Messaging And Reporting Systems Help Hospital Ease Compliance, Improve Safety

Microsoft Exchange Server 2007 Customer Solution Case Study

Messaging and Reporting Systems Help Hospital Ease Compliance, Improve Safety

Overview “Exchange Server 2007 enhancements such as Country or Region: United States unified messaging and policy and compliance Industry: Healthcare features made [this product] an immediate need Customer Profile for the hospital.” Eagleville Hospital in Pennsylvania is a private, nonprofit organization that Richard Mitchell, Director of IT, Eagleville Hospital specializes in the treatment of drug and alcohol addiction. Its services include The road to recovery: Eagleville Hospital knows it well, having addiction prevention, research, education, and training. helped people fight addiction for more than 40 years. Caregivers at the 310-bed hospital and its affiliated outpatient clinics Business Situation Eagleville Hospital wanted to improve the depend on e-mail for communication concerning patient care. system reliability of its messaging The hospital is replacing its aging Microsoft® Exchange Server environment, decrease support time, and streamline its reporting processes for 2000 messaging system with Microsoft Exchange Server 2007 hazardous events. to improve system reliability and ease compliance with

Solution governmental regulations. The hospital also is transitioning from Eagleville Hospital upgraded to a highly manual process for reporting hazardous events to a Microsoft® Exchange Server 2007 and, with help from Proactive Performance records management system based on the 2007 Microsoft Solutions, implemented a new forms- Office system. This change will help the hospital ensure a higher based records management system that takes advantage of the 2007 Microsoft level of security for patient health information and will streamline Office system. reporting processes that lead to improved patient and staff

Benefits safety. The hospital also expects to significantly reduce time  Faster deployment spent fielding support calls.  Significant timesavings  Enhanced compliance and security  Enhanced productivity for mobile users  Faster, more thorough event reporting Situation Additionally, patient health information at Eagleville Hospital, a nonprofit organization the hospital and its outpatient facilities is located in Eagleville, Pennsylvania, routinely shared in e-mail messages. provides treatment for alcohol and drug Mitchell wanted to make it easier for the addiction and related conditions through its hospital to manage the protection of patient 310-bed hospital facility and its outpatient privacy and comply with governmental affiliate, Riverside Care. Eagleville Hospital regulations such as the Health Insurance serves as a regional resource for the Portability and Accountability Act (HIPAA), prevention and treatment of alcohol and which includes provisions that address the drug addition, co-occurring disorders, and security and privacy of health data. other behavioral health problems. Riverside Care offers a number of programs, Finally, the hospital needed to update a including a 12-week program for those paper-based process for reporting found driving under the influence of hazardous events involving patients or alcohol, and adult and adolescent staff. When an event occurs, a staff outpatient services, at six sites in member fills out an Event Report form, southeastern and eastern Pennsylvania. obtains the required approvals, and delivers the form to the hospital’s Risk The employees of Eagleville Hospital and Management department. Multiple paper Riverside Care, including physicians, psy- copies of the form are maintained in chiatrists, nurses, social workers, addiction separate locations, making the form difficult counselors, group therapists, adjunctive to track. The information in each form is therapists, and mental health workers, rely manually typed into a database, and heavily on e-mail for communication con- processing delays are common. cerning patient care. The hospital used Microsoft® Exchange 2000 Server as its The multistep process may have communication server, with employees discouraged busy employees from accessing the messaging environment submitting reports. “Some events may have through approximately 300 desktop and been undocumented because the process portable computers at its seven facilities. was too slow, too complex,” says Mitchell. The hospital needed to improve and Richard Mitchell, Director of IT at Eagleville streamline reporting so that risk-related Hospital, explains how the hospital and its events could be rapidly documented. This clinics outgrew the Exchange 2000 Server would enable the review and analysis of environment: “The server computer we events, ultimately resulting in a safer were using to run Exchange 2000 Server environment. was undersized, and it was