Exchange Keeps Healthcare Center Humming

Exchange 2003 is at the heart of Virtua Health's "all-digital" strategy

Email is the primary communications medium for the 8900 staff members of Virtua Health, a multi-hospital healthcare organization based in Marlton, New Jersey. Physicians and other medical and administrative staff access mail through local and remote workstations, mobile devices, laptops, and tablet PCs, all of which generate a sizeable accumulation of messages on Virtua's two-server Exchange Server 2003 cluster. Managing a large volume of email traffic, supporting a growing base of mobile users, and exploring the integration of voicemail into its Exchange messaging are some of the top challenges that Virtua's IT group, led by Tom Pacek, assistant vice president of technology, and Andrew Gahm, network architect, confront as they strive to meet Virtua's goal of becoming an all-digital, paperless organization. Senior editor Anne Grubb spoke with Andrew and Tom about the messaging technologies they're using to tackle those challenges.

Q: Describe the day-to-day use of email at Virtua Health.

AG: We have 8800 email accounts but only 3300 workstations. We give staff many options for getting their mail: via dedicated or shared workstations, Outlook Web Access (OWA) remotely, smart phones, or via AEP Networks' Netilla device.

TP: We use email for general staff communications from the CEO or COO. Information such as our quality reports, quality indicators, and our financial performance is shared via email with the staff and physicians. The docs also use it for communicating with one another, with nursing staff, or between physician offices. Some doctors--only a few right now, though--use email to communicate with their patients.

Also, we don't use IM here, and a lot of our email communication is almost like IM. Most of our administrative staff, at the vice president or assistant vice president level, use tablets or laptops, and they're comfortable having email conversations using those systems in a collaborative way.

Q: What's your mobile-device environment like?

AG: We have between 20 and 30 active Research In Motion (RIM) BlackBerry users and a few Windows Mobile-device users. But we're trying to get rid of the BlackBerry server and replace the BlackBerries with Windows Mobile devices because of the BlackBerry licensing costs and also because we've had issues with the BlackBerry server that have prevented us from moving to Exchange Server 2003 Service Pack 2 (SP2). Our current BlackBerry software won't continue to work if we upgrade to Exchange 2003 SP2. We need to upgrade to SP2 to take full advantage of all the features available to smart phones and Exchange ActiveSync (EAS). If it comes down to smart phones or BlackBerries, the smart phones will win.

TP: As the BlackBerry contracts come up for renewal, or as new requests \[for mobile devices\] come in, we're giving them a Palm Treo--or any other device that's supported by Pocket PC. The Pocket PC/Windows Mobile devices are much more compatible with our Microsoft environment and can run some applications \[that the BlackBerries couldn't.\]

Q: What's your biggest Exchange-administration challenge, and how have you addressed it?

TP: I'd say managing the use of personal folder files (PSTs). We wanted to find a way to give users more self-service capability, to enable them to recover their own messages, for example. Several months ago, we started using Mimosa Systems NearPoint for Microsoft Exchange to archive all Exchange transactions.

AG: The product lets us bring all Exchange items--personal folders, deleted files, calendar items--into the archive, which is on an HP MSA1000 SAN. Users have the option to move attachments in their mailboxes to the archive; NearPoint replaces the actual file with a pointer to the archived version. A user can use the product's search tool with keywords to find an item quickly. For example, I used to have a 200MB PST, and I saved everything in folders. I used NearPoint to import the PST into the archive. At that point, I no longer needed to save messages in folders anymore, because they were all being saved in the archive, even deleted items.

You can also search attachments in messages. For example, I needed to look up a vendor quote, and this particular vendor sends their quotes as PDF files in messages that have only the quote number in the subject line. Previously, if I wanted to find a specific quote and knew approximately when the quote was sent, I'd need to go through about 20 emails before I found the right PDF file. Now all I need is the name of the item \[in the quote\] I'm looking for, because the tool searches attachments. I find the file I need in about two seconds, when it used to take about an hour to manually search the messages.

Q: Are you investigating other messaging technologies that will help meet the goal of making Virtua all-digital? For example, with your growing body of mobile users, are you interested in unified messaging, which Exchange Server 2007 will support?

TP: Yes, we're undertaking a unified messaging project this year. Virtua has staff in three counties. With unified messaging, you could, say, have your email read back to you while you're driving in the car. We're evaluating vendors and are testing the Cisco Unity environment--an IP voicemail system that ties into Exchange--with about 100 users.

AG: The Cisco Unity servers connect to the Exchange server and store voicemail messages on the Exchange server as email messages; the voice parts are actually .wav files. Cisco provides a plug-in for Outlook that lets you play the messages, either on your PC or on your phone. You can also just double-click the .wav file and play it on the PC that way, without using the plug-in. We're still in decision mode \[about the unified messaging application\]; we'll be meeting with Microsoft soon to discuss their voice-messaging support in Exchange 2007.

Q: What about compliance? What are Virtua's messaging-related compliance requirements?

TP: We know that we need to be able to respond when there's an incident and we have to provide data for attorneys. But we don't actually have an email-retention policy right now, mainly because we don't have much data stored in the archive yet. We'll develop a policy as we get further along with the archive. But we think it's awesome that we have an archive that can provide any information that's in the Exchange database as well as provide a record of every database transaction.

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