Managed services organizations supply implementation and operational expertise to advance the capabilities of IT, both to relieve internal staffers of more mundane uptime duties and to supply the ready sophistication needed for specific applications and analyses. These companies have myriad combinations of technical and operational skill, and vendor selection can preordain the impact of managed services.
IT in healthcare gets more complex and skill-dependent all the time. Care facilities both have to expertly implement new systems or upgrades and know how they can optimally serve clinical objectives. Outside assistance must be specific to healthcare, from clinical familiarity to cybersecurity idiosyncrasies, said Dawn Mitchell, an independent health IT consultant. “Be cautious with managed services providers that have been doing this in every other industry, recently moved into healthcare, and don’t have the internal expertise required to be successful,” she said.
The services provider has to recognize healthcare demands such as responding very quickly when system problems put lives on the line, said Lee Kim, director of privacy and security at HIMSS. In managed services, critical shortcomings have a lower priority and are addressed belatedly or not at all, she said, adding, “You don’t want a dabbler in healthcare; you want someone with an established healthcare base.”
Trusted partnership
When Comanche County Medical Center needed to upgrade to the current priority pack of its EHR to meet meaningful-use requirements, it sought a managed services provider to do the implementation, add server capacity and manage operations, according to Ismelda Garza, CIO of the rural Texas critical-access hospital. The decision came down to expertise and a trusted partnership between the managed services provider and its EHR-specific hosting solution.
The resulting close partnership with Comanche cannot be underestimated, according to Garza. “I generally see that other managed services are neither interested in becoming a true partner with my hospital nor ensuring we are successful,” she said. “Relationships are key.”
The managed services firm should probe the customer to determine the best specific solution for the immediate term and then continually improve on it, Mitchell emphasized. “You really need to look for a partner, not a vendor,” she said. “It’s definitely not one-size-fits-all, and some vendors don’t have the flexibility required.”
Expertise breadth and depth
Expertise must be broad to effectively support hybrid IT environments and deep enough to meet the expectations of clinical and operational users, Mitchell said. Also, lack of depth in a level one service desk can delay problem resolution, increase the load for level two support, and frustrate physicians and other users who expect immediate resolution.
Managed services staff should also be available to provide subject matter expertise and knowledge transfer to internal staff. “It’s a win-win when super-users can solve issues in the field, and they never have to call the help desk,” Mitchell said. End users get immediate resolutions and the number of service calls go down.
Comanche’s managed service provider’s expertise is specialized ― teams for hardware, network, data backup and more ― which supplements the four-person IT staff at Comanche who “wear many hats,” Garza said. “Having our EHR system hosted allows my team to focus its priorities on other projects concerning patient care areas and other IT projects.”
Solving problems at their roots
All contracts should have service level agreements with metrics requiring quick problem resolution and nearly continuous uptime, as well as milestones for evaluating performance, but it’s just as important to categorize issues, address the root causes of recurring problems and fix them. “When your provider can identify that 20 percent of your calls during any given month come from a group of physicians who clearly need additional training, then you work together to make that change happen.” Mitchell said. “You reduce the number of calls, and your users are happy, more self-sufficient.”
The services provider should have good reporting processes and tools to keep internal staff and users informed as to the status and estimated turnaround time-of-service requests. Long wait times and the lack of communication around them “are major dissatisfiers with service desks,” she said.
Comanche’s services provider will “notify me of issues before I know of issues,” Garza said, and it keeps her continually informed through biweekly account rep calls, daily backup status updates and monthly reports on server availability. “It takes responsibility for issues or problems; it also works with [our EHR vendor] directly to resolve issues. All these things help contribute to my confidence in its ability.”
Whether resolving a routine user access issue or planning to incorporate new breakthroughs in workflow automation, a managed services provider should always inspire such confidence, grounded in obvious know-how and the ability to put itself in the healthcare customer’s place.