Best Practices in IT Support Systems IMPROVING HELP DESK PERFORMANCE AND SUPPORT

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Best Practices in IT Support Systems

IMPROVING HELP DESK PERFORMANCE

AND SUPPORT

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C O PY RIG H T © HE AL TH C AR E B U SINE SS IN SIG H TS . A LL R IG H TS R ESE RV ED .

Creating a Robust Help Desk Environment

As organizations increasingly rely on integrated electronic records and advanced clinical applications, the quality and availability of help desk support will need to continuously improve. If issues related to clinical software are not resolved expediently, they can be a source of dissatisfaction for users, and may ultimately impact patient care. Since shortcomings in support services can have serious consequences for healthcare organizations, it is important that leaders maintain visibility into help desk performance. Healthcare leaders need assurance that critical incidents can be quickly resolved even during non-peak hours.

With healthcare institutions expanding and the number of users increasing in clinical and administrative areas, the need for responsive IT support can hardly be greater. In many cases, leaders may have to make changes if longstanding IT support models can no longer meet current needs. Organizations can regularly assess the effectiveness of their help desk by leveraging feedback from users. Improving help desk performance, has been, and will continue to be, an area of continued interest for The Academy.

Providing Support for Large Scale IT Initiatives

Organizations that are equipped to provide support services for far-reaching projects—such as information exchange and accountable care networks— can create the environments that will be necessary for long-term regional collaboration. Establishing an infrastructure to support electronic record

adoption, web application development, and information sharing on a broad scale is critical and will be central to the enterprise goals of many organizations.

Service management tools can establish key processes that will further advance the IT objectives organizations have envisioned as part of their long-term operational strategies. Such tools can ensure help desks provide maximum benefit for users and leaders. Organizations are exploring a variety of avenues through which support services can be provided. Some organizations are developing internal structures while others are affiliating with third party organizations that perform these functions.

Building the Case

Practice I: Improving Help Desk Performance and Support

Organizations Outsourcing Any IT Help Desk Services

Source: Academy Survey Results

Organizations’ Rating of Current IT Help Desk Structure

Source: Academy Survey Results

Outsource Help Desk Services

11%

Do Not Outsource Help Desk Services

89%

While outsourcing remains a possibility, a majority of organizations internally develop and manage their IT help desk processes

Very Satisfied Somewhat Satisfied Somewhat Dissatisfied 16% 79% 5%

There still exists an opportunity for improvement in overall help desk performance at many organizations

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Typical Approaches Often Fall Short

Practice I: Improving Help Desk Performance and Support

Net Result of Typical Approaches

Many organizations struggle to foster an ideal IT help desk environment Help desks fail to provide optimal service

• As organizations continue to develop their information systems suites

and improve clinical operations, help desk functions fail to grow accordingly and are inadequately prepared to accommodate user needs

• Users wait for help or are put on hold for long periods of time,

negatively impacting both the effectiveness of existing support structures and user perception of their IT function’s ability to identify and respond to service issues

Service management is unable to adjust to IT environment

• The service management structures in place at many organizations

are incapable of evolving in line with industry growth, as well as developments with new patient and user-facing technologies

• The help desk is unable to internally address requests related

to collaborative initiatives—such as information exchange, the integration of information system infrastructures, or the provisioning of network architecture to accommodate mobile access

Root Causes of Sub-Optimal Results

• There are challenges in dedicating the appropriate labor

and technical resources to improve help desk capability and functionality

• The help desk model employed may be ill equipped to

accommodate a growing clinical IT suite—leading to performance shortcomings

Root Causes of Sub-Optimal Results

• Lack of standardization and incomplete understanding of all

the interconnected relationships between software and systems hampers help desk performance

• Basic troubleshooting requests take precedent over complex

issues that require more time and attention than most analysts are able to spare

As user needs evolve, it will be necessary for healthcare IT leaders to drive growth in help desk processes to

deliver improved customer satisfaction

An effective help desk is one that is appropriately staffed with knowledgeable staff, supported by key policies and procedures,

and evaluated routinely for exceptional technical

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Generating Value for Stakeholders

IT leaders are instituting help desk models that are consistent with the level of support their organizations require to meet long-term goals for information accessibility, quality care, and data driven improvements. A thorough evaluation of existing help desk structures has allowed many organizations to consider alternative options that may generate more value for users. An efficient help desk is one that can provide 24/7 enterprise support, accommodate requests in a manner that does not impact user workflows, and utilizes all available technical resources to accurately correct issues. From a user’s perspective, ongoing developments in mobile, cloud, and single source spheres will continue to necessitate improvements in central help desk processes as well as more meaningful integration between support structures and user environments.

Key Attributes of Better Performing Hospitals and Health Systems

Practice I: Improving Help Desk Performance and Support

Tactical Approach

A.

B.

C.

D.

Managing Service and

Reducing Costs Reevaluating Help Desk Model When Necessary to Expand Service AreaLeveraging Resources Analyzing Operational Performance

Standard Practice

• A help desk infrastructure is created with a select number FTEs and governance policies

• Vendor software and support is leveraged for bolstering help desk infrastructural capability and for outsourcing functions

• The help desk is staffed with knowledgeable specialists that have access to robust tools, applications, and technologies that assist in their day to day tasks

• An internal help desk is established with the intent to offer healthcare IT support across organization

Best Practice

• Technical support is either staffed from within or outsourced to a third-party who is better suited to provide efficient staffing and workflows

• External help desk is created and outsourced to a strategic partner who understands the needs of the organization’s users and deploys the necessary resources to manage a help environment

• The help desk is staffed with knowledgeable specialists that have access including resources for patient services, practice management, and operating the electronic record

