When we set out to design our Mobile-Enabled Healthcare Platform one of the biggest decisions we made was to use Alfresco for our Business Process Management (BPM) and Electronic Content Management (ECM) services. This decision had a major impact on our product, and we’re convinced we made the right choice, so I wanted to walk you through how we made it.

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Why do we need ECM and BPM?
Before I jump into how Alfresco ended up as the answer, it is useful to consider what the question was. Why do we need ECM or BPM and why are they such an important part of our platform?

1. ECM has always been a core part of Evolve. We began life as an Electronic Document Management (EDM) system many years ago and this still forms a key part of our platform. But simple EDM is no longer enough. The shift in healthcare to patent-centric applications demands systems that support sharing and collaboration, using open standards. Our work with IHE’s Cross-Enterprise Document Sharing (XDS) and our Vendor Neutral Archive (VNA) transform simple EDRM to a next generation ECM. We needed a modern, scalable and robust ECM platform to support these demands.
2. BPM is not a term I love (I’ll come to that later), but the ability to quickly build eForms and Workflow processes are a fundamental part of our platform. We have a number of core principles that we use to help guide us when we build product. Firstly, everything we build must be driven by the user need and all our applications must be mobile first, interoperable and extensible. eForms and Workflow is one way we make our platform extensible. We want our customers to use our tools to quickly build forms and model entire care pathways. We want them to do this independently without having to wait on features to be added to a product roadmap. But in a modern healthcare environment, traditional BPM is not enough. We need tools that are simple and easy to use, yet flexible. Clinician’s behavior can not always be mapped using rigid processes. We need modern tools enabling ad-hoc tasks to be generated, dynamic processes to be modelled, simple collaboration between care providers and care recipients and analytics to measure and report on outcomes.

Our Requirements
We had a large number of requirements that were important to us across both ECM and BPM. I won’t list all of these but there are a number of important themes that deserve special mention…
1. Security – This is our number 1 non-functional requirement within Evolve and it influences everything we do. The approach we take regarding security is for a separate post, but put simply, anything that compromises security must be optional.
2. Performance – This is our number 2 non-functional requirement within Evolve and we have specific goals that we measure daily. Unfortunately, performance is not typically a good bed-fellow with security, but this can never be an excuse, so as with security, anything that compromises performance must be optional.
3. Cloud Ready – The Evolve Mobile-Enabled Healthcare Platform is a true multi-tenant cloud based platform where all components must be horizontally scalable and elastic. All components we build must support this architecture, otherwise we don’t build them.
4. Mobile-Enabled – Everything we build must support HTML 5 and iOS; and importantly for iOS it must support transparent offline use. We believe clinicians should be able to interact with our apps no matter where they are, even when disconnected.

Our Approach
Firstly, we documented both our functional and non-functional requirements for both ECM and BPM. Then we categorised these so we understood the priorities – what could we not live without and what could we compromise on. We approached this as two independent and separate exercises. We were not interested in finding one company that provided both ECM and BPM, but rather we wanted to find the product that was the best fit for our requirements. We were lucky to have worked in the BPM and ECM space for many years, so we knew intimately what our users needed out of these products. Without this experience we would have engaged directly with our customers, in the same way we do when building any product feature.

Once we had a clear view of what we needed the next step was to identify a long list of vendors we felt were a good fit for these requirements. We used a range of techniques to generate this list – from engaging with Gartner and our network of contacts in the industry through to good old fashioned desk research.

Through a combination of face-to-face meetings, online demos and “30 day trials” we filtered this long list down to a short list of candidates and then ran a formal evaluation process with each vendor. We took a series of real life clinical use cases and asked each vendor to demonstrate in front of our eyes how they would solve these problems using their products. It was a great way to quickly cut through any marketing messages and see what was under the hood.

The entire process took 9 months from beginning to end. When I tell people this they are often surprised, but bearing in mind the importance of these products to our platform it was not something we could afford to get wrong. Our decision to select Alfresco has proven it was time well spent and in the end it was actually an easy decision, but for reasons I would not have predicted…

ECM + BPM = Something new by Alfresco
ECM and BPM are traditionally two very distinct things. When we embarked on this journey we had a very clear vision to select the best tools for the job. This meant we wanted the best ECM product and the best BPM product from the best vendor in each space. We performed two separate and distinct evaluation exercises and I fully expected to be working with two products from different vendors. But midway through our journey it became clear that Alfresco offered something unique that didn’t exist anywhere else on the market. Yes, they have two separate products – Alfresco One for ECM and Alfresco Activiti for BPM, but in combination what they have created is something greater than the sum of its parts and so unique that I don’t really recognise it as either ECM or BPM. In fact, these terms describe something that I don’t really relate with. When I see the words ECM and (especially) BPM I think complex, heavy-weight, closed. Stale. Alfresco have created something different – something simple, something light-weight, something open. Something fresh. I don’t know what the term is to describe this. It’s not ECM and its not BPM, but its definitely the future.

One year on
It’s not quite been a year, but what’s it been like working with Alfresco? Honestly, it’s been fantastic. I have worked with a lot of organisations of various sizes over the years, but the working relationship that has emerged with Alfresco is remarkable, at many different levels – from technical and management though to sales and marketing. From a product point of view, they are committed to continual improvement and engage directly with customers like us to understand our requirements to ensure they are building product that helps us solve our clinical use cases. In the last six months alone they have included a number of important feature requests that have transformed how we use their products in a Healthcare setting.

I’m looking forward to continuing to work together with the Alfresco team for many years to come. We are delighted we made the correct choice and chose Alfresco.