Many, if not most hospitals have accepted the necessity of incorporating a dedicated Service Desk within their IT operations. With the complexity of new EHRs and other systems required in healthcare delivery today, “spare time” haphazard help from already over-burdened IT analysts is not enough to satisfy physicians and other users. Meaningful Use has dramatically increased the need for more support, including faster response and round-the-clock availability.

Service Desk operations, if not managed properly, can become alarmingly expensive. At least three cost factors must be understood to budget for the total cost of all services provided by your Service Desk, and to make sure it is cost effective.

To understand what your hospital is actually spending on its Service Desk operations, the first step is to recognize and consider some important differentiations between:

• Immediate or “obvious” costs
• Frequently overlooked and less direct costs
• Indirect “hidden” costs

Obvious Costs of Service Desk

Salaries of Service Desk Staff: These costs include salaries plus fringe benefits. For most purposes, using the hospital-wide average benefit cost as a percentage of salary is a suitable approach.

Software Purchases: Ticket management typically is the most common expenditure. Exact pricing varies widely by vendor. If software is purchased as a one-time expenditure, it may be amortized over the estimated life of the software.

Software Maintenance: Usually a one-time annual cost associated with the ticket management software, this expenditure may be amortized over a twelve-month budget.

Hardware Purchases: Hardware will include desktops, laptops, monitors, servers, and telecommunication equipment. Don’t forget “small” items like headphones and mice, which have to be replaced frequently in a very busy service group. Service Desks put technology equipment to hard use; to provide responsive support, agents’ equipment must be in tip top shape.

Communications Costs: This includes phone service and internet costs. If other paid services such as remote hands-on troubleshooting, conferencing, etc. are used, these costs should be included.

Frequently Overlooked Costs

On-call and Overtime Pay: Many hospitals, particularly small ones, do not have a staffed Service Desk after normal business hours, e.g. night and evening shifts. In these situations, IT service requests frequently must be handled by on-site or on-call analyst staff. Such staff, who are more highly paid (usually) than Service Desk staff, are paid a premium, either in the form of overtime, or on-call pay.  If Service Desk staff are put on-call at home, they are typically paid some form of overtime or on-call premium — which must be budgeted and reported as incurred.

Furniture and Equipment: Depending on hospital policy, this is a capital expenditure. Many hospitals do not budget or report depreciation of furniture and equipment at the department level or in sufficient detail to impact Service Desk cost reports. To understood true costs, they should.  Service Desk staff tend to put their small, immediate environs to hard use. It is common that furniture, carpeting, and other office items must be replaced more frequently than in departments that get less constant wear and tear.

Space or Rental Costs: In many analyses, space costs are ignored or taken for granted. Most hospitals are short on space and in many cases rent space off-site. The space taken by the Service Desk is a real cost, and could be used by other hospital functions which may directly, or indirectly, cause the hospital to incur additional space costs.

Utilities: Electrical, heating, or air conditioning costs are frequently not considered or reported as part of departmental costs. Service Desks commonly require additional air conditioning, because of the large concentration of staff and equipment located in a relatively small space. This can be surprisingly expensive.

Training: Initial new hire training costs and ongoing training of Service Desk agents are necessary for high productivity and quality performance. Some of the costs may be direct, based on labor costs.  Insufficient training can create less obvious costs, in terms of unmet SLAs. Certifications, such as ITIL (Information Technology Infrastructure Library) are often required of key staff; the necessary training (usually externally-sourced), and actual certification costs should be calculated.

Recruiting: Turnover is often higher in Service Desks than some other departments, partially because the agent’s job is an entry-level position, or close. Experienced healthcare Service Desk agents also are increasingly in demand. Managers must expect that a certain level of turnover, as well as expansion of operations, will require recruitment of additional Service Desk agents and supervisory staff. These efforts are normally made by the HR Department without a direct allocation to the IT department. However, if a search firm is used, these costs are identifiable and should be covered in Service Desk costs.

The Hidden Costs of Inappropriate Problem Management

Self-Solution: It is normal human behavior for a hospital staff member to try to resolve his/her problem before seeking help. However, frequent and/or lengthy attempts at self-solution are costly — and also may be a signal that users have do not have confidence that Service Desk will solve the problem quickly and well.

Involvement of Other IT Staff: IT staff, other than the Service Desk, often become unnecessarily involved in problem resolution. Many users have their favorite “go to” people among the IT analyst staff, or even within IT leadership. When users  contact these favorites instead of the Service Desk, costs go up.  Analysts’ and CIOs’ salaries are substantially higher than Service Desk agent salaries. The above-described behaviors result in an unnecessarily high problem resolution cost, particularly if the problem would not have merited eventual analyst intervention.

Involvement of Other Hospital Staff: Co-workers of hospital staff, other than IT staff, are often pulled into IT problem resolution by a frustrated user. This can be a formal or informal approach. On the formal side, many hospitals designate “super users” who are trained for problem resolution. This role is usually accommodated within budgets. On the informal side, hospital staff may identify co-workers as system savvy and consult them for problem resolution. These individuals typically have a higher salary cost than Service Desk agents, and their time “helping” is most likely not budgeted and a hidden cost to the hospital.

These hidden costs and their impact on the bottom line are illustrated in the diagram below:

Poor Usage of Service Desk Technology: Too many hospitals purchase expensive software without utilizing modules or capabilities that directly impact the Service Desk’s performance and/or costs. This occurs when Service Desk leaders do not have a mandate to optimize their usage of the software, or they don’t understand how to work these features to their advantage. To do so, they must  complete needed training, utilize strong vendor support, and take the time for new process set up and management.

Many hospitals are impacted by the costs listed above, whether they know it or not. We recommend that you perform an analysis of your operations costs to learn exactly where your dollars are going. Many hospitals that have completed such cost analyses have discovered internal solutions to reducing costs. Many, as a result,  have decided to outsource their Service Desk  operations for cost savings, consistent quality and round-the-clock accessibility.

Download our Cost Estimation for Hospital Service Desk Operations report for detailed instructions and examples to guide your assessment and analysis of costs.

For information to consider outsourcing your Service Desk or Patient Portal Service Support, please contact us. We can help save service costs because we leverage our dedicated on-shore Service Desk team across many hospitals 24X7X365.