Utilizing an Intranet in Disease Management

Utilizing an Intranet in Disease ManagementMarybeth ReganBusiness Insurance Group, Chicago, Illinois, USA

Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1471. Disease Management (DM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1482. Internets, Intranets and Extranets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1483. Intranet Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150

3.1 Inexpensive Connectivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1503.2 Ease of Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1503.3 Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1503.4 Common Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150

4. Transitioning Tools to the Intranet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1505. Intranet Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1506. Developing an Intranet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1517. Return on Investment with Intranets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1518. Using Intranets to Best Advantage in DM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152

8.1 Intranets and Strategic Patient, Provider and Community Linkages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1528.2 Intranets and Access to Corporate Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1528.3 Intranets and Improved Business Efficiencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153

9. Protecting Patient Confidentiality Through the Intranet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15310.Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154

Abstract Disease Management (DM) organizations are facing incredible challenges from outside and inside the in-dustry. A focus on costs can help both managed care organizations and self-insured employers to be more opento the potential of DM in the US.

The steep increase in spending for covered medical services has been the most disturbing development overthe past 2 years. This trend is largely reflected by the average premium growth. Provider revenues per privatelyinsured person (a proxy for spending on services) increased 6.6% in 1999, compared with 5.1% in 1998, and3.3% in 1997. At the same time, consumer demand for quality service, easy access, and reasonable deductiblesand co-payments has risen nationally. There is demand for greater accountability from the medical and ad-ministrative areas. Common challenges for DM entities mandate demonstrated quality, cost of care, out-comes and access to capital markets. Public debate over healthcare models and services has increased consumerawareness of issues that were previously internal matters. Government leaders are responding to consumerpressure with an increasing focus on healthcare issues, as evidenced by the Health Insurance Portability andAccountability Act enacted in 1996 by the US. The end result of all these changes has been an extremelycompetitive marketplace which requires increasingly sophisticated methods for sharing and tracking of infor-mation on patients, members, services, costs and quality.

Today, DM executives increasingly view information technology as an essential tool for addressing thesechallenges and ensuring the survival of the DM industry. Disease managers have always understood the needfor sophisticated systems to collect and track disease specific data, but the cost was a hindrance. As DMorganizations evolve, there is a critical need for new technologies capable of cost effectively linking all thevarious providers, and ultimately the patient. Recent technological advancements include the Intranet, an Inter-net-related technology that has the potential to dramatically improve a DM organization’s ability to meet theneeds of the marketplace. This technology and its implications for DM are discussed in this article.

PRACTICAL DISEASE MANAGEMENT Dis Manage Health Outcomes 2002; 10 (3): 147-1541173-8790/02/0003-0147/$25.00/0

© Adis International Limited. All rights reserved.

1. Disease Management (DM)

The Internet has provided many benefits to both healthcareand disease management (DM), such as 24-hour accessibility toinformation and support, online eligibility and tracking of patientconditions. The structure of the US healthcare industry has stra-tegic and operational issues which can benefit from utilizing theInternet and adding an Intranet, an internal Internet.

An Intranet can go far in supporting operational elements ofDM entities. Implementation of an Intranet strategy in a DM set-ting could provide the answer to improved quality of care, in-creased efficiencies and the demand for outcomes information.For example, consider an individual that works for a DM com-pany who has just been called by a patient with congestive heartfailure. The DM employee could click on the Intranet to find thepatient’s medical documentation (as recorded by the case man-ager) and transfer this information along with a request for treat-ment to the medical director. Once approval is received, arrange-ments could be made with the currently contracted providers. TheDM employee could then click under current contracts to deter-mine who to contact for services and send the specific request tothat provider.

With the impetus to ‘offer a market visible e-something,’many companies fail to focus on the efficiencies that can be gainedfrom an Intranet. E-health has, in varying degrees, affected every-one – patients, doctors, hospitals, managed care organizations,medical suppliers and manufacturers, benefit management com-panies, and technology companies. Most healthcare companieshave entered the e-health learning curve and this rapid influxof industry users is now driving technological innovation. Health-care and managed care organizations have explored DM method-ologies to reduce costs and improve quality of life. The DiseaseManagement Association of America defines DM as a systemof coordinated healthcare interventions and communications forpopulations with conditions in which patient self-care efforts aresignificant[1]. Furthermore, DM:• supports the physician or practitioner/patient relationship and

plan of care• emphasizes prevention of exacerbations and complications

utilizing evidence-based practice guidelines and patient em-powerment strategies and

• evaluates clinical, humanistic and economic outcomes on anongoing basis with the goal of improving overall health.

