MHS Service Desk Overview for TRICARE Data Quality Course

1. MHS Service Desk OverviewforTRICARE Data Quality Course March 4, 2010

2. Purpose • Information briefing: • Provide overview of MHS Service Desk (formerly MHS Help Desk) contract scope and current operation including: • MHS Tier support structure • MHS incident ticket (formerly trouble ticket) process • Performance metrics/call volume • Remedy has replaced ManageNow • Implementation of Information Technology Infrastructure Library (ITIL) processes/methodologies • “Partnering” in data quality efforts

3. Contract Scope • MHS Service Desk provides Tier I and II support (24 x 7 x 365) for 22 MHS systems/applications • CHCS, AHLTA, NMIS, CCQAS, EAS IV, TOL, CCE, TPOCS, DMLSS, DOEHRS-HC/IH/DR, SNPMIS, TMIP, M2, MCFAS, DMHRSi, MHS Learn, Essentris (CIS), PMITS, etc. • + 80 COTS products, devices, interfaces, Service legacies (GEMS, TEWLS, ICDB) • Future: Patient Safety Reporting (PSR), Neurocognitive Assessment Tool (NCAT) • If call does not involve supported application, user helped to “best of our ability” • Broken EUD – trouble ticket passed to maintenance vendor/ organization • B2B Gateway password reset – trouble ticket passed to DISA • TRICARE eligibility question – TOL caller referred to DMDC • Pharmacy Data Transaction Service (PDTS) – call passed to PDTS HD

4. Current Operation • MHS users contact MHS Service Desk with all issues not resolved locally (i.e., at Tier 0 – MTF/site) • Issues normally linked to specific application • After triage, MHS SD resolves issue or escalates ticket • MHS Service Desk resolves 85% of all issues • Technical issues emerge as subset of application problems; are forwarded to Network Operations or Blades Operations Groups • Unresolved issues (15%) include both functional & technical problems • Functional issues are escalated to Tier III (software developer/integrator) • Wide Area Network (WAN)/connectivity issues forwarded to DISA / SPAWAR • Hardware issues, often emerging from technical tickets, forwarded to appropriate vendor • Current business volume (CY09 averages): • 38,527 calls/month (26% increase versus CY08) • 30,137 trouble tickets/month (19% increase over CY08)

5. Call Volume 7. 6. 2. • Oct 01-Nov 03 – Call volume remained in 5-10K call band. • Mar 04 – TOL start-up added 4000 calls per month. • Jan 06 – AHLTA Deployment, post-holiday influx and 2000 additional TOL calls. • Jan 07 – MHS mandatory HIPAA training commenced via MHS Learn. • Sep 07 – Less workdays in Sep than Aug and MHS Learn revised password reset protocol • Jun 08 – 73% increase due to DMHRSI (49%) and AHLTA (24%) increases • Jul – Dec 08 – 65% (6724 to 11084) increase in DMRHSi tickets per month. “Dip” due to less workdays in Nov. 4. 5. 1. 3.

6. MHS Tier Support Structure • Tier 0 – Site support • Systems/database administrator, local information management departments, or local help desk • Tier I – MHS Service Desk • Log problem and create incident ticket • Initial triage/document symptoms • Tier II – MHS Service Desk • Resolve basic/functional issues (subject matter experts) • Includes Network Operations and Blades Operations Groups • Address connectivity/infrastructure issues • Tier III – Software developer or Defense Information Systems Agency (DISA) • Address most complex issues

7. Legend: Both Functional & Technical Issues = Functional Issues (Only) = Technical Issues (Only) = MHS Service Desk Process User Contacts MHS Service Desk Resolved? Yes No further action No Tier 1 creates Incident Ticket in Remedy Tier 1/2 SD resolve? Yes (Functional Issues) No Infrastructure issue? Escalate to (or created by) Tier 3 (SW Developer) for resolution MHS Service Desk Contract Scope No Yes (Functional Issues – SIRs & SCRs) Escalate to Network Operations or Blades Operations Groups for resolution Resolved? Yes No Ticket closed in Remedy Escalate to DISA, SPAWAR, etc. for resolution Email originator

