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Hospital Corporation Boosts Employee Productivity by Installing Two Local Communication Networks.

Hospital Corporation of America (HCA), a $3.5-billion international health-care organization providing data processing and management services to hospitals around the world, is boosting productivity, improving the quality of its documentation, and reducing costs with the help of two baseband local communications networks.

HCA, which began in 1968 with one hospital, today owns 197 hospitals in the United States and 24 more abroad. It provides contract management services to an almost equal number of independently owned US and foreign hospitals, as well as to scores of professional buildings and clinics.

HCA's approach combines new technology and sound business practices to help health-care institutions simultaneously enhance patient care quality, curb costs and generate profits. And HCA is taking its own medicine by applying new technology to its internal operations.

Xerox Ethernet local communications networks--linking professional workstations, personal computers, laser printers and an OCR scanner--have been installed in two departments, located in separate buildings at HCA's Nashville headquarters. Plans to Expand the Networks

And the publicly owned company expects to expand its communications technology in the future, with the communications networks reaching out to provide electronic mail to the health-care concern's 37 field offices.

"Our Nashville headquarters operation is organized to provide very cost-efficient, centralized support," explains Sandra Dunaway, director of the Systems Integration Department, part of HCA's Information Systems Division.

"For example, our timeshared computer system is located here, and my department has the specialist and automation tools to create really top-notch user-support materials for our corporation's customers. Our 37 district and divisional offices, on the other hand, are directly responsible for serving hospitals in their territories. If a hospital has a need or a problem, it calls a local office for a fast, personalized answer.

"What we eventually envision doing is creating user-support and marketing materials here, then mailing them electronically to district or divisional offices," she continues. "This would eliminate mail delays; and if the offices had their own terminals and printers, they could do their own customizing before printing ouy the information."

The installation of Systems Integration's Ethernet network in Nashville was the first step toward the realization of that goal. In recent years, the workload of this customer-service department has grown dramatically. Develops Distributed Systems

A major reason for this growth in workload is that HCA is flexing computer muscle in a new way: distributed and profit centers. Tapping the power of low-cost, high-powered minis and microcomputers, HCA has developed distributed systems that support pharmacy, personnel, radiology, laboratory, nursing administration, business-office and material-management applications. Medical records and physician-support systems are among the systems that are on the drawing boards for a 1985 debut.

"Users of these new distributed systems are not computer programmers," Dunaway explains. "They're pharmacists and nurses, lab technologists and personnel professionals. Such systems only provide optimum support when end users like these can learn to use them quickly and efficiently. So, in addition to developing software and systems, HCA is investing the resources needed to develop complete user-support materials."

Systems Integration prepares materials to help both timeshare and distributed system users install, operate and maintain their systems. With distributed systems, hospital staffers at various locations within their medical facility capture, maintain and process patient information as part of their daily routines.

The data can be shared with other inhouse systems, and transmitted to HCA's host computer as input for big data processing jobs. by 1987, the corporation expects distributed systems to be installed throughout its owned and managed network.

"It is the function of the Systems Integration Department to ensure that hospitals receive a total user-support package," says Dunaway. "Self-implementation is our goal. We want to make user-support packages so clear and complete that people who may know nothing about computers can install and bring up new systems without any on-site help."

Support materials include site preparation, installation and implementation manuals, user guides and training materials. A support package for just one product or service might include 1,000 pages of text and graphics--and HCA's development of new products and services shows no signs of abating. Eases Tech Writers' Workload

The installation of an Ethernet network hasn't lessened Systems Integration's workload, but it has made the job of its staff of technical writers both easier and more enjoyable. And thanks in large part to its network, the department has managed to keep pace with increasing information demands without having to increase its staff.

The Systems Integration network links six Xerox 8010 Star information systems, a Xerox 860 information processing system, a Dest optical character reader (OCR), a Xerox 820-II personal computer, a highspeed laser printer and an 80-megabyte file server.

"With our network and Star workstations, we've completely changed pulbication production methods," says Dunaway. "Previously, text was typed and retyped many times. Graphic elements and forms had to be tediously drawn in pen-and-ink, or composed on a phototypesetter. Then, we had to cut and paste text and graphics together to manually assemble the finished pages."

Now, technical writers key data in only once. Their initial typed drafts are scanned into the network system through the OCR unit.

The workstations are then used to format and edit the drafts, and to combine text with graphics. Without leaving their workstations, writers can then send manuals via the net to a laser printer to create camera-ready copy. Creates User Training Manuals

For instance, writers often specify that replicas of computer screens be inserted into their manuals. Then, they furnish "screen dumps"--dot-matrix printouts of computer displays--as guides for the workstation operators to follow in creating support graphics. Most training manuals are peppered with screen replicas, which let individuals mastering new systems compare their video screen displays with workbook samples.

Using the workstations' sophisticated graphics capabilities, operators can reproduce such screens quickly and easily, merge them with text, and paginate documents for precision copyfitting.

"It's easy to build a basic screen for each computer system on the Star workstation," says Judy Liddington, production control specialist. "Then we only need to make minor chnages in these templates to create different versions of the screen illustrations."

Workstation operators tap similar powers to transform hand-sketched charts, graphs, organization tables and system-configuration drawings into professional illustrations to accompany text. Without leaving their workstations, the documentation technicians can send manuals via the net to a laser printer to create camera-ready copy. This printer can reproduce exactly what appears on a workstation screen with exceptionally high resolution. Cuts Need for Outside Services

"In reality, our staff used to function as coordinators of outside contractors," remarks Dunaway. "Under our previous system, they couldn't create formats and laouts, or exercise any graphics creativity. Now, they reproduce entire products themselves. Morale has improved tremendously, and there are fewer mistakes. People are excited by the new tools and proud of what they create.

