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Help desk assessment report.x10

  1. 1. Pre-Sales Assessment Presentation Phase 1 Progress Report October 21, 2005
  2. 2. <ul><li>Agenda </li></ul><ul><ul><li>Background </li></ul></ul><ul><ul><li>Project Objectives </li></ul></ul><ul><ul><li>Approach </li></ul></ul><ul><ul><li>Deliverables </li></ul></ul><ul><ul><li>Current Mode of Operation & Observations </li></ul></ul><ul><ul><li>Next Steps (Phase II) </li></ul></ul><ul><ul><li>Areas for Additional Investigation </li></ul></ul><ul><ul><li>Critical Success Factors </li></ul></ul><ul><ul><li>Assumptions </li></ul></ul>
  3. 3. <ul><li>Background </li></ul><ul><ul><li>Project Sponsor </li></ul></ul><ul><ul><li>Business Driver </li></ul></ul><ul><ul><li>Team </li></ul></ul><ul><li>Project Objectives </li></ul><ul><li>Approach </li></ul><ul><li>Deliverables </li></ul>
  4. 4. Background <ul><li>Project Sponsor </li></ul><ul><ul><li>Cliff Seaholm (ITFS) </li></ul></ul><ul><li>Business Driver </li></ul><ul><ul><li>Customer HealthConnect, the largest healthcare initiative in Customer history, requires the deployment of highly available IT infrastructure to “enhance the patient care support the Customer Promise” for the future </li></ul></ul><ul><li>PC/Failures Timely Repair </li></ul><ul><ul><li>ITFS investigated potential PC support model alternatives to achieve SLA for restoring a failed PC </li></ul></ul><ul><ul><li>Of options considered, re-engineering of the break-fix process using other smart people will be investigated </li></ul></ul>
  5. 5. Background - Team <ul><li>Customer Project Governance </li></ul><ul><li>Cliff Seaholm – Project Sponsor </li></ul><ul><li>Carl Kawaguchi – Acting Project Sponsor/Ops Manager </li></ul><ul><li>Kevin Wheeler – Ops Manager </li></ul><ul><li>Sharon Bond – PMO Manager </li></ul><ul><li>Larry Faulkner – PMO Project Manager </li></ul><ul><li>Customer Subject Matter Experts </li></ul><ul><li>Erik Hildebrand – PMO </li></ul><ul><li>John Pho – ITFS IT </li></ul><ul><li>Carl Haupt – ITFS IT </li></ul><ul><li>Althea Santucci – HelpDesk </li></ul><ul><li>Mark Stanley – Software and Imaging </li></ul><ul><li>Thierry Guichard – Asset Management </li></ul><ul><li>William Bruce – BAP </li></ul><ul><li>Lisa Kendrick – Network Infrastructure </li></ul><ul><li>Carla Burget – Depot and Change Management </li></ul><ul><li>Marc Hedish – Service Delivery </li></ul><ul><li>Inventes Due Diligence Team </li></ul><ul><li>Anand Raj –Project Oversight </li></ul><ul><li>Dawneen Davis –Project Manager </li></ul><ul><li>Charlie Jackson –Project Manager </li></ul>
  6. 6. <ul><li>ITFS Strategic Objectives </li></ul><ul><li>Improve ITFS Services through the creation of a continuous improvement culture </li></ul><ul><li>Enhance organizational effectiveness and service capability through proactive workforce planning, optimized processes, and cost-effective technology innovation </li></ul><ul><li>Deliver business value by aligning ITFS services with all business requirements and creating a business partnership </li></ul><ul><li>Reduce total cost of ownership for the distributed environment and be competitive with external service providers </li></ul>Project Goal & Objectives PROJECT GOAL: The overall goal of the Business Process (Break/Fix) Re-engineering Project is to investigate and test reducing restoration time of CustomerHC business functionality for urgent areas within 20-30 minutes and within 2 hours for other important areas <ul><li>Project Objectives </li></ul><ul><li>Examine and document current Customer IT service processes and their impact on Break/Fix (B/F) </li></ul><ul><li>Assess gaps in B/F service delivery processes, parts management, resources and skills </li></ul><ul><li>Examine methods to achieve new service level agreements (SLAs) for improved response time </li></ul><ul><li>In conjunction with Customer staff, develop a future state process and model the new process as part of the pilot in one Customer facility, provide knowledge transfer for continued operation under revised SLAs and document final findings </li></ul>
