2. McKesson AMS Division – Interview of the Past, Present and Future for Employee Education Crystal Schleicher MSM 620

3. Who is McKesson  McKesson Corp. is one of the largest providers of medicines, pharmaceutical supplies and health information technology (IT) products and services in the United Stateshealth information technology (IT)  McKesson Technology Solutions develops and installs health IT systems for hospitals, physician offices, imaging centers, home health care agencies and payors. These systems include pharmacy and nursing automation, practice management, electronic health record systems, clinical decision support systems and secure online health care communication. electronic health record Reference: Rein, C. (2013, June 14). Personal interview 2

4. Interview of McKesson Division  Application Managed Services (AMS) ─ A team of 50+ FTE that specialize in the application support of the different IT Healthcare system offerings ─ The team was started in 2001 as a product offering for hospitals struggling to hire IT support staff Reference: Rein, C. (2013, June 14). Personal interview 3

5. Interview with an Orginial Manager  Crystal Rein ─ One of the founding managers for this division ─ Prior experience included 25 years managing other divisions in the company ─ Opportunity to develop new division was great last treat before retirement in 2011 Reference: Rein, C. (2013, June 14). Personal interview 4

6. History of AMS  AMS Beginnings ─ 10 FTE employees ─ 13 Software offerings supported ─ 3 Hospital clients Reference: Rein, C. (2013, June 14). Personal interview 5

7. History of AMS  Strengths in the Beginnings ─ “Everybody knew your name…We didn’t get lost in the big corporate world but did our jobs to keep the customer happy for once” ─ Very customer centric environment ─ Few department policies and procedures to communicate Reference: Rein, C. (2013, June 14). Personal interview 6

8. History of AMS  Weakness of the Beginning ─ No Standardization ─ No On-boarding tasks ─ No incorporation to large organization Reference: Rein, C. (2013, June 14). Personal interview 7

9. Present Standings in AMS  Tasks to get to the current state: ─ Develop on-boarding check list ─ Develop welcome power point presentation ─ Development of SharePoint site to store this documentation Reference: Rein, C. (2013, June 14). Personal interview 8

10. Application Management Services *AMS* New Employee Introduction Prepared by Your Leadership Team (John, Denise, Donald, Nicole and Petra)

11. Agenda  AMS Concepts  Where You Fit In  Our Customers  Our Work  Summary  Q & A Reference: Rein, C. (2013, June 14). Personal interview 10

12. CONCEPTS APPLICATION MANAGEMENT SERVICES Reference: Rein, C. (2013, June 14). Personal interview 11

13. Concepts AMS In a Nutshell… Application Management Services Reference: Rein, C. (2013, June 14). Personal interview 12 Application Management Services (AMS) was previously known as COE A Service offering to assist the customer in Management of their McKesson Applications during day to day operations.

14. Concepts Mission, Vision, and Goals Mission To provide quality, cost-effective, innovative, scalable and flexible services related to the support and maintenance of McKesson applications Vision To be the preferred support vendor recognized as a customer-centric team focused on quality, proactive support and maintenance of McKesson applications Goal To be recognized as a customer-centric business unit with a focus on the McKesson ICARE Shared principles: Integrity, Customer-First, Accountability, Respect and Excellence. 13 Reference: Rein, C. (2013, June 14). Personal interview

15. Concepts Values Integrity I do what’s right. Customer-first I succeed when my customers succeed. Accountability I take personal responsibility and expect the same in return. Respect I treat people with dignity and consideration. Excellence I insist upon quality. 14 Reference: Rein, C. (2013, June 14). Personal interview

16. WHERE YOU FIT IN APPLICATION MANAGEMENT SERVICES Reference: Rein, C. (2013, June 14). Personal interview 15

17. 16 As of January 1, 2011 Where You Fit In McKesson Reference: Rein, C. (2013, June 14). Personal interview

