In today’s healthcare IT environment, it takes a lot of support and coordination – of highly skilled and experienced technical staff – to keep a modern healthcare organization running smoothly. When a HCO considers outsourcing any portion of their IT operation, there are many unknowns and considerations to assess. This webcast will present best practices and processes in both exploring an application management support solution or partner and rollout, transition and implementation. Whether supporting a legacy or production application, the solution or partner should take complex and time-consuming tasks off of the organizations plate, allowing focus on more productive, strategic, operation improving and patient experience enhancing activities.
Itil 4 "management practices as sets of organizational resources designed for performing work or accomplishing an objective"
The mindmap includes links to posts where the practice is explained in more detail.
ITIL® is a registered trademark of AXELOS Limited.
https://www.axelos.com/
General management practices
Strategy management
Portfolio management
Architecture management
Service financial management
Workforce and talent management
Continual improvement
Measurement and reporting
Risk management
Information security management
Knowledge management
Organizational change management
Project management
Relationship management
Supplier management
Service management practices
Business analysis
Service catalogue management
Service design
Service level management
Availability management
Capacity and performance management
Service continuity management
Monitoring and event management
Service desk
Incident management
Service request management
Problem management
Release management
Change enablement
Service validation and testing
Service configuration management
IT asset management
Technical management practices
Deployment management
Infrastructure and platform management
Software development and management
ITIL History
ITIL Transition from V3 to V4
Key Concept of ITSM
ITIL Dimensions and Principles
Service Value System (SVS)
ITIL Practices
ITIL Certification Schema
IT4IT and DevOps Tools Landscape (2020).Rob Akershoek
Complete overview of the IT management tooling landscape 2020. Key market players / vendors in the IT4IT and DevOps tooling ecosystem. Automate and streamline your end-to-end DevOps tool chain.
Marlabs Capabilities Overview: Application Maintenance Support Services Marlabs
Marlabs application development and support services include application design, development, systems integration/consolidation, re-engineering, and implementation of packages.
ITIL 4 service value chain data flows (input and outputs)Rob Akershoek
High level overview of the Service value chain activities and information flows (input/outputs) based upon ITIL 4 from AXELOS (ITIL 4 Foundation).
Mapping of the ITIL value chain activities to the IT4IT value streams as defined by The Open Group IT4IT Standard.
Itil 4 "management practices as sets of organizational resources designed for performing work or accomplishing an objective"
The mindmap includes links to posts where the practice is explained in more detail.
ITIL® is a registered trademark of AXELOS Limited.
https://www.axelos.com/
General management practices
Strategy management
Portfolio management
Architecture management
Service financial management
Workforce and talent management
Continual improvement
Measurement and reporting
Risk management
Information security management
Knowledge management
Organizational change management
Project management
Relationship management
Supplier management
Service management practices
Business analysis
Service catalogue management
Service design
Service level management
Availability management
Capacity and performance management
Service continuity management
Monitoring and event management
Service desk
Incident management
Service request management
Problem management
Release management
Change enablement
Service validation and testing
Service configuration management
IT asset management
Technical management practices
Deployment management
Infrastructure and platform management
Software development and management
ITIL History
ITIL Transition from V3 to V4
Key Concept of ITSM
ITIL Dimensions and Principles
Service Value System (SVS)
ITIL Practices
ITIL Certification Schema
IT4IT and DevOps Tools Landscape (2020).Rob Akershoek
Complete overview of the IT management tooling landscape 2020. Key market players / vendors in the IT4IT and DevOps tooling ecosystem. Automate and streamline your end-to-end DevOps tool chain.
Marlabs Capabilities Overview: Application Maintenance Support Services Marlabs
Marlabs application development and support services include application design, development, systems integration/consolidation, re-engineering, and implementation of packages.
ITIL 4 service value chain data flows (input and outputs)Rob Akershoek
High level overview of the Service value chain activities and information flows (input/outputs) based upon ITIL 4 from AXELOS (ITIL 4 Foundation).
Mapping of the ITIL value chain activities to the IT4IT value streams as defined by The Open Group IT4IT Standard.
Difference between ITIL v3 and ITIL 4 | ITIL® Foundation Training | EdurekaEdureka!
YouTube Link: https://www.youtube.com/watch?v=OqTtb0r-4QY
** ITIL® Foundation Certification Training: https://www.edureka.co/itil-foundation-sp **
This Edureka video on 'ITIL® v3 vs ITIL 4' will demystify the differences between the two versions of ITIL which are ITIL v3 released in 2011 and ITIL 4 released in 2019. This video will give you a brief overview of how ITIL v3 differs from ITIL 4 and what all have been updated.
Below are the topics covered in this tutorial:
What is the ITIL® v3 Framework?
What is ITIL® 4 Framework?
ITIL v3 vs ITIL 4
Follow us to never miss an update in the future.