DM components include:• population identification processes• evidence-based practice guidelines• collaborative practice models to include physician and sup-

port-service providers• patient self-management education (which may include pri-

mary prevention, behavior modification programs, and com-pliance/surveillance)

• process and outcomes measurement, evaluation, and man-agement

• routine reporting/feedback loop (this may include communi-cation with patients, physicians, health plan and ancillaryproviders, and practice profiling).

Full service DM programs must include all six components. Pro-grams consisting of fewer components are DM support ser-vices.

Taking a proactive approach to healthcare through DM pro-grams has the potential to reduce or eliminate future healthcareexpenses, as well as improve quality of life, according to theexecutive report on managed care.[2] The hope is that implemen-tation of Internet technology will improve the chances for DMprograms to achieve these goals.

The Intranet will have as much impact as any other influenceon DM. It will breathe new life into the DM approach by offeringgreater operational and cost efficiencies.[3] According to managedhealthcare executives, the applications in which Intranets can beapplied are so numerous, and the specific uses for which they canbe employed so varied that the possibilities seem endless. More-over, the opportunities for increases in efficiencies, staff and pa-tient satisfaction and, ultimately, market share are enormous.[4]

As more managed care organizations implement or expandtheir use of DM programs, competitive DM firms have developedboth substantive Internet and Intranet strategies and proactivepartnerships with e-health companies. The Internet and Intranetare more than tools; their use offers a new way of doing businessthat will have an impact on virtually all areas of the company.Implementing an Intranet must be accorded upfront planning andattention to detail, as is required in any new business venture.Ultimately, the success of the Intranet in DM programs will bemeasured by its bottom-line impact.

2. Internets, Intranets and Extranets

Like healthcare, electronic communications and business sys-tems have experienced a period of rapid growth and change overthe past few years. After almost 20 years, the use of the Internethas increased dramatically with regard to the number and typesof users, content and structure. According to Taylor Humphrey ina recent study by Harris Poll (17 Febuary 1999), more than 100million adult Americans have gone online at least once to findhealth or medical information. Harris predicts that in the futurepatients will be using the Internet regularly to schedule appoint-ments, refill prescriptions, access updated medical research andreceive advice.[5]

The Internet is a global network of public and private com-

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© Adis International Limited. All rights reserved. Dis Manage Health Outcomes 2002; 10 (3)

puter systems most commonly accessed through the World WideWeb (WWW). The WWW is made up of two parts: telecommu-nications systems, including the physical system of fiber opticcables, wires, switches, and hubs that connect one computer toanother; and the collection of common tools, languages and sitesthat enable these various systems to communicate and share data.Intranets are internal networks that share Internet tools and lan-guages for a single company, typically accessible only by em-ployees. An Intranet’s content includes business information, ap-plications, tools and utilities that help employees do their job.When the Intranet is connected to affinity groups, physicians,health plans, or any combination of healthcare providers or ven-dors in remote locations through a secure network or the Internet,the Intranet becomes an Extranet.[6] An Extranet can be an exten-sion of an Intranet to additional strategic partners, customersand organizations focusing on the reduction of operating costs,increasing productivity through the streamlining of transactionsand the improvement of overall quality.

Organizations invest in Intranets for several reasons. Primar-ily, the Intranet is seen as a tool for getting the right informationto the right people at the right time. Additionally, Intranets arebelieved to reduce costs and cycle time associated with generat-ing and disseminating information, as well as reducing the num-ber of people required to support these activities. Quality andcustomer satisfaction are believed to be increased through the useof Intranets, by providing better and quicker access to informa-tion and reducing the capacity for error and re-work. Better accessto an organization’s knowledge, information, and data creates thecapacity for better decision-making by employees and a moreempowered workforce.

