Saving Lives Via Collaboration

Company: Brigham and Women's Hospital (BWH)

Project Leader: Michael Halle, Director of Scientific Visualization and Systems Architect

Technology In Focus: Document management and collaboration

Problem: For BWH, creating grants for medical funding required a drawn-out, complex process involving multiple geographically dispersed contributors who continually edit, revise, and update funding documents. The traditional productivity software and Internet-based file-sharing tools the hospital was using introduced version-control problems and added complexity to the process.Solution: BWH implemented WebDAV, using Xythos Software's Enterprise Document Manager, along with the open-source PostgreSQL database.

Bottom Line: In addition to streamlining and simplifying the process of generating grants for medical research funds, the software has helped the hospital and its researchers bring in nearly $70 million over three years.

Fighting an equal-opportunity disease like cancer takes the kind of cooperation few organizations even dream of. Consider the breadth of expertise--from researchers to physicians to lab technicians--involved in treating cancer, and the scope of the disease, which can attack tissue in just about every human organ, and the task seems almost hopeless.

It's not, however, thanks in part to work at research institutions such as Brigham and Women's Hospital (BWH), a teaching hospital of Harvard Medical School. A pioneer in a wide range of medical areas, BWH is renowned for clinical and population-based research, such as its landmark Physicians' Health Study, which revealed that moderate alcohol consumption actually decreases heart attack rates in middle-aged male doctors.But physicians can't live on alcohol alone. Bleeding-edge research needs a cutting-edge IT infrastructure with the ability to support a wide variety of specialist applications. While BWH's highest-performance research computation runs on Solaris servers, about a thousand individual users within the hospital require Windows, Mac, or Linux workstations. BWH's IT department also has to provide access to outside researchers collaborating with the hospital on particular projects, all while protecting unpublished secrets and patient confidentiality.

"If we want to treat a disease as extensive as cancer, we need to be able to work with as many smart people as possible," says Michael Halle, an MIT Ph.D. who serves dual roles as director of scientific visualization and a systems architect at BWH's Surgical Planning Lab (SPL), the unit of the Department of Radiology that provides imaging and computing services to physicians and scientists throughout BWH. "We need to be able to understand all of the data--from hospitals in Massachusetts to California, anywhere in the country or around the globe."

BWH's IT architecture serves the needs of research well, but until three years ago it didn't function so well for another task. To acquire funding, researchers had to go through a drawn-out, complex grant process that took time away from their actual research. "Clinical trials typically cost millions of dollars to perform," says Halle, "and procuring funding for them is a trial in itself."

GRANTING ACCESS

The grant-writing process involves dozens of globally dispersed researchers, clinicians, and institutions, all continually updating thousands of pages of related documents that may be needed for supporting evidence. Each contributor may add separate sections or revise parts of other contributors' work, so the final grant documents can easily go through 10 to 12 revisions from different authors.At the time, the hospital relied on several technologies not intended for that purpose, including e-mail and FTP. Researchers collaborating on a grant typically exchanged documents as Microsoft Word attachments, relying on Word's change-tracking feature to maintain version control.

"That works okay logistically if you have two or three people, except you can end up with serious problems in version tracking," says Halle, who designs the SPL's computational infrastructure and is supported by three systems managers in day-to-day operations. "Once you scale up to a hundred people, chaos is almost unavoidable."

Attachments also placed heavy burdens on some IT systems because they frequently included many large graphic files such as MRIs. Network bandwidth and archival storage were sufficiently overprovisioned to handle them, but the mail server itself wasn't. "A lot of our grants use graphic images heavily, so the size of our attachments became unreasonable to the point where the mail server would kick them out."

BWH also tried FTP servers for document sharing, but it wasn't very user friendly. "A lot of the people we work with are trained in their medical field, not in computer science," says Halle. "Using FTP was harder for them than we liked."

Security was another problem and a particularly important one in the competitive, ego-filled, and strictly regulated field of medical research. Ideally, document sharing would integrate into BWH's existing security and authentication model, which consists of a common authentication database providing Single Sign-On (SSO) service to Windows, Linux, and Solaris clients. The current system is based on Unix Network Information System (NIS), but Halle plans to upgrade to LDAP, so a document-sharing platform would have to support both.

