1. How to find the RIGHT Information Technology Professional (IT NERD!)
MGMA
2007 Annual Conference
Presented by:
Nancy Babbitt, FACMPE

2. Learning Objectives: You will be able to….
Assess your practice’s needs for IT support
Design checklists for selecting your own IT professional or evaluating outside IT help

3. Program outline Evaluate Needs
Important Characteristics - IT Professionals
Pro’s and Con’s
In House
Out Sourced
Checklists
Lessons Learned

4. Evaluating Needs Are you spending your IT budget wisely?
Are you getting the best value for your IT dollar?
Do you know what your Network Engineer is doing?
Can you check the quality of their work?
Rely on their advice for capital expenditures and ongoing mo costs add up!

5. What would be the impact…
If you could leverage your existing computer network to:
Make you more competitive?
Meet patient demands?
Increase communications?
Make your employees more productive and self-sufficient?
Automate your manual processes?
Streamline operations among partners and vendors?

6. 4 Case Studies Compare Your Practice

7. Keith Lynn, CEO, Augusta ENT PC
“The new era of medical practice management via electronic interfaces has required managers to rethink our personnel needs for the success of the practice. The understanding of firewalls, , viruses, and the multitude of regulations guarding the protection of patient information can be overwhelming. Just as the practice hires a nurse, billing person or a receptionist, each has special skills that contribute to the overall success of the practice.

8. Quote Continued…
In the day to day operation I must have all of my computers up and running and someone to maintain it.
I started with 3 doctors, hired an IT person at 4 doctors and have 11 today with over 150 computers and 7 servers. The IT person typically can do more than work on computers, they could also be your trainer, etc. The technical schools are a good resource for locating a potential employee, cost $20,000-$25,000.”

9. IT Support Costs -w/EHR’s
Roswell Pediatric Center, P.C., 9 servers,
105 workstations, 35 printers/ scanners, VOIP, 20+ remote users
Internal support:
IT Assistant each of 3 locations, .33 FTE
Supervisor of Information Systems, .50 FTE
Total 1.50 FTE internal IT support staff
Average Monthly cost $ 2, for Outside IT support for the last 5 years
One bad experience and our costs doubled in 6 months!
IT Assistant and Supervisor of IS Job Descriptions in Attachments

11. Susan Smith, PNP Supervisor of Information Systems Roswell Pediatric Center, P.C.

12. Davies Ambulatory Care Winner 1 FTE Physician - 4200 Annual Visit
Costs
Initial
Ongoing
EMR Software
$ 1,500 per doc
$300 per doc, per yr includes technical support and all upgrades
Hardware
$ 10,000
$ 1,500 per yr
Installation
$ 500
$ 500 per yr
Implementation
Support
Part of
Licensing
$ 1,200 per yr
Maintenance of computers and software other than EMR.
Interfaces
$ 2,000

13. Davies Ambulatory Care Winner 23 FTE Physicians – 12 FTE Mid-Level 263,000 Annual Visits – Multi Specialty
30 Servers, 5 locations, EMR also connected to the Hospitals, Nursing Homes, Physical Therapy, Hospice, and Home Health.
IT Department has 5.5 FTE, annual operating budget is $400,000.
Capital acquisitions for hardware and depreciable items, without additional location expansion, range between $150,000-$200,00 annually.

14. What’s right for your practice?
Outsourcing??
Hiring Your Own IT Professional??

15. Physician EHR Purchase Rate
TEPR 2007, Ambulatory Care Market Trends

16. IT SUPPORT COSTS $$$$ Occupation Title Mean Hourly Mean Annual $20.86
Computer Support Specialists
$20.86
$ 43,380
Network and Computer Systems Administrators
$30.39
$ 63,210
Computer Software Engineers, Systems Software
$40.54
$ 84,310
Source: Bureau of Labor Statistics

17. Competition Increasing
Identify staff with an interest and skills
Train in the basics
Some skills can be learned by following around the professionals
Some skills require certified training
Options: Local Colleges/Technical Schools, Microsoft training programs,
Microsoft server classes – 2 days, $1,000.00
PC troubleshooting
Repairing Printers and Scanners