18. Where You Fit In Managed Services Offerings 17 Reference: Rein, C. (2013, June 14). Personal interview

19. John Anderson Director, SystemCare Support John Fox Director, Application Management Services Tandra Wiley Director, Call Center 18 Nancy Cunningham Vice President, Services Where We Fit In Managed Services Support Bill Kloes President, Managed Services Todd Alley Vice President, Development and Customer Support Ray Pierce Director, Professional Services (Accelerated) Sheila Middleswart Manager, EIA Services Tiffany Egenes Mgr Engineering Services Reference: Rein, C. (2013, June 14). Personal interview

20. Donald Cox Operations (Triage / QA) Paragon Ancillary Clinicals* PWIM Denise Everett Revenue Cycle Project / Account Management HLAB / HBB HPF / HBF / ILE Nicole Harbin Horizon Core Clinicals Horizon Physician Portal Technical Application 19 John Fox Director Application Management Services Where We Fit In AMS Leadership Reference: Rein, C. (2013, June 14). Personal interview

21. AMAM Horizon Core Clinical Technical HLab / Star Lab / HBB HSM / PHS / MAC HMM / Paragon Pharmacy HPF/HBF PWIM / Interface MRM Core Revenue Cycle Paragon Revenue Cycle Paragon Clinical Reference: Rein, C. (2013, June 14). Personal interview 20 Where You Fit In AMS Functional Groups

22. OUR CUSTOMERS APPLICATION MANAGEMENT SERVICES Reference: Rein, C. (2013, June 14). Personal interview 21

23. AMS remotely backs up on-site staff that are McKesson employees IT Outsourcing (ITO) Supplement the facilities' own on-site IT staff AMS Supports 26 sites with 40 facilities today. AMS only Reference: Rein, C. (2013, June 14). Personal interview 22 Our Customers Services

24. INOVA LOUDOUN FAIRFIELD MEDICAL CENTER CHILDREN’S LA ST. JOSEPH’S CATSKILL REGIONAL GOOD SAMARITIAN COOKEVILLE REGIONAL NASHVILLE GENERAL BAPTIST PENSACOLA COMANCHE COUNTY WHIDBEY GENERAL LAKESIDE HEALTHCARE LIBERTY HEALTHCARE MEMORIAL LUFKIN MERCY IOWA PROVIDENCE OREGON 7 facilities RESURRECTION HEALTH 9 facilities ST. ANTHONY’S TROVER ITO with AMS AMS Our Customers Install Base 23 Reference: Rein, C. (2013, June 14). Personal interview

25. OUR WORK APPLICATION MANAGEMENT SERVICES Reference: Rein, C. (2013, June 14). Personal interview 24

26. Provide support, maintenance and management of McKesson Applications 24 x 7 x 365 Productive Use Support Level 2 Support (Application Expertise) Ticket ownership through resolution Proactive Application Monitoring and Alerts Routine Application Patching Application Build modifications Reports creation/modifications Reference: Rein, C. (2013, June 14). Personal interview 25 Our Work Overview

27.  Remotely supplement or fulfill the role of the hospital IT department level 2 application support analysts  Customers still have full maintenance and support contracts for their systems with the product Vendor  AMS Does not Replace tier 3 support (National Support) Reference: Rein, C. (2013, June 14). Personal interview 26 Our Work Key Points

28.  Tier 1 - Help Desk services ─ Fields incoming calls from end users ─ Provide low level troubleshooting - handles "low lying fruit" such as Installing printers, resetting passwords, zapping STAR jobs, ending a hung Citrix session  Tier 2 - Application experts ─ Usually provided by hospital employed IT staff ─ Troubleshoot and correct issues with the application.  Tier 3 ─ Product group (Vendor) support ─ Most in-depth knowledge and understand of how application works Reference: Rein, C. (2013, June 14). Personal interview 27 Our Work Support Levels

29. Customer Solution Center/ CSC Helpdesk AMS Triage Analyst AMS Application Analyst(s) SystemCare McKesson National Support Our Work Life Cycle of a Ticket 28 Reference: Rein, C. (2013, June 14). Personal interview

30.  All work requires a Unicenter ticket or Change Order  Problem Tickets ─ Reactive break-fix ─ “This was working but now it’s not”  Change Orders (formerly Service Requests) ─ Proactive application maintenance or build modifications Reference: Rein, C. (2013, June 14). Personal interview 29 Our Work Productivity

