IM boosts health care company

Because of its geographically dispersed staff and high percentage of telecommuting employees, Intellicare Inc., which operates health-related call centers, has drawn big benefits from implementing an instant messaging platform.

Through a network of medical contact centers and telecommuting nurses, the company offers medical phone support for some 250 clients, such as hospitals, health insurance companies and doctor group practices. For example, a group of doctors may hire Intellicare to handle their patient calls after business hours.

Instant messaging (IM) has helped Intellicare create a sense of virtual community among its employees, facilitated the provision of remote training and boosted real-time communications within the company, improving the flow and availability of information needed to provide services.

"Most of our work is done over the phone. We have implemented our business using a remote workforce model so we can leverage (geographically dispersed) clinical resources that would not normally be available to a traditional bricks-and-mortar organization," said Jeff Forbes, Intellicare's chief information officer. "Keeping that remote workforce model in mind is the reason why we selected an IM platform when we did."

Intellicare, which is privately held and was founded in 1997, has an operations and data center in its Portland, Maine, headquarters and call centers and other facilities in Connecticut, Maryland, Texas and Missouri. But about 75 percent of its nurses work from their homes. Due to the dispersed nature of its staff, the company decided it needed to invest in a messaging and collaboration platform that could support its virtual workforce. It made the decision to replace Microsoft Corp.'s Exchange messaging and collaboration platform with competitor Notes from IBM Corp.'s Lotus division, and soon after, about two years ago, it implemented Lotus' Sametime enterprise IM system.

"One of the drivers to migrating to Notes was that we were looking for a far broader architecture to support the business," Forbes said. "We weren't just interested in e-mail only, but in a broader platform that would facilitate education and communication and a sense of corporate community throughout Intellicare."

Prior to this, Intellicare employees weren't allowed to use IM. "We didn't permit it because we didn't have a secure platform and our IM platform carries in it data that is sensitive," Forbes said. "We like Sametime because it's an encrypted environment, it's well integrated with Notes' security model and it provides an auditable process: you can log IM conversations so if there's any issue we can go back and recreate what happened."

Putting employees on a public IM network such as the ones from America Online Inc., Yahoo Inc. and Microsoft, and securing their communications with an IM management and monitoring tool from a vendor such as Akonix Systems Inc., FaceTime Communications Inc. or IMlogic Inc. wasn't an option for Intellicare. "If you use the term 'public network' with our customers, they'd have a huge problem with it," he said.

With Sametime, which was recently re-baptized as Lotus Instant Messaging and Web Conferencing, Intellicare nurses can tap in real time a variety of peers that can assist them in advising a patient they have on the phone. "If we have a nurse whose specialty is pediatrics or even a subspecialty within that, that nurse is available to the other nurses as a resource during a call" via IM, he said. "Bottom line is, there is easy access to all the knowledge workers."

IM has also made it easier to provide training to employees. "Micro training" sessions can be set up quickly via Sametime and its Web conferencing feature to address a specific topic, he said.

Along these lines, linking a dispersed workforce with an IM tool has helped Intellicare create a sense of corporate community among employees. "About 75 percent of our nurses work from their homes, and we have to eliminate that sense of isolation that people feel working by themselves. This certainly helps us create a community. It allows for informal conversations and the building of informal relationships which are critical to any corporation. Without that, it would be very difficult to deploy this remote workforce model."

IM platforms such as Sametime have developed to such a point that Forbes sees how they are displacing e-mail communications to a certain extent. "The Sametime-type platforms will ultimately replace to some degree traditional e-mail, which has become pretty onerous and very slow. E-mail isn't designed for supporting real-time work processes, (and in particular) not medical processes where we need answers right away."

In addition to improving communications and efficiency, IM has had a real effect in keeping costs down at Intellicare. "We can leverage the resources and expertise in real time across the country to whoever needs it. This is key in managing costs in any sort of health care delivery system: not having to replicate expertise in each location you have, but to be able to share that expertise across the enterprise," Forbes said. "We see IM as a key technology not only for our remote workforce model but also to managing the health care process in the future."

Intellicare has about 200 of its 275 employees on IM now and is moving toward rolling it out to virtually everybody eventually, Forbes said. An area to which Forbes wants to extend the company's IM platform is "IM robots", thus making the IM interface the door to a variety of corporate information locked in diverse applications and systems. For example, an IM robot could be developed to grab data from human resources systems, letting employees obtain that information using Sametime.

"If you saw all the systems an employee or nurse would have to contend with (here), there's just far too many, each with its own interface. We want to take the IM robot concept and make it a major interface into other systems," Forbes said. "That way, you simplify the training dramatically and you can also have an interactive interface. So I see this IM architecture as front-ending a lot of systems that frankly it's a waste of time and money training people in."