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by Jody Buchman
Published on January 29, 2018

When evaluating a new electronic health record (EHR), an organization’s first consideration tends to center around the user experience: What will a new system mean for its clinicians? Will it enable more time with the patient? Will it result in more accurate recordkeeping and improved care delivery? How will the benefits stack up in comparison to the costs?

These considerations are vital, but there is another valuable and necessary component of a successful EHR implementation: the quality of support that is provided alongside it.

The Importance of Technical Support

In a study conducted by Black Book, it was revealed that 85 percent of responding clinicians believe their delivery of patient care services is continually impeded by subpar technical support. Further, 77 percent of nurses and 89 percent of physicians reported their hospital loyalty was gained through excellent EHR end-user experience by means of advanced technical support. Black Book also found that EHR suppliers offering comprehensive technical support options for their clients achieve higher clinician satisfaction levels, receiving approval ratings of over 93 percent.

These metrics clearly show the value of good technical support, but with such a wide variety of care facilities – rural, urban, large, small, ambulatory, surgery – how can an organization determine the best approach to take regarding support?

Choosing the Correct Type of Support for Your Organization

We can think of technical support in four tiers, with each tier providing progressively more complex support:

  • Tier 1 handles basic requests such as password resets, navigation assistance and other high-volume issues
  • Tier 2 provides additional expertise and investigation
  • Tier 3 is a step up from that for even more complex issues
  • Tier 4 includes engineering and IP, which can identify and correct system- and code-level defects and handle issues of the greatest complexity

When deciding how to provide the best support experience for its end users, an organization generally has three options:

Option 1: In-House Support

New technology can be supported in-house, typically by training existing staff on the new EHR and possibly hiring additional staff members who already possess the technical know-how. This option usually saves money in the short term but requires a significant investment of time and effort in setting up and running a training program. Another drawback of in-house support revolves around critical issues: When these issues arise, they can take longer to resolve because of the limited resources, knowledge and experience available in-house.

Option 2: Third-Party Support

Organizations can outsource some or all support operations to a third party. This usually means a higher overall financial cost, but removes the time required to set up and run a training program. Another benefit of third-party support is that there is generally a deeper level of knowledge that can result in quicker issue resolution.

One downside to third-party support is that the provider will not have the ability to fix a system- or code-level defect, as the third party will not have access to the EHR system architecture. This can result in poor system performance and can have a negative impact on patient care. According to Black Book, 82 percent of EHR clients using third-party technical support are “significantly dissatisfied with the level of response and the quality of their services in the twelve months following go-live.”

Option 3: EHR Provider Support

Organizations may choose to outsource technical support operations to the EHR provider itself, if offered. This can mean partial or full outsourcing, and it provides the organization with an immediate expert resource to assist its end users with any issue, including code defects.

While this option is generally the most expensive, it enables the health care organization to focus fully on providing care and not on IT. By outsourcing support directly to the EHR provider, an organization will receive the fastest issue resolution and will have 24/7 coverage for critical issues. This type of coverage and expertise means that any issues that arise will have a minimal impact on patient care and will keep the EHR running the way it was designed.

Considerations When Choosing How to Support an EHR

Each of these options presents its own list of pros and cons. As a rule, choosing to outsource technical support operations to the EHR provider will result in more satisfied end users, less time spent in the EHR, more time spent with patients and faster issue resolution. Outsourcing support also frees up valuable time and resources so an organization can focus on key initiatives that will advance its operational roadmap. In many cases, an EHR provider will also offer additional options that allow a care facility to run more efficiently.

Here are a few things hospital leaders should consider when weighing options for their organizations:

  • What type of support experience do I want to offer my end users?
  • Do I need 24/7 coverage?
  • What is most important: high first contact resolution, fast turnaround time, high-end user satisfaction or cost?
  • What kind of support is best for the size of my organization? For larger organizations, in-house technical support can pose more challenges than for smaller organizations
  • How much support volume do we expect and what is the cost of handling this volume internally?

The Future of Support

Technology is a rapidly changing industry, and technical support is not immune to these shifts. In the future, we expect to see three key areas of advancement that will greatly affect the support experience: consumer technology, cloud technology and artificial intelligence. It is important to also consider these variables when deciding how to best support an EHR.

Consumer Technology

We’re in an industry where there are constantly new advances that change how a user interacts with technology. The advancement from the desktop of yesteryear to the prevalence of voice-engaged tools such as Amazon’s Alexa and Google’s Home devices is just one example of this. Users are growing accustomed to technology that makes their lives easier, both at home and at work. These technologies will create new challenges around patching, security and best practices – especially on user-owned devices. It will be critical to have a strategy to address the multitude of devices, configurations and interaction preferences for a diverse user population.

Cloud Technology

EHR vendors are increasingly embracing cloud technologies to deliver their solutions, which is causing a shift in how these solutions and technologies need to be supported. With new delivery strategies and abstraction of technology infrastructure, having support closer to the delivery and implementation of solutions will result in a better, more consistent experience.

One of the biggest advantages of utilizing cloud-based technology is the ability to rapidly push new capabilities and corrections to all users. In order to take full advantage of this benefit, however, organizations need to have a strategy around the introduction of these changes so that users are prepared and not caught off guard.

Artificial Intelligence

Artificial Intelligence (AI) is rapidly advancing and becoming more prevalent in our day-to-day lives. As capabilities increase and costs decrease, there are significant opportunities to leverage AI in the support experience to create a timely, high-quality and more efficient experience that is individualized to each user. Challenges to consider when leveraging AI for support can include a return on investment predicated upon performing several frequent tasks, the data and sample size for learning behavior and a qualified team to help train and manage these new AI technologies.

Each of these advancements will carry its own range of benefits, but realizing the full value hinges on the successful deployment of each technology. When considering the future of support for an organization, it is important to honestly assess openness to change as well as capacity for implementing it, which will help determine the best approach.

Cerner is the only EHR/HIT provider in the industry offering comprehensive, four-tier technical support to clients, and we were recently ranked as the Number One Overall Vendor in Black Book’s Client Service and Support Performance report for the second year in a row. Learn more about how we can deliver a support experience that meets your end users where they are.

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