IT Service Management keeps life-blood flowing in heart of Scottish NHS
It's the Customer Support Desk in the Common Services Agency (CSA), the organization which produces statistics, supplies central finance and legal services, organizes healthcare supplies and the GPs' administration system, commissions national specialist and screening services, tackles national outbreaks of disease and environmental hazards, and runs the blood transfusion service in Scotland.
The CSA has around 2,500 staff, mostly based in Edinburgh but also working in offices throughout the country including more than 40 remote sites where statistics on cancer treatments are collected and validated.
The Desk - located in the Information Statistics Division (ISD) in Edinburgh, which provides NHS statistics for the Scottish Executive, and on Scottish health services for the general public - handles 19,500 calls a year. Some 70% of these are related to IT and 30% to information.
The 'heart within the heart' is Axios Systems' assyst IT Service Management software solution which has helped the CSA manage a huge increase in demand for information. Just three years ago the five-member Customer Support Desk team received fewer than 20 calls a week.
"The Support Desk regularly comes out top in customer satisfaction ratings but it's only as good as the information at its fingertips,"Stewart McQuillian, the ISD's Head of Infrastructure and Production, told Public Sector Executive. "The Service Management system makes life so much easier for us and our stakeholders."
assyst has been used by CSA for three years. The assyst Help Desk was set up within a month to support the CSA bringing its IT function back in-house from a private contractor.
The Desk (CSD) operates from 8 am-5.30 pm five days a week. Desk-related queries include an information service to organizations and individuals who wish to utilize health service data relating to activity, manpower and finance. These can include: How many knee operations are carried out in Glasgow? What's the elderly population in Ayrshire? How many Grade x nurses are there in Inverness?
Vital benchmarking statistics provided via the Agency's Skipper system enable comparison of performance indicators between health board, trust and hospital areas.
All information is treated as strictly confidential with no patient-identifier material stored on assyst. "There's a strict code of patient confidentiality," McQuillian stressed.
Desk staff refer information queries to relevant specialists who access NHS Scotland's own databases. Data must be interpreted carefully and sensitively by experts.
On the IT side, up to three years' information is stored on assyst whose provider Axios Systems is co-incidentally also based in the Scottish capital although it also has offices in Europe and North America.
The tool is used for:
1. Incident management
Should a PC fail, the call is linked to asset information and the equipment's serial number which comes up automatically in assyst.
The system prioritizes the call on a scale from 1-6, triggers a Service Level Agreement (SLA) or Partnership Agreement and escalation process, and is assigned to the relevant support area.
The Desk currently solves only 5% of calls first time but the CSA is assigning engineers to the unit and has drastically increased this target to 60%. "It's achievable," McQuillian said. "Working on the front line can motivate and energize engineers and underline to them that this is a key area for improving customer service."
The CSA also uses Axios' assystNET, mostly as a customer-facing tool. Users can log their own calls over the Intranet or Internet (within the NHS Scotland network) but have restricted rights. These calls are forwarded to the Support Desk.
"The other advantage of assystNET is that we can tell people the status of their calls," McQuillian went on. "They can tell immediately what's being done to sort out their problem."
Like many other organizations, communicating with staff across the whole of the CSA has sometimes been difficult. Thanks to the flow of information freed up by the Service Management system, these difficulties have been consigned to the dustbin of history.
2. Asset/configuration management
Most IT equipment is logged on the assyst database together with its serial number. The CSA has more than 2,000 PCs plus more than 100 NT servers and around 20 Unix servers plus printers and other peripherals.
Some 230 employees use remote equipment such as laptops with secure ID and authentication. They include cancer statisticians, auditors, and staff responsible for clinical coding of conditions - further evidence of the CSA's determination to doublecheck the accuracy of its data.
"We can provide lists of assets for any stakeholder and instant cost information, for instance on the price of any proposed software upgrade," McQuillian said.
The CSA has just purchased Axios' assystDiscovery product which allows organizations to track hardware and software across their networks. "We'll be able to identify equipment even if it's been moved. This will take the pressure off staff because they won't have to notify the Desk even if they shift something," McQuillian said.
3. Problem Management
Every organization needs an independent role to monitor service provision and the CSD team is no exception. The Problem Manager is responsible for SLA escalations, breaches, preventative management, management reporting and instigating service improvement programmes.
McQuillian described the CSA's Problem Management function as "our conscience and the stakeholders' conscience." Information in assyst allows management to spot trends and improve performance.
4. Management information
assyst comes with Crystal reports which the CSA complements with the Business Objects reporting tool.
"We can get weekly and monthly reports from assyst on anything you can think of," McQuillian said. Statistics are also used to manage the Department's own performance and schedule resources.
By March 2003 the Agency will also use assyst for Change Management. This will unify five different change control systems within the IT department. In future all IT changes will be carried out through assyst, following IT Infrastructure Library (ITIL®) methodologies as far as possible.
"At any point we'll know of any releases, if anything has moved," McQuillian explained. "assyst will automatically show us any dependencies - for example, if a server goes down, how many machines/people are affected? We'll only have to notify these people - not everyone in the organization. It will give us an early warning system too: When a PC fails we'll know how many other similar machines might be at risk. We'll also have an audit trail for all changes."
The CSA was the first organization to have staff qualified through Axios Systems' assyst Accredited Professional Programme (aAPP) which covers the application of ITSM disciplines and practices. Candidates sit an examination at the end of their courses which are offered by the company's Education Centers in the UK, Germany and the Netherlands.
Service improvements already realized by using assyst and problem management function have reduced:
Outstanding calls from the previous financial year from 172 to 5 (now zero)
Calls outstanding for more than 1,000 hours down from 18 to 3
Calls outstanding for more than 60 days down from 62 to 36
The number of calls which breached Partnership Agreements from 23% to 10% of the total
Over the last 3 years IT has exceeded customer satisfaction targets.
"We couldn't do without a system like this - it's the heart of the IT operation within ISD and tells us what we're doing right and what we could do better. It's our conscience as well as our workflow and management information tool," McQuillian summed up.
Axios Systems is a leading provider of Best Practice-based IT Service Management (ITSM) solutions. Our customer-centric approach combined with our award-winning solutions, ensure customers worldwide can align their Service and Support organizations with the overall business goals. Our core solution, assyst, intuitively steers users through the ITIL® processes. Axios Global Services provides a range of consulting, project management and training services. Our commitment to Best Practice is demonstrated through being the first to achieve BS 15000 certification which has now become, ISO/IEC 20000, the International standard for ITSM. Axios is headquartered in the UK, with offices across the Americas, Europe and Asia Pacific.