In the context of DM, Intranets enable employees to do thefollowing:• stay informed• be knowledgeable• access the content required for employees to do their jobs• connect with other employees and leadership• contribute knowledge and information• speed up work processes• be more self-sufficient• access corporate repositories from any location• have confidence that information is valid with up-to-date

content• learn from one another• build a corporate memory• leverage existing information and practices• learn and build skills online at any time• in the specific case of DM, manage patients, providers, ven-

dors, hospitals and DM companies.

In order to serve employees and patients, a company’s In-tranet needs to integrate content, technologies, and business pro-cesses. Intranet building blocks typically include:• content management applications• collaborative tools• publishing tools• document management tools• systems integration software to link with line-of-business ap-

plications• directory servers to knowledge, data and information• security management• web-conferencing systems• workflow tools• dynamic, flexible search capabilities• decision support tools• database management tools/analysis and reporting• customizable main Intranet screens (portals).

At the beginning phase of Intranet development, most us-ers of the technology in healthcare organizations were physi-cians using the Internet and the Web for information exchangeand research. This indicates that Intranet developers should finda ready and motivated audience within the clinical practice ofhealthcare organizations.

A corporate Intranet encourages the sharing of informationthereby preventing the hoarding of such knowledge. At the cur-rent stage of DM, where the success of new treatments can beshared between the medical director and the case managers of aDM organization, the internal dissemination of data is crucial.Intranets create a power shift because power no longer goes tothe individual who controls the information; instead power goesto those who can create knowledge from the open flow of infor-mation. It is for these reasons that Intranets have, and will con-tinue to have, a profound impact on patient care and the businessof DM organizations. Intranets have the ability to tear down theartificial walls that often hold back new knowledge and ideas inboth healthcare and DM.

Working smarter is becoming a necessity for entities to by-pass obsolescence. As businesses move online, it is importantto leverage organizational, intellectual, and social capital tomove forward. The fundamental approach of business today –geographically dispersed, more independent work, and quickdecision-making – creates a need to realize value from the un-structured, untapped knowledge depth that already exists withinDM organizations and provider networks. The development of anIntranet joins an organization’s processes and its information togenerate, gather, store, connect, and apply knowledge where andwhen it is needed.

Knowledge management is defined as any effort to link mul-tiple, disparate data and information sources, including physical

Intranets and Disease Management 149


resources like books and databases, in order to document the dis-tribution, understanding and further development of informationand knowledge through electronic means. Knowledge is what isknown as ‘leaky property’. When companies codify, standardizeand disseminate knowledge, its utility (one leg of the economicvalue equation) increases, but its scarcity (the other leg) is threat-ened. The more widely available knowledge becomes, the easierit is to expropriate, replicate and modify. If it is stored in elec-tronic form, knowledge can be copied and transferred around theworld in seconds.[7]

The Intranet is key to the sharing of information behind knowl-edge management, where the sum of the whole is greater than theparts. Knowledge management, translating unstructured informa-tion into value-generating decisions and processes, can benefitDM organizations by providing results that can be clearly bench-marked.

The development of knowledge will be the business battle-ground of the future. Knowledge is power and its developmentemerges from information – our ability to inform and be informed– which evolves from our interactions. If every provider deliversservices well, the only competitive advantage available is theorganization’s superior ideas and the knowledge that it used toimprove processes and business efficiency. These are natural by-products of institutional knowledge sharing.

3. Intranet Benefits

3.1 Inexpensive Connectivity

Intranets are low-cost alternatives to link multiple users andsites since they can often run on existing systems. With the na-tionalization and globalization of DM organizations, along withthe need for local case managers, having various multiple systemsthat are not connected is problematic.

3.2 Ease of Use

Icon-driven point and click technology has become state-of-the-art for computer applications, including the Intranet. The easeof this technology can decrease training costs by up to 50%.[8]

3.3 Integration

An organization’s dependence on proprietary hardware andsoftware decreases. Intranets offer businesses an ability to createnetworks that can easily integrate new applications, clients andhardware.

3.4 Common Standards

Organizations have the ability to construct more modularand flexible Intranet applications through ‘Internet friendly’ lan-guages.

