Content Management for Global Medical Research and Collaboration, a Case Study

The University of Michigan is home to one of the largest health care complexes in the world. It has been the site of many groundbreaking accomplishments and technological advancements in the time since the Medical School first opened its doors in 1850.


The Organisation

The University of Michigan Health System continues to be on the cutting edge of research and patient care. In 2003, U.S. News & World Report magazine ranked the U-M Hospitals 11th in the nation, and among the top in many specialties. The Medical School graduates about 170 physicians annually and is consistently ranked as one of the top institutions in the nation. Medical School alumni include Nobel Prize winners, a former U.S. Surgeon General, leaders of Fortune 500 companies, America's family health care providers,
and faculty at leading educational and research institutions around the world. The University of Michigan Medical School is also second in the nation in the number of alumni who are faculty members at academic institutions across the country. In 2004, the UMMS ranked 7th on U.S. News & World Report's 2005 list of the best medical schools. In 2001, the U-M Medical School received a record $203 million from the National Institutes of Health, ranking it 8th in the nation and third among public universities in total NIH grants. Research expenditures by Medical School scientists
totaled $257,583 million in fiscal year 2002.

The Medical School encompasses 25 academic departments, 19 clinical and 6 basic science departments, as well as the Unit for Laboratory Animal Medicine and Department of Medical Education. Together, the Medical School and the three University Hospitals constitute the Medical Center campus which is located on 84 acres of land, in more than 30 buildings and occupies more than 2 million square feet of research and education space. The proximity and close relationship between the hospitals and Medical School have fostered opportunities for collaboration between clinicians and basic
scientists for more than 150 years.

Instructional Programmes

The more than 2,265 faculty at the University of Michigan Medical School work in three main tracks: Instructional, Primary Research and Clinical. Every year they instruct approximately 673 medical students, work with more than 3,000 interns and residents and supervise 800 graduate students and post-doctoral fellows studying medicine at the University.

In 1990 the University of Michigan Medical School began a two year review process that culminated with the adoption of a completely new curriculum for the M.D. degree. Called MD21, the curriculum incorporates instruction in small groups, student-centered exercises, multi-disciplinary conferences, early introduction to patients, and increased experiences in ambulatory and primary care. Previously, in 1979, the Medical Scientist Training Program (MSTP), another unique offering, was established – to facilitate the education of superior, dedicated students in a combined
MD/PhD program. The University of Michigan is one of only 38 such NIH-funded programs in the nation.


Research requirements

The research environment at the Medical School is a vigorous one, enhanced by $307.8 million in research funds in the fiscal year 2003, and by the presence of world-renowned investigators working at the forefront of their respective fields. There is also a very strong tradition of collaboration between the basic science researchers and their clinical colleagues. As a result, working electronically with documents is a key component of the Medical School’s research program.

Over the past decade, the Medical School has ranked nationally in the top tier institutions in federally funded research. In fiscal year 2001, the National Institutes of Health ranked the Medical School eighth among all institutions, second among public schools in federally funded research, and seventh in the actual number of grants awarded. In generating approximately 70 percent of the University's total NIH research funding, the Medical School has maintained a key position of scientific leadership within and beyond the University's scientific community.

In addition to their work in research and education, faculty in clinical departments provide inpatient and outpatient care at the
University Hospitals and Health Centers, where more than one million outpatient visits are conducted each year. The unique combination of medical expertise and direct application of basic science bench research by Medical School faculty within a clinical setting offers patients at the Hospitals the highest quality of care.


The Medical School is also in the top 10 for medical student education. More than 18,000 physicians have earned their medical degrees at the University of Michigan Medical School since the first graduating class of six students in 1851.In December, 2000 The Medical School started an historic curriculum review which culminated in the introduction of a new curriculum in the fall of 2003. This new curriculum provides for an interdisciplinary approach and fully integrates the use of and access to information technology based resources, from student records to patient
records to on line testing, review and evaluation.


The operating environment

Wayne Wilson is the Assistant Director of Technical Services for Medical School Information Systems (MSIS) at the University of Michigan, where he manages a team of four who are responsible for the Medical School’s Internet infrastructure, including all servers, as well as its applications.
The Medical School is currently transitioning from operating 16 Linux, 10 Solaris, 10 Netware and 8 Windows servers to a more consolidated server environment– and expects to end up with having one Solaris V880 server, two Netware and the remainder of servers running Linux and Windows 2003 by year end. The Solaris server supports the production Oracle 9i database containing the Medical School's datamart as well as application-specific transactional data. The Netware servers provide a file sharing system for the school's administrative functions as well as several basic science
departments. The Linux servers provide the Java/Web application server infrastructure, the school’s identity management system (based on Novell's Identity Manager 2 ) help desk and email software and web file system software from Xythos – while the Windows 2003 servers provide other application support such as the on-line quiz, exam and evaluation system – and the budget forecasting system.

Most of the Medical School’s researchers are responsible for their own computing, relying on the support of Wilson’s team for central administrative applications and core business operations. “Beyond assisting them, we have compliance activities (with federal, state and school regulations), patient privacy, human safety compliance and research support effort compliance to address – in addition to providing document auditing (logging and tracking) support for all those systems,” Wilson remarked. His team also provides document auditing services for clinical trials.

For Medical School students, MSIS provides web pages so that prospective students can check on their admission status and, once admitted, offers a student portal that provides all of their online learning materials – from streaming video to class notes to all kinds of multimedia learning tools. Access to student calendars, announcements, discussions, and chat rooms are also available. “We had to do a lot of adaptation as medical school courses are not taught in a conventional way,” Wilson commented. “We have six and eight week rotations in various off site facilities and a
non-traditional calendar.”

To address these needs, the Medical School file server holds 1.2 terabytes of data and interfaces with a document management server which includes the Xythos server and web applications that interact with it. That server stores abou