Many hospitals are undertaking major transformations of their technical support functions, according to a brand new study by Black Book Research. What’s the urgency about? Poor support quality…sub-par results that are reportedly even worse than last year’s dismal numbers. Sixty percent of hospital IT leaders say that EHR vendors and third party outsourcers are falling short of tech support expectations.

How is this phenomenon impacting patient care? What are the reasons for such inferior support? And, what steps are hospitals taking to receive the results they need?

Remarkably, at the same time EHR vendors have been counting on outstanding customer experience as a primary driver of competitive advantage, many are failing to provide even average support. According to the Black Book report, hospital IT managers would prefer that their EHR vendors provide tech support, as opposed to their hospitals providing it internally or outsourcing it. But in the absence of satisfactory tech support from EHR vendors, many hospitals are employing third-party outsourcers to fill the void.

This solution has worked in some cases, but unfortunately not in most. Eighty-eight percent of clinicians reported that patient care delivery is continually impeded by inadequate tech support by outsourcers, up ten percent from last year. Eighty-one percent of hospitals employing third-party outsourcing tech support are significantly dissatisfied with the level of response and overall service in the twelve months following go-live.

Why is excellent technical support so elusive?

Unfortunately, hospitals have inadvertently been knocking their heads against several obstacles that are often built into an EHR vendor or support outsourcer’s operations or overall business model. As a result, many partnerships are destined to falter or even fail from the get-go.

• Some hospitals have hired outsourcing partners that have never worked with a hospital, and/or have no experience with a hospital’s EHR or particular type of infrastructure. This is a worst-case scenario, because despite such vendors’ assurances of great service “in all industries,” the hospital industry IS different than others, and the challenges facing hospital service desks are unique. These include the need for high-speed accurate service to clinicians on tight patient care timelines, the number and complexity of healthcare-specific systems that require support, hospitals’ requirements for 24 X 7 X 365 access, and the need for HIPAA-compliant practices.
• Another recipe for failure is outsourcing partners and EHR vendors that have not completed necessary, highly intensive due diligence on the hospital’s operations and systems before transitioning in.  Service may begin to falter almost immediately. And within a year or less, response results and overall service move to an unacceptable low — just as so many respondents in the Black Book study reported.
• Other firms — both EHR vendors and outsourcers — simply don’t have or can’t keep highly qualified analysts. In addition, ongoing training programs for analysts vary greatly in quality and frequency — a problem for hospitals with everchanging systems and procedures.
• Many hospitals find that the tech support provided by their EHR vendor and/or outsourcing partners is not tailored to their unique organizational needs. The firms may offer only a limited set of support services, thus interrupting the continuity of attention that users expect. This scenario is not uncommon: the EHR vendor may only solve EHR-related issues and another firm may only support hardware, basic office software and perhaps some of a hospital’s applications but not all. Worse, network issues may be supported only by internal staff because third parties don’t have necessary monitoring capabilities. What a morass of disconnects!
• A somewhat subtle variation of the above is related to the typical customer service paradigm of Tier 1, 2, and 3 support levels used by tech support organizations.  A firm that is solely tier-based cannot offer high-speed clinical systems support to physicians and other clinicians.  Today, clinicians need and expect immediate one-stop issue resolution, including issues with EHR usage. They cannot afford the time needed to explain an EHR problem to a Tier 1 analyst who doesn’t know the system and then be handed off to someone with some knowledge of the EHR. Worse, if the Tier 2 agent is not highly proficient in the EHR, the clinician may be handed off to yet another, more qualified agent.

Enter the clinical service desk.

The hospital IT support firms that are most effective typically offer a “clinical service desk” component to remedy the above problem.  This is “Tier 1-Plus” support…first call resolution on clinically-oriented steroids.

A relatively new concept, CSD is specifically designed for physicians and other clinicians to get first call resolution for all IT issues, including clinical systems usage issues. In other words, a physician doesn’t have to wait in a queue to get his call answered, and doesn’t go through a T1, 2, and 3 rigmarole that can take hours and sometimes days. Here’s how CSD works:

• Certain Tier 1 analysts with high aptitude are intensively trained to be expert on the hospital’s infrastructure and clinical systems; ideally they already will have worked with the specific EHRs they are supporting. These analysts also will be qualified to resolve most desktop, network and other IT issues.
• Physicians and other clinicians are provided a direct hotline to call these analysts and get a quick turnaround on most, hopefully all of their concerns, clinical and otherwise.
• The firm should be using sophisticated monitoring systems that will proactively uncover potential issues real-time. Such monitoring helps analysts resolve some issues before they get any calls, or at least enables them to anticipate and prepare for potential calls.

Frustrated hospitals are making tech support changes in 2019.

Hospital chief medical officers surveyed by Black Book will apply new requirements in EHR procurements for multi-level tech support ranging from vendors’ health records to basic help desk through engineering interventions; these requirements will be a leading competitive inpatient EHR differentiator.

If hospitals are not moving to a new EHR and are unhappy with their vendor’s tech support, they will continue to search for third-party outsourcers, albeit better-qualified ones. Hospitals that are currently using an unsatisfactory outsourcer will look for a better one. A decreasing number of hospitals will rely on in-house technical support. “The increasing complexity of healthcare technology has made it even harder for an in-house help desk team, especially in small and medium-sized communities to have sufficient expertise to meet all of an organizations’ tech support needs,” said Doug Brown, Managing Partner of Black Book.

One of the greatest benefits of large studies, in this case a vendor-independent survey of 4,400 technology support users, is the opportunity to take advantage of lessons they have learned. Healthcare tech support is on the cusp of change. As healthcare technologies evolve and improve, more hospitals are finding that they must move to a more holistic support infrastructure that better meets all users’ needs. With a lot less frustration.

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