CIO Chad Eckes: How to outsource the clinical IT help desk--without giving up control

At Cancer Treatment Centers of America, outsourced IT staff are immersed in the organization's culture
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If there's any business that needs a 24/7 IT help desk, it's healthcare. But the costs of on-call or night staff can be prohibitive--and don't always get the kind of results that a clinician sitting with a patient in front of her demands.

Clinicians want quick, accurate answers so they can go back to work "period, end of story," says Chad Eckes, CIO at the Cancer Treatment Centers of America (CTCA). "That became the bar that we wanted to live up to."

In an exclusive interview, Eckes (pictured) talked to FierceHealthIT about how outsourcing helped the organization, which has facilities in Chicago, Philadelphia, Tulsa, Okla., Seattle, Wash., and Goodyear, Ariz., create a "virtual clinical help desk," while still maintaining control over costs and quality.

FierceHealthIT: What tactics do you use to ensure that outsourced IT help desk staff offer good customer service and high level of professionalism when they communicate with clinicians?

Chad Eckes: Number one, we want to make sure that they understand the vernacular. Number two, a new analyst on our account is required to watch a patient impact video.

We never start a key meeting at CTCA, including board meetings, without a patient in the room telling us about their experience--what was good about it, what was bad about it. We record those speeches and play them to the vendor's analysts to embed the culture of CTCA. We also show them commercials so they understand who we are.

FHIT: Can you share some examples of how you maintain quality control?

Eckes: Every call is recorded. If there is an issue with a lack of professionalism, the vendor has a zero tolerance policy. They look into and address it immediately. There is an automatic survey at the end of each call. We can follow up on those standards.

Also, we everybody takes an employment test--a two hour phone interview where they're assessed for those abilities. At CTCA we have a different standard. We cannot have a typical IT person trying to engage with our customers.

FHIT: Arguably the business of healthcare is unlike any other. And communicating with clinicians can be challenging. How do you manage that?

Eckes: The cultural piece is based upon them living by our "mother standard." Treating our patients and stakeholders as we would expect and want our mothers to be treated. Understanding what it's like to be a CTCA stakeholder, even if their paycheck may be signed by someone else. I want them to believe they are the face of IT.

Getting folks to that level is key. When they're answering the phone they truly believe they are a part of our team. They're as focused on the patient as we are.

FHIT: How is talking to a clinician different than talking to any other user?

Eckes: It is about the patient. If there's a critical ticket it's all hands on deck.

FHIT: Who decides if a ticket is critical?

Eckes: The clinician. It's not triaged by us first. It's about the caller. Who else should really level a ticket? They know what the patient impact is. 

FHIT: Is this level of service possible without outsourcing?

Eckes: There is nothing that can't be replicated in-house, here. But imagine the cost of doing it. I had eight people on staff. That's for 4,500 full-time users, plus consulting physicians.

When you're looking at those types of volumes, those folks were costing me about three quarters of a million a year. That doesn't include software, the physician space, the phone system. To think about putting 50 help desk people on staff … I couldn't afford it. It would have been so cost-prohibitive it would have been ridiculous.  

It's 24/7. The way we used to handle it in the past if it was critical clinicians would be paging people and we had to have on-call people. And they were paging my expensive resources, versus help desk level folks.

FHIT: What is the most important thing a CIO should know about outsourcing the help desk?

Eckes: In addition to cultural alignment, it's ensuring tight business processes between the in-house IT group and the outsource partner. At some point there's going to be tickets that go back and forth. You have to have a smooth transition from when they get logged from the help desk and handled by a tier 2 player. If it's a high urgency ticket, making sure it is communicated, monitored, and escalated if necessary.

Similarly, we're constantly bringing on new applications. And there's a business process flow to do that, how to train the help desk that they're part of the team and skilled to handle questions on that application. It's end to end.

Editor's note: This interview has been edited for length and clarity.