also running a few other applications that impacted Solution reliability. We were fielding at least one In early 2007, with the help of Microsoft support call a day from users who had run Gold Certified Partner Proactive out of mailbox space.” Performance Solutions, a full-service IT consulting firm based in Delaware, Eagleville Hospital performed a gap analysis of the hospital’s IT needs. In remediation, and it provided the information “The Exchange Best examining its future messaging and in a very concise, well-documented Practices Analyzer tool collaboration needs—especially in the area fashion,” he says. Graham also used the of compliance—and its projected growth, planning and architecture documentation accurately documented the analysis determined that the hospital for Exchange Server 2007 implementations about 90 percent of the could benefit from a software upgrade. that is available on the Microsoft TechNet Mitchell felt that new features in Microsoft Web site, which includes disk storage issues that required Exchange Server 2007 would help the sizing guidance and deployment checklists. remediation, and it hospital more easily manage growth and “The guidance in the planning and compliance. “Exchange Server 2007 architecture documents on the Microsoft provided the enhancements such as unified messaging TechNet Web site was very valuable,” says information in a very and policy and compliance features made Graham. “It made for a smooth upgrade.” [this product] an immediate need for the concise, well- hospital,” says Mitchell. Graham also helped the hospital prepare documented fashion.” its Active Directory® directory service for To begin the upgrade, Proactive the transition. “We spent very little time Andy Graham, Consultant and Project Performance Solutions created a test readying Active Directory,” says Graham. Lead, Proactive Performance Solutions environment in the company’s IT lab. Using “We did the work in advance so that we’d Microsoft Virtual Server 2005, the firm be able to identify any potential issues reproduced both the current server early on. The Exchange Best Practices architecture at Eagleville Hospital— Analyzer was very helpful in identifying a Exchange 2000 Server running on the minor issue and providing insight into how Windows® 2000 Server operating system to easily resolve it.” with Service Pack 4—and the proposed Next, test user accounts were created as solution—Exchange Server 2007 running well as rules that would help establish and on the Windows Server® 2003 R2 enforce the foundation’s policies on internal operating system. and outbound e-mail messages. Exchange Server 2007 includes a policy engine “We wanted to have a checklist of steps based on rules that execute on Hub we could take to minimize disruption to Transport servers deployed inside an Eagleville employees,” says Andy Graham, organization’s Active Directory–based Consultant and Project Lead at Proactive environment. The Hub Transport server Performance Solutions. “It was helpful to role of Exchange Server 2007 handles all have access to the 32-bit evaluation mail flow inside the organization, applies version of Exchange Server 2007 and to transport rules and policies, and delivers use Virtual Server 2005 for testing mail to recipient mailboxes. “With the purposes.” Exchange Server 2007 Hub Transport server role, we are able to put rules on the Additionally, Graham employed the server side, where they belong, so that Exchange Best Practices Analyzer tool. policies can be enforced at the message “The Exchange Best Practices Analyzer transport layer,” says Graham. tool accurately documented about 90 percent of the issues that required “Exchange Server In May 2007, the hospital deployed help ensure that only authorized users can Exchange Server 2007 for use by more view or modify information on the 2007 will provide us than 350 people across the hospital’s completed forms. with better encryption seven locations. The hospital also plans to implement Microsoft Office Professional Benefits for e-mail messages Plus 2007, which includes the Microsoft Eagleville Hospital experienced a smooth and help us enforce e- Office Outlook® 2007 messaging and deployment of Exchange Server 2007 and collaboration client, to its administrative anticipates a significant improvement in mail retention policies staff by July 31, 2007. Because one-third of efficiency and eased compliance from its and abide by HIPAA the desktops are shared among staff mem- upgraded messaging environment. bers, many of the hospital’s employees will Additionally, by implementing an electronic regulations.” access the Exchange Server 2007 environ- records management solution, the Richard Mitchell, Director of IT, ment through Outlook Web Access, the hospital’s reporting of hazardous events Eagleville Hospital Web-based e-mail client. will become a more streamlined process.

