Is It Time for a Clinical Help Desk?

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1 Is It Time for a Clinical Help Desk? Christopher Downs Director, Account Management Cancer Treatment Centers of America Danielle Sun Manager, Clinical Systems Detroit Medical Center DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2 Conflict of Interest Disclosure Chris Downs, MBA, PMP and Danielle Sun Have no real or apparent conflicts of interest to report HIMSS

3 Learning Objectives Recognize the difference between a traditional IT help desk and an advanced clinical help desk Discuss how advanced help desk support can lead to better clinical information system adoption and physician satisfaction Identify the factors that go into the total cost of support, including the consequences of inadequate support Discuss the enablers of a clinical help desk highly-trained analysts, best practices and advanced toolset that raise the bar on traditional IT help desk 3

4 Cancer Treatment Centers of America (CTCA) Fast Facts Five hospitals nationwide Additional facilities to come CTCA is a destination hospital 90% of CTCA patients are self-referred 70% travel from a different state, traveling approximately 514 miles to receive treatment Patients we serve Treated, on average, at 2.4 other hospitals 79% have Stage III or IV cancer 66% are malnourished when they arrived 50% have received treatment elsewhere 4

5 Detroit Medical Center (DMC) Fast Facts Part of Vanguard Health Systems, consisting of five regions and 28 hospitals One of America s pioneer ACOs Eight hospital academic health system $4.3 billion gross revenue More than 2,000 licensed beds 3,050 physicians;1,300 medical students and 1,029 residents and fellows More than 15,000 employees 374,000 ED visits 8,700 births 60,000 surgeries 5

6 6 Current State Help Desk In house May not be available 24x7x365 Several numbers to call depending on what/when help is needed Low first call resolution rate Little/no metrics reporting Vendor-managed May be off-shore Little/no expertise with hospital environment Low first call resolution rate The Bottom Line Inefficient front line support models are no longer good enough There are opportunities for improvement!

7 The Cost of Lagging Behind in Support Contributes to poor system adoption Devalues IT investment Potential regulatory compliance issues Unmet quality and patient care objectives Low user satisfaction Poor customer experience May resort to workarounds Misallocation of IT resources Costly application resources filling Level 1 requests Project/other work suffers Direct and indirect costs inevitably go up 7

8 What Our Customers Really Want Quick, accurate answers so they can get back to work! 8

9 9 What s Driving Accelerated Support Needs? A changing operating model - the new realities of the healthcare marketplace More systems in play Becoming more focused on, not only clinicians, but patients Regulatory environment Meaningful Use, patient portals, etc. Consumer expectations Hospital IT systems should be always on Number of devices Both count and type PCs, tablets, Smart phones, etc. Support cost structure Pressure to reduce costs and align tasks to skill levels

10 Future State - the Clinical Help Desk What s the difference? Single Point of Contact One number to call for all IT problems and requests Trained and Certified Analysts Knowledge Management Clinical and Business System Support Proactive Monitoring Metrics and Reporting Expert 24x7x365 support of clinical processes and IT systems specific to your environment Content rich clinical and technical data specific to your IT systems for rapid problem resolution Physician and clinician support through all aspects of clinical and business system use Prevents or stops problems in their tracks, often before users are aware Customer satisfaction and service performance data for continuous improvement 10

11 First Call Resolution - Critical success factor Gets callers back to work quickly Reduces costs First Call Resolution Powerful customer care metric 11 Improves quality

12 12 First Call Resolution - Key enablers Trained and certified analysts Healthcare industry systems and processes Customer service and quality assurance Account-specific process training Advanced toolset Remote device management Access caller s device remotely Fix problems and/or instruct caller on how to issues Knowledgebase Clinical and business applications Always expanding Workflow management Service request, asset management, survey tools

13 13 Clinical Service Desk in Action - Analyst View (video)

14 When There s a Problem Well-defined escalation process Notify key stakeholders for all high-severity issue 14

15 15 Metrics Reporting - What you should measure and why

16 16 Why Consider a Clinical Service Desk?

