Computer Service Support at Glenview Hospitalp1s

Computer Service Support at Glenview Hospital

Martha Garcia-Murillo

IDEA GROUP PUBLISHING

IDEA GROUP PUBLISHING Computer Service Support at Glenview 701 E. Chocolate Avenue, Hershey PA 17033-1240, USA Tel: 717/533-8845; Fax 717/533-8661; URL-http://www.idea-group.com

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. c n I p u o Support r G Computer Service a e d I t h g i r y op Glenview Hospital1 Cat Martha Garcia-Murillo Syracuse University, USA

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Paula Maxwell Syracuse University, USA Simon Boyce Syracuse University, USA

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Raymond St. Denis Syracuse University, USA Shwethan Shetty Syracuse University, USA

c. n I up o r G a e Id t h g i r y EXECUTIVE SUMMARY Cop Joan Shroyer-Keno Syracuse University, USA

This case focuses on the challenges of managing a help desk that supports computer users. There are two main technologies that the Information Center (IC) uses to provide this service: the call distributing system and the knowledge base, which is also available on the Web. The choice of technologies affected the service provided by the help desk staff. Specifically, the call distributing system was unable to provide enough information regarding the number of calls answered, dropped, and allocated among the different staff members. The hospital knowledge base, on the other hand, is created based on people’s documentation of the problem and selection of keywords, which has led to inconsistencies in the data entry. One of the management challenges for the Information Center is to foster self-help and minimize the number of requests to the IC staff. This case presents the difficulties and some of the initiatives that the IC has considered to solve these problems.

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This chapter appears in the book, Annals of Cases on Information Technology, Volume 5, edited by Mehdi Copyright © 2003, Idea Group Inc. Copying or distributing in print or electronic forms without written Kosrow-Pour. Copyright © 2003, Idea Group Inc. Copying or distributing in print or electronic forms permission of Idea Group Inc. is prohibited. without written permission of Idea Group Inc. is prohibited.

388 Garcia-Murillo, Maxwell, Boyce, St. Denis, Shetty & Shroyer-Keno

Table 1. Glenview Employees Staff

Amount

. c n I p u o r G a e d I t h g i r y p Co BACKGROUND Staff physicians Residents Clinical fellows Research fellows Registered nurses Other employees Total employees

1,313 451 207 785 1,719 9,398 13,873

Glenview Hospital is a non-profit organization located on the east coast of the United States. The hospital was founded in 1872 as a private organization offering general medical services to the surrounding community. Over the years, the hospital has incorporated numerous services and staff. The total number of employees at the hospital is 13,873. Table 1 shows a break down of the different types of employees. The hospital also supports 1,452 medical students. The total number of people that need computer support is approximately 8,200, which is almost 60% of the employees. The hospital encompasses 62 different units that span from general medicine to more specialized medical units such as Thoracic Oncology and Neurosurgery. Table 2 lists of some of the services provided by the hospital. While many of the services are provided at the hospital, there are also some services that are supported in different locations. An example is the new hospital building that was opened two years ago to accommodate the Neurosurgery and Gamma Knife Center, Regional Oncology Center and general medicine services. This extension to the hospital was necessary because the old facility was not able to accommodate the amount of staff and equipment necessary for the growing needs and services of the hospital. The hospital also has another facility in a community nearby which offers similar services to those provided in its main location. There are also satellite offices for some specialized services. The Oncology Center, for example, has two other offices in communities nearby. Aside from the medical services

. c n I p u o r G a e d I t h g i r . y c p n I p Co u o r G a e d I t h g i r y p o C Table 2. Glenview Hospital Services § § § §

Level 1 Trauma Center Pediatric Emergency Room and ICU Regional Oncology Center Kidney, Pancreas, Bone Marrow and Stem Cell Transplant Centers Asthma Center Neurosurgery and Gamma Knife Center Alzheimer’s Disease Assistance Center Diabetes Center Burn Center Sleep disorders Designated AIDS Center

