How To Write A Health Care Service Management Standard

Transcription

1 Building an integrated medical & information technology service management standard around which best practices can grow Establishing a Medical and Information Technology Service Management (MITSM) Standard MODERATOR: Elliot B Sloane, PhD CCE FHIMSS Executive Director, Center for Health Information Research Jennifer L. Jackson BME MBA CCE Director, Clinical Engineering & Device Integration Cedars Sinai Health System SPEAKERS: Stephen L. Grimes, FACCE FHIMSS FAIMBE Chief Technology Officer ABM Healthcare support Services CE-IT Community Town Hall Meeting Wednesday, October 29, 2014

2 Why a MITSM standard? Webinar Description In the past decade, most professionals in Healthcare Technology Management (HTM) and in Healthcare Information Management/Technology have come to accept the reality of medical and information technology convergence. In fact, convergence of medical and information technologies is occurring at a near exponential rate. One of the greatest challenges for healthcare organizations today is how can they take what have long been disparate support functions (HTM & IT) and effectively integrate those functions in a manner that adequately supports the new converged technologies. This session suggests how the industry can adopt and adapt existing standards (like ISO and ITIL v3) to develop a new MITSM standard that would serve as an effective roadmap for HTM and IT collaboration and establish define a common nomenclature. This session further discusses how this roadmap could then serve as a guide for the development and adoption of best practices. 2

3 Let s begin with a story A TALE OF TWO MANAGEMENT SYSTEMS

4 A long time ago, in a hospital not too far away IT Clinical Engineering

5 A long time ago, in a hospital not too far away IT Clinical Engineering

6 Middleware as a Middle Ground Outside of Clinical Engineering scope of service

7 Middleware as a Middle Ground Both help desks reference the same knowledgebase template Developed together Clinical Engineering does first look 90% of the time Handoffs to other EIS departments are scripted Equipment Tracking/Documentation Terminal servers are maintained and tracked by Clinical Engineering Servers are maintained and tracked by IT Clinical Engineering owns the system Listed as application owner in IT database We coordinate upgrades to servers and downtimes

8 Works.well What is perfection, really? Strong communication Relationships developed, trust gained Constant presence Successes celebrated as a team

9 Information Technology Service Management (ITSM) Guidelines & Governance Strategies ISO/IEC (2005) Information Technology Service Management Part 1: Specification 9 Information Technology Infrastructure Library (ITIL) v3

10 ISO/IEC :2005 Information Technology Service Management (ITSM) The Service Management Paradigm 10

11 Control Processes Configuration Management Identifying & inventorying of devices or Configuration Items (CI) in a Configuration Management Database (CMDB) including; Configuration data Constituent component Relationships with other CIs Versions Integration of CM into other Service Management processes Provides CMDB to Service Support group Links incidents & problems to Configuration Items (CI) and to Users 11

12 Configuration Management Database (CMDB) Conduct an Inventory. CMDB is a database containing all relevant of all components or Configuration Items (CI) of a IT system and details relationships between them: Type & versions number of Operating system Applications Data set IP (static or dynamic) & MAC addresses Connection hardwired or wireless (frequency) (802.3, a/b/g/n, x inbound/outbound) HostName (logical name assigned to network device, typically servers) Security features (e.g., MDS 2 ) Configuration (current, preferred settings on features) Peripherals connected Parent/Child/Sibling connections Authorized remote access (avenues) Ownership 12

13 Control Processes Change Management Managing Change processes involving: Hardware components & systems. i.e., Configuration Items (CI) System OS & applications software Documentation associated with operating & support systems Details of changes need to be made available to Service Desk & configuration management database (CMDB) updated Change Advisory Board (CAB) authorizes changes & reviews results some CAB participation may be ad hoc is particpants include those who are involved in making changes as well as those who may/will be affected by them 13

