This document summarizes an effort by M.D. Anderson Cancer Center, Tower Strategies, and NavigationArts to redesign M.D. Anderson's website to be more user-centered and drive organizational goals. User research identified key audience types and priorities. A new governance model was established to prioritize projects. The redesigned site launched in 2009 and led to increased traffic and self-referrals while balancing user and business needs. Challenges included overcoming resistance to change and integrating new systems. Lessons included the importance of executive support, building alliances, and maintaining flexibility during complex projects.

1. M. D. Anderson Case Study:
Creating a Hospital Website that
Drives Value
September 16th, 2009

2. © Copyright 2009
Agenda & Introductions
• M. D. Anderson Case Study in 3 Parts
• Creating an effective web strategy and executive facilitiation
• User-centered approach to web design
• Challenges and lessons learned
• Does your current website serve your users and drive organizational
goals?
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3. © Copyright 2009
M. D. Anderson Cancer Center
• Leading academic medical center, located in Houston, Texas
• Ranked #1 for cancer care by U.S. News & World Report
• Treated 89,000 patients in 2008, including over 29,000 new patients
• Nearly 13,000 patients in clinical trials
• First in number of grants awarded and total grant funding from National
Cancer Institute
• 6,000 students and trainees during 2008
• 17,000 employees (including 1,500 faculty) and 1,400 volunteers
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Tower Strategies
Tower Strategies
• National healthcare consulting firm
• Focused on improving clinical and business processes through
comprehensive web strategies
• Assist organizations in shifting from an internal view to a customer
perspective and drives business transactions
• Consultants are clinicians, operating executives and marketers
• Technology and vendor agnostic
• Seek to leverage an organization's existing investments
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NavigationArts
Navigation Arts
• Full-service web consultancy providing expert advisory, design, and
development services
• Leaders in user experience design
• Create experiences that are simple, satisfying, compelling and
memorable while achieving business goals
• Service areas include:
Web Strategy Usability Testing
User Research Content Strategy
Information Architecture Content Management System Implementation
Visual Design and Branding Web and Application Development
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Evolution of the Web in in Healthcare
Evolution of the Web Healthcare
Remote Disease and
Wellness Management Innovate
Interaction, Collaboration
and Personalization Lead
Self-Service Transactions,
Dynamic Content Leverage
Static, Published Content
Participate
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Changingthe Face ofof Business
Changing the Face Business
• Healthcare websites have historically been designed “inside-out”
• Few dispute the need to change the focus to the external customer
• What do customers want?
• Personalization
• Self-service
• Interaction
• What does the organization want?
• Reduction in operating costs
• Technology integrated into existing processes
• Educated, prepared patients
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8. Example Transactions
Purchase, Donate
e-
Commerce
Family/Friend
Cancer Patient
Referring MD Staff
Referring MD Patient
Education Clinical Trials
Watch, Rate Videos, Materials Search, Be Alerted
News/
Caregiver Research
Worried Well
Read, Rate and Discuss 8

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New Web Governance
New Web Governance
Enterprise Internet Strategy Steering Team
Role: Prioritization, funding and executive oversight
DOMAIN TEAMS
ROLE: IDENTIFYING AND RESPONDING TO PROJECT REQUESTS, PROJECT COORDINATION
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Prioritizing
Prioritizing
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Changing to an Enterprise
Changing to an Enterprise Governance
Governance Model for the Web
Model for the Web
• Historically departments submitted requests to the web department on
an as-needed basis
• The web team integrated content, technology, business process to
create a customer service
• Without an overall strategy – the requests would overflow the web work
queue and the site would continue to evolve unevenly
• By determining feature requirements by customer, an overall 3-5 year
plan was developed based on organizational priorities
• The plan priorities were recommended by each of the domain teams and
approved by the enterprise governance teams
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Information Services:
Information Services:
Moving from What to How
Movin from What to How
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Changing Project Activities
