Building in for access and usability: North Carolina health system achieves multiple data access and report management goals with IT.

As the CIO of an academic hospital network responsible for the well-being of more than 31,000 inpatient admissions and 700,000 outpatient visits each year, J.P. Kichak understands the need for information control and availability. He also understands the challenges involved with making information available across a hospital network that spans a broad geographic area, encompasses numerous groups of people from diverse disciplines, and supports facilities ranging from small clinics to major medical institutions.

The primary focus of the UNC Health Care network is supporting the needs of North Carolina Children's Hospital, North Carolina Memorial Hospital, North Carolina Neurosciences Hospital and North Carolina Women's Hospital. It also supports 1,000 physicians within the UNC School of Medicine and 150 community doctors in private practices.

In the fall of 2002, UNC Health Care began investigating solutions to help it meet federal mandates for the privacy and security of patient information. UNC administration tasked the information technology team with three additional objectives: 1) to create a management portal of key operational information for management; 2) to improve availability, utilization and control of information throughout the hospital network; 3) to decrease the overall operating expense related to document output, management and distribution.

The Right Vision

The vision for the management portal was to create a single conduit to information from across the organization. Kichak's IT team was primarily concerned with integration of solutions containing the information, simplifying the user experience, and being able to blend this information seamlessly into the portal interface that would be developed as the final phase. Key requirements included connecting to the Lawson enterprise system, coordinating security context to eliminate the need to maintain numerous logins, and enabling users to immediately drill down to the specific detail area of the report they selected.

Building upon this vision, UNC spent several weeks developing a detailed picture of the technical, operational and cultural challenges it would need to overcome to achieve these goals. It discovered a complex network of systems being used to support a broad range of functions across various hospitals and focus teams. This infrastructure consisted of more than 250 Windows NT servers operating a total of 175 applications, 30 UNIX servers running more than 35 applications and an IBM mainframe with another 35 critical applications.

"Every person and every system has a specific purpose in our organization," says Kichak. "As the CIO, my purpose is to make sure each employee has the tools he needs to be effective. If anyone, at any level, at any time, cannot access the information he needs, the IT group must respond. When it comes to key infrastructure issues like these, the IT group wastes little time in the decision-making process."

The need to support numerous applications centered attention on operational issues related to meeting HIPAA guidelines and improving internal utilization of information. Critical information was scattered across many systems and available to a wide variety of people without clear accountability. Operational data was also widespread, and the diverse function, location and platform of each application made one-to-one system integration impractical. Centralizing and securing this information without hampering appropriate user access became paramount.

Planning for Utilization

The process of information distribution relied extensively on departmental reporting and document sharing through a centralized data center. Nearly 10 million pages were printed in the hospital data center annually, and the cost of equipment and supplies exceeded $250,000 in 2002. Added to this were costs for paper, microfiche and two full-time employees: one to write custom programming to burst larger reports and another to sort, package and deliver them utilizing a hospital vehicle.

With a HIPAA regulatory deadline quickly approaching, UNC Health Care conducted an exhaustive search, and in October 2002 it selected a solution that combined two products. The first, Redwood Software's Report2Web solution, was chosen for its ability to capture, organize and secure documents in a single location, improve their availability and utilization, and decrease operational costs related to handling. Report2Web also offered an open t API architecture that could be leveraged to provide content in the portal interface that would be built using IBM's WebSphere Portal solution.

Implementation of Report2Web began in November 2002, with members of Kichak's team attending a four-day training program at Redwood's headquarters. Next, the team downloaded the software to existing equipment and began establishing security and permission rights for key groups of individuals within the organization.

In January 2003, the team began loading reports from various applications into Report2Web, using digital output functions such as print streams, FTP and others standards commonly available without modifying applications. This started with nearly 500 reports per day from the IBM mainframe, enabling UNC Health Care to quickly build a centralized document repository.

By the second week in February 2003, Kichak's team had categorized documents in the Report2Web repository and began automatically bursting larger reports into personalized information for distribution to individual team members. Delivered online and via e-mail, distribution was handled for the first nine months solely by Report2Web, until development of the WebSphere interface was complete in November. At that time, users were presented with a dynamic portal interface that combined enhanced information alongside content stored and distributed by Report2Web.

According to Kichak, "The system took our most complex senior management report that contained general ledger information from every department and quickly divided it into parts, making those parts available to each vice president, based on area of focus. This entire process was done within an hour, when it used to take two to three weeks to print, sort and distribute."

Departmental Benefits

Rollout of the management portal continued across the UNC Health Care network as Report2Web was linked to other applications. By the end of 2003, 90 percent of UNC Health Care health professionals, including those working remotely at clinics and in private practices, had direct access to documents that previously were unavailable.

The management portal presented meaningful content to each user, significantly improving user adoption throughout the organization. This made it possible for Kichak and his team to discover new ways to improve operational performance at the department level. Examples of departmental initiatives include:

* The finance department now works with its 20,000-page Hyperion budget reports online, enabling it to go directly to a specific page to check totals, without having to pore through paper documents.

* The human resources department now publishes job applications on a weekly basis instead of printing them and sorting them manually.

* The patient accounting system now publishes daily, rather than monthly, input audit reports so all department managers can verify that charges have been entered accurately and make adjustments.

* Nurses have better access to daily patient roster information without having to filter through unrelated management information.

* The IT department avoids system downtime for routine maintenance by publishing information to the portal in advance.

In the first year of using the system, UNC Health Care has quantified a return on investment of twice its investment through a decrease in paper and printing costs alone. These savings include:

* a 25 percent reduction of paper output used by the data center (from 10 million pages to 7.5 million pages);

* a substantial decrease in costs associated with printing, decollating and distributing reports;

* a $65,000 savings realized by reducing the need for microfiche storage.

Implementation of the portal began a cultural change that has been embraced at UNC Health Care. The IT team is now welcomed within departments and works with each director to uncover new ways to cut costs. Three of the biggest data producers in the hospital--marketing, human resources and finance--are completely onboard, with others soon to follow.

For more information on Report2Web from Redwood Software, www.rsleads.com/409ht-208

SOURCE

J.P. Kichak

Chief Information Officer

UNC Health Care

Chapel Hill, N.C.

PRODUCT/COMPANY

Report2Web

Redwood Software

Morrisville, N.C.

www.redwood.com

REDWOOD[R]