Tag Archives: customer service

On the other side of the digital front door – part 2

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My health journey continues with multiple focuses. And my journey through digital front doors continues as well. I wrote part 1 on this topic in early November when I was in the middle of various health and dental appointments and scheduling more. I also wrote about what I thought was an awesome example of how technology has evolved in “Patient friendly testing – yes, a positive story!” in September.  The end of that story was not so positive. More on that later.

Here are a few anecdotes from my recent experience:

Cataract surgery – I had my initial consultation appointment the end of November and have surgery scheduled for mid-February. Specialized eye drops were prescribed to start taking a few days in advance of the surgery. As soon as I left the doctor’s office, I received a text message that my eye drop prescription from my doctor was pending payment with this special pharmacy – for immediate delivery to my home I should click the link to pay $82.50. I was a little suspicious of a text asking for payment like that and knew I didn’t need to have the eye drops until February, certainly not immediate home delivery. I called the doctor’s office to confirm the text was legitimate and asked how to handle the timing of delivery. I was told I could just text back regarding delivery timing which I did and got a reply that they could do that. I thought great, there’s a person on the other end. But then I received several more automated text reminders to click the link so they could ship right away. Then they called me. I talked through the timing and gave them my payment info. Their proactive communication (and persistence) was a plus, but I was more comfortable with real-time communication to coordinate specific delivery schedule and payment.

Bone health – I had a virtual visit with a Nurse Practitioner from the Bone Health clinic at my primary hospital. This was part of follow-up from my fall and pelvic bone fracture in August. The virtual visit was easy to get into and very thorough. I learned that more and more elders are asking to be seen in person – not this one unless there is a reason to “lay hands on me”. Continue reading →

On the other side of the digital front door

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Being on the other side of health care delivery is always an eye opening experience as to the progress we’ve made with technology and making it easy for our patients, and how far we have yet to go.

Now that I have more flexibility in my work schedule and we’re past the house move, I’m taking time to prioritize my own health. The newest health issue I’m addressing is cataracts in both eyes. I was pleasantly surprised when I saw that the ophthalmic practice in the area who my eye doctor referred me to has a patient portal link on their website. As I waited on the phone to make an appointment, I perused the website. I thought it was odd that the portal had the same name as my health system’s portal. When it was my turn to talk to someone, they told me my new address asking me to confirm it. I had just updated it with my health system on the patient portal last week. So I asked how they, a separate ophthalmic practice knew. They said the patient portal showed it based on my phone number. Turns out it is the very same portal as my health system. I asked if they were part of the system and they said no but they share the portal. Guessing there is more to the story – possibly an Epic Community Connect relationship?

We scheduled the initial consultation appointment at a location reasonably close at the end of November vs one at an even closer location at the end of January. But my positive response to this encounter quickly took a step backwards. As they described my next steps pre-appointment it included writing down two fax numbers. One to give my eye doctor so they could send a report from my last eye exam. And a different one to give my PCP so they could send a referral. When will healthcare finally retire fax machines??

The fact that I can remember my patient portal password means I’ve become a regular user. And that means I’m taking care of my health. Due to my injury in August, I have multiple ortho appointments and now weekly physical therapy visits.

I was late to my first physical therapy appointment due to mistakenly thinking the e-checkin on the portal would be quick. Continue reading →

Patient friendly testing – yes, a positive story!

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The role of insurers in direct healthcare services may be debatable but I have at least one positive personal story worth sharing. It involves a claims review, a proactive call from my insurance company to schedule a needed test, and the test done in my home at my convenience a few weeks later.

Blog readers may remember my recent reference to a bad fall and injury. I have a fractured pelvic bone. When I was discharged from the ED, they ordered follow-up visits with my PCP and an ortho physician. I did a virtual visit with my PCP the next week and scheduled the in-person ortho appointment for the week after that. At the ortho appointment the physician said I should get another bone density test. I hadn’t had one for several years. I assumed she would put in an order, and I would get a call about scheduling the test.

The day after the ortho visit, I did get a call. But is from my insurance company. They said that based on claims info, I had fallen in the past year so I should get a bone density test. I asked if that was per my ortho and they said no, it was based on the claims info. Can I vouch for the interconnection between these two conversations? No. But I knew I needed the test so continued with the call. Continue reading →

Vendor relationship management revisited

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For IT leaders, effective vendor relationships are critical. In previous blog posts, I have provided guidance on creating win-win relationships and outlined what makes up a successful ongoing vendor relationship.

