How your practice can get the most from tech support
■ A practical look at information technology issues and usage
Included in almost every practice's health information technology contract is access to a technical support service line. These support lines often are the first place practices turn to when problems arise with an electronic medical record system that no one on staff can seem to crack.
But when the technical support staff cannot answer the question, doesn't understand it, or simply refuses to because it is outside an area of expertise, it's a bad day at the physician's office.
These frustrating scenarios can be avoided by knowing when and whom to call on for each type of problem. In many cases, it isn't the support line at all.
According to consultants and those in the technical support industry, there are calls that shouldn't land at the support center, and those calls come because the practice -- whether it's because of an inattentive vendor or a rush to get started by the practice -- hasn't received proper training on a system.
Unnecessary calls to support service lines can cost physicians valuable time. Although it's rare, a vendor could view the support center as a profit center that charges practices for each call, or for repeated abuse. That's why experts say practices should know not only the proper use of their call centers but also the vendor's philosophy regarding their use.
Effective tech support use can be taught after the system is bought. But experts say the most opportune time to learn how to use tech support is before an EMR system is in use.
So what are the common calls practices shouldn't make to tech support, and how can they be avoided?
Practice-specific questions. Andrew Fitzpatrick, CEO of Washington Publishing Co., a Seattle-based publisher of HIPAA implementation guides and code sets, said many questions go unanswered by support-line staff because they are questions specific to the way a particular practice operates, or the way a physician practices medicine. The questions have more to do with the way the technology fits into the work flow and not a problem with the software itself. (See correction)
Before implementation even begins, Fitzpatrick said, the practice should designate "super users" within the practice whose training on the system will be far more extensive than that of others. The super users will become experts in how the new IT systems are configured for their specific practices, and therefore become qualified to answer basic questions from other users.
How-to questions. Chad Cagnolatti, senior adviser with Impact Advisors, a Naperville, Ill.-based health IT consulting firm, said there often are unique tasks performed on an EMR that physicians probably learned in training but don't do every day -- so they forget how to perform them. Or, the training was inadequate and not tailored to the way that particular user learns new skills. A support staff equipped to deal only with technical issues such as error messages or system outages won't be able to help the physician with, say, how to send an electronic referral.
Super users within the practice also are helpful in these situations, as they are in the same offices or walking the same hospital floors as other users, and thus are available to provide immediate help. Cagnolatti said practices also should ensure that adequate training is provided to everyone -- and the amount of training can't be underestimated.
However, he also said supplemental education resources that employees can refer back to, such as how-to videos, also are helpful in resolving issues.
Misunderstanding the system's capabilities. Manuel Lowenhaupt, MD, a senior executive in Accenture's Health Provider Practice and North American Clinical Transformation lead, said users need to have a clear understanding of what the system can and cannot do.
During training, vendors should "define the walls of the sandbox," said Dr. Lowenhaupt, a family physician who also founded an EMR company. "Once you've defined those walls properly in your training, then the calls can be about stuff inside the sandbox.
"If my primary care doctor was looking to have my hospital discharge summary sitting in front of him in the [EMR], but the system doesn't interface with the hospital, calling the support line saying, 'How do I get my hospital discharge summary on the computer?' is a poor use of everyone's time."
Dr. Lowenhaupt said that when the expectations, scope and scale of the system's capabilities are thoroughly covered in training, the support line is used in an efficient way.
Hardware versus software problem. Many practices aren't aware that they should have different service contracts for hardware and software. A common mistake, said Mike Cuesta, director of marketing and user experience for EMR vendor CareCloud, is a call to the health IT software vendor about hardware issues not associated with the software, such as a printer failure or a fuzzy computer monitor.
Practices should have a clear understanding of each call center's purpose -- hardware or software -- and how and when to contact them.
Time spent in training and prep work before the system is deployed will result in better, more efficient uses of the call center, experts say. But good use of a support line should not mean there are fewer calls, Dr. Lowenhaupt said.
It should mean a lot of calls, he said, as good vendors should view their clients as partners and encourage communication with them. He recommends that physicians not contract with vendors who place a cap on how many calls can be made per month to a support center.
The call center should be viewed as a tool the vendor uses to build relationships with clients. They should want to talk with their clients as much as possible, Dr. Lowenhaupt said.
He said good service line centers should adopt a Ritz-Carlton view of service: Own every problem. They may not be able to solve every problem, but they can help find someone who can and not immediately pass the caller to someone else. Practices that are made to feel as if they cannot call the support line, or experience frustration each time they call, will only lead to those practices seeking a new vendor.