AMC Web Strategy

Page 1 of 1615 11/17/2018

AMC Web Strategy

AMC needs to define direction and uses for of the Web. The current lack of strategic vision has brought the constraints of resources, time, and quality to a bottleneck halting all promises of agility. A Strategic vision will make the web an indispensable tool supporting AMC’s strategy.

Internet, intranet and extranet) for the enablement of AMC’s strategy and supporting tactics.

AMC Strategic Focus for the Web

While AMC’s efforts with the Web have been successful, yet our current processes and software limit our ability to take true advantage of the potential that this medium could afford. The web is the most accessible and direct communication to our customers (present and future), employees, clinicians, and associates. The current tactical focus has created disparate resources using multiple technology approaches for departmental solutions. The lack of an enterprise view limits AMC’s ability to inform, correspond with and transact with our employees, patients, students, researchers, physicians and business associates. A strategic focus for the web will improve the quality of our institutional communication. will be enhanced with a new framework of web infrastructure that will enhance the autonomy of institutional departments – while improving the editorial process for information publication.

While the initial design of AMC’s web resources have served many of these goals well, problems with the current architecture have limited the institution’s agility.

The most direct way to improve communication is to give communicators a global way to communicate. This is essentially what a content management system accomplishes utilizing centralized content publishing, a strategic direction, and a standardized technical architecture.

Centralized content publishing places the power of communication in everyone hands. It also is insightful enough to provide rules and order to what is being communicated. The best way to think of it is supervised email. Anyone can create a web page to communicate an item, but before the item is published, it must be authorized. Currently, centralized “publishing” of web content by IS staff separates the authors and/or editors of the content from the people doing the publishing. What a content management system does is move the responsibility of publishing to those more appropriate like a department head, a legal resource, a marketing resource, or a public relations resource. The content authors and/or editors – will write, edit, approve and publish information on the AMC public website and AMC Intranet. With distributed ownership, AMC’s agility and responsiveness can be enhanced, while improving reliability and accuracy of published information for all end-users: employees, business partners, physicians, students and patients. Presently, new components of the AMC website are published with enthusiasm, but we lack processes and infrastructure that would require sponsors of these components to maintain them. The outcome is remains of inaccurate unsupported content being displayed to the public. For example, there remain many mentions of our heart transplant program (see on the AMC website. Currently the responsible owner is Dr. Canver. A responsible owner must be indicated, and outdated content should be retired. With a content management system, processes and infrastructure will be implemented to provide a content approval workflow that will facilitate both rapid publication and consistent updates. In addition any content that has not been reviewed within the last year’s owner will be notified, and requested to update the content. If no owner is identified, the content will be removed. The current owner and defined authorizer will determine if the legacy content is suitable for publishing.

While our most remarkable advantages will come from using the web for cross-application integration and large scale process transformation, all uses, simple and complex, will rely on the publication of information. We have thus far maintained “almost” central control of content publication by how we have done web development. Yet our user community has become frustrated, and some departments – accustomed to the self service culture so pervasive in our society - have acquired their own development tools or have even hired outside web development contractors in order to meet real or perceived needs that were unmet by our current infrastructure.

This document outlines the primary problems with AMC’s current web resources, and proposes a set of processes and infrastructure changes that will enable AMC to migrate these resources into a more robust position.

Problems:

New components of the AMC website are published with enthusiasm, but we lack processes and infrastructure that would require sponsors of these components to maintain them. [1]
Web resources are conceived and implemented in a tactical rather than strategic manner.[2]
Centralized “publishing” of web content by IS staff separates the authors and/or editors of the content from the people doing the publishing[3]
Reliance on paper and e-mail distribution of documents and information burdens our e-mail systems, and enhances cost for paper duplication enterprise-wide.[4]
Poor usability of the AMC Intranet causes employees to waste too much time searching for information[5]
AMC business units are unable to respond promptly to market pressures[6]

