claims in the U.S., in partnership with Opera
Solutions, a provider of advanced analytics software solutions in which Wipro has invested a total of $53 million till date, accounting for a 20%
stake.
Chosen by a US-based healthcare organization (name not revealed) for a cloud-based engagement that will help the client better manage its B2C
and B2B stakeholder relationships.
Aug 2018
Jun 2018
Sep 2018
Appoints Ms. Arundhati Bhattacharya, the former Chairman of State Bank of India (SBI), to its Board of Directors for a period of five years effective
January 1, 2019.
Wins a long-term digital strategic engagement with a leading healthcare company (name not revealed) to enhance their user experience through IT
service desk transformation. The contract will leverage AI and automation for service desk transformation.
Oct 2018
Sep 2018

Wipro Ventures invests in Avaamo, a deep-learning company, along with other investors in a $14.2 million series A round led by Intel Capital with
additional investment from Ericsson Ventures, Mahindra Partners, and WI Harper. This investment will be utilized in expanding Avaamo’s sales and
marketing of conversational AI solutions in the growing global market. Avaamo supports healthcare companies in Discovery & Scheduling, Care
Management, etc.
Enters into an agreement to divest the company’s hosted data center services business unit to Ensono, a cloud and managed infrastructure services
provider, in a transaction valued at $405 million. According to this agreement, Wipro will transfer eight data centers and over 900 employees of its
hosted data center services business to Ensono. Wipro had originally acquired the hosted data center business along with other two businesses -
Medicare and Medicaid services – as part of the $600 million acquisition of Infocrossing Inc in 2007. Along with the sale of the data centers, Wipro has
integrated its Medicare & Medicaid services and the ERP implementation services business of the erstwhile Infocrossing business with other
divisions of the company.
May 2018
Mar 2018

Wipro: Innovation centers since 2016
12
Announced Place Description
Mar-18 Plano, Texas
Opens new Texas Technology Center to focus on developing niche capabilities in new and emerging
technologies for Wipro’s clients. This facility will primarily house Wipro’s U.S. cybersecurity center
and serve as a hub for advanced analytics practices in the U.S. The company also plans to increase its
headcount in Texas to 2000 over the next few years from 1400.
Aug-17
Mountain View,
California
Launches Silicon Valley Innovation Center to develop and focus on technologies and solutions such
as AI, virtual reality, hyper spectral imaging, machine vision and collaborative robotics & automation
to solve real-world business challenges faced by enterprises. The center has also incubated a
‘Digital Pod’ and features a ‘Rapid Proto Lab’ that allows design and engineering teams to work in a
collaborative and adaptive workspace, along with clients.
During the past decade, Wipro has invested over $2 billion in the United States with over 40 facilities across 23 states. The company has been focused
on creating jobs in the U.S. to build a pool of local talent based out of centers close to its clients.
Other updates

HPS: Adverse policy changes in healthcare insurance exchange markets have depleted value
from the acquisition
Note: HLS revenue: % of Wipro’s total revenue of the respective quarter; HLS margin: % of Wipro’s HLS revenue of the respective quarter
16.02%
16.02%
16.02%
16.02%
16.02%
16.02%
HLS revenue HLS margin
Slight
increase in
HLS margin
compared
to
previous
quarter
Margin
dropped
due to
compensation
increase
HLS margin
reduced by
more than
545 bps
compared
to
same
period last
year
Part of it is
due to loss
recognition
on HPS
acquisition
(approximately
6% of goodwill
was written off
this quarter)
Re-estimated
earnings and
indicated
a potential
loss of $125
million in
annual
revenue
from this
business
Company
stated that
the impact
of HPS has
bottomed
out and
revenue has
recovered in
this quarter
HLS margin
improved
from
negative in
the previous
quarter
Continuing
challenge
in HPS due
to ACA
ambiguity
Major impact
from the
bankruptcies
of two clients
and additional
impact from
HPS business
Challenge
with ACA
persists. The
company
is investing
in adjacent
business
and not
dependent
on ACA
Company
expects
to remain
soft’ in the
foreseeable
future
Q1 2016 Q2 2016 Q3 2016 Q4 2016 Q1 2017 Q3 2017Q2 2017 Q4 2017 Q1 2018
18.75%
13.28%
15.28%
14.33%
15.49%
16.02%
16.21%
16.00% 15.40%
14.80%
14.28%
13.70%
15.00%
14.00%
12.80%
13.90%
9.82%
(0.05%)
Q2 2018 Q3 2018 Q4 2018
13.40% 13.10%
11.37%
10.25%
14.48%
13.00%
Acquired HPS in Feb 2016 for $460 million and expected to be a leader in administrative services in the U.S. healthcare insurance with this deal
Acquired
HPS in $460
million,
expected to
be a leader in
administrative
services
in the U.S.
healthcare
insurance

Infosys: 2018 performance and highlights (1/3)
• The Insurance SBU for the company, which includes
HLS, has remained flat on a QoQ basis for the last
three quarters, trailing significantly behind overall
company growth. The softness in growth coincides with
leadership changes for the HLS business (Sangita Singh,
EVP of Healthcare, left in June 2018) as well as the
departure of the company Chief Financial Officer (CFO)
MD Ranganath during the year. This follows several
leadership changes ensuing from the departure of
former CEO Vishal Sikka, and the appointment of new
CEO Salil Parikh in January 2018.
• The operating margin has remained steady at 28% over
the past few quarters, however, the margins reflect the
combined HLS and insurance businesses.
• The company has not announced any major
acquisitions in 2018, contrasting a series of acquisitions
made during previous CEO Vishal Sikka’s tenure.
• The HLS business has won client contracts with
Molina Healthcare for infrastructure services, and
with Conduent as part of a subcontract for NY State’s
Medicaid Management Information System (MMIS).
The company has a significant position in the payer
segment with a strong client base.
• The company has launched an aggressive program to
open new operations centers across the U.S.
*Operating margin is combined for HLS and insurance business
Infosys HLS business remains flat as company readjusts to top leadership changes
Results
for period
ending
Dec 31, 2018
Total
revenue
(in USD
MM)
HLS
revenue
(in USD
MM)
Healthcare
% revenue
HLS
operating
margin
Healthcare %
revenue QoQ
growth
QoQ
growth
for
company
Mar 31, 2018 2775 186 6.70% 27.93% * 3.75% 1.52%
Jun 30, 2018 2831 187 6.60% 27.96% 0.54% 1.11%
Sep 30, 2018 2922 187 6.40% 28.34% Flat 3.21%
Dec 31, 2018 2987 187 6.26% 27.81% Flat 2.22%
Dec 31, 2018
2.00%
4.00%
3.00%
Sep 30, 2018Jun 30, 2018Mar 31, 2018
1.00%
0.00%

