Advocate Health Care is the largest healthcare provider in Illinois. Several years ago, Advocate subscribed to a hosted messaging service to help associates communicate, and it deployed collaboration software on-premises to help them manage projects. With pending hospital acquisitions and associates in multiple locations, Advocate wanted to implement a unified communications platform to help manage costs, ease administration, and improve communication and collaboration between associates. Advocate decided to move to the cloud-based services in Microsoft Office 365. With Office 365, the organization realized it could drive innovation and improve patient care by giving associates the tools they need to break down barriers of communication across the organization. In addition, Advocate will avoid additional IT costs and ease administration.
Advocate Health Care is the largest healthcare provider in Illinois and one of the top 10 health systems in the United States based on clinical performance. Advocate operates more than 250 care sites across metropolitan Chicago, including 10 acute-care hospitals, two integrated children’s hospitals, five Level-I trauma centers, a home health services company, and one of the region’s largest medical groups.
As the result of ongoing growth, Advocate employs about 35,000 doctors, nurses, and administrative and support staff, in addition to other healthcare professionals. These associates are spread over a wide geography, so several years ago the organization decided to implement a unified communications strategy to help associates communicate and collaborate to share best practices. Clear, timely communication between associates is a priority at Advocate due to the potential impact to patients.
Advocate wanted to begin by modernizing and consolidating its communications infrastructure, an aging iPlanet messaging system, but it was concerned about the expense of a major upgrade. To investigate messaging solutions, Advocate put together a team who quickly realized that a cloud-based messaging service could give it the functionality it wanted while eliminating the need to invest in an expensive on-premises messaging platform. After evaluating four cloud-based messaging systems, including Google, Advocate selected Microsoft Exchange Online, a hosted, enterprise messaging solution that provides web-based message access, 25 gigabytes (GB) of mailbox storage per licensed user, and financially backed service-level agreements.
With the migration to Exchange Online, Advocate eliminated the need to upgrade an on-premises email infrastructure and ensured a savings of US$4 million over five years. In addition, as the organization acquired new hospitals and medical practices, it found that it could bring associates on board quickly so they could be productive immediately. “Many of the hospitals and practices we acquired were already using Microsoft Exchange and Microsoft Outlook, so we never had to worry about a learning curve,” explains Rance Clouser, Vice President of Support Services and Communication at Advocate Health Care. “We also no longer worry about managing the infrastructure on-premises. Instead, we can focus on the user experience and adoption.”
The adoption of Exchange Online also helped Advocate set the foundation for moving to a cloud-based unified communications solution. To manage and share documents and best practices, hospitals within the Advocate organization were using different versions of Microsoft SharePoint Server on-premises. Advocate wanted an organization-wide unified communications solution that would eliminate siloed communication and collaboration. “Seventy percent of all sentinel events that occur in hospitals are due to a breakdown in communication. We needed more efficient communication tools to help prevent those events. We also wanted a solution to help us be more competitive from a recruiting standpoint and in the health provider marker overall by helping our associates be more productive,” explains Clouser. “Finally, as healthcare costs continue to increase and revenue continues to decrease as healthcare reform is implemented, we needed a solution that could help us control costs without forcing us to sacrifice functionality.”
To provide a true unified communications solution across the organization, Advocate selected Microsoft Office 365. Office 365 brings together Microsoft Exchange Online, Lync Online, and SharePoint Online to provide a full communications and collaboration platform. Advocate worked with a Microsoft Partner to plan and implement the migration to the cloud. “We worked with our partner when we migrated to Exchange Online, so we knew they understood our environment and our associates,” says Clouser. “Between the executive sponsorship from Microsoft and our partner working to manage any issues, our Office 365 migration was one of the smoothest transitions we have ever experienced.”
As a healthcare organization, Advocate is concerned about the security of patient data. The organization felt comfortable knowing that Microsoft could keep that data secure “in the cloud.” Advocate worked closely with Microsoft to develop a business associate agreement (BAA) guaranteeing the Office 365 solution would meet the organization’s Health Information Portability and Accountability Act (HIPAA) requirements. More importantly, Advocate believed the move to Office 365 would actually help it ensure reliability for critical services, such as email and collaboration, because Office 365 provides premium antispam and antivirus protection; geo-redundant data centers; IT-level phone support 24-hours a day, seven days a week; and a financially backed, 99.9 percent uptime service level agreement.