YouTube: https://www.youtube.com/user/edurekaIN
Instagram: https://www.instagram.com/edureka_learning/
Facebook: https://www.facebook.com/edurekaIN/
Twitter: https://twitter.com/edurekain
LinkedIn: https://www.linkedin.com/company/edureka
Castbox: https://castbox.fm/networks/505?country=in
Documentation Framework for IT Service DeliverySimon Denton
I developed this for a project that I am currently involved in. The project aim is to develop a documentation framework for the provision of IT as a Service. I devised the framework using the Microsoft Operations Framework as ‘glue’ between other frameworks like ITIL. I thought I’d share it as it might be useful to others who are in a similar situation. The end result is a relatively compact set of documents for each service offered by IT.
ITIL® 4 will be hitting shelves in February 2019, but how is it different from ITIL V3? We joined forces with AXELOS in this webinar to break down what's changing with ITIL 4, how this can benefit you and your organisation, and how you can book onto a course.
Review of Information Technology Function Critical Capability ModelsAlan McSweeney
IT Function critical capabilities are key areas where the IT function needs to maintain significant levels of competence, skill and experience and practise in order to operate and deliver a service. There are several different IT capability frameworks. The objective of these notes is to assess the suitability and applicability of these frameworks. These models can be used to identify what is important for your IT function based on your current and desired/necessary activity profile.
Capabilities vary across organisation – not all capabilities have the same importance for all organisations. These frameworks do not readily accommodate variability in the relative importance of capabilities.
The assessment approach taken is to identify a generalised set of capabilities needed across the span of IT function operations, from strategy to operations and delivery. This generic model is then be used to assess individual frameworks to determine their scope and coverage and to identify gaps.
The generic IT function capability model proposed here consists of five groups or domains of major capabilities that can be organised across the span of the IT function:
1. Information Technology Strategy, Management and Governance
2. Technology and Platforms Standards Development and Management
3. Technology and Solution Consulting and Delivery
4. Operational Run The Business/Business as Usual/Service Provision
5. Change The Business/Development and Introduction of New Services
In the context of trends and initiatives such as outsourcing, transition to cloud services and greater platform-based offerings, should the IT function develop and enhance its meta-capabilities – the management of the delivery of capabilities? Is capability identification and delivery management the most important capability? Outsourced service delivery in all its forms is not a fire-and-forget activity. You can outsource the provision of any service except the management of the supply of that service.
The following IT capability models have been evaluated:
• IT4IT Reference Architecture https://www.opengroup.org/it4it contains 32 functional components
• European e-Competence Framework (ECF) http://www.ecompetences.eu/ contains 40 competencies
• ITIL V4 https://www.axelos.com/best-practice-solutions/itil has 34 management practices
• COBIT 2019 https://www.isaca.org/resources/cobit has 40 management and control processes
• APQC Process Classification Framework - https://www.apqc.org/process-performance-management/process-frameworks version 7.2.1 has 44 major IT management processes
• IT Capability Maturity Framework (IT-CMF) https://ivi.ie/critical-capabilities/ contains 37 critical capabilities
The following model has not been evaluated
• Skills Framework for the Information Age (SFIA) - http://www.sfia-online.org/ lists over 100 skills
The move to a SaaS-based solution like SAP SuccessFactors that is updated frequently requires teams to work together in an agile fashion. This requires new levels of collaboration, automation and the ability for teams to work in parallel.
Learn how Worksoft enables the adoption of Agile-plus-DevOps testing for SAP SuccessFactors. For more information visit: www.worksoft.com.
GSS America\'s Workplace Services aim at equipping customer’s business with round-the-clock support, through its Global Operations Command Center (GOCC). Its comprehensive range of workplace services gives customers the ability to reduce their costs and improve their service levels. GSS intends to help global enterprises cut down on their infrastructure maintenance costs and provide access to expert skills.
Notes On Managed Service And Outsourcing Implementation And ManagementAlan McSweeney
Possible Managed Service Requirements
Benefits of Managed Services
Approach to Solution Analysis, Definition, Selection and Business Case Generation
Contract Management
Service Transition and Due Diligence
Service Management and Operation
Lessons Learned from Outsourcing Problems
Service management
ITIL and the Service value system
ITIL Guiding principles
ITIL Service value chain
ITIL Four dimensions
ITIL Practices
ITIL Continual improvement
ITIL Certification scheme
What’s in it for me?
Mario Vivas, CEO, River Horse
ITIL4 is out and everyone is eager to learn about the updates this release introduces. This session will summarize the key changes that ITIL4 presents with a focus on the more operational processes that organizations deliver on a day to day basis (Incident, Problem, Change and so on). The ServiceNow platform has a powerful set of baseline features and optional plugin functions that can help an organization align with the recommendations of ITIL4.
Please join us and Mario to learn about how you can start applying ITIL4 concepts in your ServiceNow implementations!
Philip Hearsum - Introducing ITIL 4 - AID2019ALVAO
Philip Hearsum je přesvědčeným zastáncem ITSM obecně a ITILu obzvlášť. Už v době, kdy působil na rozličných pozicích v komerční a státní správě, se aktivně podílel na přípravě ITILu 2011. Od roku 2013 pracuje pro AXELOS, kde má na starosti celý ITIL.
Patří tak k hlavním architektům připravované verze ITIL 4.