§ § § § § § § § § § § §

Poison Control Orthopedics Pediatric and Adult Open Heart Surgery Woman Services Thoracic Oncology Program Communication Disorders Unit High-Risk Pregnancy Center Rehabilitation Medicine Breast Care Center Pain treatment Epilepsy Center Endoscopic Sinus Surgery

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Table 3. Glenview Hospital Figures and Facts (2001) Available beds Average occupancy rate (percent) Admissions Average length of stay (in days) Ambulatory visits: Clinic visits (hospital and some group) Health centers admissions: University Health Care Center Gamma Knife Center Lully Regional Oncology Center Regional Health Care Emergency visits Total ambulatory and emergency visits

754 82 26,345 5.2

. c n I p u o r G a e d I t h g i r y Cop 395,276

92,683 63,120 54,342 11,146 118,241 45,896 989,558

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provided to the community, the hospital also has research centers in the field of Heart, Lung and Blood diseases, Allergy and Infectious Disease, Cancer, and Immunization. Associated with the Hospital is the Glenview Medical University, which supports four programs: (1) Medicine, (2) Graduate studies, (3) Health professions, and (4) Nursing. There are many functions at the hospital that rely heavily on information technology. Patient care, for example, requires specialized software to handle appointments and insurance claims information. Although many requests come from patients requiring visits to doctors, there are also requests by doctors that want to schedule specialized tests and procedures on their patients. Scheduling then is done using scheduling software. The laboratories are another example of the crucial role of computers at the hospital. Databases at the laboratory for example manage information regarding patients, tests ordered, and the results of the tests. Other services that have benefited from information technology are Admissions/Discharge/ Transfer (ADT), Anesthesia Information Management, Budgeting, Clinical Information Systems (CIS), Computerized Patient Records (CPR), Dictation/Transcription/Voice Recognition, Dietary/Food Service, Immunization Tracking, Pharmacy/Drug Management and Electronic Data Interchange (EDI)/Electronic Billing. Similarly, the university attached to the hospital supports three computer clusters each of which have 30 computers including PC, Macintosh, and Solaris machines.

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c. n I up o r G a e Id t h g i r y Cop The Information Center

Computer Support Services (CSS) at the hospital were first established in the 1960s. At that time, the main role of this department was to support the hospital mainframe computers. The few applications that were run on these systems were built within the hospital research community to conduct sophisticated statistical analysis of medical data. With the advent of personal computing, the hospital began introducing computers to support its numerous research activities and patient services. The first computer applications that were introduced at the hospital were administrative, related specifically to scheduling and claims administration as well as payroll. These two were perceived as crucial to the operations of the hospital

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Figure 1. Glenview Hospital Computing Support Services Robert J. Foels Executive Director of Computing Support Services

. c n I p u o r G a e d I t h g i r y p Co Dan Horton Director Client Services

Vincent Robbins Director Telecommunications

David Banks Director Technical Specialized Medical Services

Earl Logan Director Network & System Services

Patricia Winckelmann Director Inform ation Systems

Thomas Duff Coordinator Distributed Staff Program

because they had an impact on their revenue and staff remuneration. As the hospital grew, new applications were introduced leading to the growth of the CSS. Today, CSS is composed of six units as presented in Figure 1. Each of the Computing and Support Services Unit works independently and can make decisions regarding the purchase of equipment and software that would suit their needs. Of those seven units, Dan Horton heads the Client Services Unit, which in turn manages the Information Center, which provides technical support to the hospital. When the Information Center was first established in the late 1980s, it was a small unit that consisted of only two individuals. The Information Center currently has seven full-time and 20 part-time employees. With the exception of Seth Abern, who has a computer engineering background, all of the other full-time employees do not have a formal education in information systems and have received all of their experience on the job at the hospital and other companies. Part-time employees are all students who attend the university nearby. Most of the students that work, providing computer support at the hospital, have taken classes in information systems, but their experience is limited to their course work and some training at the Information Center. When the Information Center was first implemented, it provided technical support for the entire hospital. This was not a difficult task since there were only a few computers and, as a result, there were not many requests. With the boom in information technology in the hospital in the last 15 years, the Information Center was no longer able to keep up with requests. At that point, Robert Foels, the director of the hospital-wide Computing Support Services, decided to decentralize help desk support to the different medical units. This was also necessary because many of the more specialized units also required equipment tailored to their function. Not every medical unit was given a technical support employee. Only those units with heavy technology demands that were also more specialized received a full-time staff member. Smaller units were still supported by the Information Center. The focus of the IC was therefore to handle more general requests and, occasionally, to support units whose own technical staff was not able to provide a solution. The IC now supports Windows 95, 98, and NT operating systems as well as Solaris, Unix and, more recently, some Linux machines. They also provide support for general applications

