In the field of medicine, probably the most important tool that health care providers have at their disposal is information.
To break down multiple barriers surrounding how critical health care information is traditionally shared and accessed across vast hospital networks, the American Hospital Association was forced to look deep into its own Web content management framework to find the perfect cure for a variety of ills.
The AHA comprises several health care provider organizations, representing and serving more than 5,000 hospitals and health care networks and featuring 37,000 individual members. Interest in the organizations online presence was exploding, prompting the AHA to consider expanding the online reach of its extensive medical resources. Examples of AHA content include daily publications, magazines, press releases, online polls, educational programs, bulletin boards, white papers and other forms of health care data.
Before the AHA could centralize its diverse network infrastructure around a common taxonomy, however, it needed to mend a large continuity gap. This gap was caused by insufficient search engines, the reluctance of members to discard those areas of the site that werent as streamlined and well-designed as other parts of the site (and therefore were less functional and confusing), and the process by which content management was used.
“[One] of the problems we wanted to solve was to make it easy for our members to access content from all our sites,” said Herman Baumann, executive director for strategic development at the Chicago-based AHA. “Health care, traditionally, has been a community of silos. But today there are a lot of issues that are global and require organizations to work together. It takes more than pharmacists doing his or her thing, physicians doing their thing, nurses doing their thing; they all have to work together to improve care for patients.”
To understand the scope of what the AHA was routinely doing online, Baumann said that in any given week, the AHA will have about 100 people deploying as many as 300 new pieces of content in conjunction with about 100 updates.
The challenge was to create a single point of access featuring up-to-date information from 100,577 items of content spread across its Web site and linked to its member sites, Baumann said. The AHA required a single-sign-on-enabled CMS (content management system) tightly integrated with a search engine. This would allow users and members to find information quickly through a common “wrapper” across the top of a Web page connected via the shared-portal community.
As with anything that is easier said than done, several Web content management vendors met with AHA officials, and all showed little faith that such a vision could be achieved, Baumann explained.
“Not only [had] people never seen a model like we had, they didnt get it, and they thought we were nuts,” he said. “We actually had people try to talk us out of doing [the project] and [telling] us, We do not want a high-profile failure on our hands. We were simply looking for someone who was willing to work with us.”
The AHA discovered a willing implementation partner in Interwoven Inc., of Sunnyvale, Calif., with some assistance from Sun Microsystems Inc., of Santa Clara, Calif., as well. Baumann said Interwovens technology allowed the AHA to build its distributed CMS featuring the ability to tag metadata and keywords across 19 topic areas.
To solve its search requirements, the AHA married its Web CMS to Verity Inc.s search software. The AHA-driven taxonomy at the heart of the sites search capabilities is updated about every six weeks, said Baumann.
The AHA began its project using Interwovens TeamSite content management software. It currently also uses Interwovens OpenDeploy, which enables the hospital network to distribute and replicate all types of fresh content from development servers to Web servers for production, said Kevin Cochrane, vice president of Web content management at Interwoven.
A major project obstacle involved the need to put all the disparate organizations in the AHAs network on a single platform, a problem that Baumann said was exacerbated by the fact that they each wanted to invest in existing systems and manage Web site content.
From Interwovens perspective, Cochrane said the gargantuan task of organizing 72 Web sites on 18 hardware and software platforms consisting of at least six makes of servers and four operating systems, plus different types of Web servers and ISPs, was an arduous process.
“When you implement a common system of consolidation, servers go away. Thats hard work to do. Thats getting someone to give up a box that theyre used to managing,” said Cochrane. “Thats part of why they have to do the hand-wringing—to give up some control to a central platform but keep control of what theyre trying to do on the site and publish to it.”
Another Way to Skin
The AHA decided to standardize all its member sites on Sun Solaris servers and a storage system running on the Solaris operating system, as well as the Sun ONE Directory Server, Sun ONE Web Server and Sun ONE Messaging Server. On top of that runs Oracle 10g.
Baumann said that everyone shares the same database, but they manage and own their own logs so that users cant get into anyone elses data without permission.
Since about 60 percent of the AHA site is publicly accessible, Baumann said that smaller organizations that dont have enough content to update their own Web site weekly can automatically pool data from a myriad of AHA network sources to ensure their customers receive the most relevant health care information as soon as its available.
Still, Baumann said the road to achieve the unified AHA content strategy and shared taxonomy was not without its share of difficulties. The complexity of the prior infrastructure setup led to a few “frustrating” implementation errors for Web site owners and site users whenever a glitch occurred, he said.
“We took some lumps along the way, but we never wavered,” said Baumann. “At critical junctures we were able to benefit from a lot of help from Interwoven, Verity and Sun, who provided us with new ways to skin the cat.”
As a sign of its ongoing success, Baumann said that the Michigan Health & Hospital Association, in Lansing, has recently joined AHAs technology platform.
Cochrane said companies that undertake such a massive shared architecture and content management upheaval need to carefully consider the growing complexity of the underlying technology. It is easy to be sent awry without proper guidance at the projects helm, he warned.
“When we see a leader like AHA with great vision and good project management, I know that the technology works. If you dont have the right leader on the project setting the right goals and objectives, it doesnt matter how good the technology is; it will fail,” he said.
In the meantime, Baumann said he is gratified to see the average length per visit to the AHA portal is 5 minutes and 42 seconds. The hospital network is targeting an audience of 4.4 million viewers this year, all of which would not be possible had the AHA not determined the best way to use a highly configurable piece of software for its needs.
“It really forces you from a business perspective [to answer] what it is you really want to do. How do you want to share your content? What type of independence do you want to provide to individual sites? What are staffing ramifications? How do you manage different stuff?” asked Baumann. “It makes you ask every single question you need to answer.”
“That exercise was extremely valuable and helped our success,” he said.