1. Health Budgets & Financial Policy MHS Service Desk Overview TRICARE Data Quality Training Course May 20, 2010

2. Health Budgets & Financial Policy Purpose Information briefing: –Provide overview of MHS Service Desk (formerly MHS Help Desk) current operation: MHS Tier support structure MHS incident ticket (formerly trouble ticket) process –Remedy has replaced ManageNow Implementation of Information Technology Infrastructure Library (ITIL) processes/methodologies –Partnering in data quality efforts –Mar 2010 MHS Help Desk Trouble Ticket Report

3. Health Budgets & Financial Policy Contract Scope MHS Service Desk provides Tier I and II support 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) 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. Health Budgets & Financial Policy 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

5. Health Budgets & Financial Policy 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

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

7. Health Budgets & Financial Policy 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

8. Health Budgets & Financial Policy 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%). Total Calls Total Tickets CreatedMonthDMHRSiIASAHLTATOL MHS LEARN Monthly Totals 3552529496Jul-09 11106289333642887267522925 3908628570Aug-09 10149328529352602261021581 4142429308Sep-09 11371323429822630257822795 Totals326269412928181197863 MonthDMHRSiIASAHLTATOL MHS LEARN Monthly Totals 83%Jul-0938%10%11%10%9%78% 73%Aug-0936%11%10%9% 76% 71%Sep-0939%11%10%9% 78%

9. Health Budgets & Financial Policy 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 Remedy is Government Furnished Equipment (GFE), hosted by TIMPO –Users must have DoD Common Access Card (CAC)

10. Health Budgets & Financial Policy 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

11. Health Budgets & Financial Policy DQMC Workgroup Oversight Monthly – DQMC Workgroup reviews Tier 3 escalation % for certain key systems.

12. Health Budgets & Financial Policy Backup Information

13. Health Budgets & Financial Policy 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 https://mhssc.timpo.osd.mil

14. Health Budgets & Financial Policy Acronym Definitions 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