Signs agreement with Molina Healthcare, Inc. to manage their IT infrastructure functions, including IT operations, end-user services, and data centers.
With this agreement, Molina expects to improve its IT capabilities and operational efficiency to better serve their members, providers, and
customers while also realizing cost savings beginning in 2019.
Appoints Mark Livingston, a former executive of Cognizant Technology Solutions as head of the consulting business. This comes in the wake of Ken
Toombs resigning as head of the consulting unit in October 2018.
Appoints Michael Gibbs as an Independent Director for a period of three years. Michael Gibbs is a Global Chief Information Officer (CIO) with vast
experience in the Oil and gas sector and has previously served as the Global CIO of BP and PLC.
Sangita Singh, head of healthcare and life sciences business, resigns from Infosys (after serving almost two years). Singh was previously the head of
Wipro’s healthcare business.
Appoints Nilanjan Roy as CFO of Infosys, effective March 1, 2019, replacing M D Ranganath. Ranganath has been a part of the Infosys leadership
team during his tenure of 18 years (CFO for 3 years), and had played several leadership roles in the areas of consulting, finance, strategy, risk
management, and M&A. Previously, Nilanjan Roy worked at Bharti Airtel where he held the position of Global CFO.
Feb 2019
Dec 2018
Jul 2018
Jul 2018
Dec 2018

Partners with ValGenesis (a paperless validation company), to bring stronger compliance and quality management for its customers in the healthcare
and life sciences sectors. Infosys to integrate ValGenesis’ Validation Lifecycle Management System (VLMS) within its suite of services for the
pharmaceutical and biotech industry.
Appoints Salil S. Parekh as Chief Executive Officer (CEO) and Managing Director, effective January 2, 2018. Mr. Parekh was a member of the Group
Executive Board in Capgemini, and has nearly three decades of global experience in the IT services industry.
Jan 2018
Dec 2017

Infosys: Innovation centers since 2016 (1/2)
17
Feb-19
Providence, Rhode Island
Inaugurates Digital Innovation and Design Center and announced a partnership with the Community
College of Rhode Island (CCRI) to build and launch the Digital Economy Aspirations Lab (DEAL) to
enable and develop students for the digital jobs of the future. Infosys has already hired over 100
employees in Rhode Island toward its goal of creating 500 jobs in the state by 2022.
Dec-18 Hartford, Connecticut
Inaugurates its Technology and Innovation Hub in Hartford which will serve as the global hub for
Infosys’ InsurTech and HealthTech efforts and feature Living Labs for the Future of Insurance, the
Future of Healthcare and the Future of Manufacturing. The Living Labs enable rapid experimentation
and exploration of innovation efforts leveraging technologies such as blockchain, extended reality,
and AI. In March 2018, Infosys announced 1,000 American workers will be hired in the state by 2022
to have a special focus on insurance, healthcare, and manufacturing.
Nov-18
Indianapolis, Indiana
Begins construction on its U.S. Education Center in Indianapolis which will be a training campus
and residential center for its employees to train 10,000 new American hires as well as their existing
employees along with employees of select clients. The campus will prepare the American workforce
to master the advanced skills that are required to succeed in digital future.
Nov-18 Texas
Plans to open Technology and Innovation Hub and hire 500 American workers in the state by 2020.
The hub represents a key milestone in Infosys’ digital transformation campaign for the American
enterprises by leveraging local talent alongside the best global talent.
Sep-18 Arizona
Proposes to open Arizona Technology and Innovation Hub and hire 1,000 American workers in the
state by. The hub will have a special focus on autonomous technologies, IoT, full-stack engineering,
data science and cybersecurity.

Infosys: Innovation centers since 2016 (2/2)
18
Aug-18 Raleigh, North Carolina
Inaugurates Technology and Innovation Hub in order to work more closely with clients in the region
to develop cross-functional solutions in such areas as machine learning, artificial intelligence, user
experience, big data and cloud. This tech hub is expected to hire 2,000 American workers by 2021.
Mar-18 Indianapolis, Indiana
Opens Indianapolis Technology and Innovation Hub to train, upskill and reskill employees in the
technologies required to help businesses accelerate digital transformations and also to develop cross-
functional solutions for pressing business challenges for its clients.
Infosys plans to hire 10,000 American workers between 2017 and 2019 and open four new Technology and Innovation Hubs across the country focusing
on technology areas, including artificial intelligence, machine learning, user experience, emerging digital technologies, cloud, and big data. These four
hubs will not only have technology and innovation focus areas, but will closely serve clients in key industries such as financial services, manufacturing,
healthcare, retail, energy and more. As of now, the company has opened three innovation centers and hired over 7000 American workers in the last 18
months as part of its ongoing commitment to accelerate the pace of digital innovation for American enterprises.
Other updates

Tata Consultancy Services: 2018 performance and highlights (1/3)
Healthcare as a % of company revenues is at the lower end of the peer group: primary focus is life sciences
• The HLS business for TCS has outgrown
the company for three quarters in a row
although the growth rates have been lower
than that of peer group companies. Based
on company announcements, most of the
business is from the life sciences segment.
• The company has seen growth in life
sciences segment (through a product
offering) which has led to a bump in
revenues starting 3rd quarter of 2018.
The Advanced Drug Development (ADD)
platform notched up two wins (one US-
based pharma and another UK-based
pharma companies – names not revealed)
in the quarter ending December 2018. The
company announced a clinical trial module
as an addition to the Advanced Drug
Development platform in Dec 2018.
• The company also makes a note of the
fact that it might not have to pay any
damages in the Epic lawsuit. It is seeking to
completely set aside the earlier judgment
(to pay compensation of $480 million to
Epic Systems related to IP breaches). For four quarters ending Dec 31, 2018
Results
for period
ending
Dec 31, 2018
Total
revenue
(in USD MM)
HLS revenue
(in USD MM)
Healthcare
% revenue
HLS
operating
margin
Healthcare %
revenue QoQ
growth
QoQ
growth
for
company
Mar 31, 2018 4972 357 7.20% N.A 2.44% 3.86%
Jun 30, 2018 5051 368 7.30% N.A 2.99% 1.59%
Sep 30, 2018 5215 391 7.50% N.A 6.25% 3.25%
Dec 31, 2018 5250 399 7.60% N.A 2.05% 0.67%
7.00%
6.00%
5.00%
4.00%
3.00%
2.00%
1.00%
0.00%
Mar 31, 2018 Jun 30, 2018 Sep 30, 2018 Dec 31, 2018