I am currently serving as interim CIO at Boston Children’s Hospital, the fourth health system I have served as an interim IT leader since 2016. I am experiencing vendor relationships and the challenges of vendor management all over again. Revisiting some of my own advice has been useful to me so I decided I would share it again with my readers.

12 tips for effective vendor management is a useful refresher worth another look. Let me know if I missed anything.

I would love to hear your stories of vendors who stepped up as true partners with health system IT teams to find creative solutions, expedite deliveries and provide extraordinary customer service during the pandemic. After all, 2020 was a test for all kinds of relationships.

Related Posts:

Keys to successful vendor management

What to expect from your vendors

Ensuring go live success for large scale IT projects

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Since the pandemic, major system implementations at health systems have continued with successful go lives supported by virtual or hybrid remote/onsite teams. Many organizations have “go live” success stories in this new world of remote work. While virtual support may change some things and certainly presents new challenges, the core work of a successful go live is still the same.

In late 2019, I published several blog posts on successful go lives based on firsthand experience with a major Epic implementation. Here they are again with basic lessons and tips:

10 Go Live Command Center lessons from the field

Epic Go Live – report from the field

9 Tips for Go Live support success

I welcome your comments on any virtual or hybrid go live experiences you have been involved in during the past year. If I get enough new lessons and tips, I will write a new blog so all can benefit. After all, continual learning and sharing best practices is at the core of what we do in healthcare.

Why this topic this week? I am currently working with a client who is less than six weeks out from an ERP go live so it is on my mind a lot. We are doing what we refer to as an Independent Verification and Validation (IV&V), a framework that facilitates audits of major IT projects regardless of area and complexity.  We explore 11 categories in-depth.  The topics range from governance and budget to training and QA.  The detailed analyses for each area involve document review and interviews to ascertain the status of the project.  A risk score is assigned in each of the 11 areas and mitigations are suggested based on the findings.  Ideally, over the life of the project there are three IV&V sessions conducted prior to go live and one session after go live to ensure that projects stay on course, make corrections as necessary in a timely manner, and achieve the defined objectives.

If you think an IV&V from my advisory firm, StarBridge Advisors, is something that your organization can use, please contact us to discuss.

Knocking on the digital front door

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Health systems are learning many lessons during this pandemic that they will need to carry forward into the recovery and “new normal” phases. One of them may be the need for an integrated digital health strategy, and more specifically a patient focused “digital front door”. The almost overnight shift from in-person ambulatory visits to virtual visits during this pandemic highlighted the need for a more integrated approach for many health systems.

An integrated strategy for a patient centered digital front door has many components including the core website, the patient portal linked to the electronic health record, improved access and scheduling capabilities, call centers, and care delivery through virtual visits. The goal is to meet patients where they are and guide them along the right care pathway with efficient, consistent, and easy processes in the background.

However, these multiple components and functions are often led and directed in an uncoordinated manner by different senior leaders within the organization. The core website is typically owned and directed by Marketing and Communications with technical support from IT. The patient portal is often managed by the ambulatory team in IT partnering with the Chief Medical Information Officer, Ambulatory Services, and Marketing. Improved patient access and scheduling initiatives are often directed by Ambulatory Services or in an academic medical center by the Physician Practice Group leadership. The call center may be managed by Marketing or Ambulatory Services leadership. And telehealth may be provided by a specialized team either connected to or part of IT but be directed by physician leadership.

A successful patient centered digital health strategy needs to involve all these components in a coordinated, comprehensive manner. In some respects, who leads this strategic initiative does not matter. What does matter is that there is buy-in and collaboration from all leaders involved with a common overarching goal to meet patients where they are at and provide an easy, consistent experience to access services. Continue reading →

10 Go Live Command Center lessons from the field

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Week 2 post Epic Go Live has begun. We continue to learn and adjust. Building on my previous Epic Go Live and Command Center planning posts, there are more lessons to share.canstockphoto15204222 (1) keep calm

The last point in my most recent post was about camaraderie – defined as “mutual trust and friendship among people who spend a lot of time together”. I should add, in close quarters!

I continue to be impressed with the hardworking, dedicated IT team at the University of Vermont Health Network. I have seen many examples of teaching, helping one another and stepping up to new roles since the November 9th Go Live.

The rate of new tickets slowed down as Week 1 ended but the issues became more complex as expected. We have resolved over 65% of the tickets opened since cutover and addressed many cross cutting issues.