FTP didn't meet any of those requirements. "These are large, competitive grants based on cutting-edge research, and sometimes you might be competing with someone in your own department. You may not want everyone to see what's in your research documents," explains Halle. "The coarse mechanism provided by FTP didn't serve those social needs very well."

DAV DECISION

With most users more comfortable using a browser, BWH decided to move from FTP to HTTP. However, HTTP couldn't provide any of the access control or versioning features that the hospital needed. For those, it turned to Web Distributed Authoring and Versioning (WebDAV), a set of extensions to HTTP 1.1 that adds XML commands for features such as file locking, metadata management, and file grouping by project.WebDAV's big advantage is its ubiquity. A World Wide Web Consortium (W3C) standard, it's supported by most workstation OSs and Web browsers, including all those that BWH uses. But WebDAV is simply a protocol, not a complete collaboration environment. While most clients can connect to WebDAV servers, collaboration still requires a server-side document management application, as well as a way to integrate with the SSO system.

HOMEGROWN HEALTH CARE

Halle's first impulse was to build a system himself. "We started looking at options for constructing a collaboration system from readily available components, such as the open-source Zope," he says. "But that would probably take about half a man-year of my work."

Zope, the main component he considered, is an open-source content management application. While it met some of Halle's requirements--it's based on WebDAV and supports all of BWH's platforms--he eventually rejected it. "It didn't provide what we felt was a sufficiently simplified user interface, and it didn't offer a consistent view of the storage system structure," he says. "We wanted a system with a simple Web-based front end, as well as underlying fine-grained document-sharing controls and easy delegation of responsibility."

BWH was also worried about support. Although a commercially supported version of Zope was available from Zope Corporation, the support wouldn't have covered the extensive customization work that the hospital required. "Our biggest concern was the continued maintenance and feature enhancements," says Halle. "We quickly realized we needed something that would be supported by an external organization."OPEN SOURCE, CLOSED ACCESS

Halle still liked the idea of a system built on an open-source foundation. In particular, he was attracted to PostgreSQL, a popular open-source database. Every document management system requires some form of a database, and Halle saw no need for the extensive but costly features of products such as Oracle. "We preferred an option that didn't require an Oracle installation, with its related expense and complexity."

While BWH can't justify Oracle now, it might be able to in the future as its needs increase and it expands the collaborative system onto multiple Solaris servers. "It was important to be able to choose an open-source alternative while giving the option of later upgrading to an Oracle database should our needs require it," says Halle. "This would let us scale the solution to fit our problem, rather than scaling our problem based on the inflexibility of the solution."

Whichever database they installed, Halle and his staff didn't want to get too involved with it. "We had a preference for storing only or mostly metadata in a database, with actual grant data being stored as files on disk," he says. "As systems administrators, we all had more experience managing file systems than databases."

TECHNOLOGY TRIALFew products were available that met all of Halle's criteria, so his search for a collaboration platform was a short one. After a brief trial, BWH installed Xythos Software's WebFile Server, now called the Xythos Enterprise Document Manager. The software met most of the organization's needs, including storage of metadata in a PostgreSQL database. And because it's written in Java, it runs natively in BWH's Solaris environment.

The Xythos application provides a browser-accessible collaboration environment. Research documents are either downloaded, edited, and uploaded to the Web file server, or edited directly across the network using Web Folders, Microsoft's WebDAV client. To the collaborators on a project, what they see looks like a remote disk, except it can be organized in more useful and "socially complex" ways, says Halle.

However, the application didn't work straight out of the box. The full installation took three months, with one BWH systems architect working full-time on the project and another consultant working part-time. With help from Xythos, the staff developed two sets of custom code: One set achieves the desired SSO capability by linking the application to the user authentication database (this is currently done through Unix NIS, though Halle plans to migrate to LDAP). The second set lets the product to interoperate with existing BWH Unix user groups for file sharing within the software's collaboration environment.

Even with the customization work, Halle believes the software is an excellent investment. At any given time, it supports collaboration between BWH researchers in about 30 projects. Since going live in 2002, the Xythos-based system has helped BWH collect $40 million in grants, with another $30 million going to its external collaborators at other institutions. It has also freed up the organization's overburdened e-mail and FTP systems. More importantly, however, it has streamlined the grant-generating process, giving medical researchers more time to spend on actual research.

Is your enterprise making innovative use of a networking technology or service that you'd like us to write about? Contact Jim Carr, an Aptos, CA-based freelance business and technology writer, at [email protected].0