Wins contract with a North American healthcare major (name not revealed) to implement IgnioTM
, its cognitive automation product, to drive a
Machine First transformation to provide a seamless experience to business users and improve business metrics across the entire healthcare value
chain.
ADD platform wins a contract with a large US-based pharma company (name not revealed) signed for innovative solutions in the regulatory space.
Collaborates with Red Hat to develop microservices-based open source solutions and frameworks leveraging the Red Hat OpenShift Container
Platform, machine learning algorithms, natural language processing engines, and other Red Hat specific products and technologies that will accelerate
customers’ digital transformation journeys. Red Hat’s open source products including Red Hat JBoss Middleware, Red Hat Enterprise Linux, Red Hat
Virtualization and Red Hat Gluster Storage which address the critical IT demands of the healthcare industry.
Introduces a new version of the Connected Clinical Trials (CCT) platform at the recently concluded TCS ADD Vantage forum in Paris. CCT is a software-
as-a-service (SaaS) platform, part of TCS’ Advanced Drug Development (ADD) suite that offers a wide range of cloud based clinical solutions and
services. The latest upgraded version has the following features; Intelligent Medication, Digital Patient and Site Engagement, Virtual and Remote.
Appoints Hanne Birgitte Breinbjerg Sorensen and Keki M. Mistry as Additional and Independent Directors of the company for a period of 5 years with
effect from December 18, 2018. Hanne Sorensen is presently on the Board of Tata Motors Limited, Jaguar Land Rover Automotive Plc, Delhivery Private
Limited, Ferrovial S.A., LafargeHolcim Limited and Sulzer Limited. Keki Mistry is Vice Chairman & CEO of HDFC Limited and on the Board of Torrent
Power Ltd., CDC Group (London) and Greatship (India) Ltd.
Jan 2019
Dec 2018
Dec 2018
Dec 2018
Dec 2018

Opens new office in Denver, Colorado for more than 120 employees to enable customers digital transformation. TCS has hired 200+ employees across
the state in the last five years, 80 percent of whom are based in Denver, working with customers in sectors from travel, retail, and manufacturing,
to healthcare, media and banking and financial services.
Aug 2018
Partners with Mesosphere (the creators of DC/OS) to help customers utilize data services and cloud platforms more efficiently. Mesosphere supports
healthcare industry and others such as automotive, financial services, etc. DC/OS (Datacenter Operating System) is a platform for building, deploying,
and elastically scaling modern applications and big data. Few healthcare clients of Mesosphere’s DC/OS are Athena Health, and Wellframe (digital
health company).
Jan 2018

TCS: Innovation centers since 2016
22
Dec-17 New York City, New York
Launches Tata Innovation Center in partnership with Cornell Tech on its campus following a
$50 million investment in the University to collaborate on technology research and expand K-12
digital literacy programs in New York City.
Sep-17
Across Americas, Asia
Pacific, China and
Europe
Establishes an artificial intelligence (AI) Center of Excellence (CoE) with Intel to accelerate adoption
of AI solutions. The new AI CoE will have a strategic physical and online presence across Americas,
Asia Pacific, China and Europe and will be equipped with the latest technologies and experts to assist
Intel Nervana AI Academy members, including developers, data scientists, students, professors, and
startups, in developing AI solutions.
May-17 Cincinnati, Ohio
Opens its first Drones Research Lab in the U.S. at its Seven Hills Park Innovation Center to address the
rapidly expanding demand for unmanned aerial vehicles and business solutions across industries.
Apr-17 Pittsburgh, Pennsylvania
Partners with Carnegie Mellon University to build new facility, ‘TCS Hall’ on the CMU campus in
Pittsburgh. The TCS Hall which is supported by a $35 million grant, will house research and academic
spaces where the two institutions will collaborate on promoting next-generation technologies that will
drive the 4th Industrial Revolution, including cognitive systems and autonomous vehicles.
Note: TCS did not open any innovation centers in the U.S. However, the company opened innovation centers in India and France in 2016.

Cognizant: 2018 performance and highlights
Maintains leadership position in HLS; experiences softness in growth in Q4
• Cognizant’s Healthcare practice remains the largest by
far among the WITCH Group firms. The HLS business has
largely outperformed the company in terms of growth
(though it dipped in Q4). The OM for the HLS business
remains the highest among peer group companies.
• The Bolder Healthcare and TMG Health acquisitions have
significantly contributed to revenue from outsourcing
services which compensated for a drop in revenue due
to a ramp down of a customer relationship (see detailed
notes in next section). Around 30% of revenue increase
is due to Bolder acquisition. The company estimated
the annual revenue of Bolder around $100 million, the
combined revenue for the two quarters (Jun and Sep)
post acquisition was approximately $75 million.
• The company is also the furthest ahead in IP and
platform-based business among peer group firms,
mainly on account of the Trizetto acquisition in 2014.
A SaaS product in Lifesciences, Shared Investigator
Platform, is live at five large pharmaceutical clients.
• Cognizant remains active in acquisitions among its peer
group in the healthcare space, and has also aggressively
expanded its North American delivery center footprint.
• The recently announced departure of long-term CEO
Francisco D’Souza, and long-term President Raj Mehta
could imply further changes in leadership during 2019.
Results
for period
ending
Dec 31, 2018
Total
revenue
(in USD
MM)
HLS
revenue
(in USD
MM)
Healthcare
% revenue
HLS
operating
margin
Healthcare %
revenue QoQ
growth
QoQ
growth
for
company
Mar 31, 2018 3912 1121 28.65% 30.15% (0.36%) 2.19%
Jun 30, 2018 4006 1156 28.86% 30.88% 3.12% 2.40%
Sep 30, 2018 4078 1189 29.15% 32.13% 2.85% 1.79%
Dec 31, 2018 4129 1202 29.11% 29.45% 1.09% 1.25%
-1.00%
0.00%
1.00%
2.00%
3.00%
4.00%
Mar 31, 2018 Jun 30, 2018 Sep 30, 2018 Dec 31, 2018