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such as the Microsoft Office suite as well as more specialized systems such as Novel GroupWise, supporting accounting, electronic mail, calendar, and scheduling applications for the whole hospital. The center supports both PC and Macintosh systems. One of the problems that the Information Center faced for many years was giving support to many different applications. This happened because some of the hospital units once decided to implement software that would help them manage their patients and operations. Many of the people who wanted applications made decisions without consulting the IC staff. This led to a wide variety of programs, of which many performed similar functions. While the medical units made their own purchasing decisions, they nonetheless requested support from the IC when their systems were not working properly. In an effort to control the number of applications supported, the Client Services director in consultation with all the other units that comprise the Hospital’s Computing Support Services decided to implement an enterprise-wide system for their more basic applications, specifically those supporting payroll, staff scheduling, procurement, and budget. They also wanted to standardize their e-mail applications, calendar, and meeting room scheduling. Because the transition towards the standardized system happened only a year before, there were still many people using the old applications. Another factor that has led the Computing Support Services Department as well as Glenview Hospital administrators to consolidate their systems is the Health Insurance Portability and Accountability Act (HIPAA), which had as its goal to “provide better agreement on health data vocabularies, ensuring the privacy of health information, and addressing other issues surrounding the electronic transmission of healthcare data” (Rishel & Frey, 2001). The budget for the Information Center is determined by Foels, whose own budget is in turn decided by hospital administrators. Budget is one of the problems that the Hospital Computing Support Services has always battled with. Although information technology has an impact on many of the hospital’s functions, it is considered an expense that does not directly impact patient care. Hospitals are heavily regulated and have to keep close control of their expenses because government units or health insurance organizations determine many of their rates. This has led to the implementation of systems that were not necessarily the best or most appropriate for the hospital but instead the least expensive. The 2001 budget for the entire Computing Support Services was $94,000, which was to be allocated to pay for computer equipment and software. This generally led to a budget of only 15,000 for client services. The decision making process at the Information Center is based on team discussions. They hold weekly meetings where they discuss new ideas, poor processes, and consensus rules. There have nonetheless been situations where upper management in the Computing Support Services pushes a decision, and then it is just handed down and not really discussed for its merits. The Client Services Unit as well as most of the Computing Support Services department is composed of employees that have worked for the hospital for a long time. The culture is very traditional. People continue doing the same things because that is how they have always been done. Change is feared by most, as the culture is made up of staff with seniority and not a lot of “fresh” ideas. The primary responsibility of employees at the IC is to provide solutions to incoming requests and problems. Each employee also has a specialty area with co-workers crosstrained as backups. Other responsibilities include training of staff when new systems are implemented. Dan Horton is the head of this department and looks for improvements to facilitate the work of his staff and provide better support to the users at the hospital.

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392 Garcia-Murillo, Maxwell, Boyce, St. Denis, Shetty & Shroyer-Keno

