Customer Service
The U.S. Army Medical Information Technology Center has expanded
the role of their enterprise service desk and transformed their IT service
management processes, with a foundation built on ITIL, standards.
By Shannon Carabajal
As the Army Medical Department continues embracing technology to improve the quality of health care available to soldiers and their families, dependable, timely and accurate information technology service management becomes crucial. More and more mission-essential programs and systems are connected to the network, so when something goes wrong, it’s more than just an inconvenience; the mission is impacted and quality patient care is threatened.
Consequently, IT service support may be the first step toward optimal service delivery and a proactive, streamlined IT service desk is essential to providing and maintaining high-quality health care to all beneficiaries. To meet that need, the U.S. Army Medical Information Technology Center (USAMITC), located at Fort Sam Houston, Texas, expanded the role of their enterprise service desk and transformed their IT service management processes, with a foundation built on the Information Technology Infrastructure Library, or ITIL, standards.
USAMITC provides information management and information technology products and services to support the Army Medical Department, the Military Health System, the Department of Defense, and other government clients worldwide. Improving their processes means better, faster and cheaper service for their customers and their users which ultimately benefit soldiers and their families who rely on high-quality health care.
ITIL is a set of industry best practices for IT service management emphasizing a service desk’s role and enabling USAMITC to become the single point of contact for their customers and provide continual quality improvement, according to Terry Hessler, USAMITC configuration manager. “ITIL is the most widely accepted approach to IT service management in the world,” he said, adding that it aims to reduce costs and improve the efficiency, quality and reliability of IT service management. USAMITC has embraced ITIL to better manage enterprise processes and provide better value to their customers.
Like business improvement methodologies such as Lean Six Sigma, the ITIL framework promotes process improvements through standardization, common language and “common sense” changes, Hessler said.
He further explained that ITIL gives organizations a customizable framework for IT management to support growth and achieve their service goals cost effectively. USAMITC developed the framework for the MEDCOM process foundation including several interconnected processes: incident management, problem management, change management, release management, configuration management and service-level management.
A Framework for Army
Medical Command Incident Management
The expanded USAMITC enterprise service desk handles incident management and promotes a smarter, more efficient way of doing things through improved processes and shared knowledge, according to Joe Nystel, ESD operations manager. An incident is any event causing an interruption or reducing the quality of service.
Effective incident management resolves incidents quickly, minimizing the impact on AMEDD’s mission. “We can get users up and running as fast as possible by either fixing the problem or providing a work-around so they can get back to doing their job and taking care of patients,” Nystel said.
Beginning this April with the Southeast Regional Medical Command, USAMITC is deploying the ESD—a consolidated, standard, stable and secure service desk—throughout the entire Army Medical Command infrastructure, a move that will reduce redundancies and achieve significant efficiency improvements and cost savings for the command. The ESD deployment is scheduled for completion by March 2010.
When users, from the health care provider in the hospital to the medical logistician in theater, are impacted by an IT problem, the ESD will be the single point of contact for anyone needing assistance, Nystel said. “If they have an IT issue, they’re going to call one number or send an e-mail to one address, and they’re going to get the same level of service no matter where they are.”
Technicians assist users with a broad range of issues including desktop support, connectivity and configuration problems, mailbox configurations, and distributing software and tracking licenses for the enterprise. Providing service to all of AMEDD, as well as documenting and tracking all incidents allows the ESD to build a shared knowledge database, an important piece of incident management.
“With a shared knowledge database, a technician who finds a fix for an incident can share that knowledge by putting it in the global database,” Nystel explained. If someone at another site is having that same issue, a technician can go in the knowledge base, find the best solution and quickly resolve the incident.
Nystel added that all Army medical treatment facilities will be working together and will have access to that shared knowledge database. And with technicians always looking for new fixes and better ways to do things, efficiency stands to continually increase.
Problem Management
Incident Management is typically a reactive process, with users contacting the ESD whenever they have an issue and technicians working to find a resolution. Another critical component of USAMITC’s ITIL framework is problem management, a proactive procedure seeking to determine and correct the root cause of incidents.
According to Hessler, problem management involves investigating the underlying cause of incidents, and aims to prevent similar incidents. By working to eliminate errors, both through software changes or changes to IT infrastructure, the number of incidents can be reduced and the day-to-day medical mission will have fewer interruptions.
USAMITC will be able to do a root-cause analysis on a global scale, Nystel said, adding that once a problem is detected, removal is the next step. “We will see trends, narrow down the problem and put a stop to it.”
Change Management
Captain Jason Weir, ESD chief, said ITIL best practices extend well beyond the ESD, standardizing processes and maximizing resources throughout the entire organization. Weir added that effective incident and problem management, for example, will help identify the need for changes to existing software, hardware or documentation.
The change management process ensures that standardized methods and procedures lead to efficient and effective changes while minimizing operational impact during implementation and distribution. At USAMITC, a change advisory board oversees the change process ensuring proper testing, implementation and distribution so negative impacts to customers and services are minimized.
“Any new program, any new hardware, changes to a server and things like that must go through an approval process to make sure it’s properly tested and properly introduced,” Hessler said. “If we don’t have this process in place, work is disrupted and incidents rise.”
Release Management
In addition to changes to the existing infrastructure, new hardware and software is often released into the environment. Release management oversees the distribution and implementation of new or upgraded software or hardware, ensuring quality control during the development, implementation and distribution while considering all aspects of a release, both technical and non-technical, and its impact.
Appropriate release management ensures proper planning, testing, training and control during the release process so consistency and stability for customers is maintained, Hessler said. “It’s a holistic approach to new hardware and software releases”, he said, focusing on the customer.
Configuration Management
Configuration management identifies and controls all assets within the enterprise, while considering the nature of relationships between those assets throughout the AMEDD. By controlling the assets and monitoring those relationships, incidents and problems are more easily identified, and the impact those issues have on the infrastructure are better understood. Through effective configuration management, therefore, USAMITC can determine the technical problems of the enterprise and what is affected, so the incident or problem can be resolved quickly and appropriately.
The configuration management database is a crucial part of configuration management, Hessler said. The database is a common repository for the ITIL processes, identifying, controlling, maintaining and verifying configuration items within the service enterprise. Also, the CMDB provides relationships between configuration items denoting dependencies and connections to each other or to a provided service. From a user’s keyboard, to the software an individual needs to perform the mission, critical asset records and configurations are tracked and managed, becoming the single source of truth for the other ITIL processes.
Service-Level Management
Service-level management is one of the most important components of IT service management. Unlike the other processes which are more operational in nature, Hessler explained that service-level management is a tactical process managing the quality of services USAMITC provides to customers through service-level agreements between USAMITC and their customers, as well as operational-level agreements, between internal USAMITC divisions.
The agreements clearly outline inter-departmental processes on handling incidents, standardizing methods and ensuring best practices are applied to every situation. From a customer’s standpoint, the agreements provide substantial peace of mind by ensuring best practices are followed, and giving them an understanding of the services provided and the processes involved.
Perfecting Processes for Better Health Care
As the ESD deployment continues and the ITIL processes are perfected, Lieutenant Colonel Joseph Bentley, USAMITC commander, expects great things from the quality of the IT service support USAMITC provides and the impact that will have on health care providers, patients and the warfighter. “We have the best people implementing the best processes,” he said, “and they’re always looking for ways to improve.”
“Our soldiers and the rest of our military family deserve the best health care available,” Bentley said. “As an organization, we are committed to using technology, perfecting our processes and delivering excellent worldwide IT support so they get nothing less than they deserve.” ♦