Raymond D. Aller, MD, and Hal Weiner
Clinical IT help desks bring service to new level
Just as the personal computer marketplace progressed from Kaypros and Commodores to more sophisticated desktop machines, to sleek laptops, some medical institutions are facing the future by adding clinical IT help desks to their repertoire of IT services.
The bottom line is that inefficient frontline support is not good enough anymore—physicians are asking for more, says Chris Downs, director of information technology account management for Cancer Treatment Centers of America.
Add to that “a population of students [at teaching hospitals] that clamor and want more technology,” says Danielle Sun, manager of clinical systems and senior project manager at Detroit Medical Center. “They all use Apple. They want that kind of support, and we need to keep up and exceed that.”
How medical institutions can exceed expectations through implementation of a clinical help desk was the focus of a presentation given by Sun and Downs at a Health Information Management Systems Society conference in February.
Clinical help desks, a service often provided by third-party vendors, have evolved over the last decade with the move toward electronic medical record systems and other specialized software. This growth, mixed with pressure to reduce costs and comply with increasingly complex government regulations, has made it essential that physicians have access to frontline IT specialists who can address their needs and do so in a timely manner, according to Downs and Sun.
Traditional in-house help desks may not be manned around the clock, may have multiple phone numbers to call for help, often have little or no metrics reporting, and typically have a low resolution rate on the first phone call, says Downs, who manages the IT teams at all Cancer Treatment Centers of America sites, as well as the company’s outsourced clinical help desk.
Detroit Medical Center’s clinical help desk “operates 24/7/365, supporting all of our HIMSS stage six clinical systems, 178 active business and system applications, and our physicians, medical students, and residents,” Sun says. “It handles approximately 250,000 contacts annually. Seventy percent don’t make it to the second level, because what any caller really wants is a quick, accurate answer the first time they call.”
Besides wanting fast, appropriate answers, she continues, physicians want to speak with certified analysts trained on all aspects of a hospital’s clinical systems. “I can’t stress this one enough,” Sun says. “When you have a clinical help desk, there’s an investment in education for those folks.” The help desk must keep on top of system upgrades and new processes within hospital departments in order to support the users of those departmental systems.
The clinical help desk develops a “knowledge database” that allows analysts to answer a myriad of questions from callers, Sun explains. The database is created through interaction between a medical institution’s IT department, end users, and the help desk. “As we [Detroit Medical Center] roll out new enhancements, and upgrades, and changes, we feed that education material to our help desk so they can turn around and educate and support our clinicians,” she says.
The clinical help desk also proactively monitors IT systems to identify trends and potential problems and then communicates issues to the hospital’s IT personnel. “Even before I may know what’s happening, they [the clinical help desk] have already started the chain of communication and many, many times will resolve that issue . . . before it escalates,” Sun says. And if the situation should escalate, the help desk will alert its analysts to the problem so they are prepared to address calls from end users about the issue.
Also key to the concept of single-call problem resolution is metrics reporting, which tracks such information as the average speed for answering calls, the length of time to resolve a caller’s problem, or the types of calls that come in. This provides focal points for training and determines if the help desk is meeting customers’ needs, Sun says.
Examples of level-one calls at Detroit Medical Center include password resets, disabled accounts, printing issues, and “how-to” process questions, Sun says. Level-two calls may focus on a slow or frozen system, database server errors, duplicate patient records, interface issues, and requests to enhance applications.
It’s important that the analyst who is the first point of contact for a caller capture all key information, she adds, so that if the problem escalates to the second level, another analyst doesn’t have to call back the end user for clarification.
Due in part to such efforts, at Cancer Treatment Centers of America, use of an outsourced clinical help desk has led to a 95 percent customer satisfaction rating and 98 percent first-call resolution, while Detroit Medical Center exceeds a 90 percent customer satisfaction rating, with 70 percent first-call resolution.
An outsourced clinical help desk can also lower IT costs by resolving issues that high-paid, in-house IT staff would otherwise be called upon to handle. “We’ve seen this where instead of having level-one support provided by a help desk analyst,” says Downs, “your more senior, experienced folks are pulled in and doing level-one type support and, hence, project work suffers. Direct and indirect costs will invariably go up in that model.”
An analysis of industry data by CareTech, Detroit Medical Center’s clinical help desk vendor, found that a clinical help desk accounts for approximately seven percent of a hospital’s total IT budget. For a clinical help desk at a 300-bed acute care hospital that handles 2,200 calls a month, costs would come in at roughly $440,000 annually.
But more importantly, when physicians aren’t concerned about IT problems, they can concentrate on what they do best—providing patient care. “Our overall argument,” says Downs, “was that a clinical help desk increased patient care and satisfaction.”
PathCentral introduces plug-and-play AP system
PathCentral has unveiled its AP Anywhere Express anatomic pathology system.
Tailored for smaller and start-up pathology practices, the product is a streamlined, Web-based turnkey adaptation of PathCentral’s AP Anywhere system.
AP Anywhere Express can be deployed in as little as four weeks. It was designed for plug-and-play execution around a simple, intuitive template.
The system delivers laboratory management reporting, distribution, transcription, search, and new revenue-capture opportunities, as well as end-to-end specimen bar-code tracking.
In a separate announcement, PathCentral reported that the Department of Pathology and Microbiology at the University of Nebraska Medical Center will participate in its PathCentral Pathology Network.
The network allows physicians to upload case files using digital images so pathologists can review and render critical consulting diagnoses on a global and domestic real-time basis.
ONC guideline addresses transition of care under meaningful use criteria
The Office of the National Coordinator for Health Information Technology recently released a guideline on how health care information service providers and health information exchange organizations can support health care providers in meeting the electronic health records meaningful use criteria for transition of care measures.
The stage two measures require eligible health care professionals and hospitals to provide a summary of care record for more than 50 percent of transitions of care and referrals, provide the summary electronically for more than 10 percent of such transitions and referrals, and either conduct one or more successful electronic exchanges of a summary of care document with a recipient using a different EHR vendor or conduct one or more successful tests with a government-designated test EHR during the reporting period.
The guideline details options for supporting each measure, such as seeking standalone EHR module certification for specific capabilities.
The document is available at www.healthit.gov/sites/default/files/key_considerations_for_hios_stage_2_toc_final.pdf.
Laboratory systems certified as electronic health record modules
• McKesson has announced that its Horizon Lab 13.5 laboratory information system has received electronic health record module certification for meaningful use stage two. The LIS has been certified under the Drummond Group’s Electronic Health Records Office of the National Coordinator Authorized Certification Body program.
• Sunquest Information Systems has reported that its Sunquest Laboratory version 7.0.1003 LIS is compliant with the ONC 2014 Edition EHR certification criteria and was certified as an electronic health record module by the Certification Commision for Health Information Technology, an Office of the National Coordinator Authorized Certification Body. The ONC 2014 Edition criteria support stage one and stage two meaningful use measures.
Sunquest Information Systems, 520-570-2000
Dr. Aller is director of informatics and clinical professor in the Department of Pathology, University of Southern California, Los Angeles. He can be reached at email@example.com. Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at firstname.lastname@example.org.