Tower’s to an Enterprise Governance
Model for the Web
• Conducted interviews with executive • Recommended and facilitated a
sponsors and business owners to sustainable, objective governance
identify business drivers and structure
opportunities to enhance processes
• Ascertained low-hanging fruit to
via the Web
create early momentum
• Identified 12 customer types
• Provided project management and
• Documented 202 project ideas lead support for quick-wins
• Determined key trends between web • Created a multi-disciplinary team to
project requests and identified 7 core manage branding oversight and
requests standards for the web
• Analyzed existing development and • Conducted a gap analysis
support skill-sets and staffing model
• Developed a 3-5 year web strategic
plan that included transition plan from
the current state
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A Successful Web Experience Balances
Successful Web Experience Balances
User Needs with Business Goals
User Needs with Business Goals
NavigationArts conducted an in depth analysis of M. D. Anderson’s
environment by conducting the following activities:
Interview Stakeholders Evaluate User Needs
• HelpDesk • One-on-One Patient Interviews
• Patient Services - Learning Center
• Care Centers - Hospitality Center
• Patient Education • Family Advisory Council
• Volunteer Services • New Patient Orientation
• Physician Services • Analyzed User Data from Logs
• Researchers, Scientists • Web Survey of Current Users
• Development • Referring Physician Survey
• Trainee and Alumni Affairs • Conducted User Testing
• Graduate School
• School of Health Sciences
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Research Using a Multi-pronged
Research Using a Multi-pronged Approach
Approach
It’s important to understand more than just what users tell you about
using the web:
• It’s essential to understand the processes
they must go through, the problems they
may encounter or fear they will, the concerns Needs
they have in order to make decisions.
• It’s also important to understand the
Goals
way they actually behave, and the
information they really seek out.
Task s
• Usage patterns • Audience types Behaviors
•
•
Popular content
Referring Web sites
• Web-based Tasks Attitudes
• State of Mind
• Referring terms • Satisfaction Context
• Countries of origin • Understanding
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Determining Priorities in Wide Audience
Determining Priorities in Wide Audience Bas
Base
NavigationArts concluded that the typical Web site visitor falls onto the
following categories of need which defined priority among users:
Critical Essential Operational
Audiences that have a critical or time Groups who are essential to the M. D. Anderson has a working
sensitive need for information who are also organization in terms of awareness and relationship with these audiences and
critical to the organization in terms of access. For them, the Web site represents wants to provide targeted content for
acquisition and patient care. For them, the information and functionality they need to them. These groups may visit the site
Web is likely to be the front door to the better understand and interact with M. D. less frequently or have an indirect need
organization and must prioritize content Anderson. The Web site must provide for information and services.
and tasks that meet their needs. intuitive pathways for these audiences while
not confusing critical audiences.
• Potential Patients • Volunteers • Media
• New Patients • Donors • Current Employees
• Current Patients • Survivors • Retirees
• Primary Caregivers • Extended Family and Friends • Dependents
• Referring Physicians and their Staff • Potential Employees • Alumni
• Students • Suppliers/Vendors
• Trainees • Partners/Affiliates
• External Health Professionals (Faculty, • Community Educators
Nurses, Allied Health Professionals, • International Embassies and
Mid-level Providers, Researchers, Governments
Scientists)
• Public
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Understanding Audiences’ Mental Models
Understanding Audiences’ Mental Models
These models define the differences in the way users think about and
go about looking for information:
Hospital and Treatment Educational and Research Physical Campus and
Center Institution Place to Work
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What Did the Research Tell Us?
did The Research Tell Us?
We needed to take the emphasis off of the organizational structure and reduce
the focus on promotional activities, and focus on creating a user-centric
experience and facilitate actions users will want to engage in.
• Align content to the user’s mental model of M. D. Anderson. Acknowledge the unique
needs of different audiences and provide experiences that address each.
• Provide contextual cross-linking, topic focused searches, index lists, and expose critical
content throughout the site to facilitate the different ways users go about looking for
information.
