Parental control: Iowa Health System wrangles multiple, unruly intranets and builds a site with flexibility and consistency for 18,400 employees

Health Management Technology, July, 2006 by Proctor Lureman, Deb Langel

Sometimes it's good for an organization to get fed up with the status quo, especially if it's in the name of efficiency. At Iowa Health System (IHS), we devised an intranet site architecture that eliminated redundancy and inefficiency. Now, content that is relevant can be created and issued just once to our target audience of 18,400 employees, who work in multiple locations spread around the state.

Created in 1993, IHS is Iowa's first and largest integrated healthcare system, with annual revenues totaling more than $1 billion. It includes hospitals in Cedar Rapids, Des Moines, Dubuque, Sioux City, Waterloo, Fort Dodge and the Quad Cities, plus Iowa Health Physicians, a physician group of nearly 300 doctors in 31 Iowa communities.

IHS has more than 3,000 beds and last year recorded almost 100,000 patient admissions. Each location had maintained its own mini-intranet for posting items such as benefits updates and other announcements. These sites, supported independently by each affiliate location, had no shared functionality. While each location had common needs and requirements for its intranet, there was no tool to efficiently accomplish this goal. Duplication and inconsistency were commonplace.

Rebuild From the Ground Up

At best, these sites were confusing to navigate. For instance, an employee at Finley Hospital in Dubuque might need to find a HIPAA form customized for that hospital, but most likely, the home page did not offer clear instructions on how to navigate to the form. If he found a HIPAA form, it could pertain to a corporate policy and not be customized for Finley, and so he could easily print the wrong form. Other affiliates in the network experienced empty home pages. These problems arose because no one at the affiliate claimed ownership of the Web site. Updating Web sites with correct, timely information was a low priority.

Duplication wasted time and resources. At each affiliate, someone was responsible for adding forms and documents to the intranet, so the same form might load nine different times. It's difficult to pin down the number of hours consumed by such repetitive tasks, but we believe the figure was huge. Also, we lacked an efficient way to post corporate announcements that affected everyone. We relied on staff at each affiliate to post that news, but we couldn't be confident it would appear on a timely basis.

These problems didn't occur by design. They were just symptomatic of a growing healthcare network in which each affiliate became accustomed to presenting online information independently of the rest of the network. We concluded that the intranet had become outdated and needed a complete rebuild, no small undertaking for an organization that prides itself on advanced IT applications.

Centralized but Local

Whatever solution we engineered had to accomplish several goals. A nurse logging on in Cedar Rapids or a receptionist accessing the home page in Waterloo needed to see an organized, logically flowing page. The site also had to stress simplicity and functionality, so employees could perform their given tasks with as few clicks as possible. The days of searching around the site to find an HR announcement had to be a thing of the past. We also had to manage banner ads, which were interfering with content presentation in some locations.

The site had to contain centralized architecture management with decentralized content contribution, so affiliates could update the site with local information. To accomplish this, the intranet uses a unique and innovative structure: part of the content is populated by eBusiness and shared by all affiliates, while part of the content is managed locally. For example, employees across the state would see the phone number for the centralized IT Service Center, but employees in Fort Dodge would only see Fort Dodge weather or an article about an upcoming book fair. We also lacked a systemwide phone directory for all employees, making the mundane task of finding a number needlessly time-consuming.

To alleviate confusion in accessing forms and documents, we established the goal of building a central repository of forms and documents, so employees could easily find the customized paperwork they needed, as well as corporate forms. Finally, we determined that the days of the blank home page were over. Our new system had to enable us to deliver content to everyone in the hospital network from Des Moines.

We looked at various vendors before selecting the SiteMaker platform from MEDSEEK, based in Solvang, Calif. Medseek could meet our time-to-market demands, and the flexibility of their product was a perfect match for our organizational structure. SiteMaker is a Web-based content management program, offering tools for both experienced programmers as well as beginners to build dynamic Web content. The technology offers individual tools for graphics, workflow, architecture, scripts, appearance, content and administration with preprogrammed templates as well as the opportunity to build customized and interactive Web pages.