Cloudway Consulting Pvt Ltd Is a SAP Strategic Sourcing Consulting Company For SAP, SAP S4 Hana, SAP Ariba, SAP C4C, Success Factor and Business By Design for More Call us at +0120-4226511
Deliver on the Promise of Agile and DevOps TransformationsTasktop
IT organizations are under continual pressure to develop and deliver high-quality applications – at speed - in order to provide key competitive advantage for their company.
They’ve adopted Agile and DevOps practices. But particularly for large organizations with complex application portfolios or compliance pressures, these practices have yet to fulfill the promise of enhancing an organization’s ability to continually deliver customer value. Agile has improved development and test; and DevOps has streamlined getting code into production. But these advances have been localized improvements; to get to the next step software delivery leaders must take a more holistic approach to improving the entire lifecycle.
In this webinar guest speaker, Forrester Senior Analyst Christopher Condo will present his analysis of practices used in modern application delivery and will describe how creating an integrated value stream can help organizations regain their focus on the delivery of customer value.
Difference between ITIL v3 and ITIL 4 | ITIL® Foundation Training | EdurekaEdureka!
YouTube Link: https://www.youtube.com/watch?v=OqTtb0r-4QY
** ITIL® Foundation Certification Training: https://www.edureka.co/itil-foundation-sp **
This Edureka video on 'ITIL® v3 vs ITIL 4' will demystify the differences between the two versions of ITIL which are ITIL v3 released in 2011 and ITIL 4 released in 2019. This video will give you a brief overview of how ITIL v3 differs from ITIL 4 and what all have been updated.
Below are the topics covered in this tutorial:
What is the ITIL® v3 Framework?
What is ITIL® 4 Framework?
ITIL v3 vs ITIL 4
Follow us to never miss an update in the future.
YouTube: https://www.youtube.com/user/edurekaIN
Instagram: https://www.instagram.com/edureka_learning/
Facebook: https://www.facebook.com/edurekaIN/
Twitter: https://twitter.com/edurekain
LinkedIn: https://www.linkedin.com/company/edureka
Castbox: https://castbox.fm/networks/505?country=in
Documentation Framework for IT Service DeliverySimon Denton
I developed this for a project that I am currently involved in. The project aim is to develop a documentation framework for the provision of IT as a Service. I devised the framework using the Microsoft Operations Framework as ‘glue’ between other frameworks like ITIL. I thought I’d share it as it might be useful to others who are in a similar situation. The end result is a relatively compact set of documents for each service offered by IT.
ITIL® 4 will be hitting shelves in February 2019, but how is it different from ITIL V3? We joined forces with AXELOS in this webinar to break down what's changing with ITIL 4, how this can benefit you and your organisation, and how you can book onto a course.
Review of Information Technology Function Critical Capability ModelsAlan McSweeney
IT Function critical capabilities are key areas where the IT function needs to maintain significant levels of competence, skill and experience and practise in order to operate and deliver a service. There are several different IT capability frameworks. The objective of these notes is to assess the suitability and applicability of these frameworks. These models can be used to identify what is important for your IT function based on your current and desired/necessary activity profile.
Capabilities vary across organisation – not all capabilities have the same importance for all organisations. These frameworks do not readily accommodate variability in the relative importance of capabilities.
The assessment approach taken is to identify a generalised set of capabilities needed across the span of IT function operations, from strategy to operations and delivery. This generic model is then be used to assess individual frameworks to determine their scope and coverage and to identify gaps.
The generic IT function capability model proposed here consists of five groups or domains of major capabilities that can be organised across the span of the IT function:
1. Information Technology Strategy, Management and Governance
2. Technology and Platforms Standards Development and Management
3. Technology and Solution Consulting and Delivery
4. Operational Run The Business/Business as Usual/Service Provision
5. Change The Business/Development and Introduction of New Services
In the context of trends and initiatives such as outsourcing, transition to cloud services and greater platform-based offerings, should the IT function develop and enhance its meta-capabilities – the management of the delivery of capabilities? Is capability identification and delivery management the most important capability? Outsourced service delivery in all its forms is not a fire-and-forget activity. You can outsource the provision of any service except the management of the supply of that service.
The following IT capability models have been evaluated:
• IT4IT Reference Architecture https://www.opengroup.org/it4it contains 32 functional components
• European e-Competence Framework (ECF) http://www.ecompetences.eu/ contains 40 competencies
• ITIL V4 https://www.axelos.com/best-practice-solutions/itil has 34 management practices
• COBIT 2019 https://www.isaca.org/resources/cobit has 40 management and control processes
• APQC Process Classification Framework - https://www.apqc.org/process-performance-management/process-frameworks version 7.2.1 has 44 major IT management processes
• IT Capability Maturity Framework (IT-CMF) https://ivi.ie/critical-capabilities/ contains 37 critical capabilities
The following model has not been evaluated
• Skills Framework for the Information Age (SFIA) - http://www.sfia-online.org/ lists over 100 skills
The move to a SaaS-based solution like SAP SuccessFactors that is updated frequently requires teams to work together in an agile fashion. This requires new levels of collaboration, automation and the ability for teams to work in parallel.
Learn how Worksoft enables the adoption of Agile-plus-DevOps testing for SAP SuccessFactors. For more information visit: www.worksoft.com.
