"C"ing is Believing | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

"C"ing is Believing

February 1, 2006
by Phil Lanzafame
| Reprints

Located in Norfolk, Va., Sentara Healthcare, which provides a diverse component of health services from hospitals to managed care, is always searching for ways to improve efficiency and clinical services.

In 1996, Sentara started an experiment by using the Internet to link its then 12,000 employees and 60 locations to share information. Nine years later, that experiment has become a business critical portal widely used throughout the organization by employees, contractors, physicians, and students.

The value of the portal is derived from an integration of diverse software, data, functionality and information brought together from various systems. The strategy has been devised from disciplines ranging from knowledge management, business process improvement (BPM), enterprise application integration, mass communication and social re-engineering.

For our purposes, it is much easier to simplify the initiative into three focused components: communication, collaboration and commerce.

Phase I—Communication
We began the first phase of a data-driven portal in the fall of 2000. In retrospect, the functionality appears trivial in relation to our current expectations, but was critical in providing the initial value and achieving employee participation.


  1. All employees must have a personal profile and electronic (login) identity to participate.
  2. Each employee must have a corporate e-mail address.
  3. The enterprise portal needs to be available at any Internet access point inside or outside the organization.
  4. Shared resources in the form of kiosks or thin client appliances must be allocated uniformly throughout the organization to facilitate participation.
  5. A collaboration tool is required that would allow individuals to communicate within secure groups.

All 12,000 employees would receive an e-mail account. Previously less than half of the population was allowed access to a corporate e-mail account. We felt it was impossible to define ourselves as a connected organization without having all employees connected.

To facilitate their computer access, cyber cafes were set up in all the hospital cafeterias consisting of private spaces with Web-access computers.

The ability for employees to collaborate with each other in a virtual space was also identified as an initial function. Employees had no structured method of sharing documents, having online discussions or interacting across organizations. Servers were overwhelmed with people using shared network drives to approximate a collaboration environment. The SiteScape Enterprise Forum--a workflow and collaboration tool that lets employees work together in a shared online space--was integrated into the portal.

The final requirement was that the entire portal be secure and available anywhere there was Internet access. An authentication application was purchased and an identity management system was implemented.

This phase required significant work and planning, but the worthwhile result was a secure, electronic positive identity for each employee. We soon began to use this structure to link to internal and third-party applications for delivering insurance benefit registration, updating employee human resource information and single login to other applications requiring authentication.

With just a few value elements like a centralized corporate directory to locate phone numbers, pagers and e-mail, we had 90 percent participation within one year.

Phase II—Collaboration
One year after providing global e-mail and collaboration for each employee, it was time for the next strategy level. To provide the next increment of value it was necessary to attach each employee to a financial structure to begin our progress toward e-commerce. It was determined that the internal structure of relating business units to financial transactions was a close fit to our needs. A nine-digit number that represented the facility, division and type of function identified each discrete financial structure. All employees could be directly related to these structures and used to navigate the organization both vertically and horizontally. It also indicated the responsible owner of each cost center.

We followed the same model used in the employee profile, where a key financial indicator acted as a positive identifier and created a profile for the owner to update. The 800 profiles were incorporated into both a directory structure and searchable database.

The now Web-enabled directory was christened as Electronic Business Units (EBUs). Each owner of an EBU was able to individually update various time-related operations (visiting hours, operating hours, delivery times, messages, Web links, emergency contacts, direct paging and e-mail links). Most important was that each EBU had a staff directory by cross-referencing the individual profiles to the cost-center structure. By linking to pre-existing components, each piece of data was automatically created, changed or terminated though interfaces with the core systems.

We could literally filter the organization through multiple individual and collective components. For example, all employees of a single division could be located by facility, shift work, supervisor or other attributes. Likewise, on a horizontal level all employees or departments associated with radiology across the organization could be identified. With this in mind it was the next logical step to provide a method for collaboration with those groups as required. We have now begun our e-Contacts application which will allow people to dynamically create, manage and save groups. They can then e-mail, page, or create collaborative teams as needed.

Initially, the SiteScape collaboration tool was used for ad hoc forums to provide secure areas for people to share documents, data and messages. It was very successful, and we realized we were able to develop virtual knowledge communities based on the new data infrastructure. This meant that employees associated with facilities, related departments, and divisions could have collaboration areas generated by the natural relationship of their roles.

Phase III—Commerce
So far the strategy is working as planned. There is critical mass of employee participation based on business functions related to applications, transactions, content and knowledge repositories. The universal e-mail was readily accepted. The remote secure access became the standard as the company grew and employees became more mobile.

The next step was to add the attributes to provide the global authorization matrix. This would relate financial approval levels to managers, define the reporting relationships and allocate those responsibilities to cost centers (EBUs).

It took a year to research the model for identifying and applying roles, financial limits and reporting relationships. We defined a very simple model of identifying all managers through the human resource data, applied spending approval limits from finance policies and then allowed each manager to collect their direct reports through a Web interface.

Looking Back
In three years, we have developed and implemented a data-driven e-business model that has affected the life of each employee. The results have reduced costs, distributed applications and provided efficiency and convenience for many employees. Moreover, it has provided a new perspective of the organization. Instead of 15,000 loosely organized employees scattered over 80 locations, there is a visual cohesion that represents the dignity of all employees and allows them to fully participate with their colleagues in the organization. Through this process, it has broken down many internal barriers, delivered success to many individuals and provided a unifying component to a complex industry.

Phil Lanzafame is manager of internet products at Sentara Healthcare.

The Health IT Summits gather 250+ healthcare leaders in cities across the U.S. to present important new insights, collaborate on ideas, and to have a little fun - Find a Summit Near You!


See more on

betebet sohbet hattı betebet bahis siteleringsbahis