15 November 2007

Eastern Health is the second largest healthcare provider in the State of Victoria, Australia. The organisation provides public healthcare services to a population of 800,000 people in an area covering approximately 2,800 square kilometres in the eastern part of the city of Melbourne.

Eastern Health is the main provider of health services to residents of this area, offering a range of acute, sub-acute, mental health, and community health services from more than 50 sites. The organisation supports teaching, training, and research in the disciplines of medicine, nursing, and allied health. It has more than 7,000 staff members, including 4,300 full-time employees.

With staff dispersed over such a large area, Eastern Health required a highly available communications infrastructure that was both responsive and scalable. "As part of our ICT strategic plans, we were actively looking for a solution to consolidate and extend the functionality of all our communications," says Mark Gardiner, CIO at Eastern Health.

"We are expanding and commissioning new facilities in 2007, so consolidating our information technology infrastructure seemed the smart and logical thing to do," he continues. "What we had to remember was that we are not an information technology organisation. We needed a solution that nontechnical people could use."

Gardiner notes that Eastern Health IT services compete for funding with other departments, such as clinical services. "We had about AUD 1 million (?592,000) for ICT access across all our locations. So our decisions on any additional IT investments have to be very well justified," says Gardiner. "When considering any new facilities, we have to optimise the costs and returns. By working centrally, using the investment to serve several facilities, we can work smarter and save costs."

Eastern Health conducted an internal review that looked at its core business values, and it identified four key areas to enhance its communications infrastructure for both mobile and institution-based staff. These were: an efficient way to improve staff collaboration; incorporation of voice functionality using existing telephony services; seamless integration of a diverse range of applications; and development of a single, common interface to facilitate ease of use and learning.

"Though we already used e-mail messaging and telephony services extensively, these were not providing effective communications across all levels at all times," says Gardiner. The organisation already had BlackBerry devices and Palm Treo smartphones deployed for mobile messaging in clinical, radiological, and administrative areas. "We needed to better support our mobile practitioners, particularly in the mental health disciplines. They often have to travel very long distances to treat patients."

Eastern Health wanted to integrate voice-mail capabilities with users' mailboxes to allow for additional messaging options and to streamline the users' experience by providing multiple ways of accessing their inbox.

To keep costs down and ease user transition, Eastern Health wanted an integrated solution that included existing applications, instant messaging (IM), and the future implementation of conferencing using voice over IP (VoIP). "Our staff are medical personnel who do not want to deal with relearning new tools every time we update systems. We needed a solution that would augment and ease the transition to a new communications gateway."

Seeking to unify all its communication tools through a single gateway, Eastern Health approached Microsoft Gold Certified Partner Dimension Data in early 2007 to help identify the best solution.

Gardiner says Eastern Health was mindful of integrating any new environment into as many of its existing solutions as possible. "Dimension Data was able to convince us that Microsoft added the most value of the solutions available in the market, because of its ability to integrate voice-mail capabilities with user mailboxes to allow for additional messaging options, and to streamline the users' experience by providing multiple ways of accessing their inbox."

Eastern Health decided to upgrade from Microsoft Exchange Server 2003 to Microsoft Exchange Server 2007 with unified messaging. The organisation already offered its staff some conferencing functionality through Microsoft Office Live Meeting, but was looking at the possibility of extending its communications capabilities using Microsoft Office Communications Server 2007.

As David Quist, account manager at Dimension Data, notes: "Exchange Server 2007 offers an attractive upgrade path for future additions to the organisation's communications capability. Eastern Health was looking to develop a solution that could be expanded across all areas of messaging in the future, not just to implement individual solutions to solve its immediate needs," he says.

Exchange Server 2007 unified messaging delivers e-mail, voice mail, and faxes to users' inboxes. Users can access that information from familiar clients such as the Microsoft Office Outlook 2007 messaging and collaboration client, or from a telephone using Microsoft Office Outlook Voice Access. With Office Communications Server 2007, users can send instant messages and see the availability of other employees through presence awareness. Presence signals a user's availability using a coloured alert linked to that person's presence status as set in his or her Office Outlook 2007 calendar or Microsoft Office Communicator 2007 client.

Eastern Health began the upgrade project in early 2007. It ran Exchange Server 2003 and Exchange Server 2007 in a clustered environment using Dell blade servers across five campuses, which include 50 physical sites. In addition, Eastern Health deployed Office Communications Server 2007 on new Dell blade servers with EMC SAN drives that were used for storage and archiving.

