The Information Systems Help Desk as a Strategic Change Agent in Healthcare Organizations

Written by zhangyuan January 23, 2008 10:16

Develop a three-tier model of a healthcare organization's internal information systems or IS help desk whereby it becomes a core competency of a knowledge-based organization. STUDY DESIGN: Conducted a review of the literature regarding internal IS help desk design and management. Journal articles were reviewed for relevance and classified according to focus of article, type of article, healthcare related, and change management related. Revised traditional help desk models using concepts of organizational intelligence gathering, double-loop thinking, and system fit. Using the revised model, interviews were conducted with IS and non-IS management in healthcare organizations.

POPULATION STUDIED: The help desk literature was searched through the bibliographic database INSPEC 1969 to 2001 using the keywords technical support services, cost, and help desk. IS and non-IS management in academic and non-academic hospitals were interviewed.

PRINCIPAL FINDINGS: The help desk literature is sparse and scattered across unrelated and sometimes obscure academic and trade publications. We found 28 articles on help desk design and management. Three were related to healthcare and three to change management. The internal IS help desk typically is not regarded as a core competency of the organization; is isolated from non-IS upper-level management; is considered a prime candidate for outsourcing; is assigned low-priority in staffing and resources; is restricted to tracking the number of help calls answered and resolved; and is considered a cost center. We propose a three-tier model of a healthcare organization's internal IS help desk. At the lowest tier the help desk is a reactive unit isolated from non-IS upper-level management and is a prime candidate for outsourcing. At the second-tier the help desk is proactive, engaging in some organizational intelligence gathering through use of a help desk issues tracking database, but is still isolated from non-IS management. At both the first and second tiers, the help desk is an instrument of what Argyris has called single-loop thinking. At the third-tier, the help desk is not isolated from non-IS management. It is an instrument of double-loop thinking, represents a core-competency of the organization, and is not a candidate for outsourcing. It is part of the intelligence system of the organization and can effectively be utilized as a key tool for managing cultural, organizational, and workflow changes. CONCLUSIONS: The help desk can be a rich source of information on the purpose, nature and outcomes of organization change, and can be a strategic agent for change.

IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Advanced information systems are becoming a critical resource in clinical decision support, process improvement, reduction in medical errors, and consumer informatics. In many instances new information technology is implemented as a means to bringing about profound change in the organization. According to our proposed model, the help desk can be a key resource for implementing new information technology as well as gathering and analyzing data on the change process itself, thus becoming a key resource for effecting change.