Saturday, October 30, 2021

Optimizing your Intranet

Hi fellow CMIOs, CNIOs, Applied Clinical Informaticists, and other HealthIT friends,

It's been a while since my last post - As you know, healthcare is very busy adapting to changes brought about by our global COVID-19 pandemic. While the pandemic has and continues to be a great source of sadness and tragedy, it also brings a lot of change - I think a lot of this change is going to be very good, and facilitate lots of innovative, new ways to deliver care.

So for this post, I thought I'd piggyback onto my last post, "Welcome to Healthcare", by showing how helpful it can be to use a standardized index of healthcare to optimize your organizational Intranet

Why optimize your Intranet? It's the one 'filing cabinet' that everyone has access to, on their desktop, usually with one click. Imagine... Could your Intranet become a silo-bustinghigh-value tool that your employees use regularly to quickly find helpful information, that helps them troubleshoot problems, plan solutions, and easily learn about the people they work with? Could it also be an internal communication tool that invisibly teaches them about the structure of healthcare? I believe good indexing can do this, and I'll share why I believe this below.

But first - I'd like to provide some background, using one of my heroes, the brilliant Clinical Informatics pioneer Lawrence 'Larry' Weed, MD (1923 - 2017).

Dr. Weed and Dr. Stanley
A treasured photo of me with the great Dr. Larry Weed, 
at the 2014 HIMSS Conference.

If you've ever written a SOAP note, it's because of Larry Weed's 1968 New England Journal of Medicine article, "Medical Records that Guide and Teach" - This was the breakthrough article that changed the way the whole globe writes clinical documentationA copy of his original article in .PDF format is available on the Washington University web site by clicking here.

It's a fantastic read. What amazes me is that his SOAP note template allowed us, as clinicians, to organize our thoughts and then share them with other clinicians. One could argue that the whole specialization of healthcare in the 1960s and 1970s was made possible through his contributions to clinical documentation! 

In short - Larry Weed was right. You can't separate reading, writing and thinking - They are intrinsically connected. How you read and write shapes how you think. (By the way, if you'd like to learn more about him, you can also see his 1971 Grand Rounds at Emory University by clicking here.)

Now, borrowing from Dr. Weed's lessons that what we read and write shapes how we think - let's look back at the sample index we discussed in my last post. (Remember, your mileage may vary, depending on your institution's needs...)

Sample Healthcare Index
Note : This [DRAFT] sample index may vary from institution to institution, depending on your needs. 
Also, for clarity and brevity, it also does not reflect the Board of Directors.

This general-purpose index can help us make seven very helpful Intranet homepages that guide and teach (thank you Dr. Weed!), with landing pages specific to each operational area of your institution, but yet connected to each other logically by links and strategically-designed news/announcement links. For example, using this index :

1. The Administrative Enterprise (1) Homepage would look something like this : 

Administrative Enterprise Homepage (1)

Notice that in each of these pages, for institutional communication and awareness, there are three news banners for Administrative news local to this page, and also news from the other areas of the organization.

2. The Academic Enterprise (1.a) Homepage would look something like this : 

Academic Enterprise Homepage (1.a)

Here again, for awareness - there are three news banners, connecting Academic users with the events happening in Administrative/Research/Clinical Enterprises, and also the clinical services

3. The Research Enterprise (1.b) Homepage would look something like this : 

Research Enterprise Homepage (1.b)

Again, with its three news banners, the Research Enterprise Homepage connects users with Administrative, Academic, and Clinical Enterprise news. 

4. The Clinical Enterprise (1.cHomepage would look something like this : 

Clinical Enterprise Homepage (1.c)

While the first level of news banners here is focused on Clinical Enterprise news, the second level connects with Hospital-Based, Ambulatory-Based, and Off-Campus Services, followed by a third with Administrative, Academic, and Research News. 

5. The Clinical Enterprise > Hospital-Based Services (1.c.iHomepage would look something like this : 

Clinical Enterprise > Hospital-Based (1.c.i)

Here, the primary news links are related to Hospital-Based News, followed by General Clinical Enterprise and Ambulatory Clinical Service News, followed by Administrative, Research, and Academic News. 

6. The Clinical Enterprise > Ambulatory-Based Services (1.c.iiHomepage would look something like this : 

Clinical Enterprise > Ambulatory (1.c.ii)

Here, the news links will help connect Ambulatory Users to Ambulatory News, followed by General Clinical Enterprise and Hospital-Based news, followed by Administrative, Research, and Academic news/announcements. 

7. Finally, the Clinical Enterprise > Off-Campus Services (1.c.iii) Homepage would look something like this : 

Clinical Enterprise > Off-Campus (1.c.iii)

Here, the news links help connect
Off-Campus Clinical Services with Off-Campus News, followed by General Clinical Enterprise news, followed by Administrative, Research, and Academic News links. 

Creating this sort of framework is not easy, and would require a significant investment in time and resources to implement and maintain this. One of the biggest challenges would be maintenance - How exactly would you maintain such a framework? Would there be one central 'webmaster' team, or would there be distributed 'webmasters' in different departments, each trained to maintain their area, links, news/announcements, and files?

That being said, I do believe there could be significant benefits to this sort of structure, by educating and empowering all of your employees to strategically find solutions within a few clicks of their landing page.

Either way - I hope this sample index and these designs help you think about how to strategically design and optimize your Intranet for your own institution.

Have any experience with Intranet optimization? See any areas for improvement? Feel free to leave them in the comments section below!

Remember, this blog is for educational purposes only - Your mileage may vary! Do not make any changes to your Intranet strategy without discussing, scoping, prioritizing, and approval from your own leadership teams!