• All available help desk options are considered, a model is established, and customer satisfaction is routinely tracked and assessed

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Best Practice Case Studies

Practice I: Improving Help Desk Performance and Support

• _{Cancer Treatment Centers of America (CTCA)}

includes five hospitals across the U.S., as well as a clinic, a corporate office, and an operations center

• _{In mid 2011 CTCA selected an IT help desk provider}

to assume responsibility for Level 1 support requests after customer satisfaction scores indicated a lack of user confidence in help desk technicians

• A thorough analysis found that engaging an external

partner may provide the opportunity to increase performance while reducing expenses

• When users call into the central call center, technicians determine if they can

resolve the issue; If the request is related to clinical applications, technicians will attempt to diagnose if it is a hardware or software issue prior to escalation

• _{Continuum Health Partners (CHP) is a seven-facility}

health system located in New York City

• In 2008, after determining their help desk partner

was underperforming in first call resolution and average time to answer calls the organization decided to contract with a new help desk provider

• _{CHP’s current external help desk partner receives all}

first-call requests, provides weekend onsite desktop support, web development, and production support for the organization’s ambulatory electronic record implementation

• _{CHP’s support model includes dedicated Incident Managers on each shift at its}

central call center who oversee a pool of help desk technicians that are familiar with CHP’s support needs

Key Lessons

• Outsourcing help desk services may allow organizations to provide 24/7 support

and better delineate requests by severity and type

• _{Establishing a help desk with external technicians can reduce labor expenses as}

organizations continue to expand

• Under such a model, having an onsite Relationship Manager who oversees the

daily issues related to ticket resolution, and acts as a point of contact to resolve any problems that may arise is critical

Key Lessons

• Tracking help desk performance metrics, such as call volume and call

abandonment rate, can allow organizations to evaluate the efficacy of their current help desk structure

• When outsourcing help desk functions, it is important to select a partner that

offers value through new tools, technologies, and services that otherwise could not be developed internally

• Determining infrastructural needs related to help desk operations, including

servers and storage, physical space in the data center, and power/cooling consumption can help when developing a long-term strategy

A. Managing Service and Reducing Costs

Outsourcing Help Desk Services

B. Reevaluating Help Desk Model When Necessary

Choosing a Partner that Meets Organizational Needs

CTCA Help Desk Satisfaction Scores Impact

The investment CTCA has made in outsourcing help desk functions has allowed it to consistently exceeded its monthly customer satisfaction goals—the lowest it has ever been is 89.8%, and it is routinely over 94%

CHP Key Help Desk Performance Indicators Impact

By selecting a new external help desk service provider, CHP has been able to deliver high level support while preserving satisfactory customer service CTCA’s help desk receives about 3,700–3,800 contacts each month 85.0% Goal Lowest Score Typical Score 89.8% 94.0%

Actual Goal

73% 91%

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Best Practice Case Studies

Practice I: Improving Help Desk Performance and Support

• _{Kootenai Health is a 240-bed community hospital}

that serves patients in north Idaho, eastern

Washington, and Montana at several facility locations

• _{Kootenai has established an infrastructure through}

which it is currently enabling electronic record adoption, web application development, and information sharing throughout a local and regional care community

• _{Kootenai sought to support electronic health records}

and other community-wide collaborative IT projects

through acquiring the assets of an existing solution provider and absorbing those staff members and resources within its own organization

• This acquisition allowed Kootenai build a Health Information Services Team and

a new help desk that offers infrastructural support enterprise-wide

• _{Mercy Memorial Hospital System (MMHS), includes}

a 238-bed acute care facility and several outpatient care sites in southeastern Michigan

• _{All phone calls or online service requests are routed}

to the external help desk, which reviews and resolves Level 1 incidents; Level 2 incidents are passed on to internal MMHS support staff

• To maintain visibility into help desk performance

MMHS is able to use its IT service management tool to monitor help desk activity; the length of time for service calls and time to answer call are key metrics

• _{MMHS personnel write “knowledge articles” on certain recurring tickets that}

explain how the help desk can resolve particular issues—such as how to find documents in the electronic record—without escalation

Key Lessons

• Extending infrastructural support throughout a care community helps promote

interoperability and establishes inter-facility collaboration

• _{Leveraging the assistance of an IT services provider builds the internal capacity to}

undertake larger initiatives such as an information exchange

• With improvements in IT upkeep, larger organizations can offer IT support across

an integrated network of clinics and hospitals

Key Lessons

• _{Robust software to manage troubleshooting incidents is crucial in servicing}

requests related to clinical applications and electronic health records

• Dedicating efforts to answering calls in less than five minutes has created

opportunities to engage customers, minimize complaints related to lengthy hold times, and instill accountability standards for help desk specialists.

• Outsourcing key functions and supporting processes can generate cost savings

associated with establishing help desk structures

C. Leveraging Resources to Expand Service Area

Utilizing an IT Services Provider Service Management Tools: Effectively Monitoring Help Desk Activity

D. Analyzing Operational Performance

Impact

Potential Savings for Physician EHR Deployments through Kootenai Health’s Network The Kootenai Health Information Services team,

created with the needs of the community in mind, has grown from 12 to 79 FTEs in less than a year

“It’s about being able to provide these services at the best possible price as well as the best quality. The vision for Kootenai is to

address all these issues in the region.”

Impact

MMHS October 2012 Help Desk Problem Ticket Resolution

MMHS’s help desk has made it a priority to answer calls within 24 seconds, allowing the organization to resolve a wider variety of issues in a shorter period of time Tickets Escalated 38% Tickets Resolved 62%

MMHS’s help desk has been able to expand the scope of incidents it can provide support for.