"Of course, bills for outside design services have dropped sharply, and we're no longer at typesetters' mercy on deadlines. Projects that used to take weeks are turned around in three days or less," she adds.

The Ethernet network is also increasing the effeciency of communications among Systems Integration staffers. Users of the Xerox workstations, information processing systems and personal computers regularly exchange information and memos with one another via electronic mail.

Communications between Systems Integration network users and users of HCA's other Ethernet have also been greatly improved. The second net is located at the Center for Health Studies, a research, development and training subsidiary that shares user-education responsibilities with Systems Integration. The center's network presently connects an 8010 workstation, several 860 units and a laser printer.

While Systems Intergration develops in-depth user documentation and guides, the Center for Health Studies prepares "train-the-trainer" audio-visual packages that provide an initial introduction to the systems. Communications capabilities afforded by local networking are improving the flow of information between the two groups and reducing wasteful duplication of effort.

"Now that the center has an Ethernet, we can share information during the entire development process without re-keying," says Dunaway. "And the electronic-mail application provides prompt access to these shared documents." The Network Saves Footsteps

"The network saves a lot of footsteps," adds Judy Liddington. "Operations can share basic graphics applications stored in our file server--and it's easy to send a memo on a new application to everyone using the workstations."

Dunaway adds that the "gateway" feature, which permits the two existing nets to talk to one another, opens other communications options, too--including a linkup with personal computers used by programmers and other development staff.

"In the future, if our technical writers want to incorporate some system design specifications in a manual, they may be able to access PC-stored information electronically instead of via computer printout," she explains.

HCA also is looking at the feasibility of adding a phototypesetter or a high-volume electronic printer to its in-house photocopying center. The Xerox 8044 laser electronic printers currently linked to the local networks produce 12 pages per minute, but other available models can print much faster--up to 120 pages per minute. Company Mulls In-House Printing

"If we tie a phototypesetter or high-volume electronic printer to our Ethernets, we could eliminate all need for outside printing services," Dunaway points out.

In addition, HCA plans to link previously installed word processors to the networks. For example, its Word Processing Center was recently brought under the Systems Integration umbrella.

Previously, this center was geared to providing only general office support, and had neither the staff nor the equipment to offer specialized publications support to Systems Integration. Now, however, the expanded 14-person Word Processing Center offers both general office and specialized publications support. Supervised by Bonnie Cox, the new center also provides office automation guidance.

"HCA is a decentralized company," Cox explains. "But we're trying to make all of the people who buy text processing equipment aware of the advantages of purchasing machines compatible with Ethernet." It Assigns Most Workstations

Though Cox has cross-trained operators on Xerox and IBM equipment for service backup, five of the six Xerox workstations are assigned full time to individuals specializing in publications support. The sixth unit can be scheduled by others to produce special projects.

The Word Processing Center interacts constantly with Documentation Development's technical writers and the Quality Assurance staff--people who critically evaluate user-support packages just as end users would before giving their seal of approval.

"Revisions represenst the biggest part of the production workload," Cox points out, "and the workstations make revisions fast and simple."

Of course, external factors, such as frequent changes in federal health-care legislation and computer technology advances, impact revision requirements, too.

"When we complete documentation for a new system, we hope for a shelf life of three to five years," says Dunaway. "But external factors can change that. So, with the new distributed systems, we've taken a modular approach. The hardware-support package, for example, is broken down into many sections, each softbound as a separate booklet. Therefore, if we begin deploying a new terminal or printer, we can just add the new booklet on how to use this new piece of equipment to the hardware manual."

Bonnie Bentley, graphics specialist, spends full time creating the more-intricate support illustrations, complex forms, and visuals for overhead transparencies.

"You can do almost anything you want on the workstation," says Bentley. "If I'm creating charts, for example, I use a graphics grid to connect dots. However, I can also do free-form drawings of terminals or analyzers by removing the grid.

"The 8010 screen is like a desktop," she adds, "and on the screen are all the symbols for things you have on or near your desk. So, I just have to put the symbol for a document on top of an icon representing the laser printer to send that document to the printer." Pressing a button on the mouse control unit initiates printing.

Bentley maintains a library of the complex technical drawings and symbols she creates for use in future projects. Staff Likes Local Networking

Other HCA staffers seem to be jumping on the local-networking bandwagon. "We offered a two-day seminar on the 8010 workstations for our professionals," Dunaway recalls. "Ten people completed the course, and several of them now use the system for special projects."

Noel Brown, director, Corporate Systems Development, is one of those users. "I call on the center fo rhelp with routine documentation," she says. "But, at least once a quarter, it seems I must make a presentation without warning.

"So I'll sit down at a workstation and create graphics for both handouts and overhead transparencies. The system is very logical, which makes it easy to open files and documents, or to move copy. By using the boldface feature, as wel as different type fonts, I can draw attention to key points," she remarks.

While Brown usually makes in-house presentations, a number of her colleagues are putting on more and more seminars for HCA-managed hospitals and contract prospects. Documentation Represents Firm

According to Pat Stiltz, systems communications specialist, "We have big competitors for management contracts, which means our ability to give professional presentations is very important. Since we're selling information and management services, we can't show a concrete product. so, in essence, the quality of our documentation and presentation materials serves as a representation of the quality of our services."

According to Stiltz, local-networking technology is a valuable tool in projecting the professional image HCA seeks to maintain.

"Pictures always say more than words alone," she points out, "and with our automation capabilities, we can do incredible things with both words and pictures to produce very professional brochures and presentations."
COPYRIGHT 1985 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1985 Gale, Cengage Learning. All rights reserved.

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Publication:Communications News
Date:Feb 1, 1985
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