Microsoft Online ServicesCustomer Solution Case Study

Health IT Group Uses Online Collaboration Solution to Promote Best Practices

OverviewCountry or Region: United StatesIndustry: Healthcare

Customer ProfileSERCH is a group of 185 professionals in health information technology from 11 Southeast states, working with federal and regional partners to promote collaboration while managing health technology funding.

Business SituationSERCH used Google Groups to share information, but the solution didn’t scale as the number of documents grew. SERCH needed a more scalable, reliable cloud-based solution.

SolutionSERCH chose the Microsoft Business Productivity Online Standard Suite for collaboration services and a central document repository that members can access using an Internet connection.

Benefits Rapid deployment multiplies

collaboration benefits Central knowledge base saves time Sharing documents promotes best

practices

“Microsoft SharePoint Online is potentially one of the most useful collaboration tools SERCH has at its disposal.”

Emily Passino, Senior Management Consultant, State of Tennessee

Key stakeholders from 11 states formed the South East Regional Collaborative on HIT-HIE (SERCH) group to work together to administer funding for health IT and electronic health records under the American Recovery and Reinvestment Act of 2009. SERCH replaced its Google Groups solution with Microsoft Business Productivity Online Standard Suite, which it found more reliable and scalable. SERCH is using one of the services, Microsoft SharePoint Online, to build a document repository, share key websites, update calendars, and post meeting minutes. For SERCH, SharePoint Online is a forum for sharing best practices across boundaries and facilitates the real-time dialogue needed to bring cohesiveness to an unprecedented, high-pressure project environment.

SituationIn February 2009, the 111th United States Congress under President Obama enacted the American Recovery and Reinvestment Act of 2009 (ARRA), an economic stimulus package intended to create jobs and foster investment, and worth approximately U.S.$787 billion. Commonly referred to as the Recovery Act, ARRA includes federal tax incentives, expansion of unemployment benefits and social welfare programs, and increased spending on education, healthcare, and infrastructure. Of those funds allocated to healthcare, $25.8 billion is directed to health information technology (HIT) investments and incentives for healthcare providers to implement electronic health records. The healthcare system still relies, to a great extent, on paper and pencil, telephone, and fax, and the amount of sharing of patient health information between entities across the system is negligible. The ultimate goal of building up an electronic health information exchange (HIE) is to enable any healthcare provider, hospital, or clinic to access current, accurate patient information securely.

The responsibility for allocating and managing healthcare technology incentive funds under the Recovery Act falls to the federal agencies within the U.S. Department of Health and Human Services, including the Office of the National Coordinator (ONC) in Health and Human Services, the Centers for Medicare & Medicaid Services (CMS), and the state governments. CMS Region IV consists of Alabama, Florida, Georgia, Kentucky, Mississippi, North and South Carolina, and Tennessee. These state governments and many other state agencies across the region are now

working with their federal partners to administer the influx of new federal government funding.

Funding Opportunities Bring Challenges“Early on there was a confusing array of funding opportunities for state governments and state-designated entities,” says Emily Passino, Senior Management Consultant, State of Tennessee, and SERCH member. “Some funds came through ONC. These funds focus on the health information exchange and getting the digital highway up and running, with a great deal of money also for regional extension centers [REC] to support providers.”

Another set of funds was made available through CMS regional offices. “These funds are divided into two groups: incentives to healthcare providers to adopt or upgrade their electronic health records and use them meaningfully, and funds for state Medicaid agencies to get their systems to support electronic health records,” says Sandeep Kapoor, SERCH member from Kentucky. “And that is just the beginning.” Because these were new federal initiatives, policy makers issued complex rules and regulations that required thousands of pages of explanation. The ensuing confusion among the state governments and CMS regional offices was not surprising, according to Kapoor. “There were lots of rules, regulations, agendas, and unknowns,” he says. “All of the states faced the same challenges about how to spend the money and get the technology to the providers. At the same time, we all faced the double challenge of shrinking state budgets and a dearth of resources to put

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“All of the states faced the same challenges about how to spend the money and get the technology to the providers.”

Sandeep Kapoor, SERCH member from Kentucky

these policies into action. We all had existing day jobs, and so for most of us, this was an added duty to an already heavy workload.”

First Steps Toward Collaboration For that reason, in April 2010, approximately 40 key stakeholders decided to bring some consistency and order to the management of new incentives for health information technology. They formed a group called the Southeast Regional Collaborative for HIT-HIE (SERCH). It consists of representatives from 11 Southeast region states (CMS Region IV and Louisiana, Arkansas, and Virginia) including state-level Medicaid staff, HIE staff, REC staff, state public-private partnerships, and HIT coordinators. These state level participants are joining in conversation with representatives from their federal partners including the CMS Regional Office, the Office of the National Coordinator in Health and Human Services, and the Health Resources and Services (HRSA) Regional Office.