• Recognize that the majority of users do
not come through the homepage; An Effective Site Structure:
ensure that all pages have appropriate • Has a coherent underlying concept
context and avoid dead-ends. • Anticipates users’ questions
• Balances breadth and depth
• Design an experience on the Web that
• Provides more than one way to
demonstrates the excellence and expertise
get to content
of the organization while raising awareness
and facilitating access.
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ProvidingContext through Peripheral
Providing Context through
Peripheral Vision
Vision
Each of the primary user groups have some
unique information needs and some needs
that overlap with other groups.
(1)
Build brand
perception through
an understanding of
the breadth of the
organization.
(2)
Answer user needs
through the depth
and relevance of
information.
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The Answer?
The Answer?
Create equal paths for patients and professionals with a focus on
patients and their families through contextual tools and exposed
access to critical in-depth information…
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21. Access to Business or
General Information
Primary User
Focused
Navigation
Key Tasks Drive Action
– Meets Prioritized
Goals of Business and
Users
Paired with Real Stories
Direct Access to
Deeper more
Contextually
Relevant Information
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Challenges
Challenges
• Very large site to be migrated/updated
• Old site: about 10,000 pages
• New site: about 4,500 pages
• Vast content: text, images, multi-media, links, etc.
• Old department-centric Information Architecture
• Didn’t start out as such years ago, but evolved that way
• Natural “undertow” from the organization
• Natural mental model for staff, but rarely helpful to site visitors
• Simultaneous web content management system (WCMS)
upgrade/development
• Necessary: old WCMS could not support new concepts
• Added complexity & difficulty to execution within project timeframe
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Challenges
Challenges
• Staff turnover during project
• Represents a step backward as team learns new concepts
• Recession = constraints on filling vacancies and use of contractors
• Multiple vendor relationships
• Worked with four agencies at different points
• Complementary roles and expertise
• Used web-based collaboration tools, frequent conference calls,
selected face-to-face meetings
• Impact of new URLs on search engine rankings
• New Information Architecture = 99.9% new URLs
• Predictable short-term fall in search engine rankings
• Manageable with mitigation strategy
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LessonsLearned
Lessons Learned
• Buy-in and support from top management and governance structure
crucial to overcome local resistance to change
• Alignment is vital anyway if this is a business strategy
• Difficult to convince some staff that departmental IA isn’t best
• Leverage when “special interests” argue against the greater good
• Build alliances with other key departments
• Can’t do it alone
• Projects are discussed & debated outside of one department’s range
of vision, so need friends and allies
• Use of contractors can free up staff to work on the “new”
• Pro: builds buy-in by current staff & deeper/faster hands-on
experience
• Con: time to ramp contractors up & make them effective; adds cost
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LessonsLearned
Lessons Learned
• Tight project tracking, including daily status checks on key deliverables
• Projects have many moving parts
• Needs formal project management PLUS informal approaches
• Nagging helps
• Maintain flexibility/adaptability during life of the project – things will NOT
go according to original plan
• Many surprises along the way – lots of “unknown unknowns”
• Content isn’t always what you think it is
• Technology helps & hinders
• Flexibility can also be stressful to project team
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Results & Next Steps
Lessons Learned
• New site launched in May 2009
• Post-launch:
• Site visits from search engines did drop 28% in month following
• Site visits from search engines recovered and now up 12% versus
pre-launch
• Total search engine rankings up
• Patient self-referrals up 14% versus same months in 2008
• Next Steps
• Proposed next phase to senior leadership
• Got approval for analysis & planning during FY2010
• Goals: “portal” capabilities; personalization/customization; better
targeted marketing; new improvements in customer service
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Questions?
Questions?
Alan Powell
Director of Internet Services
M.D. Anderson Cancer Center
Sue Sutton, RN, PhD
President and CEO
Tower Strategies
877-309-0400
Denise Lodge
Senior Consultant
NavigationArts
703-584-8920
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