History has given intranets a bad name; yet modern iterations of these tools represent an opportunity for Trusts to improve working practices and processes across the estate. Plus, specialist implementations of Microsoft SharePoint like Cloud2’s Hadron 8020 make deployment and the route to ROI faster and pain-free.

It seems like the fragmentation of technology both in the NHS (the demise of NPfIT) and in our lives generally (all those cloud services we like to use) make larger IT propositions look outdated. But there’s a big difference between Big Bang and big ambitions.

Big Bang deployments are indeed out of favour. But deploying lots of small solutions to solve a multitude of discrete problems brings its own constraints. By definition, small tools cannot extend to solve big problems. Simon Hudson, founding Director of healthcare intranet specialists, Cloud2, says, “A bunch of individual, siloed applications has too many limits – the business processes you’re trying to improve become disjointed. Users don’t know where to go to solve their real-world problems, or have to log in many times – often a challenge in NHS IT setups. If the current bed state is in one application and deep clean request forms are in another, it’s a recipe for confusion, error and wasted time.”

This is why one of Cloud2’s NHS clients found themselves struggling with no less than 126 different systems – and all their attendant complexities, maintenance schedules, servers, human resource specialisation requirements and impenetrable user experiences. Instead, says Hudson, “with an enterprise intranet, you get one consistent place to do everything.”

From vision to value

Luckily, creating an enterprise-grade intranet need not be a Big Bang project. Instead, it needs to be a project with vision. Cloud2 Marketing Manager, Ed Tomlinson says, “It’s much better to buy into a platform which solves the problems you’ve got today, but which has the capability of solving the problems you’ll have tomorrow. You don’t have to switch it all on at once, provided you have a coherent vision. Our research shows that intranet projects fail primarily because they are too narrowly focused on ‘phase one’ outcomes, and then fail to scale to the other functions you might really want. SharePoint, Microsoft’s intranet server software, can do practically everything an NHS Trust needs of an intranet; it just demands forethought to extract maximum value”.

What that maximum value might look like is much more than the outdated concept of the intranet as a dusty and unloved document repository. Hudson has a clear and programmatic set of deliverables; indeed, he says “if it isn’t doing all these things, then it’s not a proper enterprise  intranet”:

  • Communication: the original role of an intranet, it should be not just a noticeboard, but a source of deep insight, including external information sources and a route to sharing all the knowledge of all the people involved in the Trust.
  • Content: your intranet should include a critical mass of content, from policies and procedures through to full staff contact information and profiles and their working documents. (Tomlinson also points to social network-style profiles as one of the fastest ways to drive engagement on an intranet). It will include powerful search functionality to make all that information usefully available, and forms workflow so that, say, filling in a leave request and then getting it approved by the right person, becomes simple and natural. Finally, to make content creation a controlled process, it should include content lifecycle management with statuses like creation, approval, publication and expiry embedded as defined processes. In this way, the intranet becomes a tool of governance, not just storage.
  • Collaboration: A good intranet will support real-time collaboration - working on a document together, regardless of location or device. It will also deliver offline collaboration, with alerts for document handovers, for example, or for driving research (“who do we know in paediatrics that could help with this question?”). Says Hudson, “The really good part is when that collaboration happens both inside and outside the ‘firewall’, embracing external stakeholders and people out in the field.”
  • Business Processes: An effective intranet applies raw knowledge to real line-of-business tasks and challenges; from registering patients to submitting expenses. It can provide an application portal to interface with legacy systems, or individual processes can be built into the intranet itself.

Hudson says, “An intranet should do all these things easily; I should be able to find anything I need within a few tens of seconds; on any device, anywhere I need to do business. And no Trust should underestimate the importance of these back office processes. It’s easy to forget that a lot of the inefficiencies within NHS Trusts occur because too little attention is given to non-clinical activities. Only one third of the staff in a typical Trust are clinicians. The rest are there to keep the lights on; and if you don’t get that right, clinical delivery is compromised; surgeons are stuck in slow and inefficient processes, morale is impacted… and that’s before we even mention patient records.”

