Perception Versus Reality: Application Support Services Performance

For many healthcare organizations, change is a certainty. In increasingly complex environments, organizations are undergoing digital transformations and are increasingly reliant on software and technology. Improving operational efficiency and patient throughput, driving business growth, and meeting quality standards, while continuing to improve patient safety and maintain compliance, can be overwhelming.

However, this transformation comes at a significant cost to most organizations. Many have made substantial financial investments to support these technical, business, and clinical imperatives. Healthcare organizations face the formidable challenge of both working to achieve significant utilization and to benefit from their investment, while also reducing long-term operational costs in response to declining reimbursements.

Multiple Support Challenges Facing IT

Pursuing electronic health record (EHR) optimizations and the impact that EHRs and other major software installations have on clinician and patient end users, coupled with competing information technology (IT) support needs can create havoc—even for well-staffed, funded, and managed IT departments.

Today’s IT support teams can be challenged in many ways, including:

  • Supporting live sites while simultaneously maintaining other imperatives, such as aggressive application rollout schedules to additional sites.
  • Providing support for new organizations added to the enterprise through provider service agreements, joint ventures, and mergers and acquisitions.
  • Managing enterprise efforts to add or transform its business (i.e., significant community outreach initiatives or new service offerings) or other significant mandated standards.
  • Expanding support services beyond the providers’ internal environment, such as providing patient support for personal health records or other patient portal access.

In order to remain compliant and competitive, healthcare organizations must ensure that these challenges do not negatively impact end-user expectations. Customer satisfaction, both provider and patient, drives utilization and can cause irreparable damage to these valuable relationships if not treated as a key performance target. Using service-level agreements (SLAs) and following industry IT best practices can help keep organizations performing at their best.

Perception Versus Metrics - Almost One in Four Organizations Rely On Perception

A recent survey of U.S. healthcare IT leaders, conducted by CTG’s Healthcare and Life Sciences practice at the recent HIMSS 2016 in Las Vegas, revealed surprising results about many organizations’ approaches to service-level satisfaction. Of the respondents, 75 percent indicated that they follow at least one of the industry’s accepted IT service management best practice standards, such as those of the Help Desk Institute (HDI) or the Information Technology Infrastructure Library (ITIL®).

Of the 75 percent who indicated following an industry best practice, 91 percent reported that they meet or exceed customer expectations. The remaining respondents, or almost 25 percent, answered that they do not follow any accepted standard for service delivery, yet they still say they “generally meet” customer expectations.

Lack of Standards Leaves Organizations in the Dark

CTG found it encouraging that the majority of healthcare organizations reported following HDI or ITIL® best practices and that those organizations report extremely high customer satisfaction levels. However, the fact that as high as one in four organizations do not follow these standards is alarming.

Without tracking application services support against defined SLAs or industry best practice metrics, healthcare organizations are in the dark about their true IT service performance. They cannot accurately measure performance effectiveness or quality nor can they identify areas that may be the cause of ineffective support.

In other words, an organization that relies on perception or instinct about end-user application support satisfaction puts itself at risk of a significant competitive disadvantage to organizations that are tracking against defined performance metrics. In this case, perception is most definitely not reality.

Moving Towards Reality

Healthcare organizations must realize that comprehensive, accountable, and standardized application services support is mission critical in today’s environment. Ultimately, these services affect the overall operation of the business, the productivity of divisions and employees, and the quality of patient care provided. Every organization has opportunities to create a best-in-class service organization, even in a climate of operational-cost reduction. Organizations that follow standards, or have SLA metrics in place, have the advantage of knowing where to best focus their enhancement or cost-reduction efforts. However, SLAs and standards do not make an organization bulletproof. These organizations may have strong customer satisfaction scores but higher operational costs. Regardless of where you are in the spectrum of managing and measuring your support organization, periodic evaluations will be needed to achieve continuous improvement with user satisfaction and operational costs.

Assessing and Standardizing

Qualified application support experts should conduct an assessment of an organization’s support model, which reviews the current skills, processes, and technologies. These experts review and evaluate the organization against industry best practices such as the eight maturity categories from the HDI, as well as ITIL®/ITSM performance standards. The eight maturity categories based on HDI include:

  1. Resources: focuses on the environment and systems that support management and delivery.
  2. Performance Results: scrutinizes the metrics used to measure application services support performance.
  3. Processes and Procedures Reviews: examines the existence and maturity of practices and policies in place associated with application services support operations and delivery.
  4. People Management: focuses on the existence and maturity of workforce plans and practices, including reviews of volume of work, staffing levels, time allocated to service requests, and other factors.
  5. Strategy and Policy: focuses on the communication of the purpose and delivery expectations of the application services support team both internally and with the user community.
  6. Leadership: analyzes the communication and alignment/integration of the application services support team with organization and information technology goals.
  7. People Satisfaction Results: reviews the methods in place to manage employee satisfaction.
  8. Customer Satisfaction Results: explores the methods in place to manage customer satisfaction.

Completing this type of assessment provides the organization with a baseline understanding of its current operating environment and aids in defining a future state for an improved application support model. The assessment also results in a holistic view of the organization’s strengths and weaknesses, opportunities and threats, and recommendations unique to the needs of the organization. Specialists use these findings to define objectives, goals, and deliverables associated with implementing SLAs or a set of standards and operating metrics guided by HDI and/or ITIL®/ITSM.

Leveling and Maximizing

As organizations focus on the costs associated with their service model, it is imperative that they evaluate their overall resource allocation. Do existing support analyst resources have the necessary skills to do the job they are assigned, or alternatively, are they overqualified for their assigned tasks?

In addition to helpdesk support, organizations must protect their EHR investment by looking at new ways to manage basic production support tasks. In many cases, organizations transition their more senior analysts to basic production support responsibilities. While many organizations call this support Level 2/3, CTG has found that many times there are still opportunities to right size support by aligning ticket or issue resolution with analyst skill set.

Organizations should focus the efforts of their more skilled analysts on system optimization initiatives and on improving resolution time for complex issues.
In order to achieve this, organization should:

  • Incorporate technology that supports end-user self-help for simple issues like password changes.
  • Utilize knowledge-based tools to reduce the need to constantly recreate solutions.
  • Implement continuous improvement processes designed to reduce the recurrence of common issues that, over time, financially strain an organization.

Whether addressing these improvement initiatives in-house or looking for outside assistance, remember this: reality always trumps perception. A little self-discovery within your organization will go a long way in gaining insight as to where your organization can improve.

For more information about what CTG can do to help support your organization’s Application Management needs, visit our Application Advantage information page HERE.


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