31. Severity 1 Critical urgent issues Impact to whole departments Major System Unavailable (“System Down”) Severity 2 A medium urgency issue that affects multiple users A high urgency issue impacting a single user Impacts patient care and financial viability Severity 3 Low urgency issues Issues for which an alternative solution or work around exists May be inconvenient but do not result in a complete disruption of work Our Work Problem Ticket Severities 30 Reference: Rein, C. (2013, June 14). Personal interview

32.  Criteria ─ Critical urgency issues ─ Impact to whole departments ─ Prevents users from performing job functions ─ Adversely impacts the delivery of patient care  Examples ─ Major System Unavailable (“System Down”)  Warm Hand-off required  Bridge Line / Admin Notification  Initial response < 15 minutes (standard business hours) < 30 minutes (after business hours / weekends)  Target Resolution < 4 hours (standard business hours) < 4 hours (after business hours / weekends) 31 Our Work Severity Level 1 SLA’s Reference: Rein, C. (2013, June 14). Personal interview

33.  Criteria ─ A medium urgency issue that affects multiple users ─ A high urgency issue impacting a single user  Examples ─ System Performance Issues ─ Multiple Equipment or Software Malfunctions – Affecting Patient Care ─ Patient unavailable in clinical systems  Warm Hand-off required  Initial response ─ < 1 hour (standard business hours) ─ < 2 hours (after business hours / weekends)  Target Resolution ─ < 8 hours (standard business hours) ─ < 24 hours (after business hours / weekends) 32 Our Work Severity Level 2 SLA’s Reference: Rein, C. (2013, June 14). Personal interview

34.  Criteria ─ Low urgency issues ─ Issues for which an alternative solution or work around exists ─ May be inconvenient but do not result in a complete disruption of work  Examples ─ Difficulty with Computer Produced Reports ─ Single User Equipment or Software Malfunction  Tickets addressed during Business Hours only  Initial response ─ < 24 hours (standard business hours) ─ Next business day (after business hours / weekends)  Target Resolution ─ < 5 days (standard business hours) ─ < 5 days (after business hours / weekends) 33 Our Work Severity Level 3 SLA’s Reference: Rein, C. (2013, June 14). Personal interview

35.  In Scope ─ Table modification ─ Maintenance (ex. FDB updates, STI/ESD Moves) ─ Max 40 hours of work; less than 1 month in duration  Out of Scope ─ Enhancements requiring design work ─ Application customizations or code changes ─ Requests requiring Product Development Reference: Rein, C. (2013, June 14). Personal interview 34 Our Work Service Requests

36.  Acknowledged within 8 business hours  The start date and end date (“Due Date”) to be agreed upon  Change control process by customer Reference: Rein, C. (2013, June 14). Personal interview 35 Our Work Service Request SLA’s

37. SUMMARY APPLICATION MANAGEMENT SERVICES Reference: Rein, C. (2013, June 14). Personal interview 36

38. Summary  AMS Concepts ─ Assist the customer in Support and Maintenance of McKesson Applications ─ Customer Centric ─ ICARE Principles Reference: Rein, C. (2013, June 14). Personal interview 37

39. Summary  Where You Fit In ─ Support Organization within Managed Services ─ McKesson Provider Technologies (MPT) ─ McKesson Technology Solutions Reference: Rein, C. (2013, June 14). Personal interview 38

40. Summary  Our Work ─ Remotely function as level 2 application support analysts ─ Do not Replace tier 3 support (National Support) ─ Support Applications in Production (Live) ─ All work requires a ticket ─ Primary tool is CA Service Desk Manager Reference: Rein, C. (2013, June 14). Personal interview 39

41. Questions?? 40 Reference: Rein, C. (2013, June 14). Personal interview

42. AMS Future  Continue to work on SharePoint  Develop a checklist of educational areas classes can be maintained  Development of mentoring programs/on- boarding buddies Reference: Rein, C. (2013, June 14). Personal interview 41