Gardiner's team examined the functionality and features of Exchange Server 2007 unified messaging, completed the proof of concept, and defined the deliverables the organisation expected from the final implementation. Says Gardiner: "What was critical for us was the ability to smoothly integrate our existing data with Exchange Server; we had nearly 7,000 mailboxes to manage. We also wanted to integrate Office Communications Server 2007 to give us IM and the potential for conferencing with VoIP through our main telephony supplier, Cisco."

A pilot began in June 2007. The 100 trial users returned overwhelmingly positive feedback to Gardiner and his team. "Everyone in the pilot wanted all the features. Using the presence feature, they could see who was available, and mobile staff could check their calendar using Office Outlook Web Access," says Gardiner.

The unified approach also allows practitioners to identify the most effective way to contact other staff, and helps make automatic call re-routing possible if the person changes location. This is an important issue for patient care if a practitioner is on the road and needs to answer an emergency call.

The pilot introduced a minimum of disruption to normal working. "We had very clear communications (from Dimension Data) on how to implement the Exchange Server 2007 unified messaging solution. We experienced no grief, no business downtime, and no impact at all on our hospitals. The whole implementation was quite seamless," says Gardiner.

The organisation plans to move all its services progressively to Exchange Server 2007 in the near future, with more than 4,000 seats accessing the new environment.

Gardiner says the next phase of deployment will be aimed at new hospital and health facilities currently being constructed and launched. "At the moment, two large hospitals are being built and we are implementing a major expansion to three other existing facilities. These will all benefit from the cost advantages of deploying unified communications solutions like Exchange Server 2007 with unified messaging and Office Communications Server 2007. Including the ICT costs in the building process means an opportunity for us to consolidate our IT resources much better in future," he says.

By deploying a unified communications solution based on Microsoft Exchange Server 2007 and Office Communications Server 2007, Eastern Health has improved internal communications and optimised its existing IT investments. The new environment offers improved management for all Eastern Health distributed locations, which translates into more rapid and effective patient care and better use of resources.

Exchange Server 2007 with unified messaging and Office Communications Server 2007 help Eastern Health staff, both in hospitals and on the road, to stay in constant contact easily, and to use their time most effectively to provide improved patient care. Office Communications Server 2007 makes it possible for employees to know immediately if other specialist staff members are available, and how they want to be contacted.

Eastern Health boasts a significant mobile fleet for its mental-health services, with workers keeping in contact using a range of handheld mobile devices and phones. By taking advantage of the Exchange Server 2007 integrated voice-mail capability, users can now retrieve voice mail and e-mail too, using Office Outlook Voice Access.

"We have a number of hospitals in East Melbourne, and Exchange Server 2007 unified messaging has helped us in communicating extremely effectively across them," says Gardiner. Working with only their phone extensions and the speech-enabled interface, Eastern Health staff have instant access to all messages, wherever they are.

Deploying unified communications through Exchange Server 2007 and extending its capabilities with Office Communications Server 2007 has helped reduce overall IT expenses. Eastern Health has installed voice-mail access to 7,000 mailboxes; without the need for expensive upgrades to its existing private branch exchange systems. And with Office Communications Server 2007, it anticipates using VoIP functionality for even more savings in the future.

Responsiveness in a clinical environment is critical to the delivery of the right services at the right time. "With Office Communications Server 2007 presence management, we can locate medical personnel much more effectively than with e-mail. We can get information to the right people quickly, so they can act on it immediately," says Gardiner. Another positive aspect is the potential for staff to use the Office Communicator 2007 client as a conduit for internal calls. "Using Office Communicator 2007 for internal messages between staff will allow Eastern Health to better control [costs], as well as offer better, centralised server management," David Quist, account manager at Dimension Data says.

Full-time access to all staff through a single interface has also made workers at Eastern Health more efficient at completing everyday tasks. Gardiner notes that the time saved in looking up phone extensions alone is significant, because staff can plan their calls by checking the presence icon to see who is available. The bonus is that the training time required for staff to learn systems and applications is much shorter than for a separate system, because the interface is already familiar to them.

"Prior to deploying Microsoft Exchange Server, we had to endure many disparate messaging solutions to get important information across," says Gardiner. "We had to learn a new product each time, but with unified messaging we don't have to do that any more. We have a single interface that makes us more effective and is a smarter use of our time. We can definitely say that unified messaging has helped us in working more efficiently. It is a qualitative difference. It is a unified solution and it gives us a better way of working."