How can Application Managed Services help your organization? [podcast]

Is your team struggling to dedicate time to strategic projects because they're bogged down with supporting and maintaining your EHR? If so, you're not alone. We hear from clients all the time that with competing priorities on the table, they could really use an experienced team to take on tier 2 application support — and give their teams the space to pursue the work that really matters to their organization.

In this podcast, Service Delivery Manager John Lanari sits down with VP of Managed Services Ian Mamminga to discuss how Managed Services can act as a strategic partner to your organization. They'll discuss the reasons organizations pursue Managed Services in the first place, as well as how to be successful in choosing, integrating, and collaborating with a Managed Services partner.

If you're interested in hearing more about Nordic's own Managed Services model, we'd love to talk to you about your current staffing plans and how our model compares. 


Show Notes

[00:00] Intros
[01:42] Why clients are pursuing Managed Services
[05:18] How to successfully incorporate Managed Services
[07:47] Visibility vs. a hands-off approach
[08:41] Where your team can refocus with the help of Managed Services
[10:32] How to find the best Managed Services partner

Podcast speakers


John Lanari: Thank you for joining the HIT Breakdown. We've got an exciting discussion planned for you today around Managed Services and the increasing role that it's playing with organizations, as they are scaling to meet their growth with their IT departments and the demands of supporting technology in healthcare organizations.

My name is John Lanari, and I serve as a service delivery manager with the Nordic Managed Services team. I'm joined today by Ian Mamminga. Ian, would you like to introduce yourself?

Ian Mamminga: Yeah, good afternoon everybody. My name's Ian Mamminga. I'm a vice president in our Managed Services group, and work alongside John.

John: Thanks, Ian. We're excited today to talk to you about Managed Services and the growing opportunities that we've been hearing from our clients and other organizations. Ian, what have you found that organizations are looking to alternative solutions for, like Managed Services, today?

Ian: Yeah, great question, John. There's actually quite a few reasons why we've talked to several of our client partners about Managed Services lately. One of the most common ones, I would say, was really around different priorities and competing priorities with our client partners. So, things like managing a live EHR system, doing upgrades and scheduled maintenance for that, but carrying that on, all the while trying to do strategic initiatives and projects. Sometimes that's challenging for folks.

Really, those two things are very different and sometimes even come from different head spaces, right? Somebody's trying to do the support of the EHR, at the same time doing a project, right? If you have a high or urgent ticket that comes in, a lot of times that's going to take precedence, as it should, and then the projects sometimes delay. We have a lot of clients, who are interested in really separating out that work and looking for core competencies, and also allowing people to work at the top of their license. That's one thing I would say, John.

The other is really around quality and satisfaction. Some of our clients are very interested in setting the right expectations with their end users and really trying to guarantee turnaround times. One of the things we provide for our clients, as you know, is really service-level agreements or some guaranteed turnaround times. Some of the clients we work with have those and operate on those today and maybe just want to tighten those up or improve those. Some of our client partners don't have those at all. Some of them have them, but maybe don't really utilize them or report off of them. We have a full spectrum of opportunity really kind of around that space today.

So those are a couple things that come to mind, John.

John: Yeah, it's so interesting when I speak with some of our clients is while that focus on customer satisfaction is growing day by day because we come across it, whether we're going to a restaurant, whether we're interacting with our internet service provider, that focus on customer satisfaction is just becoming a bigger part of our lives and a bigger part of what we expect when we're interacting with technology.

Ian: Yeah, one other thing that I was just thinking about too, that we see is really ... You know we focus a lot in our Managed Services group on supporting and maintaining the live EHR systems for our clients. The other thing that is very important to our partners today is really trying to smooth out and then predict what that demand looks like. Both from a financial perspective, so that demand curve from an end user's perspective goes up and down month over month as it should, and as it's expected to. However, that's tough to plan and account for if you're an individual client.

The financial side of that's also challenging. So how do you get a consistent service level without really moving your resources up and down quite a bit month over month. So giving a very consistent service at a fixed price point is another reason we've had a lot of discussions around Managed Services lately.

John: You know, one other area that I know we've encountered regularly and more and more frequently is with organizations who have business initiatives or business goals as they're looking to extend out to Community Connect affiliates, as they're looking at acquisitions or adding on new practices, new specialties within the organization. They've got a need to take advantage of their existing staff to roll out their EHRs and their other technology solutions to those areas while still maintaining, as you've been mentioning, that great quality service and the turnaround times that they've established with their existing partners.

Ian: Yeah. That makes sense. Great point.

John: What have you found, Ian, that organizations are doing to be successful incorporating Managed Services into their teams, their structures, the processes that they already have in place?

Ian: Yeah, there's quite a few things I think we could cover on that topic. You know one of those I think really comes down to just how do you operate and also how do you onboard a service like this. Some of it does depend on what services are provided, right? So in our example, we may work with a client and do something very granular or something tactical where we're just providing a service or a small component of the EHR management. In other examples, we may be doing the entire enterprise management of the system, right? Those models may look a little bit different, but in each case I think a big component of the onboarding process and really getting to know the teams is getting to know their process first.

So, sure we have some best practices and ideas on how-to things like change control and governance processes and committees and structures, but really want to get to know what's the operating procedures for that client and really try to integrate ourselves to that as well during the onboarding process. I think that's an important step in the right direction there.