To ease the transition to Office 365, their partner implemented Active Directory Federation Services so that associates can maintain a single set of credentials in Active Directory for Office 365 and other on-premises solutions. Advocate also developed a comprehensive communication plan to help desktop and mobile associates transition to the new services. Email downtime was avoided by providing all associates access to their email through Microsoft Outlook Web App throughout the transition, which took place over a single weekend. “We fielded a moderate increase in help-desk calls on Monday and Tuesday, largely due to mobile device setup, but by Wednesday everything was back to business as usual,” says Clouser.
A Unified Platform for Collaboration
To help promote organization-wide best practices and end siloed communications, Advocate is moving to a central place for associates to go for all their content and collaboration needs.
To prepare for the transition to SharePoint Online, Advocate created a unified look and feel for its company intranet. It will use SharePoint Online to store important documents so that associates across the organization have access to them.
The organization also started transitioning on-premises SharePoint Server sites to SharePoint Online. So far, it has successfully migrated three sites to the cloud, and it plans to migrate the remaining sites to the cloud by the end of 2013.
Advocate worked with their partner to support the migration efforts and to create a self-service tool that allows associates the ability to easily create their own basic collaboration sites.
The IT team at Advocate also worked with Human Resources to create an associate directory in SharePoint that tracks demographic information, such as associates’ skills and interests, which is vital information to help the organization connect talented associates with key strategic initiatives. Associates can use the Skill Search feature in SharePoint Online to search for colleagues that have special medical expertise or areas of interest in research for consultations. Advocate will also enable associates to create My Sites for internal social networking.
A Tool for Driving Innovation
Advocate is using SharePoint Online to develop workflows to help the hospitals run more efficiently and to manage patient care. For example, the organization faced some challenges tracking patient transporters. After looking at third-party products, it realized it could build a workflow in SharePoint Online to track transport requests, manage queues, and know when transports were completed.
To track patient satisfaction and success after discharge from the hospital, Advocate built a virtual call center workflow for contacting patients for follow-up care. Information about patients who have been discharged is provided through SharePoint Online. Nurses use the information when they contact patients to ensure that patients are following the instructions they received from their medical team before leaving the hospital. Nurses can make notes to close a case or to recommend follow-up contact and care. This effort can help reduce readmissions and increase patient satisfaction, two key measures in a hospital setting.
A Robust Communication Experience
With Lync Online, Advocate can provide a highly secure, real-time communications solution that associates can access from any computer with a broadband network connection. The organization had a previous enterprise solution for instant messaging (IM), but most associates never adopted it, opting instead to use public instant messaging clients, such as Yahoo! or AOL. Advocate set up federation through Lync Online with key vendors, including their partner and Microsoft. It is also federated with medical partners like Cerner, the provider of its electronic medical records solution, and sister hospitals outside the Advocate network in the Chicago area.
Now that associates have Lync Online, they can see each other’s presence information, start an IM session, videoconference, PC-to-PC call, or an online meeting when they see a contact is available. They can send files instantly, or share an application or desktop to view information. The IT team is also taking advantage of desktop sharing capabilities with Lync Online to help the company’s dispersed workforce troubleshoot desktop issues. SharePoint Online interoperates with Lync Online, so associates can also see presence information and start IM sessions or meetings from directly within the SharePoint Online interface.
A Familiar Messaging Experience with Extended Capabilities
With Exchange Online in Office 365, Advocate can ensure the same level of service for messaging that associates have always experienced. Associates can access email through Outlook Web App or through the Outlook client on the desktop. Because of the interoperation between Exchange Online and Lync Online, associates can also view presence information, start an IM session, or hold an online meeting using Outlook or Outlook Web App. Advocate has also integrated its Cisco TelePresence conferencing service with Exchange Online so that associates can easily book rooms for larger videoconferences.
For the IT team, the latest version of Exchange Online offers several capabilities that help ease the administration burden without sacrificing security. With the Role-Based Access Control feature, the IT team can manage user accounts and access, and delegate tasks such as creating distribution lists to associates. IT can also automate repetitive maintenance tasks and reporting through the Windows PowerShell command-line interface.