SETTING THE STAGE When the Information Center was first established, it did not keep any records of the problems and solutions given to common computer related problems. As Horton states, “the Information Center relied on the broad knowledge of our employees to solve our clients computer’s needs.” The problem with this approach was that on many occasions people who were inexperienced with any given problem would then have to spend many hours working on something that another employee had already resolved for another user. Given such inefficiencies, the then director decided to begin documenting the problems and solutions to the problems. When the idea was implemented, one of the employees was dedicated to write manuals which were then given to all employees providing computer support. Although this provided some relief in the amount of work that was necessary to solve a problem, it still was time consuming to find the answer in a manual that was becoming increasingly lengthy. IC employees created several versions of homemade databases until 1995, when it decided to implement a DOS-based help desk software package named CallOnUs. The vendor updated the system in 1997, but, after that, it ceased providing support. When the decision was made, CallOnUs was not one of the leading software applications to support help desk services. The price for top competitors ranged between $20,000 and $34,000 while CallOnUs was purchase by IC for $5,400. CallOnUs has two interconnected purposes. It is used as a call tracking system to record and prioritize a customer’s e-mail, phone, or walk-in requests. Employees log the requests as incidents in the system and assign them to a queue for troubleshooting. The system tracked the history of the incident from origin to completion. The CallOnUs system also functions as a knowledge base and contains more than five thousand documents. These documents include procedures, policies, and information used by the IC staff. They use this information when interacting with customers, training new staff, and supporting the staff of the smaller medical units when troubleshooting incidents.

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. c n I p u o r G a e d I t h g i r . y c p n I p Co u o Universal Call Distributing r G a e d I t h g i r y p o C In the early days of the Computer Clients Services Unit, a few employees provided technical support as part of their obligations. There was no dedicated call center to support users. Instead, the user called the CSS employee. This did not pose a problem at first, but, as the number of users grew, employee personal telephone lines were completely overtaken by hospital employees requesting help. At the request of the employees that were taking those phone calls, the then director of the Client Services Unit decided to purchase software to handle technical support. Since the Unit had not budgeted for such a purchase that year, the criterion for selection was, once again, price. Unfortunately, the technology at the time of installation was already outdated. While more sophisticated systems were becoming available, the IC was unaware of the developing technologies that could better support the center’s future growth, primarily because they did not do much research into the product selection. The phone system that supports the help desk routes customer phone calls through the IC. Given its primitive features, the phone system has no way of tracking calls and producing reports to analyze production. As Horton stated, “metrics are implemented to understand how we are doing and find ways to do better.” Without a way of producing call statistics, the IC is merely reacting to the loudest complaints instead of proactively analyzing deficiencies and determining solutions.

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Information Center Web Site In 2000, the Information Center implemented a Web site to support users. At this time, it was clear that the evolving hospital intranet could also accommodate technical-support material. Because the IC did not have a person with Web technologies expertise, it hired an outside independent consultant to develop the page. The IC Web site includes a search engine for the CallOnUs knowledge base. There are also various links to information that can solve customer questions. The function of the site is to provide efficient self-help for the hospital user community. Hospital users can reach the CallOnUs knowledge base from the Glenview Hospital home page. From the home page, users first click on Staff Support, then on Information Center, then on Support Services, and finally on the “search for a solution” link that uses the CallOnUs knowledge base. The Information Center’s Web site has 40 links presented in two panels on its main page. One panel is organized alphabetically while the other is organized by main topics. The link to reach the CallOnUs database is in the alphabetized panel. When users reach the knowledge base, they have several search options. One method is to use the general search engine that accepts multiple word entries. The user can search by keyword or by symptom. If the user cannot find the solution, the other option is to send an e-mail to the IC, for which the address is at the bottom of the knowledge base page.

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CASE DESCRIPTION

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Most of the problems associated with the use of the CallOnUs knowledge base are related to poor data administration. As stated by McNurling and Sprage (2002), challenges of managing information resources derive from problems associated with ambiguity of language and undefined structure. They find that in the world of data administration, there are several tasks: (1) clean up of data definitions; (2) control of shared data; (3) management of data distribution; and (4) maintenance of data quality (p. 214).

c. n I up o r G a e Id t h g i r y Cop Data Definition

Data definition refers to the consistency of definitions used in the logging or input of data. Any IC staff member with access to CallOnUs can create a knowledge document, which requires the entry of between two and eight keywords. IC staff and end users use these keywords to search the system when trying to resolve problems. Each staff member has the freedom to use any words he thinks are best for the document. For example, to describe a common problem with an operating system, the terms Windows95, Win95, Windows 95, Win95 or Windows-95 are used. Because of the multiple terms that can define a problem, numerous incident solutions can result from using the full search query and the user has to read all of them to find his or her particular answer. At the Web site, users experience similar problems. When using the search engine, they can create a query by subject or problem symptom. However, this too takes several tries because employees creating knowledge documents use many different keywords to describe the same problem. As a result, users do not retrieve all of the information available in the knowledge base applicable to their problems and the information retrieved is often not helpful. This creates a situation where a user prefers to call the IC for help rather than solving the problem alone.

