A Formula for Dramatically Improving Healthcare IT Customer Service

Proactive walkthroughs by IT field engineers enabled one hospital system to satisfy users, reduce help desk calls and generate savings.

It’s a scenario that could keep any healthcare IT executive awake at night.

You’re responsible for nearly 16,000 computers, laptops, tablets and IT devices for an eighthospital system in the midst of major expansion efforts. Meanwhile, the stakes for system reliability and ease of use are getting increasingly higher as Meaningful Use guidelines are requiring doctors, nurses, specialists and staff to learn to work electronically after decades of paper dependencies.  On top of all that, your hospital system leaders want more than mere compliance – they want to lead the way in the new all-electronic world. And, of course, they want to keep costs in line, too.

A team from CareTech Solutions found a way to manage that challenging situation. Knowing the status quo was not good enough to stand up to future requirements, the team developed a success formula that redefined IT customer service in this hospital system. A reactive, respond-to-the-call approach was transformed with the addition of a proactive, face-to-face, preventative action plan. IT field engineers conducted walkthroughs, much like doctors doing their rounds.

But there’s more to the story. For this white paper, we’ve asked the following CareTech team members to shed some light on how and why the approach works:

  • John Karras, Senior Client Executive, Technical Systems
  • Dean Figlioli, Director, Field Services and Deployment
  • Madhu Nallabelli, Automation Development Team
  • Mike Meadows, Automation Development Team
  • Richard Bugarin, Delivery Team Supervisor
  • Mike Callan, Delivery Team Supervisor
  • Jason Sparks, Delivery Team Supervisor


Karras: We’ve been developing our walkthrough process for a few years now. Our initial goal was to reduce the number of service tickets in the urgent category, but it was also in response to keeping up with demand. The number of IT assets we’re servicing has doubled in just a few years, and our staff levels are about the same.

Figlioli: From the perspective of the people we serve, using IT tools is no longer a matter of choice — it’s become a necessity in patient care. If I’m a physician doing mobile dictation or if I’m a nurse administering medications, if a device is down for a certain period of time, the impact directly affects patient care. All healthcare IT departments have had to rise to this challenge.


Karras: The key word is proactive. We now engage with our clients daily on a face-to-face basis. We take care of high-order tickets based on their priorities. We address the needs of the operating rooms and the emergency rooms, as well as the administrative areas. We provide extra equipment, and because of the demands and degree of patient care, they grow into that surplus. They’re busy, but they want to know that we’re giving them the attention and service they need.

Figlioli: We have 32 field engineers with each responsible for about 500 devices. They’re not just going through and fixing problems. They’re working directly with users, building relationships, providing a source of regular support. They’re also tracking issues so we can monitor and respond to trends and gauge the impact on the organization.

Each device is checked on a scheduled walkthrough. But you can walk and walk, and it doesn’t mean you’re going to discover. So our team came up with a way for our people to walk through an area efficiently.


Nallabelli: To make it easier for our field engineers to spot a computer in need of service, we developed a visual indicator for them – a blue icon on the bottom of the screen that turns red when there is an issue, such as an out-of-date anti-virus file.

The computers need to be rebooted at least once a week. The rebooting enables log-in scripts to be run so the computer can remain compatible with the system. The scripts could include Microsoft patches, anti-virus patch files, or an application, for example, an Internet Explorer upgrade.

Meadows: We know our users are very busy, and sometimes computers don’t get rebooted often enough. We’ve given our field engineers the ability to log in as an administrator without having to turn the user off to fix those certain issues.

Also, when a user or field engineer clicks on the red icon, they can see a menu we’ve developed to show the complete status, so the field engineer knows what to do to fix the problem.

Karras: The tools that our team developed allow us to be efficient. If we had to check every device, we’d never get through the day. And these proactive fixes are saving us from issues that could have otherwise surfaced in the middle of the night or caused a delay in patient care.