Cognizant: 2018 healthcare business highlights (1/2)
Appoints Brian Humphries, currently the CEO of Vodafone Business, as its CEO and a member of the Board of Directors, effective April 1, 2019. This
follows Francisco D’Souza, who co-founded Cognizant and has served as CEO since 2007, stepping down from his current position. D’Souza will
continue to serve as full-time Executive Vice Chairman.
Conduent a technology-led business process services company headquartered in New Jersey, formed in 2017 as a divestiture from Xerox, announces
it is terminating its subcontract with Cognizant to deliver IT outsourcing services as part of a subcontract for a $500 million contract with NY State’s
MMIS. Conduent has reportedly filed a lawsuit for $150 million against Cognizant for breach of contract. Conduent has also shifted the work to Infosys
(estimated at $45-50 million a year). Ashok Vemuri, CEO of Conduent is a former senior executive of Infosys.
Proposes to acquire Texas-based Softvision, LLC, a privately-held digital engineering and consulting company focused on agile development of innovative
software solutions and platforms. With the acquisition of Softvision, Cognizant is expanding their digital engineering capabilities to become a leader in
software product development. Softvision works with clients in financial services, retail, consumer products, healthcare and other industries.
Elects Board member Michael Patsalos-Fox as its new Chairman. He succeeds John E. Klein, who has served as Chairman for nearly 15 years, and
will remain a Board member. Patsalos-Fox is currently Chairman, President and CEO of Vidyo, a leading visual communications services provider.
Previously he was CEO of Stroz Friedberg, Inc., a global cyber security firm, a position he held from 2013 to 2016.
Feb 2019
Dec 2018
Oct 2018
Sep 2018

Cognizant: 2018 healthcare business highlights (2/2)
Acquires Advanced Technology Group (ATG) to expand Cloud ‘Quote-to-Cash’ capabilities. ATG, with headquarter in Kansas provides customer and
revenue management consulting and implementation services focused on the Salesforce Platform. Its clients include financial services, healthcare,
communications and technology companies.
Sep 2018
Acquires Bolder Healthcare Solutions, a provider of revenue cycle management (RCM) solutions to hospitals, physician practices, and other specialist
healthcare organizations in the U.S. Bolder Healthcare Solutions was founded in 2012 and has 2,400 specialists serving 1,400+ clients located in the
U.S. Bolder Healthcare has made number of acquisitions after its formation, few examples: Business Dynamics Ltd. (RCM provider), Healthcare
Receivable Professionals, Inc., Prospective Payment Specialists, Inc.
Mar 2018

Cognizant: M&A in the U.S. healthcare (since 2014) (1/2)
Proposes to acquire Texas-based Softvision, LLC, a privately-held digital engineering and consulting company focused on agile development of innovative
software solutions and platforms. With the acquisition of Softvision, Cognizant is expanding its digital engineering capabilities to become a leader
in software product development. Softvision works with clients in financial services, retail, consumer products, healthcare and other industries.
Acquires Bolder Healthcare Solutions (a provider of RCM solutions to hospitals, physician practices, and other specialist healthcare organizations in
the U.S.) to boost revenue cycle management services for providers.
Oct 2018
Apr 2018
Acquires ATG to expand cloud-based ‘Quote-to-Cash’ capabilities. ATG, with headquarter in Kansas, provides customer and revenue management
consulting and implementation services focused on the Salesforce Platform. Its clients include financial services, healthcare, communications, and
technology companies.
Acquired Health Care Service Corporation’s (HCSC) subsidiary TMG Health as part of the expansion of its strategic relationship with HCSC. TMG Health
entered into a new, expanded multi-year service agreement to continue providing information technology, business process, and other services to
HCSC’s various operating units and subsidiaries.
Acquired Idea Couture, a global firm offering a broad range of digital innovation, strategy, design technology services. As a part of Cognizant’s
digital business, the company promotes Idea Couture for designing patient-centric health services and technologies.
Feb 2018
June 2017
Jul 2016

Cognizant: M&A in the U.S. healthcare (since 2014) (2/2)
Exclusive strategic partnership and acquisition of an ownership interest of 49% in ReD Associates (a strategic consulting firm specializing in the use of
human sciences to help business leaders better understand customer behavior). For healthcare clients, ReD Associates helps them in the area of
innovation, patient services, and commercial effectiveness.
Acquired TriZetto Corporation for $2.7 billion in cash to offer world-class healthcare IT solutions. At present, Cognizant claims that the TriZetto suite of
products (such as core administration, care management, and provider network management) supports more than 60% of the managed Medicaid
lives in 42 states in the U.S.
Nov 2014
Apr 2016
Acquired Cadient Group Inc., a full-service digital marketing agency that serves a broad spectrum of life sciences companies in the pharmaceutical,
biotechnology, consumer health, and medical device industries.
Oct 2014

Cognizant: Innovation centers since 2016
28
Feb-19
Boulder, Colorado
Opens Accelerator global technology center and innovation hub with 100-person Cognizant
Accelerator team focused on developing Cognizant’s offerings in artificial intelligence, blockchain and
IoT. Cognizant Accelerator is the company’s incubator and venture investing division that develops
new product concepts, and oversees their development and market introduction.
Aug-18 Irving, Texas
Opens its newest U.S. regional technology and service delivery center in Irving, Texas with plans
to create 1,100 new jobs by 2023. The center is comprised of 50,000 square feet and will house a
10,000-square-foot training facility and provide services for Cognizant’s Dallas-area clients in various
industries, including insurance, healthcare and retail.
Aug-18 Mesa, Arizona
Opens U.S. regional technology and service delivery center in Mesa, Arizona. The center will house
over 500 new employees, increasing Cognizant’s statewide workforce to nearly 3,000 employees
at facilities in Phoenix, Chandler and Mesa as it addresses strong demand for specialized digital
technology and business process services.
Sep-17 New York City, New York
Opens new Cognizant Bronx Training Center in partnership with Per Scholas to provide tuition-free
training and direct hiring opportunities to New Yorkers who seek new careers and professional
advancement opportunities in the growing IT, digital and tech sectors.

HCL: 2018 performance and highlights
HCL continues with its impressive performance in HLS; IP-led acquisitions driving Mode1, Mode2, Mode 3 strategy
• Though HCL’s momentum in HLS has been
the strongest among the WITCH Group
companies for the year. QoQ growth has
been the strongest among its peer group in
Q4 2018.
• HCL made aggressive acquisitions in 2018.
The company has focused on growth led
by IP through acquisitions, announcing
a $1.8 billion acquisition of a portfolio of
IBM’s software assets in Dec 2018. On the
IBM deal, the company sees an increase
in revenue to the tune of $625-$650
million annually. The contribution from
the incremental revenue toward the HLS
business is unclear currently.
• The company made acquisitions earlier
in the year with Actian ($330 million), and
C3i Solutions ($60 million) both of which
will contribute directly to the HLS revenue
growth.
Results
for period
ending
Dec 31, 2018
Total
revenue
(in USD MM)
HLS revenue
(in USD MM)
Healthcare
% revenue
HLS
operating
margin
Healthcare %
revenue QoQ
growth
QoQ
growth
for
company
Mar 31, 2018 2037 235 11.50% N.A 0.85% 2.46%
Jun 30, 2018 2055 263 12.80% N.A 12.28% 0.88%
Sep 30, 2018 2098 270 12.87% N.A 2.66% 2.09%
Dec 31, 2018 2202 286 13.00% N.A 5.93% 4.96%
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
14.00%
Revenue growth over the last four quarters