Solutions

Processes and infrastructure will be implemented to provide a content approval workflow that will facilitate both rapid publication and consistent updates.[7]
Strategic initiatives must dictate tactics, and will guide the overall framework of AMC web resources.
Content authors and/or editors – will write, edit, approve and publish information on the AMC public website and AMC Intranet. With distributed ownership, AMC’s agility and responsiveness can be enhanced, while improving reliability and accuracy of published information for all end-users: employees, business partners, physicians, students and patients.
Paper and e-mail distribution of documents and information will be reduced. Communicating through dynamic and frequently updated web resources, internal and external news can be conveyed more efficiently and more globally than with paper or e-mail.[8] Reducing the use of paper for the pharmacy formulary, College catalog, telephone directory and College syllabi will not only reduce the cost and time required to produce these static documents, but will also improve the accuracy and currency of these resources.
By separating the design of the websites from the content will enable AMC to build and maintain websites that meet or exceed usability standards, and therefore assist users in finding the information they need in a prompt and efficient manner – thereby representing AMC as an efficient, responsive institution. Content authors and editors will author end edit the content – not the “look and feel” of the websites – which will be managed centrally by web development team – who have skills and training in web graphic design.

Risks

AMC Cultural Implications

At least a few cultural implications come with advancing AMC’s Web capabilities. These challenges may include:

Self service
Transparency/Customer integration into process
Mental models based on personal behaviors and preferences

Self service has been a revolutionary change in how business transactions occur. Examples include stops at the gas station, cafeteria or fast food lines, ATM, online or telephone banking transactions, airline reservation websites, and home lab test kits. AMC uses of the web have provided content or have some simply, focused transaction capability.

Without moving to more sophisticated underlying architecture, we will see more and more departments acquiring their own tools to do Web development, spend our money accordingly, and miss the opportunity to create an infrastructure and culture that moves content management both horizontally and into the hands of our management collectively.

Self service web content management tools provide the capability to significantly alter the value we gain from our Web investments. For example, our “webmasters” currently are receiver, editor, publisher, maintainer, and technical application developer of our Web efforts. With content management tools, the organization can adopt standards as to who and to what level of investment content will be published, standards for refresh of content, professional standards for publishing and offer a consistent menu of site design templates. The webmasters then become architects who reinforce the publishing standards. Institutional managers become the editors for their respective departments – with sub-editors and authors feeding and revising content on a continuous basis.

We have budgeted for these tools because certain individuals understand what the tools can do. However, we have not 1) contemplated how the tools would be adapted to use at AMC and with what organizational impact (requiring buy-in) and 2) assured that disparate Web efforts that are springing up, (e.g., procurement) will align and not quickly “hit the wall” once our key resources refocus to a content tool based effort. Coordination of web efforts under this new framework is the only way that AMC’s strategic focus can be maintained,

Transparency. The Web makes organizations “transparent” to their customers. For instance, appointment scheduling at AMC typically occurs via telephone or face to face encounter. A first step toward web use is to allow the Customer to request an appointment via a Web page and then send a follow-up email noting the appointment. The next stage of Web sophistication is that of extending the available block schedule via the Web to the Customer, allowing them to select from the schedule the appointment time, and then generate an immediate online confirmation. In essence the customer becomes fully integrated into the business process, and the way about which the work has been performed is changed and perhaps hybridized. Allowing such transparency may be a cultural challenge to AMC’s way of doing business.

Mental Models. A third challenge is potentially presented from the mental models we have about the Web. Simply said, our organizational demographics view the Web much like the general population. The under-40 population expects self service Internet access to health, employment, and education content and processes. We are behind the curve, and potentially lacking in understanding of this expectation. Though our Internet presence is basic, the statistics below provide representation of 2003-2004 activity.