As well as oiling the wheels of everyday Trust activities, a specialist healthcare intranet delivers a host of additional benefits in tow. Making documents usefully accessible, yet with the assurance and security of managed workflow, de-risks the organisation. It creates a regime compliant with external audit bodies, produces a low-maintenance audit trail, and can even reduce corporate insurance premiums.

With NHS Trusts being some of the most physically dispersed organisations in the country, an intranet can also massively reduce travel cost and time inefficiencies – along with producing associated environmental benefits. Tomlinson adds, “Another environmental benefit is a reduction in paper and paper forms. Cloud2’s independently commissioned analysis showed that for a typical 3000-seat trust, a properly implemented intranet will yield £3-4million in savings; a major proportion of that being reductions in travel and paper.”

Hadron 8020: Cut 80% from your intranet deployment cycle

However, the fact remains that SharePoint intranets have a reputation for complexity. Cloud2 has therefore developed Hadron 8020, a SharePoint product implementation and methodology designed to massively reduce the complexity and deployment cycle of intranets specifically in healthcare settings. Hudson says, “It adopts the simple approach that most NHS organisations have the same core needs, and we can preconfigure the architecture to addresses those needs. In most cases we have over 80% of an intranet specification already configured to a Trust’s explicit and tacit requirements. Instead of building it from scratch, they can spend their time thinking about the elements we haven’t yet addressed or which are genuinely unusual in their organisation.”

“A traditional SharePoint engagement demands 4-6 weeks just on the requirements gathering, and then an 8-16 week build cycle (or even longer), with testing and debugging after that. With Hadron 8020, we typically specify the requirements in just one week, build in 2-3 weeks, and, crucially, see value-generating user-acceptance in 8 weeks, often less. It’s well documented that the longer a project takes to deliver, the higher the chance there is of failure, so this accelerated process hugely de-risks the deployment - and also means clients can rapidly move to the next phase and do more exciting things.”

As well as rapid deployment, Hudson has further sound advice for a successful SharePoint implementation:

  • Define it as a business project, owned by operational staff, not a technology project (owned by ICT) or a communications project (owned by the Comms team). This will ensure that the focus remains on measurable, business-specific outcomes.
  • Get advice from the experts. NHS professionals are not information architects, so use a Partner like Cloud2 to provide that crucial knowledge of informational structure, tempered with a realistic approach which appreciates that data is only useful if it is presented to staff in ways which are meaningful in their day-to-day work lives.
  • Don’t give in to the temptation to write code. SharePoint delivers all the functionality needed to develop massively functional intranets, fresh out of the box. Bespoke code involves expense, and also the need to document and support the changes made – plus the further temptation to keep bolting on more complication later.
  • Talk to the users. Says Tomlinson, “Most NHS organisations already have an intranet, and, usually, too many users say they hate it. So, identify how they really use it, where their expectations and frustrations are, and chart a realistic path to something genuinely useful.” Hudson adds, “It’s quite common for users to have different needs to those which the managers responsible for the project think they have– and often those needs are really simple. Don’t get hung up on trying to execute over-specified applications which nobody uses, if users on the ground just want to find their documents and have a good staff directory. Part of our philosophy is that the first results of an intranet should touch everyone in the organisation, not a privileged few.”

Intranets have come a long way from the unwieldy behemoths of a decade ago, and they are becoming ever more user-friendly. With the launch of Microsoft Surface devices and the proliferation of touchscreens at the bedside, one of Cloud2’s recent developments is complete touch support within Hadron2. The company is also developing tools for the rapid importing and restructuring of data from legacy file servers; and many providers are putting effort into designing highly naturalistic interfaces, including elegant app-like tools for a ‘wow-factor’ which drives user adoption and speeds up the familiarisation process.

Intranets are no longer unwelcoming to users. They no longer require 12 months to deploy. And they no longer suck up new resources for each new business challenge resolved. It’s the ideal time to have big ambitions to improve the back-office functions of a Trust, without big bang ICT.

Cloud2: http://www.cloud2.co.uk/

The Hadron Solution: http://www.cloud2.co.uk/solutions/hadron/


by Nick Saalfeld

Journalist, Microsoft Health