Another key to deploying a clinical IT service desk is understanding the personalities of physicians, he says.
"I say that with a smile," Fuschillo says. "You need training to recognize that and appreciate that. They may have just had a patient pass away under their care, and now they're moving to another patient, and if the systems aren't working, you can appreciate that the emotions of that individual are a little different than the rest of us. What they experience when they go through the course of the day is incredible."
Clinical IT service desk personnel are "trained to respond to those calls, and be able to calm somebody down, or at least expect that level of disruption," he says. "Some of the IT service desk vendors we looked at did not have that healthcare niche, and you can tell during the questioning—they failed to provide the adequate responses that we were hoping for."
Physician satisfaction with the in-house service desk system had been in the 20%–30% range; that jumped to about 95% with the outsourced CareTech service, Fuschillo says.
Hospitals are realizing that they need to continue to centralize IT service desk features and not disperse them through different service lines, Fuschillo says. Decentralized IT service desks are "costly, inefficient, ineffective, and no one owns it," he says. "The more centralized the similar skill sets, the more accountability. Who's responsible for passwords? Who's responsible for change control? Who's responsible for the production environment, the data that's housed in there, and on and on? You're going to see a more centralized model, taking direction from key business owners who are leaders across the organization" such as CMIOs and CNOs, he says.
Fuschillo finds the return on investment of implementing an improved IT service desk to be difficult to summarize for a CFO, but he says when properly implemented, "patient care is not disrupted. Clinicians remain on the floor, treating the patient with minimal workflow interruptions."
Detroit Medical Center's extensive automation at its seven hospitals, all certified for meaningful use Stage 1, means its systems must perform well. Just making sure the software itself is up and running isn't sufficient, Francis says.