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Control of Shared Data The CallOnUs knowledge base is used and maintained by all employees in the Information Center. When an employee is trying to answer a user’s question, he will spend a few minutes locating the documents that will help to solve the problem. Because of the lack of standardized data definitions, there are occasions when he will not be able to find the exact solutions. If he cannot find an answer in the knowledge base, two things can happen. One is to ask other employees who are also providing help desk support. This is common because many employees are frustrated with the knowledge base and rely on each other’s knowledge. If none of them knows the answer, then the employee will inform the user that he will try to find a solution and will call her later. When no solution is found, the employee then proceeds to create a document outlining the problem and solution that he was able to recommend.

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As a result of the hospital having technical support staff in other units aside from the IC, there has not yet been a consolidation of documents. Each unit maintains its own knowledge base system. One of the problems associated with this set up is that there have been many occasions when one of the units was not able to find a solution to a problem for which the IC had already found an answer. This means that whenever an independent unit faced a problem that it could not resolve, an employee would call the IC for help.

. c n I p u o Quality r Maintenance G of Data a e d I t h g i r . y c p n I p Co u o r G a e d I t h g i r y p o C As stated by Fisher and Kingma, “Data quality is one of the critical problems facing organizations today” (2001, p. 101). It has been estimated that error rates in industry are as high as 75% (Redman, 1998). According to the Data Warehousing Institute poor customer data quality costs U.S. companies $611 billion a year (2002). The metrics often associated with data quality are: accuracy, timeliness, consistency, completeness, relevancy, and fitness for use. Table 4 provides a description for each of these variables Because each employee is able to document the solution to the problems that he faces when supporting users, there have been multiple documents answering the same question. The simple addition of documents that solve problems that have already been logged contributes to the problem of retrieving these documents in subsequent periods. Differing levels of expertise have further led to the creation of documents that provide inefficient or inadequate solutions to a problem. When an employee proceeds to provide support, he may be making things worse in the long term by giving solutions that could have negative effects on the overall performance of the system. This in turn leads to other problems.

Table 4. Definition of Data Quality Variables

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Accuracy Timeliness Consistency Completeness Relevancy Fitness for use

Definition

Lack of errors, the data conforms to a real world value of fact Data is not out of date The data represented is the same in the entire data collection The data is represented in all of its degrees and variables The applicability of the data to the particular situation at hand The data is represented in a format that best serves the user’s purpose

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Help Desk Support Flow Employees at the IC log all incoming phone calls, e-mails, or walk-in visits into the CallOnUs system as incidents. When a user makes a request, the employee searches the knowledge base several times with a variety of keywords in an attempt to resolve the customer’s request. If the incident is resolved, the employee documents the solution in the knowledge base. If the incident is not resolved, the employee forwards it to the appropriate queue for higher-level support. The request sits in the queue for up to three days until an employee attempts to solve the problem, or until the customer contacts the center again inquiring on the status of the problem. The time lag occurs because no one at the center is responsible for responding to questions left unanswered by other employees. It is only due to the unrecognized efforts of some employees that these requests are eventually resolved. If the customer contacts the center again, one of two things will occur. First, the employee will look for the incident report or start the resolution process with the customer again. This process includes searching the knowledge base again. Alternatively, the employee can forward the incident to the next level of support in another queue if he cannot resolve the incident. If the incident is resolved, the employee documents the solution. Alternatively, due to a lack of communication, the incident may be logged a second time and then two different

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Figure 2. Incident Flow Diagram

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Incoming client problem via phone, walk-in or e-mail logged in CallOnUs as incident

Knowledge base researched in attempt to resolve incident Level 1

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Look up incident and attempt to resolve

Incident resolved?