Statistics / Jan. 2003 / Jan. 2004 / Jan – Dec. 2003
Hits on entire site
Average per day / 122,377 / 153,109 / 1,439,281
Visitor Sessions
Average per day / 4,068 / 4,852 / 47,153
Unique Visitors
Visitors who visited more than once / 4,890 / 7,208 / 64,383

AMC’s Intranet – despite its aging design and discontinuous organization – has become a successful method of sharing information, providing business tools, hosting documents (such as the recently migrated Hospital Policies and Procedures – which are no longer available in a 3-ring binder). Our goal is to use these small tactical successes as a model for a more coordinated strategic approach to the problems outlined on Page 1. Why are the Hospital Policies and Procedures online, but not those of the Practice or College? While we should applaud the initiative taken by the hospital to deliver these documents digitally, we have failed to provide an infrastructure that would cause all entities to deliver these important documents in one consistent manner across the enterprise. With a revised model of web development and implementation, this infrastructure will facilitate such a coordinate approach – and will also facilitate the processes that will enable us to move AMC to the next level of web interactivity.

Next Steps

The first “stage” of Health Web evolution (see Table 1) is publication. As described above, our current publication efforts, while successful, have been managed centrally. Shifting from these current processes and infrastructure to a new model of distributed content management and publication will require buy-in from all levels of the organization. This shift will improve efficiency, improve our public image, and reduce waste, yet we must implement the transition in a deliberate and careful manner. Managers or department heads must understand that they may expect to spend 2 – 3 additional hours every month reviewing content that had been authored or revised within their department. We may find that some departments take an active, aggressive approach and will make the most of the freedom afforded by self service, while other departments may require hand-holding and encouragement during this transition.

A core component of our first steps toward this migration will therefore be a needs assessment, selection and installation of enterprise web content management software.

While publication is an important and necessary component of both our intranet and public internet sites, AMC will also focus on one or more initiatives from higher stages of web evolution in order to better reach our strategic goals. While we will maintain several existing resources (web-based medical school applications, web-based exams for medical students), two salient initiatives that have been identified are: materials procurement on the intranet (eliminating the need for a “green requisition” for stock supply items) and web-based physician/service referrals.

These initiatives are proposed as pilot projects for the new web development and implementation infrastructure because they represent projects that are either already approved or already in process. These initiatives also represent significant opportunities for process improvement, cost reduction and revenue enhancement:

Intranet-based materials procurement
This system would automate the ordering of stock supply items for all AMC departments. AMC employees would see reduced latency to order fulfillment, and reduced paperwork, while the materials management department would see similar improvements in work process from eliminated paperwork.

Web-based physician/service referrals
An enhancement to the physician referral directory that is currently in development, this system would permit any department offering a service to patients and/or referring physicians to retrieve information (e.g. referral criteria, pre-op instructions, etc) or submit information (patient history, pre-registration forms, insurance information etc). The system would have limited interactivity: information submitted would be forwarded to the appropriate department – and confirmation of receipt would be managed by telephone. Nonetheless, this enhanced level of service – which would be available to all departments – would provide a level of self service that many patients and referring physicians are coming to expect.

In Summary, AMC’s web infrastructure – developed in the summer of 1997 by a physician and a small team of work-study medical students – now needs an upgrade in order to support our growing reliance on this technology. No longer a fad – web technology represents an opportunity for AMC to carefully and deliberately move our business toward one of enhanced automation, transparency and self service for our staff, students, and business associates.

AMC Web Strategy

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11/17/2018

Table 1 represents the typical and necessary evolution of Web use in a healthcare organization. The Appendix is provided as a reference to baseline concepts. Table 2 further presents our capabilities, potential desired state (where the authors believe work should occur), perceived priorities (where the authors believe, yet must validate with leadership the strategic or transformational value resides), and certain key leading practice or competitive Web sites where we should look, to follow tactical efforts or understand necessary functionality.

Table 3 represents select key attributes by evolutionary stage for further understanding of what we are likely to require of AMC in framing our decision making, resourcing and approach.

Table 4 is provided via outside research to challenge or support our leadership perspectives on perceived priorities.

Table 5 provides critical success factors in rank order to assure we consider certain elements in our thinking as we move the AMC Web from being a decentralized/tactical to strategic/shared resource.

Table 1 – Health Web evolution by Community Need

Adapted from FCG, Cisco Systems and CGE&Y sources