Also with help from Proactive Performance Faster Deployment Solutions, the hospital designed and built a Graham says that new features of Web-based Event Report form using the Exchange Server 2007—such as the Microsoft Office InfoPath® 2007 Exchange Best Practices Analyzer Tool, information-gathering program. This form the Move Mailbox wizard, optimized will be made available to employees from browser access, and support for previous an internal Web site. With a standard Web versions of Microsoft Office Outlook—have browser, staff will access and complete the saved as many as 30 hours of planning form and sign it digitally. Once submitted, and deployment time and have enabled automatic e-mail notifications will inform all Proactive Performance Solutions to make involved parties of the new report and better use of its resources. actions required through an established workflow. Each time the form is updated, “The tools in Exchange Server 2007 have the reporting database will auto-matically helped us do the majority of the implemen- update as well, providing current data with tation work in advance, making for a quick, which the Risk Management department nondisruptive swap. It’s been a very stable can generate reports. transition to the new environment. The deployment features of Exchange Server The Event Report Web site, enabled by 2007 enable us to better leverage our Microsoft Office SharePoint® Server 2007, resources. I personally appreciate the provides a link to the master form, central- ability to script and schedule a substantial ized storage for the completed forms, and portion of the migration, which substantially the ability to view and manage all reduces the amount of time, especially off- submitted forms. Management staff will be hours time, spent on migration activities,” able to set the status of individual forms says Graham. and sort and view them according to status. Role-based security access, a function of Significant Timesavings the hospital’s Active Directory service, will Mitchell says that his staff will save at least abide by HIPAA regulations,” says Mitchell. a half-hour per day in time spent fielding The type of information the hospital support calls. “With our old environment, transmits is highly confidential, including we had about one call a day from a user drug and alcohol addiction information and who was out of mailbox space,” he HIV statistics, all considered protected explains. “With Exchange Server 2007, information. “If the security of this everyone will have twice as much mailbox information is compromised, patient privacy space.” As a native 64-bit application, is compromised, and the hospital can be Exchange Server 2007 has higher held liable for damages—as well as fines limitations for memory and cache, providing from state and government agencies—and better performance and scalability—even subject to lawsuits. And simply, the as employee mailbox sizes grow. hospital’s reputation can be damaged,” he says. Mitchell says that this timesavings will benefit the hospital because, instead of Mitchell cites the multi-mailbox search “With Office InfoPath working in a “reactive environment,” it can capability of Exchange Server 2007 as an 2007 and SharePoint proactively implement new tools and important technology. Multi-mailbox search technologies. “We’ll be able to undertake makes it possible for administrators to Server 2007, we’ll be projects we haven’t had time for and search multiple mailboxes for specific able to report events allocate resources to project work instead information or keywords—for example, of support work.” One of these planned “patient name and address” or “patient much faster. We projects is to implement Office InfoPath name and HIV status”—and then route any anticipate reducing the 2007–based information-gathering forms messages containing those criteria to a and make them accessible through Office mailbox that can be made available to time of two days that it Outlook 2007 for the purpose of data human resource personnel, compliance currently takes to collection and forms management. officers, or others. The hospital IT administrator can create rules in report an event to just Mitchell also says that now his team will Exchange Server 2007 to purge the system a few hours.” have the ability to restore deleted of those messages after a certain amount messages, something they couldn’t do with of time. Richard Mitchell, Director of IT, Exchange 2000 Server. “We used to have Eagleville Hospital to tell people they were out of luck if they Enhanced Productivity for Mobile Users accidentally deleted e-mail. Now, with Use of Outlook Web Access has enabled Exchange Server 2007, we can do a the hospital to upgrade its messaging message-level restore.” system and provide all users, many of whom work remotely and share computers, Enhanced Compliance and Communication with e-mail access, even if they don’t have Security access to the full Office Outlook 2007 e- Exchange Server 2007 helps keep patient mail client. Outlook Web Access looks and health information safeguarded. “Exchange feels like Office Outlook 2007 and helps Server 2007 will provide us with better users work productively because they have encryption for e-mail messages and help rich Web-based access to their Inbox. The us enforce e-mail retention policies and use of Outlook Web Access in conjunction For More Information with the Office Outlook 2007 client enables Microsoft Server Product Portfolio For more information about Microsoft Eagleville Hospital to meet its business For more information about the Microsoft products and services, call the Microsoft needs. server product portfolio, go to: Sales Information Center at (800) 426- www.microsoft.com/servers/default.mspx 9400. In Canada, call the Microsoft Faster, More Thorough Event Reporting Canada Information Centre at (877) 568- With its 2007 Office system–based records For more information about Microsoft 2495. Customers who are deaf or hard- management system, Eagleville Hospital Exchange Server, go to: of-hearing can reach Microsoft text will be able to minimize delays in reporting www.microsoft.com/exchange telephone (TTY/TDD) services at (800) events and create a safer overall envi- 892-5234 in the United States or (905) ronment. “With Office InfoPath 2007 and 568-9641 in Canada. Outside the 50 SharePoint Server 2007, we’ll be able to United States and Canada, please report events much faster. We anticipate contact your local Microsoft subsidiary. reducing the time of two days that it To access information using the World currently takes to report an event to just a Wide Web, go to: few hours,” says Mitchell. www.microsoft.com Moving from a paper-based system to an For more information about Proactive electronic forms-based system will help Performance Solutions products and improve the overall safety of the hospital services, call (302) 375-0451 or visit and clinic environment because, according the Web site at: to Mitchell, “it will expedite the reporting of www.proactiveusa.com such risk events and allow us to analyze the data more easily to determine cause- For more information about Eagleville and-effect relationships.” Mitchell says that Hospital products and services, call (800) the new system will enable Eagleville to 255-2019 or visit the Web site at: better recognize risk trends, better comply www.eaglevillehospital.org with safety requirements and regulations, and enable staff members to focus on new projects by freeing up time through newfound efficiencies.

Software and Services  Technologies  Microsoft Server Product Portfolio − Active Directory − Windows Server 2003 R2 − Outlook Web Access − Microsoft Exchange Server 2007 Standard Edition Hardware  Microsoft Office  Server computer with dual-core Intel − Microsoft Office InfoPath 2007 Xeon Processor 5130 (2 gigahertz, 4-MB − Microsoft Office Outlook 2007 cache, 1333-megahertz front-side bus) − Microsoft Office SharePoint Server and 8 gigabytes of RAM 2007

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Document published July 2007