  7. 7. Current & Future Service Level Agreements (SLAs) <ul><li>FUTURE REQUIREMENTS </li></ul><ul><li>7x24x365 support for: OR/ICU, ED, Inpatient rooms, Inpatient Rx, Inpatient ADT, Ancillaries (Lab/Rad/EKG) </li></ul><ul><li>Extended coverage for: Nurse Stations, Outpatient exam rooms, Urgent Care After Hour Clinics, Registration, Appointment Call Centers </li></ul><ul><li>90% of the time, need business functionality provided in the same physical location . Class A users need their business functionality provided in the exact location. </li></ul><ul><ul><li>Includes cart-based PCs, desktop PCs, and laptop PCs </li></ul></ul><ul><ul><li>Printing functionality </li></ul></ul><ul><ul><li>- Assumption – All workstations are “Managed Workstations” </li></ul></ul><ul><li>The replacement PC has at least the same functionality as the one that malfunctioned. This includes the access rights necessary to do the work needed. </li></ul>LINK – Current ITFS Severity Level Standards A 2 hrs .5 hrs B 4 hrs 2 hrs C 8 hrs 8 hrs D 24 hrs 24 hrs 80% yield 90%yield Current Future 74% 70-80% Needs additional clarification on A, B, C & D
  8. 8. Project Approach <ul><li>Understand & document Customer IT current mode of operations </li></ul><ul><li>Establish baseline process and service levels </li></ul><ul><li>Identify and analyze opportunities of improvement </li></ul><ul><li>Develop a new modified process to achieve enhanced service levels </li></ul><ul><li>Develop plans for pilot and seek necessary support and resources </li></ul><ul><li>Conduct the pilot / gather pilot data </li></ul><ul><li>Review pilot performance against the baseline and analyze gaps </li></ul><ul><li>Develop final recommendations / success criteria for proposed changes. </li></ul><ul><li>Complete overall project documentation </li></ul>
  9. 9. Project Deliverables <ul><li>Current Mode of Operation Documentation (Due Diligence Report and Presentation) </li></ul><ul><li>FMO Documentation </li></ul><ul><li>Pilot Project </li></ul><ul><li>Summary Findings and Recommendations </li></ul><ul><li>Project Plan, Meeting Minutes, Test Plan, Knowledge Transfer Plan </li></ul>
  10. 10. Project Review – Phase I (Due Diligence) Overall Approach Phase 1: Due Diligence Milestone Milestone Phase 2: Process Optimization <ul><li>Present and validate Due </li></ul><ul><li>Diligence Report </li></ul><ul><li>Present final deliverables </li></ul><ul><li>Achieve knowledge </li></ul><ul><li>transfer </li></ul>Break-Fix Process Re-engineering Program Governance <ul><li>Outline the scope of services (service stack) for due-diligence </li></ul><ul><li>Establish governance model & communication plan (wk 1) </li></ul><ul><li>Identify SMEs </li></ul><ul><li>Conduct one-on-one interviews with the SMEs </li></ul><ul><li>Document current state findings </li></ul><ul><li>Identify areas for further analysis </li></ul><ul><li>Design and validate Future State Processes </li></ul><ul><li>Plan pilot </li></ul><ul><li>Implement and test pilot </li></ul><ul><li>Prove/disprove desired SLA and recommendations </li></ul><ul><li>Transfer knowledge </li></ul><ul><li>Present final deliverables </li></ul>
  11. 11. Project Review – Phase I Due Diligence - Overall Approach 9/19/05 9/26/05 10/19/05 Project Planning Interviews and CMO Documentation CMO Presentation and Findings Due Diligence Findings Presentation 10/21/05 Kick-Off Meeting Phase 1 - Due Diligence Break-Fix Process Re-engineering Program Governance <ul><li>Outline the scope of services (service stack) for due-diligence </li></ul><ul><li>Establish governance model & communication plan (wk 1) </li></ul><ul><li>Identify SMEs </li></ul><ul><li>Conduct one-on-one interviews with the SMEs </li></ul><ul><li>Site visits and observations </li></ul><ul><li>Follow-up data gathering </li></ul><ul><li>Document and validate current state findings including process maps </li></ul><ul><li>Document new requirements </li></ul><ul><li>Review IT Governance and Business-IT alignment aspects </li></ul>Finding report and presentation