HCL: 2018 healthcare business highlights (1/2)
Acquires Strong-Bridge Envision (SBE), a digital transformation consulting firm headquartered in Seattle, WA for approximately $45 million. SBE
specializes in customer experience strategy, business transformation, and change management. It will become a part of HCL’s global digital and
analytics business and enhance their digital consulting offerings.
Acquires select IBM software products for $1.8 billion which represent a total addressable market of more than $50 billion. These products are in
growing market areas like security, marketing and commerce. HCL expects large-scale deployments of these products to provide an opportunity to
reach and serve thousands of global enterprises across a wide range of industries and markets.
Appoints Prateek Aggarwal as the new CFO from October 01, 2018, following the retirement of Anil Chanana. Prateek Aggarwal has served across
several leadership roles and led various strategic initiatives since 2012.
Signs end-to-end IT infrastructure services deal with Falck, an international leader in the ambulance and healthcare markets. HCL will help Falck in
business transformation by consolidating, simplifying and standardizing the company’s IT infrastructure operations through a centralized global
service delivery model. Flack has 37,000+ employees and operates in 35 countries.
Mar 2019
Dec 2018
Sep 2018
Jun 2018

HCL: 2018 healthcare business highlights (2/2)
HCL and Sumeru Equity Partners (a technology and growth-focused private equity firm) forms a joint venture to acquire Actian Corporation for
$330 million in an all-cash deal. Actian provides hybrid data management, cloud integration, and analytics solutions to multiple industries including
healthcare. HCL owns 80% and Sumeru Equity Partners owns 20% of the JV entity which in turn to own 100% shareholding of Actian Corporation.
Apr 2018
Acquires C3i Solutions from Merck & Co., Inc. (in NJ, USA) for $60 million cash. C3i Solutions provides multi-channel customer engagement services
for the life sciences and consumer packaged goods (CPG) industries. C3i has 3,800+ employees and serves one million life science professionals
each year and supports 1.3 million end users across 175 countries.
Apr 2018

HCL: Innovation centers since 2016
Aug-18 Seattle, Washington and
Noida, India
Opens IoT COLLAB, a dual-location IoT innovation centres in Seattle, Washington, and Noida, India that
serve as collaborative incubation lab for Fortune 500 companies accelerate IoT initiatives by bringing
together technology experts, partners, financial advisors, and other relevant IoT stakeholders. The IoT
COLLAB help organizations navigate the journey from concept to full-scale deployment.
Mar-18
Redmond, Washington
Opens a technology development center (Lab 21) in Redmond, Washington, to showcase collaboration,
investments, and advocacy on Microsoft AI platform/Cortana Analytics in the Azure Cloud. This center to
focus on development and deployment of solutions based on the Microsoft AI platform for enterprise
customers in the areas such as business intelligence, big data, and advanced analytics.
Feb-16
Redmond, Washington
Launches Internet of Things (IoT) Incubation Center in Redmond, Washington, USA, designed to leverage
Microsoft Azure IoT Suite to accelerate enterprise IoT adoption. The incubation center will build vertical
solutions focused on two key growth areas: industrial & manufacturing, and life sciences & healthcare,
with use cases around industrial automation, remote patient monitoring and fleet management, among
others.
Other facts: Over the past three decades, HCL has built a strong ecosystem in the United States, which now includes more than 15,000 employees, with 64%
of the team hired locally. HCL has also made significant investments in global delivery centers anchored in the U.S. with a collection of strategic technology
labs creating new age processes, applications, and platforms for global customers.

33
Innovation Centers launched by WITCH companies since 2016
Please move the cursor over the centers to view details. If it is not working, kindly click the link https://indd.adobe.com/view/e7ebd4a7-adec-428e-b93d-e83cbb1ea8f7
Wipro Infosys TCS Cognizant HCL
Redmond
Mountain view
Mesa Arizona
Seattle
Boulder
Texas Plano Irving
Cincinnati
Hartford
Providence
New York City
Raleigh
Indianapolis

Financials and market performance: Select
global consulting firms

35
Accenture (1/6)
The company reported net revenue of $6.8 billion in the healthcare and public service (H&PS) segment for the year ended November 30, 2018. H&PS
witnessed lower growth rates due to the impact of the U.S. Federal business as contracts wind down. Nevertheless, the health business is growing in upper
single digits with increasing demand from payers as well as providers.
Results for period ending
Dec 31, 2018
Total revenue
(in USD MM)
Healthcare and public
service
(in USD MM)
Healthcare % revenue QoQ growth
Feb 28, 2018 9585 1642 0.5%
May 31, 2018 10314 1703 3.7%
Aug 31, 2018 10149 1708 0.3%
Nov 30, 2018 10605 1754 2.7%

36
Accenture (2/6)
Following the passing of Chairman and CEO Pierre Nanterme after stepping down in January for health reasons, David Rowland, CFO, becomes an
interim CEO and is appointed to the Board as a Director of Accenture. Independent Director Marge Magner is appointed as the company’s Non-
executive Chair of the Board. The company also appointed KC McClure, who currently leads Accenture’s finance operations, as CFO.
Acquires Knowledgent, a data intelligence company expanding data management capabilities and helping companies become digital and intelligent
by gaining deep insights into their businesses and customers. Based in New Jersey, Knowledgent helps enterprises harness the value of their data
and create a competitive advantage using cutting-edge data technologies and significant experience in the life sciences, healthcare, and financial
services industries.
Feb 2019
Jan 2019
Wins contract with CAQH, a non-profit healthcare alliance to develop and launch a new technology platform that will streamline professional
credentialing and data sharing between delegated health providers and health plans. The CAQH ProView for Groups platform enables provider
groups to submit a single roster of their delegated providers through a centralized portal giving plans access to standardized, updated files in one
convenient location.
Opens an innovation hub in Atlanta, spanning 30,000 square feet of space and located on Georgia Tech’s campus at Technology Square. The hub
serves as a place where clients can co-innovate with Accenture teams to ideate, rapidly prototype and then scale innovative products and services
for the digital economy.
Jan 2019
Dec 2018