17 17 Advanced IT Needs Advanced IT Support What you should expect

18 What about Cost? - Consider total cost of ownership A clinical help desk: Can be the most cost-effective and successful solution Often budget neutral or less expensive than a traditional help desk Helps avoid direct and indirect costs associated with the traditional help desk Misallocated, costly IT resources Misuse of clinical/administrative staff (creating IDs, etc.) Poor system utilization Low caller satisfaction and more 18

19 What about Cost? Cost per resolution based on severity level 19

20 What about Cost? - Owned versus outsourced 20 Savings Compared to Customer Owned scenario can vary based on SLAs, call patterns, duration, complexity and type of call * Data from - Enterprise Support Solutions

21 Cancer Treatment Centers of America Service Desk 21

22 Where We Started Outsourced to global, multi-vertical help desk vendor Service not delivered as promised Delivery not aligned with CTCA business goals/mission/vision Began search for new help desk partner Dissatisfied end users Lack of performance reporting or tracking Service not viewed as critical clinical partner No visible return on the investment 22

23 Making the Right Choice for CTCA IT help desk transformation a FY12 strategic priority Help desk function not a CTCA core competency Pursued new outsourcing arrangement Selected new vendor partner Healthcare-specific focus Cultural fit Skilled analysts who understand CTCA s clinical environment Advanced toolset 23

24 Partner Selection - A closer look IT guiding principles / strategic filters 24

25 Aligning Service Desk Support Performance requirements Ensure a live voice without extensive waiting period Receive answers and corrective action while on the phone Be served by customer service folks that provide the Mother Standard of Care Enable downstream support by ensuring data is complete, accurate, and distributed to the right 2 nd level analysts to ensure issues can be addressed in a timely basis 100% up-time required 25

26 In Pursuit of Gold - What it takes to get there Engage in positive, visible change Appointed on-site client liaison Established communication; held regular on-site meetings Built bridges with IT staff Solved user problems/requests in a timely, consistent manner Changed the culture, one satisfied user at a time Expect some learning curve Initial challenges and corrective action 26

27 27 Performance Metrics - Are users satisfied?

28 Service Excellence - Continuous improvement efforts Advanced access provisioning Gets new employees up and running quickly Improves IT/hospital staff productivity Reduces costs Streamlines processes High satisfaction level 28

29 Clinical Service Desk Maturity Model CTCA 29

30 CTCA s Future State - What we re striving for Satisfied end users Service viewed as a critical clinical partner Rigorous performance reporting or tracking Measurable return on the investment 30

31 Detroit Medical Center Service Desk 31

32 Aligning IT and Business Goals 32 One of the largest U.S. healthcare systems to reach HIMSS Analytics Stage 6 100% CPOE; 100% medication scanning Places significant emphasis on its EMR Rolled out system-wide in 2008 Keeps clinical teams connected to the common goal of patient safety and improved care Recognized that an advanced IT support model focusing on clinical applications was the key to: System adoption Meeting patient care goals Realizing the full benefit and value of its IT investment

33 Advanced Clinical IT Support - A critical priority DMC put in place an advanced clinical Service Desk Clinicians can count on high-end service 24x7x365 Staffed by analysts with a deep knowledge of the hospital s clinical environment Key part of DMC s holistic view of service delivery Currently supporting HIMSS Stage 6 clinical systems environment 178 active business and clinical applications 3,050 physicians; 1,300 medical students and 1,029 residents and fellows Approx. 250,000 annual help desk contacts 33

34 34 Typical Support Queries Level 1 EHR Issues Password resets / account disabled Hung / frozen application sessions Patients not displaying in patient list Patient record not updating (non-interface) Patient record locked (non-med order profile) Printing issues / printer rerouting (all Cerner modules) Firstnet configuration Record resends How To process questions Modify a patient list Create a patient list Patient missing from patient list App bar customization Level 2 Problem Issues Application wide slow response/ freezing Database / server errors Duplicate patient records Patient record merges Data integrity issues Interface issues ADT / transactions failed Module / application enhancement requests

35 35 Clinical Service Desk in Action - Clinician View (video)

36 36 Performance Metrics - Are DMC users satisfied?

37 37 Service Level Agreement Management

38 Continuous Improvement Metrics reporting and proactive root cause analysis Identify issues, trends and need for improvement Conduct routine user satisfaction surveys Self-service Implemented automated forms to create efficiencies Reduced call volume and costs Focused analysts on clinical calls, not password resets, etc. Satisfied users Incident management Revised escalation protocols Escalated rapid notifications 38

39 Clinical Service Desk Maturity Model DMC 39

40 How We Got There Gained commitment from DMC senior leadership to invest in advanced IT support Working with a vendor partner who employs: Best practices Advanced toolset Support of all DMC clinical and business apps Skilled analysts who understand DMC s clinical environment On-going multimodal training Clearly defined SLAs Open lines of communication 40

41 41 When is the Right Time? - The sooner the better!

42 Thank You! Christopher Downs Director, Account Management Danielle Sun Manager, Clinical Systems 42

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