GSS America\'s Workplace Services aim at equipping customer’s business with round-the-clock support, through its Global Operations Command Center (GOCC). Its comprehensive range of workplace services gives customers the ability to reduce their costs and improve their service levels. GSS intends to help global enterprises cut down on their infrastructure maintenance costs and provide access to expert skills.
Notes On Managed Service And Outsourcing Implementation And ManagementAlan McSweeney
Possible Managed Service Requirements
Benefits of Managed Services
Approach to Solution Analysis, Definition, Selection and Business Case Generation
Contract Management
Service Transition and Due Diligence
Service Management and Operation
Lessons Learned from Outsourcing Problems
Service management
ITIL and the Service value system
ITIL Guiding principles
ITIL Service value chain
ITIL Four dimensions
ITIL Practices
ITIL Continual improvement
ITIL Certification scheme
What’s in it for me?
Mario Vivas, CEO, River Horse
ITIL4 is out and everyone is eager to learn about the updates this release introduces. This session will summarize the key changes that ITIL4 presents with a focus on the more operational processes that organizations deliver on a day to day basis (Incident, Problem, Change and so on). The ServiceNow platform has a powerful set of baseline features and optional plugin functions that can help an organization align with the recommendations of ITIL4.
Please join us and Mario to learn about how you can start applying ITIL4 concepts in your ServiceNow implementations!
Philip Hearsum - Introducing ITIL 4 - AID2019ALVAO
Philip Hearsum je přesvědčeným zastáncem ITSM obecně a ITILu obzvlášť. Už v době, kdy působil na rozličných pozicích v komerční a státní správě, se aktivně podílel na přípravě ITILu 2011. Od roku 2013 pracuje pro AXELOS, kde má na starosti celý ITIL.
Patří tak k hlavním architektům připravované verze ITIL 4.
Cloudway Consulting Pvt Ltd Is a SAP Strategic Sourcing Consulting Company For SAP, SAP S4 Hana, SAP Ariba, SAP C4C, Success Factor and Business By Design for More Call us at +0120-4226511
Deliver on the Promise of Agile and DevOps TransformationsTasktop
IT organizations are under continual pressure to develop and deliver high-quality applications – at speed - in order to provide key competitive advantage for their company.
They’ve adopted Agile and DevOps practices. But particularly for large organizations with complex application portfolios or compliance pressures, these practices have yet to fulfill the promise of enhancing an organization’s ability to continually deliver customer value. Agile has improved development and test; and DevOps has streamlined getting code into production. But these advances have been localized improvements; to get to the next step software delivery leaders must take a more holistic approach to improving the entire lifecycle.
In this webinar guest speaker, Forrester Senior Analyst Christopher Condo will present his analysis of practices used in modern application delivery and will describe how creating an integrated value stream can help organizations regain their focus on the delivery of customer value.
The Payer of the Future: Modernizing Health Insurance with API-led ConnectivityMuleSoft
Legislative and technological disruption to the healthcare industry has driven payers to rethink how they engage with patients, providers, and partners. In the wake of these market changes, forward-thinking health plans have thrived amidst change by leveraging connectivity to develop solutions to marketplace challenges. Join us for a discussion with Healthfirst, Deloitte, and Salesforce to learn how health insurers are leveraging API-led connectivity in tackling common payer IT challenges, including:
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Midsize Organizations and the Changing Business LandscapeWorkday, Inc.
With the impact of COVID-19, midsize organizations are looking to gain insight into their business and workforce to quickly respond and adapt to a shifting business landscape. See how Workday can help midsize organizations navigate the changing world of work and build confidence in the way forward.
Webwheel Technologies Private Limited is a leading provider of Information Technology Solutions, with a sharp focus on delivering solutions that generate business value for our clients. We strive to achieve a shared vision of performance that yields tangible returns in terms of innovation, growth, and increased efficiencies for our customers.
Test Data Management: A Healthcare Industry Case StudyTechWell
As IT systems increase in both scale and complexity, delivering quality applications becomes more challenging. In addition to creating and executing test scenarios, testers need to create and maintain the test data that enables test execution. Test data management (TDM) creates and processes data in test environments using business knowledge and technology. Test data is created based on requirements provided from consumers. With TDM in your software delivery process, teams dependent on data can focus on creating and executing test scenarios instead of having to provision the data to run these tests. Shaheer Mohammed and Jatinder Singh present a case study that recaps the successful creation of a TDM team. They review what worked well, share lessons learned along the way, touch on the challenges of managing protected data in the health-care industry, and discuss innovative tools and processes that enabled their success.
Learning's Big Data Problem: Measuring & Analyzing ImpactWatershed
The wave of information known as Big Data has been growing exponentially in recent years. That's why it's critical for organizations to not only get better at collecting more meaningful data, but also understanding just what it all means.
Join us for a webinar next week, when we'll we review the results of Brandon Hall Group’s 2016 Learning Measurement Study and 2016 Learning Analytics Study, identify what organizations are measuring (and what they aren’t), and how they're making use of that data.