Y

Documented in knowledge base if needed Any Level

N

Y

Client calls again?

Incident forwarded to appropriate queue for higher level support Level 2

N

Incident resolved?

Y

N

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Client calls again?

Incident researched, updated and moved accordingly Level 3

N

Incident resolved?

Y

N

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396 Garcia-Murillo, Maxwell, Boyce, St. Denis, Shetty & Shroyer-Keno

employees may try to solve the problem, thus wasting staff time. The process repeats itself each time the customer calls back. The tension between the customer and the employee can escalate with each callback. Figure 2 shows the steps in the resolution process.

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If the user cannot find an answer on the Web site, they can call, e-mail, or walk to the Information Center. Unanswered calls and busy signals have created customer frustration, but the staff is unaware of reasons why calls are missed when staff is available. Neuma Adams, the head nurse in the radiology department, recently sent Horton a written complaint detailing the days and times her department placed support calls. She followed up with a phone call that stated: “When are you going to do something about this? We are all too busy to deal with these kinds of tech problems. We need your department to get things done to help us.” Horton was unable to provide anything to her other than an apology. Often, the employees are on the phone for extended periods with customers trying to solve customer callbacks on previously logged problems. Because of these long calls over unsolved incidents, no one is available to answer incoming calls regarding new incidents. Frustrated clients hang up and send inflammatory e-mails to Horton. He is not sure how often this happens because the phone system does not log hang-ups or missed calls. He does not know when the peak call periods occur or who is making the most support calls because the phone system provides no metrics. Employees are increasingly becoming frustrated and accusing each other of not “pulling their own weight” with regard to solving incidents when they are first logged into the system. Two of his most experienced front line employees left, and their replacements also left two weeks later.

. c n I p u o r G a e d I tFACING THE ORGANIZATION h g CHALLENGES i r . y c p n I p Co u o r G a e d I t h g i r y p o C In order to increase the efficiency and reduce the workload of his employees, Horton instituted a tiered model consisting of four levels. The original tiered support level does not start from a planned strategy. Instead, it comes about as a result of the specialization that some of the employees were achieving in the handling of calls. Eventually, Horton decided to give these employees particular responsibilities. It originally had only two levels: desktop support

Figure 3. Tier Model Support for Glenview Hospital John Thomas Executive Director Com puting Services

Dan Horton M anager Level 1 Inform ation Center

Jeff Hazzelmyer Manager Level 2 Desktop Support

Dustin Beal Director Level 3 Network Engineering

Client Support and Consulting Accounts Administration Com puting Policy Violation W eb/Phone/E-mail contacts

Problem Resolution Tech Consulting and Evaluation Tech Docum entation Review On-site Support

IT Engineering & Im plementation Projects Network Comm unication O perations

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and network engineering. Over time, the model evolved to include the four levels that are now in place. The biggest challenge this created for him and his staff was increasing the number of incident resolutions at Level 0 in order to reduce the workload of employees at Levels 1, 2, and 3. Horton feels that he does not have accurate numbers for percentages by tier. He needs to know this breakdown in order to justify improvements in certain areas. Figure 3 shows the tiers.

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Level 0 helps users solve problems themselves via the Internet, intranet, or printed material. There are printed User Guides that answer some basic computer set-up questions and the search engine on the internal site that queries the help desk knowledge base. Ideally, Horton stated that he “would like to get 15% [of support directed] to level zero.” This would reduce the number of incidents requiring staff time. Unfortunately for the Information Center, most hospital employees are not particularly knowledgeable about computers and will rarely take the initiative to learn by themselves. This is further exacerbated by the perception of many that computers are not their responsibility but rather the care of their patients. They, therefore, delegate all types of computer problems to the technical support of their medical unit or to the staff at the Information Center.

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Level 1 is the Information Center staff, and is the point of first contact by customers whether they come to the help desk personally, use e-mail, or phone. Among the tiers, Level 1 employees have the closest relationship with users because they are the point of initial contact. The Level 1 staff must also communicate thoroughly with customers to understand their needs and solve the problems quickly and efficiently to provide good customer service. Horton believes that “Level 1 should be able to resolve 55% of the incidents.” If Level 1 staff cannot resolve the issue, they assign the incident to the next level.

