Dartmouth-Hitchcock, a nonprofit health system with hospitals and clinics throughout New Hampshire and Vermont, had 12 different siloed IT service management systems for different application teams, infrastructure and desktop support.
THE PROBLEM
The health system had two different help desks using two different service management platforms. Employees were tracking requests and issues with three unrelated databases – SharePoint, Excel and Outlook – and also within applications.
Meanwhile, the health system had also concluded it needed to move to a comprehensive electronic health record as well as an enterprise resource planning platform. As a result, Dartmouth-Hitchcock needed a comprehensive service management system.
PROPOSAL
Cherwell Software, a vendor of enterprise service management software, would replace all of the vertical siloed systems in five months.
Teams would be able to escalate problems and requests between themselves on a single platform. And the help desks would be merged and able to cross-cover.
MARKETPLACE
There are a variety of vendors of enterprise service management software on the market today. Some of these vendors include ASG Technologies, Atlassian, BMC Software, CA Technologies, IBM, Ivanti, Microsoft and ServiceNow.
MEETING THE CHALLENGE
"All of information systems uses Cherwell; however, many other operational units also use Cherwell for service management," explained Bill Weyrick, director of information systems at Dartmouth Hitchcock Medical Center.
"Security uses it for ID and parking sticker requests. Supply chain for materials requests for nursing unit supplies and patient transportation," he added. "The Patient Safety Simulation Center uses it to track all of their assets. The health system's Value Institute uses it to track project requests. The list goes on."
The health system uses the new technology to replace unsupportable old databases created in Access, FileMaker Pro and 4th Dimension software by operational staff that have since moved on.
"The Cherwell IT service management system is fully integrated with Active Directory and our instance of Security Assertion Markup Language for single-sign-on and to pull in customer and technician demographics into Cherwell objects as needed," Weyrick explained.
"One of the most important integrations is with our Epic EHR," he said. "As computer assets are onboarded, moved and changed, the integration updates Epic with that critical information for printer mapping and role-based provisioning."
It also is integrated with the health system's PeopleSoft ERP system for approval escalations, financial accounting and other structure data like location. Further, it is linked with LANDesk for workstation discovery attribute population.
There are several SQL level integrations to pull server data into the configuration management database. And the health system is actively integrating with its program management system Work Front. It has plans to integrate with its EQ2 clinical engineering system. Overall, there are around a dozen active integrations and several others in the works.
RESULTS
In the end, the health system has consolidated two help desks running separate IT service management systems, executed a massive single-day launch of 14 electronic health record applications from Epic, supported the launch of Epic's pharmacy system Willow.
Since Dartmouth-Hitchcock adopted the new service management technology, the IS team has serviced 550,000 tickets and nearly 26,000 change requests, the configuration management database has grown to 60,000 records, and two million emails have been processed.
"We have replaced more than a dozen legacy service management systems in IT," Weyrick said. "We have also been able to sunset many operational databases that were a struggle to maintain. We are now able to roll out comprehensive EHR and ERP business critical software to new member organizations utilizing a single platform for incident and change request tracking."
He added that Epic EHR is "a technical beast" to manage. It also is very prescriptive about how problems and changes are managed.
"Luckily, their prescription is very IT service management best practice-centric," he said. "That is what Cherwell brings us. We are able to customize that best practice processes that Cherwell provides out of the box to manage Epic's many environments, constant requests and complicated infrastructure."
ADVICE FOR OTHERS
An enterprise service management system provides a standardized and unified platform for IT across teams.
"They are on the same page for enterprise-level incident management, problem management, change management and release management," Weyrick said.
"The comprehensive configuration management database allows the linkage of assets to these critical technology management processes," he explained. "It extends out to operations to provide local service management to business units previously using outdated and unsupportable platforms. This is an investment that pay off in spades."
Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com