  12. 12. Process Centric Approach Customer-IT (NOPS) Customer Business Client Services ITFS ENS HD Patient Care Site Support BAP IMAC-D Financial Manage- ment Software And Imaging Desk-side Support Asset Manage- ment Break-Fix Network Infrastruc- ture National Help-Desk Solution Center Depot Manage- ment Problem Manage- ment Managed Project Deployment PMO
  13. 13. Current State
  14. 14. Infrastructure “ When I turned on my computer today, I received an error message that my Customer HealthConnect couldn’t be found, so I called the National Help Desk and passed over to the Physician’s Help Desk. CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Telecommunications and network infrastructure provisioning </li></ul><ul><li>Continual support for electronic operation and communication </li></ul><ul><li>Database storage, management, and operations </li></ul><ul><li>Backup and restoration </li></ul><ul><li>IT Service Continuity Management </li></ul><ul><li>Establishing OLAs across IT organizations may help to achieve service levels </li></ul><ul><li>HealthConnect – Major initiative that provides a program-wide systems for records and clinical content </li></ul><ul><li>Web access portal </li></ul><ul><li>Enterprise data repository </li></ul><ul><li>134,000 end-users supported across 430 MOBs and 30+ medical centers </li></ul><ul><li>LAN infrastructure with fiber backbone, WAN </li></ul>
  15. 15. Help Desk “ My call was answered promptly and the Help Desk agent was very friendly. She attempted to help me and asked me several questions but it became clear that something must be wrong with my PC that would require a visit by an on-site technician. ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Provide prompt, tiered “1 st line” service for assistance throughout the region (Physician’s and General HD) </li></ul><ul><li>Classify incident and attempt to resolve incidents on first call </li></ul><ul><li>Generate tickets for Incident, Requests for Change, and Service Requests </li></ul><ul><li>Improving first call resolution at the Help Desk </li></ul><ul><li>Integrating with Site Support Specialists </li></ul><ul><li>Solution Center piloting L2, L3 for expanded remote problem resolution </li></ul><ul><li>3 NHD call centers with 211 agents </li></ul><ul><li>99.9% of incidents reported via telephone </li></ul><ul><li>Calls have increased 50% since early 2004 </li></ul><ul><li>32,347 Incidents per month avg 2005: .04% Critical, .23% High, 74.77% Med, 24.97% Low </li></ul><ul><li>73% of incidents are resolve on first call </li></ul><ul><li>199, 207 calls (Aug, 2005) </li></ul>
  16. 16. Help Desk “ The Help Desk agent asked me to verify my location and other information and said to expect someone from ITFS to stop by my desk before noon. I said that I would be on rounds but my assistant would be there.” ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Dispatch tickets to the appropriate resolver group </li></ul><ul><li>Provide warm handoff to Solution Center for level 2 and level 3 problems </li></ul><ul><li>Information sometimes entered incorrectly, or not updated, causing delays in service response </li></ul><ul><li>There may be time delays between help desk response and on-site response </li></ul><ul><li>Sometimes tickets may be incorrectly dispatched </li></ul><ul><li>Remedy is primary tool for help desk, dispatch, and SLA management </li></ul><ul><li>Many physicians call the general HD number </li></ul><ul><li>90% of dispatch incidents go to ITFS. </li></ul>LINK: Process Flow Diagram
  17. 17. Help Desk
  18. 18. Availability Management “ I logged onto my Customer HealthConnect account via a shared computer, checked on the status of my patients and then began my rounds. ” ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Ensure that necessary systems and data are readily available </li></ul><ul><li>Assist with training of service personnel and customers, particularly regarding new initiatives </li></ul><ul><li>Total availability of all processes (uptime) difficult to measure </li></ul><ul><li>Support for new initiative sometimes affects SLAs initially </li></ul><ul><li>Availability Management Plan includes provisioning for a 99.96 uptime </li></ul><ul><li>XD General Office – used in personal environment with individual login and data </li></ul><ul><li>XD Shared – used in shared environments with workstation logged into network </li></ul><ul><li>XD Simplified – used in individual walk-up environment </li></ul>