Presenters:
David Wentworth, Principal Learning Analyst with Brandon Hall Group
Michael Rochelle, Chief Strategy Officer & Principal HCM Analyst with Brandon Hall Group
Mike Rustici, CEO & Founder of Watershed
During this webinar, you'll learn more about:
-The metrics organizations are using
-The outcomes organizations are measuring
-How data is being analyzed
-Data analysis as a skill set
-How High Performers approach measurement & analytics
Transform Your Cloud Validation Strategy from Cloudy to ClearTechWell
Security, data privacy, reliability, and regulatory compliance are critical factors when evaluating whether to move business applications from in-house, client-hosted environments to a cloud platform. Quality assurance plays a vital role in ensuring that the appropriate level of risk assessment, verification, and validation takes place to ensure business continuity during the migration to a new cloud platform. Vandana Viswanathan shares an introduction to the five components of a sound cloud application validation strategy: cloud provider qualification process, validation strategy development, end-to-end risk-based testing approach development and implementation, governance through change management, and preparation for an organization audit/inspection. As a result, you can create an effective QA plan to verify the implementation of a cloud-hosted solution. Vandana provides tips for developing a tactical approach to ensure your organization is audit/inspection ready and meets the criteria for business, security, and data privacy requirements for both regulated and non-regulated business critical applications.
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GEMMA Wean has an optimised nutritional balance and physical quality so that it flows more freely and spreads readily on the water surface. The balance of phospholipid classes to- gether with the production technology based on a low temperature extrusion process improve the physical aspect of the pellets while still retaining the high phospholipid content.
GEMMA Wean is available in 0.1mm, 0.2mm and 0.3mm. There is also a 0.5mm micro-pellet, GEMMA Wean Diamond, which covers the early nursery stage from post-weaning to pre-growing.
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
Dr. David Greene R3 stem cell Breakthroughs: Stem Cell Therapy in CardiologyR3 Stem Cell
Dr. David Greene, founder and CEO of R3 Stem Cell, is at the forefront of groundbreaking research in the field of cardiology, focusing on the transformative potential of stem cell therapy. His latest work emphasizes innovative approaches to treating heart disease, aiming to repair damaged heart tissue and improve heart function through the use of advanced stem cell techniques. This research promises not only to enhance the quality of life for patients with chronic heart conditions but also to pave the way for new, more effective treatments. Dr. Greene's work is notable for its focus on safety, efficacy, and the potential to significantly reduce the need for invasive surgeries and long-term medication, positioning stem cell therapy as a key player in the future of cardiac care.
Our Team
Best in KLAS – HIT Implementation Staffing and Support
Clinical workflow and operations experts
Average Staff HIT Experience: 12 Years
Our company culture - Strive for success, you get the entire Galen team behind every project
Cross-section of clinical and non-clinical healthcare application expertise
2.0MM Hours Healthcare Experience
280 Customers served in the last 2 years
Boutique, healthcare-focused services & solutions company
For over a decade, Galen has built a solid reputation of providing high-quality, expert level IT consulting services to health systems, hospitals and physician practices.
The foundation of our growth and success can be attributed to our people. It’s what we care about as a company that makes us unique.
Our Value Proposition:
We transform data into actionable, profitable information
Provide world-class Technical & Professional Services to healthcare organizations that interoperate, aggregate, convert, harvest and optimize clinical patient information within their multi-vendor systems portfolio including Practice Management, Electronic Health Record & Health Information Exchange.
Deliver a suite of fully-integrated Products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes.
Webcast Homework: Read My Blog: http://blog.galenhealthcare.com/2016/04/19/more-than-backfill-how-will-you-ever-fill-that-chair/
I’m a story teller by nature and the intent of this webcast is to share our collective story of application management & support – the lessons we’ve learned, the best practices we’ve accumulated and the insights we’ve gathered.
Once, the key person at a client I had worked with before went out on medical leave, and I was asked to “be them” for a few weeks.
More recently, I have been asked to play this role as the lead admin is preparing for a conversion and implementing a brand new software product.
The organization cannot afford to not have her on the new implementation…but to say filling her shoes is “Tier 2 support” is an understatement at best.
When you have an enterprise application that is used by hundreds of users a day, connects with multiple ancillary systems via interfaces, is responsible for the delivery of healthcare for individuals, and drives billing operations, you can’t just hire a temp.
You need to find someone who is not only an expert in the applications that you are using, but also someone who understands relationships and how to work with a team
Laura Gold
St. Luke’s Help Desk, Tier 3 Support, ancillary & pms application expert
TouchWorks configuration, end user training and support
Sara Whittaker
St. Luke’s Help Desk, Tier 3 Support, ancillary application expert
Acute Billing and Coding expert
Training, implementation, and onsite application support
One of the first things to managing the support is to know the environment well. Not just how the applications work. We need to know everything about the architecture of your server farm. This allows us to see what feeds into and out data flows out of the applications we will be supporting. Many times during this review, we find one-off applications, interfaces or other connections that have been overlooked in the initial scoping of the project. Also a spreadsheet that lists all the servers, what resides on the servers, IP addresses of servers and clusters, and the System Environment Specifications of each can be a very helpful resource when troubleshooting with vendors. On this sheet it is also very helpful if we understand on the database servers if there are more databases that reside on the server or cluster. This alerts us that we need to take into consideration any specifications for those vendors as well.