SERCH is working to consider common regional solutions for HIT-HIE, solve cross-border issues, and pool resources to stretch limited dollars. SERCH focuses on knowledge sharing, coordinating resources across grant programs within and between the states, and aligning program and policy decisions. In addition, as grant opportunities arise, SERCH states consider partnering with each other (either collectively or as a subset of states).

“SERCH is a voluntary group with no budget that sprang up among folks who have lots of different funding sources from the federal government to advance health

information exchange,” says Passino. “We recognized that we could learn from each other and look for opportunities to pool our resources. Instead of different states doing things differently, we could share best practices and help each other out.”

SERCH holds weekly conference calls to address hot topics and provide a forum for open discussions about issues, policies, and new regulations from the federal government. However, it quickly became clear that the group needed a more formal mechanism for sharing documents and to build a knowledge repository for everyone to use as a convenient reference. “We had no way to share information efficiently,” says Passino. “If you didn’t go to a conference in Orlando, it likely meant that you wouldn’t hear about what was discussed there, unless someone you knew could pass along a Microsoft PowerPoint deck. You had to spend time phoning and emailing around to try and get reports and information.”

SERCH’s diverse membership is key to enacting incentives designed to promote sharing of patient health information across state borders. However, members were often unaware of important meetings or events outside of their geographical jurisdiction. “With this legislation, there are a lot of issues around data crossing borders so we’re not always aware of outreach events, workshops, and seminars the government is doing to get healthcare providers involved,” says Kapoor. “We needed to have some kind of calendar or schedule where we could see when things were happening.”

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“With this legislation, there are a lot of issues around data crossing borders.... We needed to have some kind of calendar or schedule where we could see when things were happening.”

Sandeep Kapoor, SERCH member from Kentucky

At first, a member of SERCH suggested using the online collaboration services from Google Groups, and the rest of the group agreed. However, as SERCH grew to approximately 185 people and more and more documents were uploaded, members reported that using Google Groups to handle the growing number of documents was getting unmanageable. Some of the members were unfamiliar with the Google interface and resisted having to learn something new. Also Google Groups was discontinuing support for the Pages and Files features.

“We liked the idea of a cloud-based solution for a group such as ours, with volunteers from different organizations,” says Kapoor. “We just needed to find an online collaboration solution that was more user-friendly, scalable, and reliable. And now that we had seen the potential of online collaboration, we wanted to find and implement an alternative quickly.”

SolutionIt was during one of the weekly SERCH conference calls that a participant recommended Microsoft Business Productivity Online Standard Suite, a collection of cloud-based communication and collaboration services from Microsoft Online Services. (A cloud-based solution means that the services are hosted and managed by Microsoft and provided to customers over the Internet.) Through the Microsoft offering, SERCH can take advantage of a low-cost, per-user, per-month subscription to access Microsoft SharePoint Online, Microsoft Exchange Online, Microsoft Office Communications Online, and Microsoft Office Live Meeting

over the Internet—without investing in software licenses or hardware support.

“We had already talked about Microsoft Office SharePoint Server 2007 as a collaboration platform for SERCH because everyone was familiar with the functionality,” says Kapoor. “We discussed whether SERCH could use a state’s existing Office SharePoint Server environment. But we are all volunteers with busy day jobs, and no one wanted to take the responsibility of having the SERCH group hosted in their own SharePoint Server infrastructures. So a cloud-based version of SharePoint was ideal.”

SharePoint Online provides personalized My Site websites for SERCH members to manage and share important documents and team sites for group collaboration projects. It interoperates with the familiar Microsoft Office applications that everyone in SERCH uses for their daily work. SERCH members dispersed across many states can all access the same information from anywhere they have an Internet connection using a PC, smartphone, or other device.

With the Business Productivity Online Standard Suite, SERCH gains access to all the online services; however, the group decided to focus initially on using SharePoint Online. SERCH worked with Microsoft to set up a 90-day trial for SharePoint Online and deployed it to 30 people beginning in July 2010. Deploying the trial was surprisingly simple; within minutes of signing up online, the SharePoint services were available and the process of enlisting members to join commenced. The trial period finished in

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"As a CTO, what really excited me about SharePoint Online was the ease of setup. SharePoint took less than two days to deploy to members, and now Microsoft is basically taking care of everything.”

Sandeep Kapoor, SERCH member from Kentucky

December 2010, and SERCH immediately purchased 120 licenses for the solution.

To inform SERCH members of the new online solution, Kapoor sent everyone an email with documentation about the Business Productivity Online Standard Suite and a customized user manual. “It was a simple matter to set up accounts for each SERCH member,” he says. “Because most people had some kind of exposure to SharePoint technologies, it was easy to get people signed up and ready to go.”

The state of Kentucky volunteered to be the facilitator for SharePoint Online and immediately began uploading important documents and sorting them by topic. Initially, the site’s primary purpose is to be a central repository for useful information that SERCH members can easily find. In addition to the main site, SERCH has set up two My Sites for subgroups within SERCH: one for a group working on Disaster Preparedness; and one for a group responsible for communicating to providers and the public information about health information technology and Medicaid. Employees from six of the SERCH states, plus the bordering state of Texas, used SERCH to collaborate on applying for an RTI Disaster Preparedness Grant. They were successful in their application.