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Another department handles Level 2 incidents. Level 2 employees focus on technical knowledge. They have to spend more time on each incident than Level 1 and have more onsite advanced customer support responsibility. Level 2 employees resolve a variety of incidents including hardware, software, and network problems. Ideally, Horton would like Level 2 to handle 27% of the incidents. All too often, Level 2 employees refer incidents they cannot resolve to Level 3.

Level 3

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This is the Networking Support level. Employees in this tier are internal experts with a strategic planning focus. They have limited user contact, and mainly deal with network and server related issues. Horton wants Level 3 to handle 3% of incidents, “or even less.” John, a new employee at Level 3, received a Level 0 User Guide during his orientation. Although he has worked for the hospital in other capacities for several years, he stated, “I have never seen one of these,” even though the guides had been distributed to all new staff in the last two years, and are available at the Information Center. Upon receiving the User Guide, John was able to quickly solve an incident that the Level 1 and 2 employees had been working on for two days. Copyright © 2003, Idea Group Inc. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. is prohibited.

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Table 5. Percentage of Requests Handled by each Tier Levels

Target

Actual

Level 0 Level 1 Level 2 Level 3

15 % 55 % 27 % 3%

10 % 45 % 30 % 15 %

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Table 5 presents the targeted and actual percentages associated with each of the levels.

In an effort to reduce turnover and increase productivity, the Information Center intends to institute four projects: (1) an updated phone system with extensive reporting capabilities, (2) an innovative call tracking/knowledge management help desk package, (3) an enterprise web based e-mail system, and (4) an enterprise account management system. The standardization of e-mail and accounting should reduce the number of requests.

. c n I p u The Phone r System o G a e d I t h g i r . y c p n I p Co u o r G a e d I t h g i r y p o C The problems with the universal call distributing system are causing the Information Center to look at two alternatives for upgrading this equipment: (1) a new automatic call distribution system (ACD) and (2) an Internet Protocol (IP) telephony system. Both phone systems have enhanced features that track and route calls, but they also generate reports and allow greater communication between the call tracking software and the Internet. The ACD system is ideal for organizations with exceptionally high call volumes, and works by queuing incoming calls and routing them to technicians when they become available. The IP based system has the greatest degree of functionality because it incorporates both voice mail and e-mail with auto attendant, virtual extension, automatic call distribution, and single key voice mail response capabilities. Price is the most important factor considered in the choice of phone systems. While the IP system is more expensive than the ACD, it has many more functions associated with the computer telephony integration. At this point, no decision has been made.

Updated Knowledge Base The existing help desk package, CallOnUs, installed in 1995 and upgraded in 1997, met with initial resistance among users until a management directive required all help desk technicians to use CallOnUs. While the CallOnUs system proved satisfactory in its early stage, as the number of knowledge documents increased and the service spectrum of the IC increased, the effectiveness of CallOnUs decreased. There are three main problems with the system: knowledge documents have no set search terminology or standards; it has an ineffective search engine; and it cannot cross connect to the IC Web page to allow easy access by Internet users. Another problem faced by the IC is that the vendor, after a series of mergers and acquisitions, ceased development of the product and announced that it would

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Computer Service Support at Glenview 399