Don’t forget, we need to know all this information not only for your Production environment but also any test, dev or training environments.
Discussions need to take place to understand our role within your organization and within the IT reporting structure for your department. At a minimum we need to be mindful of shared duties for applications that overlap. For example – the Acute System has a patient portal and they have their own support team. The ambulatory also uses that portal and we might support only the ambulatory user / patient build, interfaces from our system into the portal, etc. However the other support team will handle all upgrades, patches and general troubleshooting. Understanding the boundaries of this support structure, who we will be interacting with and developing a working relationship with team for cohesiveness is imperative.
The other caveat to knowing our role is to fully understand any and all downstream and upstream applications and if the support team has the responsibility of those applications as well These can be interfaces, remote connections, web-based, peripherals (Dragon, Speechmics)etc.
How does the system handle future customizations, new build, new implementation upgrades, monthly patching?
We need to work out the details of the best mechanism for our support team to have connectivity to any and all these systems.
Do we access the primary applications via Citrix or VPN, Securelink or are we assigned a VDI?
If we have need to access the servers directly will we have admin rights to do so?
How do we reach users? Does the organization have a mechanism for us to view the users desktops? VNC, Join Me or skype screen sharing are a few ideas.
Will we have admin rights to the users desktops for when we have to add an icon or adjust IE settings, etc.
If we have a device that needs installed such as a printer or scanner, do we support that or do we have a Device Support team that will do those things for us?
Also make sure that there are licenses available to add our staff to those applications.
Knowing our audience is also imperative. We need to know and be introduced to front line staff, Providers as well as our counterparts with in IT.
System Admins, Security and Privacy staff, Desktop Helpdesk or Device Support.
Understanding the role of those we work with and how the chain of command flows, what is the change control policy, how are requests for new build filtered through this chain of command. Are there any committees that we need to present issues, updates too. Are there specific forms or shared drives where we need to store monthly reports or project work?
Also, we need to be introduced to the venders. Making sure that the vendors know who will be supporting their product is very important. Especially if you have assigned support people and they have been used to working closely with another staff person on your side of the house. If we need access to a vendor support portal then that will need to be initiated from your organization.
A client’s onboarding process for a Galen Healthcare Solutions consultant at the start of an Application Management project varies from client to client. Our process depends upon the client’s needs and requirements.
We go through a discovery phase with each client, prioritizing their needs and requirements, resulting in a customized onboarding process.
Our customized onboarding process with each customer, allows us to build efficiencies into the onboarding process, and thereby making transitions smoother and more efficient for both our customers and Galen’s consultants.
The following describes components of our onboarding processes that we use with our clients.
Background Checks - Handled through Galen Healthcare Solution’s Human Resources vendor
Include criminal checks – 7-year history, based on employee’s SSN.
County, State and Local checks are run and include sex offender registry searches.
Are not typically delivered to the client unless specifically requested. The documentation is kept on file by Galen and available if requested or needed as per an audit.
Drug screening tests
A clear 9-panel urine drug screen.
Like the background checks, these are not typically delivered to the client, but we confirm that we have the tests on file for our consultants.
Health Screening
TB Screenings, Flu Shots and other immunization records are common requests for consultants who are working on-site, specifically in clinics .
IT Agreement
An agreement on the rules for confidentiality and access to a client’s information technology and computer systems applied to all non-public patient and business information
Network and application access
Per the IT Agreement and the needs for each consultant, the client provides the required system accesses. The length of time it takes for access to be granted to a consultant varies depending upon a client’s internal processes. We set clear expectations that our ability to begin work for our client depends upon having system access.
Laptops and hardware requirements
Client requirements dictate which computers and other hardware a Galen Healthcare Solution consultant will use. Consultants can always use Galen’s own securely protected computers.
FBI Fingerprinting
Some clients require a Galen consultant to have in-state fingerprinting completed. This is usually a step that is contingent on preliminary steps being satisfactorily finished. Galen consultants may do this while on site working the first week.
Once the required background information is completed and distributed as required, the actual transition of work responsibilities can start.
Galen’s approach for transitioning to managing applications is flexible and agile in meeting the needs of the client. It depends upon the client’s team that Galen is taking over and their plans to transition off team members and/or leave some to work with Galen consultants. Typically, we develop the transition plan with a “Lead” Galen resource who will help manage this transition. The lead resource helps to ensure that the Galen team have all the resources and information needed to do the work as effectively as the current team. Based on what the client wants impacts who on Galen’s team does what and how many are needed to eventually manage the application. However, it is important to note, we stress the need for some overlap time with the existing client team and to have clear expectations of how long those team members will be available to the Galen team during this transition. We will be discussing this requirement in more deteail later in the webcast. While it can be a lengthy, involved process, Galen has developed some proven methodologies to smooth the process.
Most clients start with an introduction to the organization, similar to new employee orientation.
Interviewing staff that are shifting off the project to discern their day to day activities is probably the preferred method.
Most organizations will also have repositories of workflows, documentation specific to set up or build work and troubleshooting methodology. Links to or copies of this documentation are very helpful while they ease and speed up the process.