By migrating to Office 365, Advocate can realize its goal of providing unified communications across the organization to improve productivity and drive innovation without sacrificing stability and security. It can consolidate its on-premises solutions to reduce costs and administration, and it can also provide a more scalable solution that brings associates together to improve patient care.
Drives Innovation and Better Patient Care
Advocate has already taken advantage of SharePoint Online in particular to create workflows that help the organization improve patient care. “The patient satisfaction program we created in SharePoint Online was a huge win for our organization, because we can see measurable improvements as a result,” says Clouser.
When all the hospitals have migrated to the new solution and the silos are gone, Advocate expects that teams across the organization can work together to find ways to improve patient care through better processes and improved communication. “By using SharePoint Online, the IT team can be more innovative in how we solve problems in-house without relying on third-party solutions or on other parts of the organization,” explains Dennis Giles, Director of Communication Connection at Advocate Health Care. “SharePoint Online really lends itself to helping us find the simplest, most efficient solution to a problem.”
Clouser believes an important benefit for driving innovation is the ability for associates to create and own processes. He explains, “By using the self-service tools in SharePoint Online, teams can create sites and workflows to solve problems creatively, and then work with teams at other locations to ensure best practices across the organization.”
Improves Communication and Collaboration
By providing a unified intranet through SharePoint Online, Advocate can help to bring the organization together to work as one team. “We can migrate all these siloed sites to a common platform with a unified look and feel, which will create a real cross-collaborative place for organization-wide projects,” says Giles.
With Lync Online, associates at Advocate have a way to communicate with each other in real time, no matter where they are located. With the interoperability between Lync Online, SharePoint Online and Exchange Online, associates can also more easily start conversations and discuss projects, because they can see each other’s presence information. “Instant messaging has been a huge relationship builder,” says Giles. Associates can also use Skill Search to locate subject matter experts inside the organization quickly to answer questions or work on projects, and they can also easily reach out to federated colleagues when they need help.
Clouser also believes that having so many options for communicating—IM, online meetings, and every level of videoconferencing from immersive room-based systems to desktop-based conferencing through Lync Online— empowers associates by providing flexibility. “What we really wanted to do was provide a market basket of capabilities for associates to use to communicate,” he explains. “We wanted to provide tools for every level, from the desktop between two people to a large, immersive conferencing experience with numerous participants. Office 365 has enabled that.”
Helps to Avoid IT Costs
By eliminating its on-premises SharePoint Server environment and transitioning to online services, Advocate expects to avoid IT costs for maintenance, licenses, and hardware upgrades. “We are projecting about a $1 million savings per year by transitioning to the cloud,” says Clouser. “That is in addition to the $4 million cost avoidance we originally expected when we moved to Exchange Online.”
More importantly, by signing up for Office 365, Advocate has stabilized IT costs for communications and collaboration. “We can much more easily budget for growth with Office 365,” says Clouser. Advocate has another large hospital merger in the works for 2013. It expects to bring those associates on board quickly by using Office 365 and avoid taking on the cost of additional infrastructure. “By using Office 365, we did not have to purchase new hardware, and we also avoided the cost of hiring additional IT staff,” explains Clouser.
Enables IT to Focus on Business by Easing Administration
Advocate wanted to ensure that implementing a unified communications solution would not increase the burden on its IT staff. By transitioning to Office 365 cloud-based services, it can focus on increasing employee productivity and on the projects to help the business, while relying on Microsoft to manage the
infrastructure and ensure reliable service. “With our most recent acquisitions, we will have added approximately 5,000 more associates, but the IT team can manage those accounts without adding more staff,” explains Clouser.
The IT team has also experienced decreased call volume for help-desk calls regarding communications and collaboration tools, which enables them to focus more on business initiatives and less on troubleshooting issues. “The ease of administration for Office 365 is a positive benefit to the organization, because rather than solving technical issues, we can focus more on solving organizational and business issues,” says Giles.
With the transition to Office 365, Advocate has built the unified communications platform it wanted to help enhance communications and ultimately strengthen patient care.