14 Releases Processes Release Management Planning for deployment of system changes: firmware, software (including patches, fixes, updates, upgrades) and hardware Design & implementation of procedures for Distribution/installation of system changes Ensuring that changes are traceable, secure and Ensuring that only authorized/tested versions are installed Protecting critical operations thru safeguards & rollback plans 14

15 Resolution Processes Incident Management Record/document all incidents An incident is an event which is not part of the standard operation of a service and which causes or may cause an interruption to, or a reduction in, the quality of that service Priority of incident determined by criticality (considering clinical, operational, and financial impact) Escalation processes (a needed based on time & criticality) Technical service level: moving from 1 st through 2 nd and 3 rd Hierarchical level: moving up management chain Timely restore to normal operation Document resolution 15

16 Resolution Processes Problem Management Occurs when incident or incidents require investigation (i.e., indication of a problem ) A problem is an unknown underlying cause of one of more incidents Identifies & proactively acts to address underlying root cause by either Solving problems or Creating work-arounds for known errors Documents problems & associated resolutions in KnowledgeBase (i.e., compendium of known problems & associated resolutions) 16

17 Service (or Help) Desk Function Single Point of Contact (SPOC) between service providers and users reporting incidents & making service requests Manages incidents & service for quickest resolution and/or restoration of service Triages Elects appropriate support (CE, IT) based on issue & criticality Monitors service progress and escalates to 2 nd & 3 rd level of appropriate service as necessary Keeps users informed of service status Provides statistics for reporting, analysis, continuous performance improvement 17

18 Integrated Service Desk 18

19 Integrated Service Desk 19

20 Integrated Service Desk 20

21 Integrated Service Desk 21

22 Relationship Processes Client & Business relationship management Based on an understanding of the client and their needs, establish & maintain effective relationship between those providing service (e.g., in-house staff, vendor) and the client (e.g., clinician, administration) Document & communicate Service Level Agreement (SLA) i.e., a written agreement between a service provider that documents services and agreed upon service levels Vendor management Manage vendors to ensure provision of seamless, quality service Agree upon & establish Service Level Agreements (SLA) with key vendors including Service requirements Scope Level of service Communication processes 22

23 Service Delivery Processes Service level management defining, agreeing, recording & managing levels of service Documented in SLA Routinely reviewed & adjusted to ensure relevance & effectiveness Service reporting producing timely, reliable, accurate reports for informed decision making & effective communication includes Performance against service target levels Non-compliance Performance reporting following major events Trend information Satisfaction analysis Service continuity & availability management ensuring that agreed upon service continuity & availability commitments to clients can be met in all circumstances 23

24 Service Delivery Processes - continued Budgeting & accounting budgeting and accounting for cost of service provision Capacity management ensuring that service providers have, at all times, sufficient capacity to meet current & future needs of the client Information security management managing information security within all service activities implementing requirements of the information security policy managing risks associated with services & systems 24

25 Future of Healthcare Technology Support Future Delivery of Patient Care Converged Healthcare Technologies Service Desk Incident/Problem Management Clinical Engineering Support Change/Release/Configuration Management Service Level Management Continuity/Availability Management Capacity Management Security & Risk Management Financial Management Shared Technology Management Guidelines 25 Information Technology Support

26 Implementation Guides & Best Practices Integrated Service Desk Incident/Problem Management Change/Release/Configuration Management Service Level Management vendor/contracts management Continuity/Availability Management emergency/disaster management Capacity management Security & Risk Management ISO & related guides, ISO Financial Management???? 26

27 Discussion Points Trend: Converged technologies (e.g., software-based medical devices & networked medical systems) leading to some form of converged or collaborative support paradigm for CE & IT 1. Is there a preferred model for the CE & IT relationship? How many of your are currently reporting to IT? 2. Does CE adopting and adapting an ITSM strategy (like ISO/IEC or ITIL) make sense as a way of establishing an effective bridge between CE & IT? i.e., can we create a shared Medical & Information Technology Service Management (MITSM) guideline that gives us a common set of strategic & tactical points of connection a common syntax 3. Where do we go from here? 27

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