4. Transitioning Tools to the Intranet

This section outlines the key transitioning tools to the inter-net, with a brief description of each:• Line-of-business Applications. This involves operational work-

flow directly affecting day-to-day business of the company.Examples include expense reporting, and order input.

• Employee Tools. These are tools that employees commonly useto accomplish their daily work process. An example wouldbe a company telephone book.

• Informational Sites. Informational sites are departmentalIntranet sites that describe the scope of activities that thedepartment managers utilize. For example, the risk manage-ment department Intranet site explains insurance coverage,disaster recovery planning, and modeling techniques used toanalyze business risk. This can be used by the case managerto track patients.

• Community Content. This comprises features that employeeswill find useful from a personal perspective. Examples in-clude access to freeway traffic reports, online company clas-sifieds, and hyperlinks to sites that provide information andraise money for specific causes.

5. Intranet Application

Ortman reported that healthcare Intranets are being devel-oped for many areas including human resources, finance, materi-als management, physician relations, clinical medicine and pa-tient access.[4] Many technology professionals believe that investingin a healthcare Intranet is a justifiable risk with tremendous po-tential.

Intranets allow community doctors to retrieve informationabout their hospitalized patients from remote sites. Most hos-pitals now have legacy systems that are character-based ratherthan web-based. Indeed, Morris stated that ‘they are only avail-able to people inside the hospital. It’s a clunky use interface thatdoctors don’t like’. Healthcare providers sometimes have to signonto one system to look up information such as hemoglobin andserum chemistries, a different system to view x-ray results andyet another to look at discharge summaries. Morris further statedthat ‘this allows for tremendous efficiencies in clinical time andleads to increased market share for the hospital, because doctorsare more likely to send their patients to a hospital that providesthat kind of service’.[4]

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Sloan Kettering, a prominent hospital in New York city knownfor their cancer programs, has not only developed its Internet, butalso its Intranet system. The evolution of Sloan Kettering’s onlinesystem began in 1996, when James Dockery (a physician at SloanKettering) backed an effort to integrate radiology images intoits corporate Intranet. As the system developed, physicians de-manded more online information. Having images online elimi-nated the problem of lost film, a situation causing annoyanceamong radiologists. It also demonstrated to physicians the In-tranet’s potential.

Now, with the Intranet’s consolidation of disparate informa-tion systems, radiologists have also realized the value of havingreports from other specialists available. Indeed in the Baldwinarticle, Schwartz, the director of Sloan Kettering’s Advanced Im-aging and Informatics Lab, stated that ‘if you get a perplexingfinding, you are able to look at pathway results, operative reports,and history and physicals that can offer insight’.[9]

The Intranet’s reach is broad in other ways. Five physiciansin Sloan Kettering’s affiliated clinic in Barcelona, Spain, some-times log on to view DM guidelines. Available since 1999, theschematic diagrams outline the course of treatment for a givencancer.

6. Developing an Intranet

Following are ten tips that can assist in producing a qualityIntranet site:

1. Obtain consensus from key stakeholders. Once brain-storming is completed and a final agreement on the statement ofwork is made, top management can then decide on the most im-portant areas to be launched. Early identification of problems,discussions, and consensus with peer groups will facilitate prog-ress. For DM organizations, the senior management, medical di-rector, and the director of case management need to be involvedin the process of developing consensus.

2. Apply lessons learned from the consumer website. Imageis important internally and DM employees can be positively in-fluenced by many of the same features that work for externalcustomers. Creating a solid internal brand will help launch theIntranet and continue enthusiasm for its usage and maintenance.For DM organizations that act as an extension to payers, it isimportant that an individual identity is preserved both internallyand externally.

3. Understand your core competencies with human resources.An Intranet group within a DM organization will need individualswith different types of skills. With limited resources, it is criticalto identify and locate individuals with the skills that are needed

to maintain and improve the Intranet site. Outside contractors canbe hired for the rest of the project.

4. Take technical cues from best practice standards on theInternet.Use graphics, proven programming languages and data-base tools. Thoroughly research hosting options. Ensure that net-work infrastructure for Intranet delivery is in place and testedprior to launch.