18. Whatever your choice???? How Do You Know They Know Their Business…
Protect Your Practice
Whether you stay in house or go looking for a company outside your practice here are some things you need to know, Learn from my mistakes

19. No Professional Organization Membership/Education- Just For IT Professionals.
Polling organizations (Big Companies)
KLAS survey reports, Full IT Outsourcing Study 2005
Dunn and Bradstreet, Customer Satisfaction
Magazine/Newspaper sources

20. Examples of Companies of Excellence….
Top rated D & B customer satisfaction surveys
Starting November of 2003, Dun and Bradstreet conducted a Customer Satisfaction/Past Performance Evaluation of our customers. On a scale of 1 to 5 (1 being the best), TENCorp customers rated their satisfaction levels with the Company to be 1.03.
This evaluation was commissioned by the Commonwealth of Massachusetts for contract ITC16 and was rated as best of all companies surveyed!
TENCorp has continued to provide this high level of service winning the highest rating in 2004, 2005, and 2006.

21. Magazine Article
Industry praise for GreenPages merger, CRN, the IT industry's most recognized magazine highlighted the customer and service benefits of the TENCorp / GreenPages transaction.
The article highlighted the additional customer support, competitive pricing, and expanded coverage as major benefits for customers

22. HIMSS – Healthcare Information Management System Society
Is the healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare. HIMSS represents more than 20,000 individual members and over 300 corporate members. HIMSS frames and leads healthcare public policy and industry practices through its advocacy, educational and professional development initiatives designed to promote information and management systems’ contributions to ensuring quality patient care.
Annual Dues $140.00, local chapter only $30.00
Excellent Annual Conference for IT Professionals

23. CIO - Boot Camp College of Healthcare Information Management Executives, CHIME
The Healthcare CIO, Chief Information Officer, Boot Camp is built around a research-based model of CIO success pioneered by CHIME, called the CIO Success Factors. The CIO Success Factor model is founded on seven critical and developable skills that study showed are inherent in successful healthcare CIOs.
Combining presentations, small group discussions, case-study, mentoring, and interactive problem solving, the Healthcare CIO Boot Camp’s learning methodology is practical, personal, and uniquely tailored to the needs of the participants.
3 days, Registration cost $2,995.00, limited to 40

24. Argument Can Be Made… Can you find the perfect in house person?
That can provide the same benefits?
Not all of us have access to big companies with good ratings our experience started out good, grew too fast we got left behind

25. College Degree – Important?
Intern - Pursuing bachelors in computer science or a related field, experience with Microsoft operating systems and basic PC configuration and repair.
Network Engineer - BA/BS, 1 year experience supporting Microsoft desktops and networks.
Associate Network Engineer - BA/BS, 3+ years experience including server administration.
Senior Network Engineer - BA/BS, 7+ years experience including servers, routers, network planning, project management.
Software Engineer - all levels, Visual Basic, VB.NET, Visual Studio, SQL Server, ASP.NET

26. Sample Job Description
Successful candidate will be part of an experienced team of professionals providing IT services to Georgia businesses. Must have experience in the following: Networking, systems, Firewalls, VPN, System Administration, Active Directory, and all aspects of PC support. MUST have the following: 3+ years exp. Ability to troubleshoot IT problems. Organized and detail oriented; Good communications skills; Proven experience interacting with clients. Prefer: 5+ years exp., MSCE or UNIX exp. This is NOT an entry-level position Salary history must be provided. Please send resume and cover letter to:

27. Typical Job Ad for IT Professional by an IT Firm -Benefits
We offer a full compliment of top notch benefits including: highly competitive salary, performance-based bonus program, health care benefits, dental, vision, life insurance, disability insurance, 401K plan,  medical expense account, ongoing technical training and Microsoft Certification. 