As promised, more lessons to share:

  • Handoffs between shifts – Ensure that key issues and work in process is reviewed and turned over to the next shift to keep things moving smoothly. Try to have people scheduled several days in a row for continuity vs on one day and off the next.
  • Seeing the “forest for the trees” – In the first few days, the focus is on closing tickets but as cross cutting issues and themes emerge, the focus needs to shift. As broad issues are defined, you need clarity on what teams and modules are involved, who is on point to lead the issue resolution, and what help is needed.
  • Escalations – It is very helpful to have highly engaged executives and operational leaders rounding and raising up the greatest pain points for users that need more focus. These escalations may come through in-person visits to the command center or email.
  • Ticket analysis – Have resources available who know the tool and can slice and dice the data to help leaders and teams see trends and where to focus.
  • Hospital daily huddle – If the organization has a daily huddle, the command center lead should attend. It’s good way to hear firsthand how all departments are doing and what their key concerns are.
  • Command center “walk-ins” – If the main command center is at the hospital you may get walk-ins – well intentioned users who want to escalate a specific ticket or issue. Command center leaders should manage this so the teams working tickets aren’t given conflicting direction on priorities.
  • Email management on steroids – Staff working tickets stay in the system and don’t watch their email. But leaders get a lot of emails and it’s hard to keep up given the pace. At the end of each command center shift, go back through your inbox to ensure that any escalations are dealt with – other email can wait.
  • Multiple locations for support – If there are a main command center and multiple other locations for support staff and triage, ensure they are well coordinated with good communication between.
  • Document management – Everyone involved needs easy online access to reference material. Dynamic information such as shift schedules need to be maintained. Having at least a few binders of printed reference information helps as well.
  • Ramp down plan – When you start adjusting command center hours, it will help to have a checklist ready on what needs to be considered and implemented (i.e. staff schedules, re-location of teams, communication to users, logistics like food and transportation, etc).

Stay tuned for more reports from the field….

Related Posts:

Epic Go Live – report from the field

9 Tips for Go Live support success

9 Tips for Go Live support success

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My first blog post published back in 2014 was called “Three Days and Counting…” written as we approached a major Epic go live at Michigan Medicine. This week’s post could be called “Five days and canstockphoto15204222 (1) keep calmcounting….” as we approach our Wave 1 Epic go live at University of Vermont Health Network on Saturday 11/9.

We were originally scheduled for a 11/1 go live. But in mid-October after much deliberation with operations and IT leadership, our CEO, Dr. John Brumsted, made the decision to move the go live back one week. As he said in his communication to the entire organization, “This decision is in the best interests of our patients, our people and our Network. It gives us the time we need to get to a place where we are confident to go live and it allows users additional opportunities to prepare”.

Planning for the two-week 24/7 command center and support structure started a few months ago. With just five days to go, the plan is pretty much finalized. Highlights and some tips to share based on our game plan:

  • Physical setup/location – Where your command center is located will depend on space available but ideally it will be in the hospital. We are fortunate to have primary and secondary locations at the University of Vermont Medical Center where we’ll have approximately 80 people. We will also have a triage team (to review and route the tickets entered online) and trainers (to answer “how to” questions) co-located offsite. In addition, we’ll have local support centers at each of the hospitals involved in Wave 1.
  • Overall call flow and phone setup – We have a documented decision tree/call flow starting with the super users reporting issues they can’t address. Phones are programmed to route calls to the appropriate support staff depending on user role and/or application involved.
  • Reporting issues – When you are dealing with thousands of issues, you need to use a common tool and standard process. We use ServiceNow and all tickets will be entered and tracked through this tool. Dashboards have been created for leaders to monitor ticket volume and trends.
  • Staffing – A command center operating 24 hours a day for two weeks means people are scheduled for 12.5 hour shifts including time for handoff to the next shift.
  • Leadership roles – Multiple leadership roles have been defined and scheduled for these same shifts. Roles include a physician and nurse leader from IT, someone to monitor ServiceNow tickets and trends, and someone to be overall command center leader.
  • Huddles – There are huddles scheduled throughout the day for each operational area to review broad issues and trends that will then role up to the executive huddle at the end of the day.
  • Communications – This is a critical function to embed in any command center. As high impact issues are resolved and trends are identified, communications staff will work closely with command center leadership to push out daily updates and specific tip sheets.
  • Reference documentation for support staff – Wwith the intensity and pace of a major go live like this, you can’t rely on personal knowledge. Documentation will be available to all support staff and will be reviewed in advance to ensure everyone is comfortable with the plan and what is expected of them.
  • Logistics – And last, but not least, don’t forget about food, parking and transportation arrangements.