“We have ten folders in the main shared document space that contain a total of approximately 100 documents,” says Passino. “Most are in the public domain but they are key documents, such as approved strategic plans and provider directories that everyone needs to see, all in one central location.” SERCH members are also accessing SharePoint Online for contact

lists, links to important websites, weekly meeting minutes and agendas, event planners, shared calendars, and a section for frequently asked questions (FAQs).

BenefitsSERCH was founded spontaneously by a group of state employees faced with significant logistical and administrative challenges while introducing and managing unprecedented incentives for health information technology and electronic health records. Geographically and administratively dispersed across state and federal agencies, SERCH members found an easy way to collaborate through a Microsoft cloud-based solution that helps them maintain a central repository of information and share best practices.

“Microsoft SharePoint Online is potentially one of the most useful collaboration tools SERCH has at its disposal,” says Passino. “The site is a collection of documents and websites that members think are key to our efforts, so we can get directly to the data we need. It’s a great way to deal with ‘information overload.’”

Rapid Deployment Multiplies Collaboration Benefits For SERCH, the rapid deployment, low cost, and ease of use provided immediate ratification of the group’s decision to move to a Microsoft cloud-based solution instead of staying with Google. With new rules and regulations arriving almost daily, SERCH members don’t have time to waste with learning curves or complex deployments. “As a CTO, what really excited me about SharePoint Online was the ease of setup,” says Kapoor. “SharePoint took less than two

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days to deploy to members, and now Microsoft is basically taking care of everything. The experience gave us great insight into the benefits of cloud computing in general.”

Quick deployment to users means SERCH can easily accommodate new requests from people or groups that want to take advantage of SharePoint Online. As a result, the solution is growing organically, spreading the benefits of online collaboration across different jurisdictions. For example, SERCH recently added some consultants for the RTI grant to contribute to their ongoing work on disaster preparedness. “It was simple to add them and now we have a subgroup within SERCH that got the disaster preparedness grant,” says Passino. “They will be using SharePoint Online to put up a calendar, manage their project, and store their documents.”

Central Knowledge Base Saves Time Now that SERCH members can go to the document library on SharePoint Online to quickly find information they need, everyone is getting work done more quickly—an invaluable benefit for busy professionals. As members build up a FAQ section, more and more data is available for quick reference, something that Kapoor finds particularly valuable. “At times there have been things I don’t know, say about the rules and regulations on provider qualifications for reimbursement. I have gone to the SERCH site and the FAQs and found the answer there,” he says. “Or if I have a question on health information technology, rather than trying to find the answer myself, I just go to one of the recommended websites, and there are FAQs and the policy documents. Now we

have a good knowledge base for people to help answer various questions in their states, and that’s been extremely beneficial.”

Another way that SharePoint Online is saving time for SERCH members is through online calendars and event planning. It used to be easy to miss an important meeting or conference, but with SharePoint Online, SERCH members can promote important events and share supporting documents to keep everyone up-to-date. “Members thought it would be helpful to include meetings that fit certain categories into our calendar, especially larger events that all the states might be interested in,” says Passino. “I think the calendar use will grow over time.”

Sharing Documents and Online Forum Promote Best PracticesThe fact that SharePoint Online provides a central location for critical documents that are always available is a huge boon for SERCH members because of the unusual circumstances surrounding the Recovery Act. “The fast pace of gearing up to allocate health information technology funding with short deadlines, makes this a very challenging work environment,” says Passino.

With everyone trying to get things done in new and difficult circumstances, having the stability and reliability of an online forum that’s always available for sharing best practices is a great relief. Once members of SERCH have identified the best way to get something done, they can pass on the good news to others. “SharePoint Online is so valuable as an ongoing repository of resources and information for the group. If

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“SharePoint Online is so valuable as an ongoing repository of resources and information for the group. If someone manages to get something finished and approved, sharing that achievement is incredibly important.”

Emily Passino, Senior Management Consultant, State of Tennessee

someone manages to get something finished and approved, sharing that achievement is incredibly important,” concludes Passino. “We have hospitals and providers out there expecting to be paid, and if we ask others how they calculated such and such, and to share that formula, it’s huge. Seeing something getting done right is a great incentive to keep up the good work, and for that we are very grateful.”

Microsoft Online ServicesMicrosoft Online Services are business-class communication and collaboration solutions delivered as a subscription service and hosted by Microsoft. With these offerings, customers can cost-effectively access the most up-to-date technologies and immediately benefit from streamlined communications, simplified management, and business-class reliability and security features. For IT staffers, Microsoft Online Services are backed by strong service level agreements and help reduce the burden of performing routine IT management, freeing up time to focus on core business initiatives.

For more information, visit: www.microsoft.com/online

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Document published April 2011

Software and Services Microsoft Online Services− Microsoft Business Productivity

Online Standard Suite

− Microsoft SharePoint Online