A helping hand for clinicians: How clinical help desks can improve care, increase adoption, and contain costs

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The IT Help Desk (ITHD) is a critical component of any healthcare organization’s IT operations’ support of their electronic health record (EHR) investment.

For the early adopters, this has been true since the late 1990s/early 2000s when wide-spread EHR implementations and adoptions began in earnest. It’s not a stretch to say EHRs have greatly increased the need for specialized clinical system support for clinicians. Along with these increasing clinician support needs, the scope of the traditional ITHD has grown, expanded, and stretched analysts to their limits.

Despite the industry’s move towards EHR adoption, ITHD advancements, and the acknowledgment that accurate and timely support is key, many clinicians continue to face long wait times or unnecessary escalations when they contact their hospital’s or health system’s ITHD with EHR-specific inquiries. Many healthcare organizations have incorporated some level of dedicated Clinical Help Desk (CHD) support in addition to their traditional ITHD by either creating new internal capabilities, outsourcing these critical services, or some combination of the two.

An October 2017 Black Book survey reported that insufficient specialized technical support for clinicians and other users of the EHR can lead to a host of unintended consequences, including physician burnout, reduced user adoption, and even subpar patient care. Eighty-five percent (85%) of the survey’s more than four thousand respondents indicated that inadequate support impedes their ability to deliver quality patient care. Seventy-seven percent (77%) of nurses and 89% of physicians reported improved loyalty as a result of positive end-user experience during advanced tech support.

So how does an organization set about establishing a CHD?
The problems and the advantages identified above are clear, so for those organizations that have made the strategic decision to set forth on the CHD journey, where do you begin?

There are several fundamental tactical decisions that must be made regarding direction. Each direction decision involves different technical, procedural, and logistical decision points. One such decision is whether the CHD will be external or internal, which includes deciding whether the support will be onsite or offsite and if these resources will be part of the ITHD team or the Application team.
For an internal approach to CHD, there are several high-level decision points provided below that must be considered. These decision points assume an organization has an established ITHD with standard support tools.

• Onsite—does the organization have the real estate to add additional resources?
• Offsite—does the organization have a current remote work philosophy?
• Technology—does the organization have the proper technology and tools, including remote support such as a Remote Support Agent Call Management tool?
• Human Resources—does the organization have a proper position description, development plan, and pay rate for this specific role?
• Training—does the organization have the resources to train for the specific application?
• ITHD or Application team—which part of the organization should own the development and ongoing management of the services?
• Processes—will any new processes need to be created to support the addition of targeted support?
• Design—does the organization have the expertise to identify and design a solution?

While each organization’s approach is unique to their environment, in my 25 years of IT operations experience, I’ve seen a number of successful approaches to addressing clinician EHR support. Here are just a few:

Build your own CHD. Some organizations have looked internally to staff their CHDs with resources familiar not only with the organization, but with hands-on use of the chosen clinical applications. This is a step up from providing the answers to the IT help desk because the analysts you place in this role will have experience in the clinical environment. Ideal candidates include trainers who know the EHR well; ITHD analysts that possess a strong foundation knowledge of the EHR and are looking to extend their professional skills; or “super users” from various parts of the organization. Most healthcare organizations have clinicians or support resources who are experts in their technologies—the ones that other clinicians go to naturally.
Keep support with ITHD. If support must remain with general ITHD resources, steps must be taken to prepare them properly. First, build a database of FAQs. Determine the most commonly asked questions about using the EHR and then train your ITHD agents to address these issues. Make the questions and answers available in an easily accessible document or searchable database. Make sure your ITHD understands the clinician/patient touch points that are critical to care. While the ITHD agents may not be able to resolve the issues, they can be educated on what incidents take priority and how to act. These two activities can result in a reasonable first-call resolution rate, resulting in immediate improvements to user satisfaction while also providing clinicians the confidence that the proper knowledge exists to prioritize effectively.
CHD Outsourcing: For many providers, contracting with an outside organization for CHD services has proven to be an approach that provides immediate improvements without pulling from existing, already overextended analysts. Companies that work in this space can quickly assess the organization’s environment and unique needs, develop targeted performance metrics, such as availability and first-call resolution percentage, and bring together a team and methodologies for implementation and delivery. These organization cans use the clients’ existing tools, or if needed bring some or all of the tools to the table. These partners already have clearly defined delivery models and infrastructure in place and assume the responsibility of training CHD staff appropriately while maintaining proper staffing levels across the life of the engagement. Given the frequency of turnover at most healthcare organizations, that alone can be a huge benefit. In most cases, the savings that can be derived from upstream and downstream productivity can provide some offset to the expense of working with an external partner. Organizations that choose this approach most often face the following:
o Limited help desk analysts and IT resources to assign to a new specialized service
o Need to deploy internal resources to other strategic initiatives
o Seeking a partner who can bring the knowledge, experience, tools, and methodologies quickly into their environments

Sending clinicians who need EHR-specific help to a general ITHD that is not equipped with the tools and knowledge necessary to quickly and accurately support these users is likely costing you much more than you think. This lack of effectiveness and efficiency has a dollar impact at all levels. Understanding the cost savings from the value being provided versus focusing on the cost of delivery is an important factor to consider in the decision process. Regardless of an organization’s decision to keep their CHD in house or seek out a qualified partner, it is clear that creating some form of CHD will be a significant benefit. By doing this, you can give clinicians the support they need, when they need it, to drive positive satisfaction for patients, clinicians, IT support staff, and the organization as a whole.

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