37
Accenture (3/6)
Wins a contract with Pierre Fabre, a private French pharmaceutical group with offices in 47 countries including the U.S., to build an intelligent IT
platform to support and improve the performance of a range of functions including finance, accounting, procurement, order management, and
manufacturing. The new integrated platform will be built on SAP S/ 4HANA and SAP Ariba and deployed across all Pierre Fabre’s sites in France.
Creates an open life sciences partner ecosystem designed to help independent software vendors and life sciences companies, and team up more
effectively to accelerate drug discovery efforts. The ecosystem is an integral part of the cloud-based informatics research platform being developed
by Accenture and Merck.
Dec 2018
Nov 2018
Opens an innovation hub in Seattle in which clients co-innovate with Accenture teams to design solutions for the digital economy. Accenture will
add 300 highly skilled technology jobs by the end of 2020 and expand its U.S. apprenticeship program.
Introduces Ella and Ethan, two interactive virtual-assistant bots that use AI to constantly learn and make intelligent recommendations for interactions
between life sciences companies, patients, health care providers (HCPs) and caregivers. The Ella and Ethan bots are part of the Patient Engagement
Support solution in the Accenture Intelligent Patient Platform, a digital health solution that supports patients throughout their healthcare
experience, from participation in clinical trials through managing ongoing treatment and wellness.
Collaborates with Merck and Amazon Web Services (AWS) to launch a cloud-based informatics research platform designed to help organizations
in the life sciences industry accelerate innovation in drug development research. The platform allows life sciences researchers and informatics
professionals to quickly aggregate, access and analyze research data from multiple applications.
Nov 2018
Sep 2018
Sep 2018

38
Accenture (4/6)
Completes acquisition of designaffairs a strategic design consultancy headquartered in Germany with a presence in the U.S. This acquisition
bolsters Accenture’s capabilities around smart products, smart services, platforms, and new business models for the digital reinvention of industrial
companies. designaffairs focuses on the following industries; automotive design, industry 4.0, health care, building technologies, household
appliances, and consumer electronics.
Completes acquisition of Pillar Technology, a smart embedded software company expanding its Industry X.0 practice in North America. Pillar
Technology, headquartered in Ohio brings more than 20 years of experience in the rapid, agile development of high-quality and user-friendly
embedded software used in smart, connected products in healthcare and other industries.
Appoints Gene Reznik as Chief Strategy Officer, succeeding Omar Abbosh, effective September 01, 2018. Mr. Reznik was Senior Managing Director
of Technology Ecosystem & Ventures and held several global leadership positions in Accenture’s Communications, Media & Technology operating
group.
Acquires hardware engineering firm Mindtribe to bolster its Industry X.0 practice to help companies redefine smart connected software and physical
products. Mindtree, based in San Francisco, creates innovative connected hardware integrated with digital services for healthcare, automotive and
other industries.
Aug 2018
Aug 2018
Aug 2018
Aug 2018

39
Accenture (5/6)
Acquires Kogentix, a company providing open source big data and AI services and solutions to strengthen Accenture Applied Intelligence’s growing
data engineering business, particularly in North America and harness open source big data and advanced analytics technologies. Kogentix,
headquartered in Schaumburg, Ill., Chicago has clients in technology, high-tech, healthcare, consumer goods, and financial services companies.
Acquires an AI technology from California-based Real Time Analytics Platform, Inc. The technology will be integrated into the Accenture Touchless
Testing Platform, further strengthening its analytics and cognitive capabilities. The integration of Real Time Analytics Platform will further enhance
the AI-driven capabilities of the Accenture Touchless Testing Platform to help clients increase productivity and agility.
Jul 2018
Jul 2018
Helps Northside Hospital in transforming supply chain and procurement operations to reduce utilities and telecommunications costs.
Jun 2018
Launches Accenture Google Cloud Business Group (AGBG) with Google Cloud to help deliver superior customer experiences and accelerate their
digital transformation journeys. AGBG, with an initial focus on the retail, consumer packaged goods, and health industries will develop intelligent
solutions leveraging data-driven insights.
Jul 2018

40
Accenture (6/6)
Wins six-year $138 million contract to help The Commonwealth of Virginia’s Department of Medical Assistance Services (DMAS) to implement and
operate core systems for Medicaid claims processing and operations. Virginia is going to be the first state to develop and implement a new Medicaid
system complying with the latest Centers for Medicare and Medicaid Services (CMS) standards for modularity to enhance system flexibility and
responsiveness.
Wins Modernization Contract (of $62 million) from Veterans Benefits Administration (VBA) to upgrade and enhance its information technology
infrastructure as part of the VBA’s commitment to improving the delivery of services it provides to Veterans.
Feb 2018
Jan 2018
Accenture and Global Center for Health Innovation form a working group to explore data-driven solutions that better integrate the continuum of
addiction services (first responders, ER, and inpatient, outpatient, behavioral health) to improve treatment and move toward prevention. Global Center
for Health Innovation provides a platform for global healthcare leaders – health systems, investors, and innovators – collaborate to develop
solutions to solve high-priority healthcare issues.
Mar 2018

41
Atos (1/2)
The public and health business reported net revenue of $5.2 billion for the year 2018. North American clients that contributed significantly to Atos’
Healthcare business include Texas Department of Information Resources, Allscripts and McLaren Health Care Corporation. The healthcare sector had new
customer wins in North America. Cybersecurity had significant growth in the public and health sector and a major win with a large U.S. hospital.
Results for period ending
Dec 31, 2018
Total revenue
(in USD MM)
Healthcare and public
service
(in USD MM)
Healthcare % revenue QoQ growth
Mar 31, 2018
3631
1033 (13.7%)
Jun 30, 2018
3650 1024
(0.9%)
Sep 30, 2018
3354
951
(7.1%)
Dec 31, 2018
3844 997 4.9%

42
Atos (2/2)
The Ministry of Justice (MoJ), UK, has called in Atos’s CEO over a sweeping IT systems outage that led to courtroom chaos across the country. The
outage could lead to major fines. Atos was contracted with the MoJ back in 2014 to deliver its end users computing services, a contract worth
£125 million.
Collaborates with Bayer and RWTH Aachen University to evaluate the use of Quantum Computing in research and analysis of human disease
patterns. Computing and life science experts from these three institutions will use the Atos Quantum Learning Machine to research the evolution
of multi-morbidity human diseases from large data repositories.
Jan 2019
Nov 2018
Atos acquires Syntel (an IT services company with 23,000 employees) for a cash consideration of $3.4 billion to expand end-to-end services to
customers in North America. Syntel is a global provider of integrated information technology and knowledge process services in the area of product
engineering, IT operations, Testing etc. for the clients from industries such as healthcare, life science, banking, insurance, retail etc. This acquisition
will increase Atos’s global revenue by ~$1 billion.
Appoints Michel Alain Proch as Group Chief Digital Officer to lead the group internal digital transformation strategy. Michel Alain Proch also serves
as SEVP and CEO of North America. The group announces many other leadership changes as well across different divisions and regions.
Jul 2018
Feb 2018

