Dartmouth-Hitchcock Medical Center

The Dartmouth-Hitchcock healthcare system includes Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Children’s Hospital at Dartmouth, Norris Cotton Cancer Center and Community Group Practices located throughout New Hampshire.

In 2002, Dartmouth-Hitchcock implemented a CMS (WebBuild) in an attempt to standardize its Web presence. The landscape, however, remained fragmented and departments continued to develop their own Internet presences, outside of the CMS. The small team of two full-time employees was unable to provide much content oversight or implement a strategic vision for the sites. In 2004, the “e-DHMC” initiative laid the groundwork for future success, which included:

• Hiring a dedicated team of Web content professionals to provide oversight and strategy for the Dartmouth-Hitchcock Web sites.
• Replacing the original CMS with one that offered more flexibility.
• Replacing the expensive and cumbersome externally-hosted search product with an in-house solution.

Three of DHMC’s early and noteworthy accomplishments include:

DHMC Transparency Initiative
Began in 2002 with the premise that “DHMC should be a national leader in providing information to the patients and the public it serves regarding key quality and cost outcomes as well as information on health and healthcare to promote patient decision making.” Rather than being dependent upon others to share and explain our information, DHMC wanted to be in control of information sharing in order to:

• Provide patients with good information to make informed decisions.
• Offer the public/patients accurate and honest data on the quality and costs of services.
• Promote the science of clinical practice and improve the quality of care at DHMC.

Charges for Health Care Services
Provides a centralized portal for charge information, personalizable data, contact information, and third party comparison, all oriented to the patient population. The site includes costs associated with doctor’s office and ED visits, diagnostic tests, surgeries, procedures, medical conditions and hospital stays.

Out-of-Pocket Estimator
Provides more personally-relevant information and allows patients to self-serve information at any time. User testing showed that breaking the flow down into distinct steps helped users understand the process. A phone number is present on every page as a call to action and a reminder that you can call for assistance. Search tool that groups results by department, pages, specialists, Health Encyclopedia information, events, quality reports and more.

From these early DHMC initiatives, other organizations have learned that:

• In reporting transparency, challenges include picking the right measures, providing comparative context, updating the data and keeping providers in the loop.
• Culture change is hard. Managing the political process of “taking control” of external-facing sites takes a lot of time, skill and energy.
• It is important to build a strong, centralized team and develop/enforce policies that clearly empower that team as the authority over the external-facing Web sites.
• Project management discipline is the key to survival. In a healthcare environment, you’re never going to have enough people to do all of what’s asked of you, so it’s crucial to set priorities and manage your time accordingly.

In 2011, DHMC has:

• A combined team of Web content professionals (7 FTEs) and Web developers (2 FTEs) with oversight and strategic control of all external-facing Web sites.
• Moved all to the Open Text Content Management System.
• Redesigned the DHMC Web site, with content organized by audience.
• “Separate but related” Web sites for the children’s hospital and cancer center, using the same CMS and applications as the main Dartmouth-Hitchcock Web site.
• Marketing and Communications has embraced social media as part of its digital strategy, including a robust YouTube channel, and a growing Facebook presence.

After investing a tremendous amount of time, energy, and money into developing a standardized Dartmouth-Hitchcock Web site, DHMC Web leaders recognize that the landscape has changed considerably. While a large institutional Web site will always have its place, the future is in delivering the content that users want – in the way they want to consume it — instead of relying upon users to visit the DHMC Web site. This means, DHMC and other Web leaders must focus efforts on:

• Developing a mobile device strategy, including creating downloadable apps for the most-requested content (maps, directions, phone numbers, provider profiles).
• Engaging with audiences through social media.
• Developing a robust content strategy based on telling the institution’s story, and using video as much as possible to tell that story.
• Continually testing and revising Web sites to meet user needs. In many cases, this will mean slimming down the content that’s on the Web sites, instead of simply adding to the clutter.