Triaging the system
Ballad Health is an integrated community health improvement organisation operating in 29 counties across Tennessee, Virginia, North Carolina and Kentucky. Created by a merger of two healthcare organisations, it boasts a workforce of 13,000, a system of 21 hospitals and post-acute care and behavioural health services serving over one million people.
With so many team members and patients, as well as differing workflows, the organisation decided to adopt ServiceNow as its primary operating platform. The platform was already being used by one of the two pre-merger organisations; however, it had been heavily customised which, in time, caused support and ticket issues as well as challenges with workflows, identity and access management.
"There were multiple domains within Active Directory and none of them were in sync", says Tony Stiltner, ITSM manager at Ballad Health. "Custom workflows created thousands of duplicated tickets. Trying to manage through that and help the access management teams prioritise their work was very difficult. We couldn't even upgrade the application across the board for our new or existing modules".
Ballad Health decided to return to an out-of-the-box ServiceNow solution to gain a healthier foundation set, standardise and automate its key processes and gain a better oversight of its IT operations.
ServiceNow and Ballad Health worked together over one year to completely rebuild the Now Platform and start from scratch before merging and unifying all the systems, processes and work approaches—including IT Service Management, IT Operations Management, Strategic Portfolio Management and IT Asset Management among others—while focusing on ServiceNow Automation Engine to improve processes and workflows.
Healing the workflows
"We had 14,000 open tickets in Identity and Access Management (IAM)", says Morton. "Employees were overwhelmed and discouraged sorting through all the tickets one by one. It was demoralising".
Ballad Health began applying Automation Engine with the Active Directory spoke to its processes and exploring the impact of access management automation. One simple yet powerful solution was to allow for an import file with all the new employee hires to be uploaded into Epic, dramatically reducing the number of tickets that were created by adding employees one by one as they did with the previous process. Prior to ServiceNow, IAM was receiving multiple tickets per new hire depending upon the type of Epic account required.
The accounts were then manually built by analysts. Manual efforts put a strain on hospitals and health systems, which can impact clinical and non-clinical teams. With Automation Engine, the new process has greatly reduced the number of tickets, and thanks to an import template, the analyst can now import the file directly into Epic to reduce manual efforts.
Ballad Health engages a variety of contractors, which range from billing specialists to IT professionals to doctors and nurses. Automation also had a significant impact on the onboarding of those contractors, reducing its length from 186 days to one, and on the process of registering new students. It used to take days to input the up to 300 clinical residents that East Tennessee State University sends to Ballad Health each year. Now it's a simple upload of one spreadsheet.
The process of applying for USB exemption—enabling the by-default disabled USB ports in the organisation's machines—was also automated and shortened the wait time from 451 days to two.
Overall, automation changes have had a huge impact on the organisation and reduced Identity and Access Management (IAM) ticket volume from 10,000 to 300—a reduction of 97%.
It took Ballad Health only one year to completely rebuild and redesign the system and the use of Automation Engine allowed the organisation to drastically simplify its workflows and cut down on escalations. Team members no longer feel overwhelmed and internal customer satisfaction has improved.
"When I first met the team, they were struggling to see the light at the end of the tunnel", says Morton. "To see them thriving is probably the biggest source of pride for me".
A simple chart of the processes
For a clearer view, the Now Platform provides the team with tabs measuring the work queue, analytics around incoming service desk tickets and catalogues of tasks and incidents.
IT metrics provide feedback on performance in service management, incident management, change management, customer engagement, problem reduction and portfolio management. All are easily accessible and clearly organised and the Epic electronic medical records (EMR) integration allows for all the work to be managed in one place across multiple teams.
"We created a dashboard tracking what problems our nurses are reporting", says Morton. "This brings awareness to the most common issues and we can use that as a starting point for further work".
But ServiceNow is also enabling the organisation to focus on providing better services externally. Automated and simplified workflows mean that doctors and nurses can focus on performing their jobs without frustrations and delays.
"ServiceNow allows us to get to the problems more quickly", says Steve Hill, senior director of operations at Ballad Health. "We had a patient registration issue that would have taken a day to fix before. Now, within just a few minutes, we knew what the problem was and where it was. We were back up within an hour. The ability to identify these problems early and get them to the right person is where ServiceNow makes a difference that's critical to healthcare".
Future procedures
Ballad Health is dedicated to expanding its automation journey. "We need to be looking at reducing the amount of time it takes for clinicians, nurses, doctors and others to do their work", says Morton. "We want them to look at one dashboard and get all the data they need instead of spending time on the phone, waiting for us to help them".
Ballad Health is working on automation for asset management and is planning to integrate EMR Help with Microsoft Teams.
"Also, an implementation of electronic health record (E.H.R.) assists will be a critical component to our Community Connect programme, making things easier for the clinical staff", says Morton. "Data will transfer over at the push of a button instead of being communicated over the phone. It will also prevent errors". Predictive intelligence analysing tickets for routing efficiency is also in the cards. In short, Ballad Health has big plans with ServiceNow following its slower beginnings.
"I'm very proud of the work we've done to get to where we are, considering where we started and the situation we were in", says Stiltner. "And to be able to use the Automation Engine, do project management, and integrations with other systems has been great".
"When I used to go to meetings, it was about this problem and that problem", says Morton. "You can see things flow now. You can always improve and we're going to. But it's made a huge difference already; we have come a long way".