5. Integrate traditional business applications. Wheneverpossible, take advantage of business applications on other com-puter platforms. Use a three-tier approach to line-of-business ap-plications by using the Intranet, (i) as the user interfaces to anexisting legacy application located on a mainframe or other com-puter; (ii) with special translating software; (iii) as an intermedi-ary that ensures that the two systems understand each other.

6. Be realistic about the scope of the project within the DMcorporation.When a statement of defined work for the DM orga-nization is completed, protect from ‘scope creep’, which can ruinthe project’s timetable and budgets. If changes are needed, re-evaluate the original plan and modify it accordingly.

7. Create an atmosphere and climate for collaboration withother DM organization employees. Communication is the key tosuccess in a rapid application development.

8. Celebrate each and every milestone. Do not wait for pro-ject dates to release new programs. Allow the work that has beencompleted to be viewed by all. Progress is a great motivator; itpoints to the contributors, and identifies where difficulties maybe occurring.

9. Develop a pilot with stakeholders. Create a β group andpre-launch the DM’s Intranet prior to completing quality controltesting. Allow a number of personnel to view the results. Presentthe near-finished product to all executives prior to the launch date.

10. Celebrate the completion of the Intranet with all in-volved from the DM organization, especially the developmentteam. Launch the Intranet site with a full marketing and publicrelations blitz including teasers that build anticipation. Measureresults regularly.

After the Intranet becomes a corporate tool, it makes senseto extend it to providers, vendors, business partners and affiliatedcompanies. This is the process of building an Extranet. An Ex-tranet is the culmination of bringing web technology into thebusiness environment and redefining the way business is done.

7. Return on Investment with Intranets

Insiders know that using Internet technology to produce In-tranets and Extranets is the best return-on-investment bet in theinteractive marketplace today. These initiatives address some ofthe real problems facing companies, such as managing corporate



legacy databases and vast private networks, and the increasingdemands of administration. The opportunity for higher profitsthrough improved efficiency and productivity resulting from In-tranet technology is achievable with manageable technical effortand cost. The primary challenge to maximize the Intranet’s po-tential is in education and managing change.

The Internet was the first step in a technical revolution thatcontinues to have a major impact on society. The business use ofInternet technology, specifically Intranets and Extranets, will ul-timately have a similar impact on the world’s economy. The pur-est proof is the return-on-investment provided by Intranets. In-tranets and Extranets improve productivity and save money. Theycreate more net income to business. Intranets usually return 100%of their implementation costs in less than 6 months.[6]

Unlike many public web sites, the return on a corporate In-tranet is easy to measure. Using basic Internet tracking tools, thenumber of Intranet visits can easily be measured. Benchmarkingstudies can determine the exact savings that the use of a singleapplication produces. By combining these tools, the dollar sav-ings of each application are easily determined. For example, theIntranet permits the staff in a physician’s office to enter the au-thorization request online by using a browser. Before it can betransmitted, the system automatically verifies that the request hasbeen properly completed and includes all required information.Once it is complete, the workflow software automatically routesthe request through the approval process. Under normal circum-stances, the review and approval may occur completely automat-ically, and the reply is sent to the physician almost instantane-ously. Where exceptions occur (or for quality review purposes),the approval may be forwarded to other departments for process-ing. The results are substantial improvements of process cycletimes (typically 50 to 70%, or greater); reduced processing costs(often greater than 50%); fewer processing errors and requiredre-work; and lower paper, storage, phone, fax, courier and mail-ing costs. In addition, the Intranet completely eliminates the prob-lem of lost authorization requests. Staff time is also reduced bothin the physician offices and in the management service organiza-tion because the status of pending authorizations can be viewedonline, eliminating the need for telephone inquiries. Most impor-tantly, patient, health plan and provider satisfaction is vastly im-proved.

Certainly, no new technology is without challenges. Health-care organizations planning to capitalize on Intranet technologyshould devote significant effort to upfront planning. It should berecognized that each organization is different and there is no ‘one-size fits all’ in Intranet design. The strategic goals each DM or-ganization has for Intranets will vary depending upon a numberof characteristics, including organizational size, services pro-

vided, market position, competitive position and geographicallocation.