Many times, sitting with a client resource while they are working through an average day or more provides the consultant the opportunity to pose questions and uncover information, workflows or assumptions overlooked by the organization.
I would add that as we develop the transition plan that we generally have one Galen lead who will help manage the transition with the client team and ensure that we have all the resources and information we need to the job as effecivly as the current team. It is important to have some overlap time with the existing team and to know how long they may be available to the Galen team. Then add that we will talk about this more in depth later in the webcast (or that Laura will)
Resourcing and Best Practices to provide a better level of service than you received prior to engaging in staff augmentation
Our Goal: For the level of service that you receive to be better than prior to engaging staff augmentation services.
We want you and your end users to have a superior experience and not even know or be aware that there has been a ‘change of staff’ responsibility.
This goal is accomplished by investigating current practices and workflows, keeping an open line of communication between organizational leaders, managers and support staff and having a clear understanding of where organizational responsibilities lie, with existing staff or newly created staff, leaders
You may say and think to yourself “Our organization is not going to allow any changes to existing/legacy system..… but this is not a realistic statement. There is one thing we know to be a constant in life and that is CHANGE. Things change.
When you look at the timeline that is in place when the decision to change EHR Vendors is made thru final GL implementation a process that is known to take often 2+ years anything could happen. Reporting standards could change, patient safety issue present, equipment needs to be replaced/updated, vendors leave the work space, key personnel may unexpectedly take a medical leave of absence.
We will be reviewing some of the area to be aware of and plan for.
We really, really like the word cloud!! If it can be kept, perfect, if you can make it better AWESOME!!
Helpdesk, work flow, training, documentation, go live support, new provider/practices/users, daily/weekly/monthly tasks, credentialing, duplicate accounts, value and quality based incentive programs.
There's a lot to think about when you are turning over your IT baby to a new team
What applications will we be assuming responsibility for? EHR, PMS, Phone software (Televox), messaging services
Help Desk- how many applications are being supported by the help desk? Tier I vs Tier II support SLA (service level agreements)EHR, PMS, Phone system….
Workflows- operational chain of command, who does what?
New Providers/Practices/Users transfers, New hires, closing practices.
Go Live support for new practices and providers number of support staff on site, length of support 2 weeks, 3 weeks? Follow-up site visits
Daily, Weekly, Monthly operational tasks EOM,
Credentialing- DEA, license, Insurance carrier
Value and Quality Based Incentive Programs MIPS, PQMH/PCSH, CQS…reporting information gathering
Training- for new sites, programs, etc
Documentation- Internal where is it stored, Drives, Shares, who has access to it?
Interview, Observe, Document
http://www.wordle.net/create
^^ use this website if we want to change collage, just add word and it randomizes it for us
Hear it, see it, write it
The best WAY to find out how a team is currently producing is to sit with that team observe their workflows and interview them as to when, why, where, how and who of their daily work life.
What do you consider are the challenges and current struggles in your day to day work life? Often coming in with a fresh perspective and the experience of having worked in multiple systems with multiple approaches, we maybe able to recognize areas of process improvement.
Interview and Observe: I can not stress this enough, your new augmentation team will only be as good as the support documentation that is available to them. It is imperative to factor in time to allow your augmented staff the opportunity to interview your existing staff in their day to day functions. The interview process should take place over at least a week, longer if it is at all feasible to cover every day of the week.
If you have a large organization with many moving parts and roles/responsibilities that are going to be assumed this process would need to be longer. For good measure interview more than one person in the same role as often person A and Person B may have the same role but may be responsible for different aspects of that role.
EXAMPLE: (remove actual names) You may have an organization that has a team of trainers……..possibly use Kelsey/Ron vs Megan/John.. both trainers for staff, but one are in Allscripts, and one are in idx? And what level are they training? Are they training basic workflows or more in depth of each application
_____________________________
The observation process allows for discovery in the real time work environment, with practical real time scenarios. It also allows for workflows to be observed that may not be documented well within the health system. In anticipation of an augmentation staff coming on board, you probably created an outline of ‘All” of the duties that are performed by the various departments with your organization. BUT I can guarantee you that your users/staff they are doing work for you, work that needs to be done, but it is not documented ANYWHERE, as to how it is done, when it is done and perhaps even why it is done.
EXAMPLE: Error Queue ( different clients utilize different department to address errors, lab, interface, how are they divided up? __________________________
This is the benefit of the observation process…..you see what is really being done. And if it was not documented previously it will be now. You know why? Because your new staff augmentation people are going to create that documentation, so 3, 7, 11 months from now when that weird thing comes up that has to be done once a quarter that only Beverly did, they will know about it and do it. It will save everyone time and heartache and allow service to run more smoothly without undo interruption
EXAMPLE: __________________________
Interview, Observe, Document
Help Desk How many applications are being supported by the help desk? EHR, PMS, Phone system, third party add on application such as midmark, phreesia, etc….
What is considered a Tier 1 vs a Tier 2 ticket?
What is the current SLA (service level agreements) expectation? What is the On-call expectation? Is it a 24/7 shop or are certain applications unavailable at specific times, daily down time for back up? Ticketing priority, response times, escalation process, breached tickets. Will your augmented IT team have access to all of the systems or is there an access limit to a certain members of the IT team?