John: Yeah, and we've certainly found that with some of our clients today as well, that that ability as they're looking and assessing potential partners, the ability to show that partnership, that interest in learning about the way that they function today, the decisions that have already been made in the past regarding design, workflow, system configuration, the way that they function and interact with their physician practices for example really being interested in learning how they function today, and then bringing that additional expertise that you certainly have with an application, whether it's Epic or another vendor.

Ian: One other thing that I think, I guess goes back to what we'd already talked about a little bit too is just why we're in the business to help that client? Is it to provide a higher level of service? Is it to provide a more consistent financial outcome or financial run rate on the support side. One of the things that's always important is what is the outcome, right? What are we shooting for, and what's that common goal? That's going to be a conversation that starts in the early conversations and extends in through our onboarding process.

Then that becomes something that we're going to talk about and manage too and expose in our ongoing reporting and kind of operations side as well.

John: Ian, what do you find organizations are interested in as far as visibility into that sort of day-to-day maintenance or the opportunity to be hands-off and leave that work up to someone else?

Ian: Yeah, that's a great question. Really, I'd say it's in the middle, John. Really, what we try to do is we try to provide the ongoing support and maintenance on behalf of our client partners, so really do the best support and maintenance of that EHR system. We are taking on that burden and providing great service, and our clients really don't want to do that in many cases or don't have the capacity or time or whatever it may be. On the flip side, you know, they don't want to be in the day-to-day management of it, but they do still want to have some oversight and visibility. We provide with our services a monthly report and a series of feedback and kind of checks and balances around that. We're going to expose some of the data sets and what's important, so there's kind of the right visibility, I would say, on the services.

John: Ian, what do you find teams end up doing once Managed Services are incorporated into organizations? How do teams get refocused, or where do they place their efforts?

Ian: Yeah, that could take on a couple different forms. One of the things that we see, probably the most common thing we see is really that division between support and maintenance and really what I'll call strategic initiatives. So in many cases, we're always challenging ourselves to work at our own top of our license within our teams. Many of our client partners are doing that same thing and really looking at what's important from an organization roadmap perspective, and what are things that people are better suited to do at the facilities of the health systems today?

Many times that's extending the EHR, whether that's new solutions. It could be new initiatives or other systems. It could also be things like population health or other strategic initiatives. A lot of times we see our client partners refocusing their efforts for some of those things and really wanting to hand off some of the support and maintenance because maybe that doesn't feel like it's in their wheelhouse, or it's not best suited at least for their team.

John: Some of the feedback that we often receive as well is it's a great opportunity for organizations to take their staff and let them work on, give them the opportunity to work on the stuff that's really important as well as strategic for the organization, so there can be a big boost in employee satisfaction. Also a great opportunity to make sure that they're becoming the partners that they want to be with the operations side of the house. So they start to give the attention, and the understanding that can be really necessary for having a successful EHR as well as a system that really meets end users' expectations and their goals for satisfaction.

So Ian, as organizations are preparing to look for a Managed Services partner, is there anything that you would recommend that they consider, to look for, as far as the organization itself or how you can find the best partner?

Ian: Yeah, great question. I think the answer probably has a lot of different components to it because really it's an important decision. If you look at these arrangements, these are really long-term partnerships, and so you really want to go in and do some homework ahead of time. A couple things come to my mind. One of the things I just mentioned is using the word partnership. These are going to be long term relationships. You want to have a partner that you know and trust and evaluate a lot of different components of the service, not just the cost, but also the quality.

That leads to the second point. I think the focus really on this needs to be on the end users and really how to provide the best support on their behalf, and so quality has to be a big component of that. And how do you measure that and sustain that over time using a variable demand curve? So those are important components. I think the other thing that comes to mind is just finding a partner that has the right knowledge.

So, in my experience, it's very key to actually know the system and how to manage and operate and maintain it. So knowledgeable resources and having enough of those to have the size and scale needed to actually meet the demands and flex up and down as needed are very important components of the selection. How about you John? Anything else come to your mind?

John: Yeah, we've certainly found that with some of our existing clients today, where the opportunity to look ahead six months, 12 months, three years down the road, what do you have for major upgrades, double upgrades that need to happen at the same time? How are you as an organization anticipating that you will grow, and to what extent are you going to need to pull in those extra bodies for three months, for six months, maybe just for two weeks? Is the partner that you're selecting capable of meeting the variable demands just as you've mentioned?

Ian: Yeah. Yeah, it makes sense. I think the other thing, you know we talked a little bit about knowledge of the EHR and the system being of great importance. The other component of that is also just experience and knowledge of how to support and maintain systems and using industry terminology. That's important, especially early on in the engagement, to make sure you're talking the same language, whether it's the priority of requests or incidents and the service levels and turnaround times. Those structures can be very different when you go client to client, so it's very important to have a lot of experience in that space, so not only is the onboarding quick, but also then the ongoing support and language and communication.

John: Yeah, and the opportunity or the ability of that organization to coach you through those areas where, as you've mentioned previously, if a service-level agreement doesn't exist today, what's the right way to roll that out and to define it within the organization? To what extent does it make sense to start with an application or a tool like an EHR, and then expand it across the IT organization as a whole?

Ian: Makes sense.

John: Well thank you Ian. This has been a great discussion. I appreciate all the insights that you've been able to bring. Hopefully others who are listening have found some new ideas that they can bring back to their organization for further discussion. If you are interested in talking more about Managed Services, don't hesitate to reach out to us here at Nordic for an understanding of Managed Services and the way that we interact and help organizations today.


Topics: Managed Services

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