Ultimately, however, the enormous potential of intranets restsupon the fact that there is no other cost-effective mechanism forlinking providers, payers, and DM organizations in a complexhealthcare delivery network. With the challenges facing thehealthcare industry today, the ability to access, share and usecritical information is an essential component of any strategy forsuccess.

8. Using Intranets to Best Advantage in DM

DM offers great potential to provide better treatment out-comes at a lower cost. Its dual focus is on providing all elementsof care in an integrated fashion throughout the continuum of careand on continually measuring quality and costs for the durationof treatment. A DM company can connect their employees andhealthcare providers via an Intranet for competitive advantage.An Intranet is an ideal tool to collect and track timely and accurateinformation to manage patients who are enrolled in the DM pro-grams. For example, an Intranet allows a patient’s daily changesto be tracked by both the case manager and the medical directorof the DM company.

8.1 Intranets and Strategic Patient, Provider andCommunity Linkages

DM organizations function as a complex web of provid-ers, physicians, hospitals, outpatient services, pharmacies, pay-ers, employers, community service organizations and others. In-tranets provide a cost-effective tool for improving and streamliningcommunications and business processes among the providers.Possible uses are the contracted home care agencies directory todetermine the agency most geographically appropriate for thepatient, access to clinical guidelines, protocols and patient infor-mation.

8.2 Intranets and Access to Corporate Information

Most DM organizations have many department-specific orproblem-specific systems that were developed to meet a particu-lar need. This practice becomes a larger stumbling block as theentity grows. Intranets can give users easy access to informationfrom a variety of sources. For example, uses could include ex-pense and sales budgets, updated forecasts, revenue variance re-ports, a list of current patients under case management, and pro-vider manuals.

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8.3 Intranets and Improved Business Efficiencies

Cost savings can be achieved through improved processes andalso through administrative cost reductions. For example, timeconsuming processes such as scheduling meetings or communicat-ing with employees about benefit changes will be more efficient,but cost savings are also realized from the resulting decrease in sta-tionery and mailing costs. Human resource departments had some

of the first systems available to incorporate capabilities that enabledemployees to look up, modify and enroll in benefits programs online.

9. Protecting Patient Confidentiality Through the Intranet

There have been justifiable legal and ethical concerns aboutpatient confidentiality with DM healthcare organizations regard-

Table I. Summary of potential areas for consideration for use of the Intranet

Content type Description

Announcements from leadership Push important information out to all employees

Quick surveys Provide a place to capture feedback from employees on issues

Competitor activity Push important information to employees, help create a sense of urgency for business outcomes, providereal-time benchmarks on the company’s performance

Company-specific external media news Educate the organization on the company’s place in the marketplace

Updates on company initiatives Provide common understanding on status of company-wide initiatives

Best practices Share practices across the organization to encourage cross-pollination; allows employees to learn from others andbenchmark their own practices relative to those being recognized in other parts of the organization

Departmental information Departmental descriptions, services offered, contact information. Provide information to employees to facilitate thelocation of people and organizations they need to interact with; create a broader awareness of the membershipand activities of the entire organization

External syndicated information Provide information on work/home topics to build interest and address the ‘personal side’ of employees’ lives

Classified advertisement postingservices

Create a mechanism to draw employees in, facilitates connecting employees who might not otherwise come intocontact

Suggestion box Create an outlet for opinions, assist leadership in understanding the cultural ‘pulse’ of the organization

External business news updates Create a broader awareness of the bigger picture

Corporate information Reduce paper and cycle time by publishing human resource policies and procedures, benefits information, regulatory information and policies, and other types of information for easy access by employees; information can be linked to associated contacts or departmental homepages

Organizational charts Provide visual representations of organizations and reporting relationships for employees, possibly with links tocontact information and biographies, as well as photographs

Alliance/partner websites Provide links to organizations that are closely involved or related, possibly with password protected access intospecified areas on their Intranets

Event and bulletins/calendar Notify employees of upcoming events or provide bulletins with important information

Job postings Post internal positions and provide capability to apply, post a resume, and receive a notification of results

Training opportunities Locate information regarding available training as well as information regarding price, timing, and procedures forregistration. Provide online training via the Intranet

Publications Web seminars, newsletters, manuals, presentations, reports, and financial documents

External web-based information Provide the capability for employees to search for or link to external sites based on particular needs

Marketing information Supply information and presentations that employees can use with customers, partners, and suppliers formarketing the organization’s services

Academic and professionalpublications

Employees can access journal articles with the latest research and knowledge in particular fields of study; paperscan be located and printed via the Internet

Periodical subscriptions Employees can search the media on any given topic from a variety of sources subscribed to, such as Reuters,The New York Times, Harvard Business Review, etc.