43
Capgemini (1/2)
Appoints Laura Desmond as a new Director to The Board of Directors. Laura Desmond is Founder and CEO of Eagle Vista Partners, a strategic
advisory and investment firm focused on marketing and digital technology and has been a member of Adobe’s Board of Directors since 2012.
Launches the Global Health and Wellness Digital Framework, developed in partnership with the Consumer Goods Forum (CGF). The framework aims
to provide CGF members and stakeholders with a guide on how digital can support the goal of positively impacting behavioral change to help
people live healthier lives.
Dec 2018
Oct 2018
Signs an agreement to acquire Leidos Cyber, the commercial cybersecurity arm of the FORTUNE 500 company Leidos to strengthen its capabilities
in North America.
Appoints Carole Ferrand of Capgemini’s new Group CFO. She succeeds Aiman Ezzat, who earlier this year transitioned to the role of Chief Operating
Officer alongside Thierry Delaporte. Appoints Patrick Nicolet as Chief Technology Officer (CTO) for the group.
Jun 2018
Jun 2018
Based on publicly available information, Capgemini does not seem to have much traction in healthcare. Its acquisition of LiquidHub in 2018 could potentially
add some pharma clients.

44
Capgemini (2/2)
Wins a contract with Terumo BCT, a US-based global leader in blood component, therapeutic apheresis, and cellular technologies, to set up two
global innovation and development (I&D) centers in India. As per the agreement, Capgemini will help Terumo in the areas of research and
development, product engineering, and usability engineering.
Acquires Liquid Hub, a digital customer engagement firm that specializes in developing and delivering compelling customer experiences. In the
pharmaceutical front, its Specialty Pharma Insights Platform aligns interactions across channels to provide a more seamless experience for
patients, healthcare providers, and other channel partners.
Feb 2018
Feb 2018

45
DXC Technology (1/2)
Appoints Rajiv Bansal, former Infosys CFO as Senior VP and Head of Finance, Americas. Rajiv was at Infosys for 16 years and held key positions as
CFO and Advisor to the CEO and Board.
Acquires Luxoft, a European digital strategy consulting and engineering services firm, for $2 billion. Luxoft had revenues of $911 million over the
previous four quarters.
Mar 2019
Jan 2019
Acquires ServiceNow partners, TESM and BusinessNow to strengthen its ServiceNow practice globally. The addition of the two companies enables
DXC to offer customers an expanded range of cloud-based and as a service solutions. DXC Technology is a long-term strategic partner with
ServiceNow and delivers solutions to modernize workflows and processes for organizations across a variety of industries including financial
services, healthcare, retail, transportation, and logistics among others.
Nov 2018
There is no public info on DXC’s healthcare business financials. The business seems to be largely built around public sector healthcare, mainly Medicaid
services.
Acquires argodesign, a product design consultancy which will enhance DXC’s capabilities in interface design and user experience that are key
elements in delivering digital transformation solutions. Texas-based argodesign’s specific disciplines include product strategy, design research,
information architecture, software experience design, hardware industrial design and brand identity across industries including healthcare. The
company will continue to run independently and serve its clients worldwide as a growth partner to entrepreneurs and an incubator of new
products.
Oct 2018

46
DXC Technology (2/2)
Completes acquisition of MMS to enhance DXC’s position as a leading technology provider of Medicaid services and enables the company to offer
a broader array of benefits to more states. The net purchase price for the equity interests of MMS is estimated to be approximately $220 million.
MMS helps state Medicaid agencies in the administration of the states’ Medicaid programs, including business processing, information technology
development, and administrative services and contributed 1% of the overall company’s revenue in 2017.
Signs a five-year contract of $400 million with the Wisconsin Department of Health Services (DHS) to manage the technology and business processes
associated with its Medicaid program. DXC will provide fiscal-agent services which serve about 1.2 million members annually, manage the current
systems and operations and enhance the state’s MMIS.
Oct 2018
Aug 2018
Completes the separation of its U.S. Public Sector (USPS) business and combines it with Vencore Holding Corp. and KeyPoint Government Solutions
to form Perspecta Inc. (an independent public company). Perspecta helps healthcare organizations in improving patient care, advance public health,
lowering costs, speeding innovation through services such as cloud, analytics, applied research etc. DXC has received $984 million cash from
Perspecta related to this separation.
Jun 2018

47
IBM (1/3)
Collaborates with Aetna, Anthem, HCSC, PNC Bank to create an inclusive blockchain network that will benefit multiple members of the healthcare
industry and enable organizations to build and deploy innovative digital solutions.
Signs a $325 million agreement with Juniper Networks for seven years to help manage the company’s existing infrastructure, applications, and IT
services to help reduce costs and enhance their journey to the cloud. Juniper Network builds healthcare IT network based on open standards,
simplicity, and automation.
Jan 2019
Jan 2019
Elects Martha E. Pollack to its Board of Directors. Dr. Pollack is currently the 14th President of Cornell University and a leader in the field of AI.
Dec 2018
Ancestry, the world’s largest consumer DNA network, selects IBM Planning Analytics as a Service on the IBM Cloud for its business planning and
forecasting processes. IBM, along with Data41, worked with Ancestry to create high-speed analytics and forecasting solution on the IBM Cloud.
Acquires Red Hat, leading provider of open source cloud software for approximately $34 billion. This acquisition is by far IBM’s largest deal ever and
brings together the best-in-class hybrid cloud providers and will enable companies to securely move all business applications to the cloud. Red Hat
will become a unit of IBM’s Hybrid Cloud division, preserving the independence and neutrality of Red Hat’s open source development, current
product portfolio, and go-to-market strategy and continue to be led by Jim Whitehurst (CEO) and Red Hat’s current management team.
Nov 2018
Oct 2018
There is no public info on IBM’s healthcare business financials. However, the healthcare vertical is distributed among cognitive, global business service and
tech services & cloud segments.