  19. 19. Break/Fix, Desk Side Support “ When I returned to my desk, everything was working again. My assistant said that the ITFS staff replaced my computer because the software needed to be re-loaded and they didn’t want me to be without access any longer than necessary.” ► LINK: Minutes from Interview CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS LINK: Process Flow Diagram <ul><li>Responsible for resolving any hardware or software issue that occurs and cannot be solved remotely, including hot swaps </li></ul><ul><li>B/F and DSS includes support for printers, PDAs, and other devices attached to computers </li></ul><ul><li>Specialized locations for some computers (i.e. wall mounting) may require additional time </li></ul><ul><li>Locating computers may be difficult if asset and/or CAD systems aren’t updated </li></ul><ul><li>Remedy ticket resolution process may be optimized </li></ul><ul><li>Resource quality/skill sets remain and issue and ramp-up time and training may be improved </li></ul><ul><li># of RFCs/SRs has increased from 742 in Jan to 1,802 in September. Incident includes h/w and software </li></ul><ul><li>Most projects are July-Dec and via augmented staff </li></ul><ul><li>Approx. 5% of incidents dispatched to ITFS are reassigned to other service providers </li></ul><ul><li>1/3rd of all sites have technicians in the building. 2/3rds of the sites require tech travel time </li></ul><ul><li>PC hardware failure rate averages 3-5% annually </li></ul>
  20. 20. Break/Fix, Desk Side Support
  21. 21. Break/Fix, Desk Side Support
  22. 22. IMAC-D “ The ITFS technician also left a set a guidelines for our department move next week and said that they would move the computers during the weekend so we wouldn’t experience any down time. ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Responsible for managing installs, adds, moves, changes, and disposal of computers and printers. </li></ul><ul><li>Much of IMAC-D work is contracted to external companies </li></ul><ul><li>Procurement process time can be an issue and also impact swap-out depot </li></ul><ul><li>Use of Depot inventory for IMAC creates additional overhead in accounting </li></ul><ul><li>No OLA for IMACs between other organizations </li></ul><ul><li>Communication of the IMAC service levels to business partners will enhance customer experience </li></ul><ul><li># of IMACS per month: 7,190 in NCAL, 3,260 in SCAL </li></ul><ul><li>Because of refresh, number of Installs has greatly increased </li></ul><ul><li>Current service level for IMAC-D is 5 to 10 business days and varies </li></ul><ul><li>Some Service Area (such as SF) also maintain a separate inventory of about 20 PCs (in addition to break-fix inventory at the depot) for the purpose of IMAC-D </li></ul>LINK: Minutes from Interview
  23. 23. IMAC-D
  24. 24. Depot Management “ I replaced Dr. Carillo’s computer with one from the depot.” ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Responsible for maintaining the required levels of configured computers needed to meet swap out for BF </li></ul><ul><li>Manages returned computers, including provisioning of spare parts and warranty and out-of-warranty supplier communications </li></ul><ul><li>Additional depots may be needed for facilities with enhanced SLAs </li></ul><ul><li>Facilities space issues may need to be resolved </li></ul><ul><li>Spare and whole-unit provisioning not automated </li></ul><ul><li>Depots are strategically located, but not at all sites. </li></ul><ul><li>Approximately 1% of the total population of PCs in that area is kept in the depot inventory </li></ul><ul><li>10-20 machines are imaged and ready to go at any time, depending on site </li></ul><ul><li>Depots are replenished now by manual process </li></ul>