28. COMMUNICATION IS KEY!
English Language -- Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. Telecommunications -- Knowledge of transmission, broadcasting, switching, control, and operation of telecommunications systems. Mathematics -- Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications. Oral Expression -- The ability to communicate information and ideas in speaking so others will understand. Deductive Reasoning -- The ability to apply general rules to specific problems to produce answers that make sense. Written Comprehension -- The ability to read and understand information and ideas presented in writing. Oral Comprehension -- The ability to listen to and understand information and ideas presented through spoken words and sentences. Problem Sensitivity -- The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
Complete Computer Specialist Job Description in the Attachments

29. Can Your Company Offer This?
Do you want a job... or a career?  At Healthcare IT Nerds you'll have a career path to higher value skills and compensation.  You'll learn valuable skills like how to manage clients and projects.  Because we are growing at a rate of 50% a year,  you'll have the  opportunity to advance along both technical and management tracks.

30. Benefit Offered by an IT Firm
As part of our commitment to providing an optimal work/life balance to our employees, Healthcare IT Nerds’ provides onsite childcare as one of our many benefits. Our goal at the center is to provide the highest quality childcare in a safe, respectful and nurturing environment in which children can develop the life skills, habits and ideas needed to grow successfully in the world.

31. Company Experience: Availability, mission critical products
HIPAA Compliance / Disaster Recovery
Healthcare Workflow
Healthcare software
Practice Management Systems, Document Imaging Software
VOIP, Computer based telephones
Electronic Health Records
Interfaces, Spyware, Firewalls, Home and Remote Users
Hard to find a company with HC experience, banking, government, law firms

32. What to expect in your relationship?
Technical Expertise and Communication
Awareness of Budget and Resources
An advocate to cut through product hype and maximize performance
Long term planner, implementer, and strategists.

33. Expectations Continued…
Proactive industry watcher
Keen ability to troubleshoot and solve problems.
Provide scheduled upkeep of networked systems, security policies, back up and virus protection systems, and preventative maintenance.
Be INTERESTED IN YOUR COMPANY’S “IT NEEDS”!

34. Outsourcing Can Provide….
Access to high level skills when needed, while paying a reduced rate for help desk and repair services.
A business person who uses technology in a cost effective manner to solve business problems.
Help determine if a company is using their current technology to it’s fullest capacity and show how to maximize the products it already owns.

35. Outsourcing Continued…
Help during implementations and upgrades
Strategic Insight into how new solutions and technologies can reduce cost and streamline operations.
Provide fast, cost effective emergency response when problems cannot be avoided.

36. Pro’s to Outsourcing
Combined Expertise rather than relying on one individual
Defined Process make IT costs and performance more predictable an dependable
Track and Manage with sophisticated software

37. Con’s To Outsourcing Their priorities may not be your priorities
Access depends on how much you pay
Too many fingers in the pie, with the BIG team approach

38. Pro’s To Hiring Your Own
Responsible only to your company
On site all the time, reduces cost in lost productivity
If you are completely down
Repairs to workstations, printers, etc.
Reinstalling programs
Re-entering lost data
Can do other job responsibilities, training new hires, etc.

39. Con’s to hiring your own…
Hard to keep the good ones
Competing with the job market
High Salaries
Excellent and Unique Benefits
No place to move up to, stagnant position, unless your company is growing significantly
Some are very specialized, may know Windows NT but not Backup Software

40. How to find the RIGHT company !

41. Company Checklist How long has your company been in business?
How many contract clients do you support on a monthly basis or annual basis?
What size clients do you currently support?
Do you currently support any Healthcare clients? Contact information for references.
What is your current client retention rate?
Who in here has a friend who is a computer specialist who fixes things for them on the side? Even if hiring individual – some moonlight

42. Company Checklist continued…
How many full time computer engineers do you have?
What is their education level?
What is the highest education level?
What is the lowest education level?
What certifications do you require?
What is your average turn over rate for employees?
How are new employees trained?

43. Company Checklist continued…
Are individual technicians assigned to clients or a team?
What incentives or procedures do you have in place for technicians to:
Reduce return calls or multiple trips
Lower the amount of billable time
Document procedures including problem resolution
Provide polite and courteous services to end users

44. Company Checklist continued…
Does your company guarantee response times to calls?
Describe those guarantees and the metrics used to derive them.
How are requests and problems handled and processed?
What is the average resolution time among open tickets?