no longer support it at the end of 1997. Therefore, in 1999, the Information Center began to search for a new product to replace CallOnUs. Initial research indicates that the upfront licensing and installation for new systems from other vendors is likely to cost $250,000. The increasing number of customers with varying technological needs has forced Horton to make radical changes in both the technology and structure of the Glenview Hospital Information Center. The hospital, the users, and the patients all depend on the ability of the IC to effectively deal with technology problems that arise in a timely manner. There is a delicate balance between organizational and system change. Managers must consider stakeholder acceptance in these decisions. Horton has realized that to better serve his customers and decrease the pressure on his staff two things need to be changed. First, certain departmental procedures must be changed or augmented so that either users can solve their own problems or appropriate levels handle the calls. Second, technological improvements need to be made at the IC that will result in better customer service. Horton also needs adequate information to allow him to understand where the problems are within his own organization. While there has not been a lot or research done with respect to the selection of the new system, it is clear that there are now more sophisticated tools to handle customer requests. One approach, for example, is the assignment problem. This is now being updated to Fault Systems, which provide a more optimal assignment of technicians to service faults (Lazarov & Shoval, 2002). The IC is therefore coming to a point where major decisions need to be considered. Horton is running the risk of losing more staff, and the hospital is being negatively affected by systems that are not supported appropriately. The future of the Information Center and users at Glenview Hospital will thus be determined by decisions taken at this time.

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a e d I t h g i r y p o C ENDNOTE

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c. n I p u o r FURTHER READING G a e Id t h g i r y Cop 1

The name of the organization, the industry, and the people involved have all been changed to preserve confidentiality and privacy.

HISTBA. (2002). Health Information and Technology Benchmarking Association. Retrieved May 27, 2002, from the World Wide Web: www.histba.com. Marcella, R. & Middleton, I. (1996). The role of the help desk in strategic management information systems. OCLC Systems and Services, 12(4), 4. Skip the help desk. (1997, March 17). Information week, 73. Rishel, W. & Frey, N. (2001). Integration Architectures for HIPAA Compliance: From ‘Getting It Done’ to ‘Doing It Right.’ Gartner. Stinton, I. (1996). Helping the Help Desk. Work Study, 45(1). Yoon, V. Y., Aiken, P., & Guimaraes, T. (2000). Managing Organizational Data Resources: Quality Dimensions. Information Resources Management Journal, 13(3), 9.

c. n I p u o REFERENCES r G a e d I t h g i r y p o C

Data Quality and the Bottom Line: Achieving Business Success through a Commitment to High Quality Data. (2002). Seattle, WA: Data Warehousing Institute. Retrieved

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400 Garcia-Murillo, Maxwell, Boyce, St. Denis, Shetty & Shroyer-Keno

November 7, 2002 from WWW: www.dw-institute.com/research/ display.asp?id6064#RS. Kingma, C. F. (2001). Criticality of data quality as exemplified in two disasters. Information and Management, 39, 109-116. Redman, T. C. (1998). The impact of poor quality on the typical enterprise. Communications of the ACM, 41(2), 79-82. Rishel, W. & Frey, N. (2001). Integration Architectures for HIPPA Compliance: From ‘Getting It Done’ to ‘Doing It Right’ (Strategic Analysis Report): Gartner. Shoval, A. L. (2002). A rule-based system for automatic assignment of technicians to service faults. Decision Support Systems, 32: 343-360. Sprague, B. M. (2002). Information Systems Management in Practice (5th ed.). Upper Saddle River, NJ: Prentice Hall.

. c n I p u o r G a e d I t h g i r y p BIOGRAPHICAL Co SKETCH

Martha Garcia-Murillo has a PhD in Political Economy and Public Policy from the University of Southern California, where she was a research associate at the Center for Telecommunications Management. She is currently an assistant professor at Syracuse University’s School of Information Studies, USA. She has also worked at the International Telecommunications Union in Geneva, Switzerland.

. c n I p u o r G a e d I t h g i r . y c p n I p Co u o r G a e d I t h g i r y p o C Paula Maxwell is pursing an MS in Information Management at Syracuse University, USA, and is also a technical analyst at the university’s Computing and Media Services department.

Simon Boyce is currently pursuing a joint Juris Doctor and MS in Information Management degree at Syracuse University, USA. He has an MA degree in Political Science from Ohio University. Raymond St. Denis has an MS in Information Management from Syracuse University, USA. He is a member of the US Army Reserve.

Shwethan Shetty has an MBA in Marketing from the University of Pune in India. He is currently pursuing an MS in Information Management from Syracuse University. Joan Shroyer-Keno is a database administrator for a computerized maintenance and logistics management project for surveillance systems equipment. She is pursuing an MS in Information Management at Syracuse University, USA.

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