48
IBM (2/3)
Bausch + Lomb launches the new eyeTELLIGENCE applications on the IBM Cloud to help eye surgeons and surgical facilities work more efficiently
using Stellaris Elite vision enhancement systems. Using Watson IoT services on the IBM Cloud, Bausch + Lomb will have a centralized view of
operational and performance data from its Stellaris Elite systems and allows to pinpoint and respond to technical and service requests made by
surgeons and staff promptly, as well as identify system conditions that can be addressed proactively.
Oct 2018
Deborah DiSanzo steps down as the head of IBM Watson Health and will move to the IBM Cognitive Solutions’ strategy team. She will be succeeded
by Dr. John Kelly, Senior Vice President for Cognitive Solutions and IBM Research. Dr. Kelly joined IBM in 1980 and his portfolio includes IBM
Analytics, IBM Security and IBM Watson, as well as IBM Research and the company’s Intellectual Property team.
Oct 2018
Watson Health wins contract with DeKalb Medical to detect sepsis by adopting a systems-based, data-intensive approach with the help of
CareDiscovery (part of Watson Health). IBM helped DeKalb transform the way they measure system-wide performance by organizing data and
analysis into a usable dashboard and shift the diagnosis and treatment of sepsis that helped lower mortality rate and significantly reduce the
length of stay for patients.
Sep 2018
The Department of Veterans Affairs announces a one-year extension to an ongoing public-private precision cancer partnership to connect AI
technology with genomic data to provide cancer therapy for veterans. The precision oncology collaboration has so far assisted the treatment of
more than 2,700 veterans.
Jul 2018

49
IBM (3/3)
IBM expands service agreement with Anthem (a leading health insurance company), As per this expanded agreement, IBM to provide enterprise
services for mainframe and data center server and storage infrastructure management. As a part of the engagement, IBM will also help Anthem
in building AI capabilities. Since 2015, both the companies have implemented over 130 bots, automated over 70% of the monthly high-volume
repetitive tasks.
Jul 2018
Partners with Aramark to speed up digital transformation in the healthcare technology support and maintenance process. Aramark supports more
than 1,000 hospitals and senior living facilities through its food, facility, and clinical technology services.
Jun 2018
MediStreams chooses IBM Cloud for healthcare provider billing solutions. MediStreams (founded in 2009) develops healthcare RCM solutions for
hospitals and provider partners in the U.S.
Jan 2018
Note: IBM’s Watson Health business had several setbacks during 2018, resulting in top management changes and multiple exits. The Watson Health
business was also featured in a series of media stories related to the failure of Watson Health in meeting customer expectations. The core services business
has reported new contract wins during the year. IBM’s $34 billion acquisition of Red Hat Linux can position the company favorably in cloud computing, and
the company’s push in blockchain-related services could position the company as a leader in the emerging technology.

50
NTT DATA (1/2)
Wins $60 million contract from the National Institute of Allergy and Infectious Diseases (NIAD) for five years to provide IT service desk and field
services support to its Office of Science Management and Operations and aid their research to understand, treat, and prevent infectious,
immunologic, and allergic diseases.
Receives a new large-scale Business Process as a Service (BPaaS) contract including application management services, BPO, and infrastructure
services with the U.S. healthcare payer (unnamed) for 7 years. This client has provided healthcare insurance services for nearly 50 years in North
America.
Mar 2019
Nov 2018
Wins a contract for a large-scale healthcare project in North America.
Sep 2018
Appoints Eric Clark as Chief Digital Officer (CDO). Previously, Clark held the position of President of application services for NTT DATA Services. As
CDO, Clark will leverage NTT DATA’s global R&D innovations and investments in cloud, digital and security, as well as digital assets from other NTT
companies to help clients design their digital journeys.
NTT Corp. will merge its subsidiaries Dimension Data, NTT Communications (NTT Com) and NTT Data into a new, massive IT company that will offer
everything from IT consulting to cloud and communications. The group plans to establish a new holding company called NTT Inc. under NTT
Corporation by the third quarter of the fiscal year ending March 31, 2019.
Sep 2018
Aug 2018
There is no public financial info on NTT data’s healthcare business. The core business, which includes acquisitions such as Dimension Data and Dell Services
has a long legacy in the infrastructure services business.

51
NTT DATA (2/2)
Receives renewal contract from Cedars-Sinai Health System for outsourcing services such as service desk, end-user device services, user access
administration, and data center operations. Cedars-Sinai Health System is a California-based non-profit academic medical center.
Aug 2018
Promotes Bob Pryor as new CEO (of NTT DATA Services) effective July 01, 2018, to replace John McCain, who has served as CEO since.
Jun 2018
Appoints Yo Honma as Representative Director, President and CEO of NTT DATA Corporation. Previously, Yo Honma served the company as
Representative Director and Senior Executive Vice President for Japan & Asia region. The company also announces several leadership changes
across different divisions and regions.
Partners with DataFirst, Inc. to deliver clinical AI to healthcare organizations in improving quality and decreasing the cost of patient care. DataFirst
is a software development firm that provides end-to-end, scalable migration and interoperability solutions for healthcare IT.
Partners with Independent Health to provide a wide range of IT services designed to drive innovation and reduce cost. Independent Health offers
commercial, Medicare and Medicaid plans to approximately 400,000 members in Western New York. NTT DATA Services will provide 24/7 service
desk support, desktop engineering, messaging, mobility, telecom, and network asset management services.
May 2018
Mar 2018
Feb 2018

52
Bonus Download
The download contains data from 2017 on client wins, partnerships and M&A for the
11 global healthcare IT consulting firms we track in this report.
Two years of data for client wins, partnerships and M&A
Download

53
The WITCH Doctors
Arpita Bose Das
Brand Transformation and Operations
Bharath Natteri
Research and Analysis
Kaushik Dutta
Sharanya Anandraj
Market Intelligence and Research
Research
Arpita is responsible for managing brand transformation initiatives for Damo and its clients. She specializes in thought leadership
led brand transformation, and manages Damo’s global content operations.
Bharath is a licensed Chartered Accountant from India and a Chartered Financial Analyst (USA). He is adept at financial analysis of
Indian companies and global corporations.
Kaushik is responsible for managing market intelligence and research needs for Damo and its clients. His primary focus areas include
digital transformation and global technology markets.
Sharanya is responsible for market intelligence and research needs for Damo. She has delivered projects related to market research
in life science, pharma, and healthcare.

54
Disclaimers
All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or
endorsement by them.
This report is based mainly on secondary research. Damo Consulting therefore takes no responsibility for any incorrect information published by any
company.
No part of the report may be resold without written permission of Damo Consulting.
You may reproduce or reuse any or all parts of the report by giving Damo Consulting due credit.
All statements of fact, opinion, or analysis expressed in the report are those of the respective analysts. The information used and statements of fact made
are not guarantees, warranties or representations as to their completeness or accuracy. Damo Consulting assumes no liabilities for any short term or long
term decisions made by any clients based on analysis included in our reports. This report is not to be taken as investment advice.
The report was prepared independently. Damo Consulting did not accept any monetary or non-monetary compensation for consideration or mention in the
report.

About Damo Consulting
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Damo Consulting is a growth strategy and digital transformation advisory firm that
works with healthcare enterprises and global technology companies. We help develop
and implement digital transformation strategies and enable market growth strategies.
We specialize in thought leadership led brand transformation and actionable healthcare
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