8. Incident Ticket Closure(since 19 July 09) • For all MHS support organizations (Tiers I, II or III): • When Remedy incident ticket is placed in a “resolved” status, e-mail notification with resolution summary is automatically sent to incident requestor • Requestor has five days to respond if they non-concur • Incident is automatically moved into “closed” status unless incident requestor non-concurs (via e-mail or phone) • Customer satisfaction surveys activated in Dec 09 • Generated when incidents are closed • Currently limited to one survey per originator per week

9. Incentivized Performance Metrics(Oct 08 – Sep 09) Green = PositiveYellow = AcceptableRed = Negative White = No payment

10. “Top 5” MHS Systems (Jul 09 – Sep 09) 3rd Quarter in comparison to 2nd Quarter: DMHRSI increased from 32126 (1.5%), IAS increased from 6098 (54%), AHLTA decreased from 14551 (36%), TOL decreased from 8260 (1.7%), and MHS LEARN decreased from 9331 (15.75%).

11. Future • Using Remedy, implementation of Information Technology Infrastructure Library (ITIL) framework/processes • Commercially accepted best business process for IT service management • Phased Remedy Information Technology Service Management (ITSM) version 7.x Implementation: • Jul 09: Incident Management implemented • Replaced vendor proprietary tool (ManageNow) as enterprise trouble ticket management tool • Sep 09: Problem Management implemented • Nov 09: Change Management implemented • External business processes must be developed before tool functionality can be fully leveraged • Apr 10: Configuration Management Database (CMDB), Asset Management and Knowledge Management Modules will be implemented • Remedy is Government Furnished Equipment (GFE), hosted by TIMPO • Users must have DoD Common Access Card (CAC)

12. “Partnering” • MHS Service Desk supports the applications that code encounters, create third party bills and document MTF workload • TPOCS, CCE, ADM, CHCS, EAS IV, AHLTA, etc. • We support TMA data quality improvement efforts • MHS Service Desk will assist in every way possible

13. Backup Information

14. Contact Information • MHS Service Desk: • Telephone toll free (1-800-600-9332)(CONUS) or by using country access code (OCONUS) • Fax: (210) 338-3435 • E-mail (for questions): mhssc@timpo.osd.mil • To request incident: https://mhssc.timpo.osd.mil

15. ADM – Ambulatory Data Module B2B – Business to Business CCE – Coding and Compliance Editor CCQAS – Centralized Credentials and Quality Assurance System CHCS – Composite Health Care System CIS – Clinical Information System CONUS – Continental United States CSR – Customer Service Representative CUD – Common User Database CY – Calendar Year DISA – Defense Information Systems Agency DMDC – Defense Manpower Data Center DMHRSi – Defense Medical Human Resources System internet DMLSS – Defense Medical Logistics Standard System DOEHRS-HC – Defense Occupational and Environmental Health Readiness System – Hearing Conservation DOEHRS-IH/DR – DOEHRS – Industrial Hygiene/Data Repository EAS IV – Expense Assignment System IV EUD – End User Device GEMS – Global Expeditionary Medical System HD – Help Desk ICDB – Integrated Clinical Database ITIL – Information Technology Infrastructure Library ITSM – Information Technology Service Management ICDB – Integrated Clinical Database M2 – MHS Management Analysis and Reporting Tool MCFAS – Managed Care Forecasting and Analysis System MHS – Military Health System MHS NOC – MHS Network Operations Center MTF – Military Treatment Facility NMIS – Nutritional Management Information System OCONUS – Outside Continental United States PDTS – Pharmacy Data Transaction Service PMITS – Patient Movement Items Tracking System SCR – Software Change Request SIR – System Incident Report SNPMIS – Special Needs Program Management Information System SPAWAR – Space and Naval Warfare Systems Command SW – Software TEWLS – Theater Enterprise-Wide Logistics System TMA – TRICARE Management Activity TMIP – Theater Medical Information Program TOL – TRICARE Online TPOCS – Third Party Outpatient Collection System TRICARE – Tri-Service Health Care Acronym Definitions