Our command center and support plans for go live are well defined. They may not be perfect, but a lot of thought and preparation has gone into them. The key is to be flexible and adaptive as the days go by.

As I always tell my IT teams, we are part of the extended care team. While we don’t touch patients directly, the staff who do depend on the systems and support services we provide. This is never truer than at go live time!

Related Posts: 

Crunch time and why IT matters

IT takes a village

Three Days and Counting…

Plans, processes, people: lessons from a successful EHR implementation

12 tips for effective vendor management

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An EHR implementation involves more than just the EHR vendor. As we approach the November 1st Epic go live at the University of Vermont Health Network, the interfaces and interdependencies with other canstockphoto26237556 (1) VRMvendors become more critical. As we review issues and risks that need executive level attention, multiple vendors are involved. Whether it’s ensuring their system implementation and interfaces are ready on or in advance of November 1st, or it’s a product that we already use that just needs to work in a new environment, we are counting on them to share our sense of urgency and deliver as expected.

As I assist with some of these vendor relationships and escalations, I’m drawing on many years of experience with IT vendors – both software and infrastructure. We are fortunate to have a strong supply chain management team that partners with IT. They are involved from early on in vendor evaluations through contracting. They stay connected to IT and step in to lead or assist when we have vendor issues after implementation.

Two of my previous blog posts provide guidance on creating win-win relationships with vendors. In “Keys to successful vendor management” I outlined some key success factors:

  1. A good product roadmap: It should be clear what core solutions are available now and what their path forward is for the next several years.
  2. More service than sales – a strong service culture should be evident in the sales cycle and demonstrated throughout the duration of the relationship. A focus on service should be engrained in every one of their employees.
  3. Total Cost of Ownership (TCO) – you and the vendor should develop this together. It should include initial one-time fees, ongoing costs for their products and services, all required 3rd party products, and your internal staff. There should be no hidden costs or “gotchas” later.
  4. Reputation – be sure to do your in-depth reference checks. Colleagues in similar organizations are a great source of honest, candid information and experience – good and bad. If your vendor is going to host or manage the application/service for you, check on the change management and operational maturity with colleagues and references. Resources like KLAS, Gartner and others can be leveraged as needed.
  5. Solid contract – once it is negotiated and signed, you may never have to look at it again. But if you do, ensure you are protected.  There is growing market consolidation among larger vendors; start-ups are often acquired by larger firms. Ensure you are protected under these scenarios. Ideally you have someone in your Legal or IT department who focuses on technology contracts and knows the common issues and standard terms.
  6. Implementation – your vendor should provide onsite resources that are integrated with your internal team. Issues tracking and resolution is a joint effort. Status reporting should be a shared effort with a very objective, accurate view.  It should include an executive dashboard on status, milestones, issues and budget.
  7. Escalation – problems will inevitably occur. Escalation process should be clear from the start with a point person for both the vendor and your organization.

Continue reading →

Press 1 for… Press 2 for…

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Does hearing this cause anxiety and impatience? Or do you think, great, I’ll soon be talking to the right person to help me? I am usually impatient when it comes to getting help with something. I find it frustrating canstockphoto20456258to listen to a long list of phone options, to wait for someone to be available, then get bounced around between call center staff and repeat my information multiple times.

But call centers and automated attendant systems are our new reality. There will be more use of artificial intelligence (AI) and Chatbots in the future. If designed properly, the customer experience can be a positive one.

I admit that I quickly forget the experiences that are smooth and positive. But I remember the ones that aren’t. I had one of those not so positive experiences this week.

While driving on the freeway last Friday, something flew off a truck and hit my windshield creating a crescent like crack the size of an orange. Not something to ignore and put off.

Making the call to my insurance company and being routed to the auto glass service they partner with involved getting redirected to different numbers, providing the same information multiple times, and still not getting the result I needed. In the end, I got it worked out when I contacted the service provider directly.

This not so positive experience reinforced how important it is for us to design the optimal flow and support structure for our command center (a call center on steroids) during our upcoming Epic go live at the University of Vermont Health Network. Customer service encounters in some form are an everyday experience. They should be easy, quick, and have a positive outcome. Continue reading →