  25. 25. Imaging and Software Distribution “ Then, I filled out a work order so that it would be re-imaged and I updated the trouble ticket.” ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Responsible for maintaining current image builds, including patches, and new releases </li></ul><ul><li>Images computers for depot and IMACs </li></ul><ul><li>Potential to reduce time spent duplicating and imaging at all facilities </li></ul><ul><li>Training on the processes will be helpful in making sure processes are followed </li></ul><ul><li>Roles and responsibilities between ITFS and vendors related to Depot needs to be clearly defined </li></ul><ul><li>2 builds for express desktop (Win 2000 and XP) </li></ul><ul><li>Core image includes h/w layer, OS, IE, McAfee, Tivoli, Lotus, Citrix, Health Connect, MS Office (some) </li></ul><ul><li>Images stored on servers at 700 facilities, loaded on-site </li></ul><ul><li>Geography config, and active directory managed by RadioOS Manager </li></ul><ul><li>Merlin used for updates (4 hours), EPO for virus scans </li></ul>LINK: Minutes from Interview
  26. 26. Change Management “ Dr. Carillo’s assistant asked if they could get some new software installed. I showed her how to access the HUB to submit an RFC.” ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Change management system and CABs review and approve RFCs </li></ul><ul><li>Manages SRs </li></ul><ul><li>Some confusion over guidelines for RFCs and SRs </li></ul><ul><li>Process sometimes lengthy </li></ul><ul><li>Sometimes gaps occur between an RFC request/approval and the accompanying SR needed </li></ul><ul><li>Communication is challenging. Technical briefings and targeted communications are more likely to be effective. </li></ul><ul><li>47,547 RFCs registered at HD (August, 2005) </li></ul><ul><li>Standard RFC SLA: 10 days </li></ul>
  27. 27. Asset Management “ I returned to my desk to update the ticket with, and relate the new asset information then changed the status of the one that I brought back from ‘in-use’ . ” ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Maintains the CMDB, appends weekly vendor feeds </li></ul><ul><li>Responsible for tracking all assets and their location </li></ul><ul><li>Perform quarterly audits of locations </li></ul><ul><li>Responsible to audit software licensing compliance </li></ul><ul><li>Touch points between ITFS services and asset management improving but need monitoring </li></ul><ul><li>Better integration between Location Center (assets) and local support services groups might help improve SLAs </li></ul><ul><li>Desktops: 147,041 </li></ul><ul><li>Laptops: @30,000 </li></ul><ul><li>Monitors/Terminals: @190,000 </li></ul><ul><li>Printers: @80,000 </li></ul><ul><li>Network Devices: @40,000 </li></ul><ul><li>Servers: @14,000 </li></ul><ul><li>90% of the IT assets are in the database </li></ul>LINK: Minutes from Interview
  28. 28. Problem Management “ This was the third time during the week that the Customer HealthConnect software was corrupted. I’ll need to see if this is being addressed during my next Problem Management meeting. ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Root-cause Analysis </li></ul><ul><li>Develop plans to improve problem resolution </li></ul><ul><li>The mix of High-Medium problems could change dramatically </li></ul><ul><li>Problem management is shared across NOPS but often problems are impacted by shared services </li></ul><ul><li>There are ~ 16,000 PC problems each month (across all of Customers Medical Centers & Medical Offices </li></ul><ul><li>All Customer HealthConnect problems rank “High” </li></ul><ul><li>Local Problem Management teams meet weekly to review data </li></ul><ul><li>Local and Regional teams meet and roll up problems </li></ul>
  29. 29. Managed Project Deployment “ It looks like the Department is about due for new computers.” ► CORE ACTIVITIES OBSERVATIONS KEY DATA POINTS <ul><li>Manages refreshes of computer hardware </li></ul><ul><li>Works directly with supplier teams to schedule deployment services </li></ul><ul><li>Resources issues have impacted refreshes </li></ul><ul><li>Refresh issues have impacted B/F - DSS </li></ul><ul><li>1/4 of hardware is refreshed each year </li></ul><ul><li>21,597 PCs have been refreshed, 3,000 still left </li></ul><ul><li>99% of refreshes are completed at night </li></ul><ul><li>There is no SLA defined for the refresh </li></ul>LINK: Minutes from Interview LINK: Process Flow Diagram