Service providers in the proximity ofthe office

Provide employees with information regarding nearby parking, restaurants, entertainment activities, etc. withinwalking distance from the office. This eases the transition for new employees and makes veteran employeesaware of new offerings

Financial information Provide the ability to access ad hoc requests for disease-specific information, types of treatment, geography, bestpractices, treatment cost, and days off work

Office supplies An online catalog/listing of standard stock office supplies with the ability to place a request and an order

Emergency contact/crisismanagement information

Provide up-to-date lists of responsible parties and contact information



ing patient data captured on their systems as well as vendors’ andinsurance companies’ systems. While no security can be com-pletely foolproof, a number of security tools have been developedthat provide reasonable levels of security for most Intranet appli-cations. Firewall technology can be used to protect an Intranetfrom unauthorized users or to protect programs and informationfrom other internal and external networks. Data encryption andother related techniques can be used to protect the integrity andconfidentiality of information while being routed through the net-work. Digital signatures can be used to verify the source andauthenticity of a message or transaction. Available security fea-tures can be combined within the site to restrict access to spe-cific functions and information (i.e. clinical guidelines or medicaldatabases) to authorized users only. Table I summarizes potentialareas for consideration for use of the Intranet.

10. Conclusion

Intranets are a powerful new tool for addressing many ofthe challenges currently facing DM including: improving patient,member, and provider satisfaction; increasing operational effi-ciencies; reducing costs; and improving the overall quality ofcare. Intranets provide an ideal means for making patient, mem-ber, services, cost, and quality information accessible across theentire continuum of care – services for the whole episode of carethroughout the disease. Workflow capabilities inherent in prop-erly designed Intranets and Extranets offer real opportunities toimprove and streamline many of the administrative problem areasassociated with DM (such as eligibility and benefits determina-tion, referrals, authorizations and claims processing). Intranetsalso offer DM organizations the opportunity to significantly en-hance and upgrade their existing information technology infra-structures without having to replace costly legacy systems.

Ultimately, however, the enormous potential of Intranets andExtranets rests upon the fact that there is no other cost-effective

mechanism for linking providers, payers, and employers to-gether in a complex disease-specific delivery network. With thechallenges facing the DM and healthcare industry today, the abil-ity to access, share and use critical information is an essentialcomponent of any strategy for success.

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4. Ortman N. Healthcare intranets are healthy investments that pay for themselves.Manage Healthcare Exec 2001; 11 (8): 42-5

5. Taylor Humphrey. Harris Poll #11[online]. Available from URL: http://harrisinteractive.com/about/healthnews/HI_HealthCareNews2001Vol1_iss.7.pdf [Accessed 1999 Feb 17]

6. Haylock CF, Ford C, Muscarella L. Net success, using intranets and extranets togain advantage. Holbrook (MA): Adams Media Corporation, 1999: 170

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About the Author: Marybeth Regan is an internationally recognized expertfocusing on healthcare issues including disease management, e-healthcareand privacy (HIPAA). Dr Regan has extensive experience in the develop-ment, marketing and implementation of products and services developedfor the payor and provider environments. Ms Regan is a frequent presenterat local, national and international conferences and has published numerousarticles on e-Health, Healthcare Policy and Disease Management. She holdsa B.S., M.S. and D.B.A. in International Healthcare from the InternationalSchool of Management, Paris, France. Dr Regan currently teaches at theInternational School of Management, Paris, France, the University of Phoe-nix and the University of ChicagoCorrespondence and offprints: Ms Marybeth Regan, 880 Guerin Road,Libertyville, IL 60048, USA.E-mail: [email protected]

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Utilizing an Intranet in Disease Management