Sparks: We set a schedule for the walkthroughs. We also establish criteria for what the field engineers should check. They may walk from a nurse station to an intensive care unit to a critical ER area. They visually can check devices quickly, looking for indicators, or they may get an email verification even before they reach the site showing a certain number of devices that may not have run pattern files.

They’ll talk with our end users, many of whom are too busy to place a call with the IT help desk, but they know we’ll be walking through. They know us on a first-name basis.

Our field engineers get asked all kinds of questions. They’re equipped to answer any kind of computer question. For example, if they’re asked how to power on a particular mobile device, they can show them how, print out a document with the steps, or point them to the Web where they can get answers at any time.

The doctors and nurses need to have good bedside manners, and so do we. Figlioli: We make sure new field engineers shadow an experienced field engineer for a period of time to make sure our standard of delivery remains high.

Bugarin: For the emergency rooms and critical areas, we have three shifts. Between 7 a.m. and 9 a.m., we take care of any issues that many have overlapped from the night shift. A lot of times, when the morning shift comes in, they won’t address a computer issue right away. They’ll just tolerate it while addressing their work. Between 10 a.m. and noon, during our mid-day walkthrough, they’re more likely to engage the engineer with the issue. We do our afternoon walkthroughs between 3 p.m. and 5 p.m. to capture the change from the day shift to night shift.

Our walkthrough schedules are less intense for non-critical areas, but every field engineer is assigned to a location, and within a five-day span, will cover their entire territory.

Callan: We alternate areas so the clinical staff gets used to seeing different people who are part of our team. This helps our team members be fully flexible and to know the lay of the land and be comfortable with the clients. When we do proactive walkthroughs, our field engineers are not just fixing a problem – they’re helping to educate the users as well. If there’s a certain trend in one area, we’ll get with the unit manager and provide documentation to help them help themselves.


Figlioli: I review user surveys daily, and they’re trending very high – from 4.8 to 5 on a 1-5 scale. Before the walkthroughs, we’d get 3’s and 2’s.

Karras: We also track ticket counts, and that number has dropped, with a very significant decline in the number of urgent tickets. And when you consider that we’re servicing twice the number of devices, that’s remarkable. We used to get a lot of tickets during off-hours, which involves getting people out of bed at 2 a.m. or 3 a.m. to fix the problem. That has dropped down to a very small amount, meaning less overtime costs. Add that up, and it translates into major savings for our client.


Callan: We get a lot of positive feedback from our customers, especially when we empower them to help themselves. Not only does that help reduce help desk calls, but they are genuinely pleased to learn something they didn’t know before. It’s gratifying for us that they’re happier,  which makes us happier.

Bugarin: Our users address our field engineers by name because they know them. I’ll get feedback from managers and directors who tell me how appreciative they are that their particular engineer can always be counted on to be available and helpful. They’re familiar with us and just glad to know that the support is going to be there.

Sparks: Our field engineers are there to help everyone, so I will hear from three levels of management up that they know and appreciate their efforts and effectiveness.


Karras: Besides satisfying users and reducing costs, we’ve also improved the customer service reputation and image of the IT department. We’re not hidden behind some wall anymore.

We’re not just an email address or a voice on the phone. They see and know our faces. They know we care and that we’re available.

I believe that’s why our satisfaction ratings have gone way up. It’s not that we did a bad job before. Looking back, some of the tickets that were classified by the user as urgent in the past may not really have been so. It’s just that without the personal connection, service and attention, the frustration levels rose more quickly. When you sum it up, it’s about communication.

Bugarin: Another benefit is the shared learning and the improved ability to spot and address trends. One of the requirements of field engineers is that they report to their senior leadership of that area what their findings were, and they also share it with the team, so if anyone else goes to that area, they’re familiar with what issues have arisen so they can recognize trends. It’s a constant flow of communication between the field engineer and the rest of the team.


Proactive walkthroughs are an investment, but they can reduce help desk tickets, lower overall costs, satisfy users and enhance the reputation of IT in your organization. Key to the success of such an effort is a strong support system that includes a process, a schedule, objectives, team communications, and importantly, technology that enables field engineers to be efficient and effective.