Example: We’ve worked with clients that have separate IT teams for Ambulatory care practices and Hospital based care. The Hospital system is the source of truth for MRN, medical record numbers. Prior to merging duplicate accounts in the Amb Care setting, the Hospital database needs to be checked to confirm the correct MRN. If your Ambulatory IT team does not have at least view access to the Hospital system database, another resource will need to be engaged to verify those accounts, thus slowing the process of correcting a patients medical record .
How are end users access the HelpDesk? Are they calling a Help Desk phone #, are the able to access the ticketing system in a self-serve format and enter tickets on their own behalf? This is important as often users CALL into the other help desk those staff get more of the critical information we need to investigate the problem, rather than when staff log their own service now tickets.
Do you have a dedicated Line for providers to call with application issues? If so, how is that managed and what is the expectation for service, the same as the originating SLA or different?
What are the top 3 problem tickets your organization encounters and how are they resolved?
I bet they are duplicate accounts, locked of the application and the system is running slow. Are you open to suggestions of changes in workflow that may help reduce costs or more evenly distribute work?
Example: If locked out of the application tickets are handled by Tier II support, would you consider altering workflows, security and /or permissions to allow Tier I support to handle that?
What are the daily weekly and monthly maintenance jobs tasks that need to be addressed?
Examples: daily: PM system early morning status checks, monitoring error queues and addressing the errors either by refiling or building out the order code if you are monitoring a lab error queue, duplicate accounts/patient merges, monitoring inactive task lists
weekly: what staff/department head meetings need to be attended? who will be responsible for budget forecasting of money and hours on the project, coordinating larger build projects, activating/inactivating orders
sending off error queues to the interface team
monthly: end of month checks and reports, upgrades, onsite support requirements for GL support or 1:1 training
Duplicate, Incorrectly merged patient accounts
PHI in the incorrect chart
Start this slide with an assertive comment about the importance of data integrity and ensuring the quality of data. We will own this responsibility as much as your staff because at the end of the day it is about providing quality care and accurate records.
What is the process when Duplicate accounts/charts are identified? Who is identifying and reporting them, end users, HIM, providers? Is this an IT responsibility to investigate and correct or is there another department those responsibilities fall to? Are there other systems or databases that need to be reviewed for duplicates, prior to corrections?
For Example: referring back to the example discussed in previous slide where: The Hospital system is the source of truth for MRN, medical record numbers. Prior to merging duplicate accounts in the Amb Care setting, the Hospital database needs to be checked to confirm the correct MRN. We’ve observed the report of a simple duplicate account require system checks in 4 separate applications( IDX, EPIC, Allscripts, CMS Merge) and reviewed thru 5 different departments ( Site-End User, HelpDesk-IT, HIM, EPIC, IDX/Allscripts) prior to even being able to complete that request.
What is the process when charts have been merged incorrectly resulting in two patients health information now residing in one medical record? Again, who is responsible for investigating and untangling the records? IT, HIM,? Does an incident report need to be completed?
Documents scanned into the incorrect chart? What is the process for correction? Who is notified and how, email, ticket, internal system notification?
Again the Interview, Observe and Document methodology will come into play here with all three of these scenarios as charting errors and duplicate accounts are a frequent re-occurring theme in most health organizations.
Value and Quality Based Incentive Programs
Which programs are you currently reporting to? How is reporting currently managed? Will that team remain in place during the transition?
Is there a Value Based/Quality Team that meets on a regular basis. Who decides which measures to report against? Who is monitoring the reports and the measures for updates and changes.
EXAMPLE: _______________________________
Are you currently doing site visits to review the program compliance and address concerns? If so, is it one person or more than one and how often and how long are the visits. (St Luke’s only has one person, Alison Gibson, and she would visit a site for about four hours. In the time I worked with her she was pretty much scheduled to do site visits everyday).
If you are utilizing reporting services that have licensing fee requirements, such as Direct Messaging how is that service agreement going to be managed? Who will be responsible to request additional licenses and deactivating license for providers that have left your organization.
This is a great topic to include. I would add in that if we are not taking this over that the relationship with the quality team is pivotal and indirectly linked with the day to day work in the applications and it is important to have an understanding of the overall plan
When transitioning from one system to another, what will happen when the client hires new employees?
Will they move immediately to the new system? Or be in a position to learn the old one before moving to the new one?
Who will train them?
Will there still be training classes for them or will all of those staff have moved onto the new health record system?
When transitioning from one system to another, what will happen when the client hires new Providers?
All of the items we previously discussed for new employees need to be addressed but also
How are State licenses, DEA, NPI, Direct messaging managed, added and updated?
How is Insurance carrier credentialing and provisioning addressed now and is that process going to remain in place?
Will you be acquiring new practices during the transition period?
If so which healthcare system will they be put on?
What is the on site service requirement for on site support?
When staff and providers leave what is the process?
Do we inactivate them in the programs to leave them active?
Who is responsible for the intake and output of the security forms (if security forms are in fact needed for new or terminations of accounts)
Application Support Structure
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