Foundational Principles for Clinical Service Desk that Drive Clinician Satisfaction and Operational Efficiency

This article was also published by Becker's Health IT and HISTalk.

No one would argue that achieving provider satisfaction is a top goal for healthcare IT support leaders and teams. What if your IT service desk could deliver satisfaction to clinical staff, too? Could a slightly different approach to IT service desk operations lead to more efficiency and productivity for your help desk analysts and their satisfaction?  

Our journey to rethink IT support has led to the evolution of our Clinical Service Desk for Epic support. Rooted in our healthcare operator heritage and support of Epic facilities nationwide, we understand that IT service desks are more central to healthcare operations than ever. We have experienced first-hand how minutes matter when troubleshooting IT issues and that streamlined clinical workflows allow care teams to deliver higher quality patient care.

Our new approach to the Clinical Service Desk was piloted with Epic-based facilities at HCA Healthcare. Through the specialized IT services and support we provide to these hospitals and clinics, we have enabled analysts to

• work at the top of their license with 35% fewer incidents for Epic Level 2 Teams than traditional IT Service Desk support.
• provided 30% faster issue resolution because analysts with Epic knowledge and healthcare IT skills equate to higher quality support.
• and increased employee satisfaction.

How is this possible? Here’s a peek into the building blocks of our IT support model.

Identify common challenges

Early analysis of your organization’s priorities for IT support is a natural first step as you look to evolve your clinical IT support services. You will want to baseline your provider, clinician and even patient satisfaction as it relates to IT issue resolution and the effects on hospital operations. For example, if your hospital routinely experiences issues printing discharge instructions then that will impact the timeliness of patients being discharged, patient and clinician satisfaction and the efficiency of patient throughput.

Other challenges often relate to your workforce and their bandwidth, budget constraints, recruiting, employee retention and talent development. If your IT support team is experiencing high turnover, poor morale, inadequate training or vision for career potential within your organization, then those situations could be factors contributing to overall IT support efficiency and ability to resolve issues timely.

Approaches to start addressing common challenges: 

• Analyze metrics from a variety of perspectives. What are your high-volume issues reported by providers, clinicians, and revenue cycle employees? Do you have recurring workflow challenges or training opportunities? What about EHR-build related incidents?
• Examine your issue intake process for data quality and efficiency. If a provider reports an issue, it can be difficult to get in touch with them to follow up, obtain more information or even help resolve the issue. Is enough information or the right type of information being collected during the first call? Would better data on that first call help resolve the issue more quickly for a busy provider or clinical staff?
• Evaluate your tools and training. When you analyze high volume issues, would additional analyst training have helped with resolving the issue at the first point of contact? Would a different level of access enable the level 1 analyst the ability to resolve the issue sooner? Do you have an effective IT service management tool that allows for next-level analysis? Are there configuration, knowledge base or workflow improvements within your ITSM that could help analysts resolve more issues during the first contact?

Build a team-focused culture

One of the key drivers in the evolution of our Clinical Service Desk for Epic support specifically was this: how can we “shift left” the issues being handled by our level 2 and level 3 analysts?

Our level 2 and level 3 application support and clinical informatics resources were finding it difficult to focus on project work. Their bandwidth for heads-down time to make progress on Epic initiatives often was limited because they were pulled into resolving support issues.

We recognized it was just as important for us to encourage and foster a partnership and team-focused culture as it was to analyze metrics and data for process improvement. As we actively listened to our colleagues and clients, we began to better understand their frustrations, workflows, ways we could cross-train and collaborate more.

When we looked at the tickets being misrouted to level 2 and 3 analysts and missing information and the impact that those processes from our traditional service model were having on project work, bandwidth, and overall employee satisfaction, we knew our next step was to go beyond standard application training.

Develop a training program

While having a vast library of knowledge articles for analysts is important, it doesn’t replace having specialized knowledge of clinical systems and understanding of healthcare operations. With HCA Healthcare as our parent company, we had the unique opportunity to build and increase the knowledge of our service desk analysts in many ways.