45. Company Checklist continued…
Is their a difference between critical and non critical calls?
What is your definition of a critical and non critical call?
How are our charges billed?
Describe your companies use of remote diagnostics and remote service?

46. Company Checklist continued…
What are your normal hours of operation? Is service support available outside of those hours?
Do you require a signed contract? If yes, please provide a blank contract to review the terms.
Do you require a minimum length of commitment to a maintenance contract, 1 year, 2 year, 3 years ?

47. Company Checklist continued…
Do your technicians have experience with _____? Fill in your major software programs names here, and include all of your back up software, connectivity hardware, special operating systems (UNIX), VOIP, etc.
Does your company have experience with HIPAA Privacy and Security standards?
Does your company have the ability to customize and implement a disaster recovery program for our company?

48. Company Checklist continued…
When an employee of yours is terminated, how do you ensure they will no longer be able to access OUR network?
Do you guarantee return of our companies keys and personal property within 24 hours of discharge?
What proactive measures do you take to ensure up time?
What resources do you have available for clients to track and measure your performance?
Do you provide visibility into your process, if yes, how?

49. Company Checklist continued…
What resources do you have available to clients to track their IT budget?
How are services charged and what is the charge? An agreed upon “maintenance contract” or only charged for used hours?
In a maintenance contract, can unused hours be rolled over?
If extra hours are needed for upgrades is there a charge?

50. Individual Checklist
How long have you been a Professional IT Support person?
How many clients have you had in the past?
What size clients have you supported?
Have you supported any Healthcare clients? Contact information for references.
Why did you leave your prior jobs?
Who in here has a friend who is a computer specialist who fixes things for them on the side? Even if hiring individual – some moonlight

51. Individual Checklist continued…
What is your
education level?
What certifications
do you have?
Do you have experience documenting procedures including problem resolution
Can you provide polite and courteous services to end users?

52. Individual Checklist continued…
Will you be willing to ask for help in an area that is not your specialty?
Will you commit to keeping our computers running 24/7?
How will you handle, process, and prioritize requests?
What would you estimate your average ticket resolution time to be?
Will you be able to access our system remotely? If yes, what expenses would you expect our company to pay for you?

53. Individual Checklist continued…
Do you have experience with _____? Fill in your major software programs names here, and include all of your back up software, connectivity hardware, special operating systems (UNIX), VOIP, etc.
Does you have experience with HIPAA Privacy and Security standards?
Does you have the ability to customize and implement a disaster recovery program for our company?

54. Individual Checklist continued…
Do you have experience working with and tracking an IT budget?
What proactive measures do you take to ensure up time?
What resources do you have available for us to track and measure your performance?
Do you provide visibility into your process, if yes, how?

55. Employment – IT Professional
Employment agreement
90 day notice
Confidentiality clause
2-3 year term
Termination clause, withhold $ for return of keys and physical property
Defined Productivity and/or hours
Are you going to pay hourly with overtime or salaried.

56. General Guidelines Security Sweeps / Intrusion Testing
Pay another company to try to break into your system
Do tell your IT Professional you will be hiring another company to perform a Security Sweep annually, more often if problems are identified.
Do NOT tell your IT Professional when the other company will be performing the Security Sweep
Average Cost: $ per IP Address

57. Are you on the same page?
Technology, a tool for increased productivity
Not a bottomless hole through which money flows
Who has control?

59. Measures For Success
Hire through a network of qualified sources – list serves, same software, IPA, Hospital reference.
Have trial or test period for days
Communication Skills, Communication Skills, Communication Skills
Beware the Used Car Salesman
Don’t be afraid to get a 2nd opinion
People soft recruiter, small world, usually someone knows someone who knows or worked with the candidate
Geek Squad Example – inappropriate pictures in the bathroom with cell phone camera
Access to confidential data and can cripple your business
Can not give you the answer, small to medium groups use outside support for expertise and train as much as you can in house. Larger practices hire your own, they are usually more reliable and accountable.

60. Attachments Roswell Pediatric Center, P.C. - Job Descriptions
IT Assistant –each location
Supervisor of Information Systems
Job Description Computer Support Specialists
Sample Outside IT Contract