  30. 30. Managed Project Deployment
  31. 31. Next Steps (Phase II)
  32. 32. Next Steps (Phase II) Service Delivery & Support Model Customer User BUSINESS PARTNER INFORMATION TECHNOLOGY Service Delivery Service Support Infrastructure
  33. 33. Next Steps (Phase II) Process Optimization Plan Summary Report Project Close Out RE-ENGINEERING PROGRAM GOVERNANCE Final Deliverables Submission and Presentation Pilot Implementation Testing and Validation 9/19/05 9/26/05 10/19/05 10/21/05 Project Planning Interviews and CMO Documentation CMO Presentation and Findings FMO Documentation FMO Presentation and Findings Pilot Implementation Planning Due Diligence Findings Presentation FMO DESIGN & VALIDATION ASSESS PROJECT CLOSURE PILOT IMPLEMENTAION PILOT PLANNING Kick-Off Meeting Phase 1 - Due Diligence 12/09/05 11//30/05 12/16/05 11/7/05 11/14/05
  34. 34. Next Steps (Phase II) Process Optimization Plan RE-ENGINEERING PROGRAM GOVERNANCE Project Close Out Pilot Implementation Testing and Validation 12/09/05 11/7/05 10/24/05 11/14/05 11//30/05 12/16/05 FMO Design & Validation FMO Presentation & Validation Pilot Implementation Planning <ul><li>Develop implementation recommendations </li></ul><ul><li>Develop implementation plan </li></ul><ul><li>Develop risks mitigation plan </li></ul><ul><li>Develop change management & knowledge transfer plan </li></ul><ul><li>Review plans and get buy-in from stakeholders </li></ul><ul><li>Develop measurement & monitoring plan </li></ul><ul><li>Assess current skills and gaps and develop awareness management plan </li></ul><ul><li>Implement pilot in Northern California </li></ul><ul><li>Update process with the field testing learning </li></ul><ul><li>Conduct user acceptance testing </li></ul><ul><li>Execute knowledge transfer plan </li></ul><ul><li>Document finding and further recommendations </li></ul><ul><li>Present Final Deliverables and Presentation </li></ul><ul><li>Analyze assessment data </li></ul><ul><li>Identify areas for further analysis </li></ul><ul><li>Conduct follow-up interviews to capture additional information and identify gaps to achieve desired business objectives </li></ul><ul><li>Prioritize gaps </li></ul><ul><li>Develop “to-be” business process </li></ul><ul><li>Define roles and responsibilities </li></ul><ul><li>Define measurable metrics </li></ul><ul><li>Identify and document risks </li></ul><ul><li>Conduct review workshop </li></ul><ul><li>Check for ITIL compliant process mapping </li></ul><ul><li>Validate and present FMO </li></ul>
  35. 35. Next Steps (Phase II) Deep-Dive <ul><li>Integration points, roles, and handoffs between ITFS, Site Support Specialists, Solution Center, and other groups </li></ul><ul><li>Improved swap process, depot management and automated replenishment </li></ul><ul><li>Ticket management and additional operational efficiencies </li></ul><ul><li>Training of key personnel on process improvements </li></ul><ul><li>Incident classification processes and remote diagnosis </li></ul><ul><li>Problem management (root-cause analysis) and processes improvements that provide opportunities to reduce B/F issues </li></ul><ul><li>Other Areas? </li></ul>
  36. 36. Critical Success Factors <ul><li>Prove/Disprove whether 30 minutes MTTR can be achieved and at what cost for 90% of the time (new model for B/F) </li></ul><ul><li>Pilot Site and Key Site Support Specialists are identified </li></ul><ul><li>Model is replicable, scalable, and sustainable </li></ul><ul><li>Roles and responsibilities are clearly defined and communicated </li></ul><ul><li>Knowledge transfer is achieved </li></ul>
  37. 37. Assumptions <ul><li>Pilot for NCAL only </li></ul><ul><li>Trained site support specialist team already in place at pilot site </li></ul><ul><li>Pilot site must have sufficient time and resources to devote to the pilot </li></ul><ul><li>The various aspects needed are involved and part of project realization team </li></ul><ul><li>Impacts of other process changes have been considered and adjusted for </li></ul>
  38. 38. Thank You