First, we leveraged cross-training and team-focused culture to bolster application and workflow understanding. Second, we made a significant investment in training our analysts through the Epic certification process. We identified areas and key workflows where we needed to increase our knowledge base, and interested service desk analysts became Epic certified in those areas.

As we started to build a foundational Epic application aptitude through certification training, we had level 1 analysts spend time with level 2 analysts so they could better understand the end user pain points and how to ease the workload for level 2 analysts. This training and collaboration were key in making our “shift left” strategy a reality.

Areas to consider in a clinical service desk training program: 

• Develop a solid understanding of the fundamentals of healthcare operations.
• Offer training that covers clinical application knowledge from workflows to features and build specifics.
• Help analysts develop empathy for providers, nurses and clinical staff during transition lifecycles and the impact system changes can have on daily tasks like scheduling and registration.
• Explore internal training options and new collaboration opportunities with level 2 application support teams.
• Analyze your organization for communication gaps and consider ways you can encourage more open communication and place a focus on cross functional collaboration.
• Start strategic planning and budget considerations for additional Epic certification training to help evolve your traditional IT support model to a clinical service desk model.

Establish strategies to scale support

Scale is a huge benefit of the clinical service desk model. However, achieving scale will depend on the ability to instigate change and deliver results in other areas.

A few strategies that are essential for scaling clinical service desk support: 

• Identifying high volume issues, workflows and tasks for process improvement will shift workloads left, gaining operational efficiencies. It's important to consider different types of workflows and identify tasks that will help the team free up time for more complex issues.
• Improving L1 clinical knowledge will drive higher resolution of issues on first contact, improving end user satisfaction. Achieving operational efficiencies is a shared responsibility between service desk analysts and the application support. Your analysts need knowledge of the EHR system and the ability to find improvement opportunities.
• Shifting work left is the cornerstone for achieving scale within the clinical service desk. When your clinical service desk has knowledge across multiple workflows and you can identify tasks important to the application teams, that’s where you can achieve the most ROI from shifting work left.

Reassess workflow and resource capacity

When we considered the project work that level 2 application analysts were dedicated along with the support metrics, we uncovered that they were spending around 50 percent of their time resolving issues that could potentially be addressed earlier in the support cycle. By adjusting workloads and priorities, we aimed to give analysts more bandwidth to work on initiatives, take on projects, and drive optimization efforts. Part of this involved finding low-complexity and repeatable build items that could be handled more efficiently, freeing up resources for more complex tasks.

Sustaining a clinical service desk means ongoing review of key performance indicators (KPIs), continued training with new builds and releases, and fostering a culture that views clinical service desk analysts as part of the larger Epic team.

Tactics to get you started:

• Establish key performance indicators (KPIs) and reporting metrics to measure the effectiveness of training, analyst access changes, and process improvements. We focus on quality measures such as first contact resolution and customer satisfaction and the ability to shift support work left from level 2 to level 1.
  
  
• Improve collaboration and communication by establishing a regular cadence of meetings to identify recurring issues, understand the root cause, and determine if the service desk can resolve them with the right information and training.

Bottom line

What challenges are your IT support teams facing? Lack of specialized knowledge in clinical systems can lead to the inability to triage issues effectively, result in a low first contact issue resolution rate, high support staff turnover rate, and less than desirable work-life balance.

For organizations building an internal clinical service desk, there must be a significant and intentional investment, along with a willingness to let go and trust the process of building your own talent pipeline.

If opting to buy and outsource the clinical service desk, a true partnership approach is necessary to understand the environment deeply. Organizations must carefully evaluate how they will build the return on investment and configure their resource model accordingly.

Ultimately, sustaining a clinical service desk requires sharing the journey transparently, continuously measuring and improving, and fostering a culture of collaboration between the service desk and application teams. This strategic initiative can drive long-term operational efficiencies and improved clinician satisfaction when executed thoughtfully.

More resources 

• Watch this Becker’s webinar for a more in-depth discussion on clinical service desk with Chris Wickersham, AVP, Customer Support at CereCore, and Cassandra Momon, Director, Epic Services at CereCore.
• Download this guide In Sync with Care: The Future of Clinical IT Service Desks. This ebook explains how healthcare organizations can make the shift in IT support.