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The Power of Consistent Content Structure: A Health Care Story


In a white paper entitled Developing Community-Based, Standardized Hospital-Discharge Summaries, Intel Corporation and a number of health care organizations in Portland, Oregon, describe a community-wide collaboration that reduced hospital readmission rates and emergency room visits by aligning hospital-discharge processes across a number of area hospitals. Although the white paper doesn’t use the terms structured content or content modeling, these are central concepts. An important part of this initiative involved addressing inconsistencies in the structure of a common form, a document that every hospital uses: the hospital-discharge summary.

Inconsistencies in the structure of a common form are the antithesis of intelligent content.

What’s the big deal about inconsistencies in a form? What problems were these hospitals facing? According to the white paper, “High rates of readmissions to hospitals put the health of patients at risk and, under new U.S. regulations, increasingly hurt the bottom line of hospitals.”

One Intel blogger describes the financial risk this way: “Hospitals with readmission rates considered too high now carry risk of having portions [of] their Medicare reimbursements withheld.”

That’s some incentive to change.

How could standardizing the hospital-discharge summary – this piece of every hospital’s overall content model – help address these problems? That’s one of the things this team set out to discover. As part of a larger health care transformation effort, they decided to “re-engineer and standardize elements of the hospital-discharge process and the discharge-summary document.”

After the team attained consensus on how to standardize this document (including aligning the changes with various electronic-health-records systems and clinical-records practices), the hospitals began to use the new hospital-discharge form. Now, from one information system to another, every hospital-discharge form uses consistent labels:

  • Facility name
  • Date of admission
  • Length of stay
  • Attending provider
  • Principal final diagnosis
  • Etc.

This hard-won consistency in structure has made the content related to hospital discharges more intelligent. I say “hard-won” consistency because, as simple as these new labels look, anyone in the content business knows how difficult it is to reach these kinds of agreements – especially within or across large organizations with established processes, tools, and terms that have evolved independently.

What was the payoff for putting in all the effort? Transitioning to this consistent content structure, along with making other process changes across this group of hospitals, led to preliminary results that promised improved patient outcomes and lower readmission rates. Beyond the local impact, this team’s efforts set an example “that other health care organizations across the country can look to as they, too, seek to lower readmission rates, improve patient care, and reduce financial risk.”


I’m sharing this story on the Intelligent Content blog because the story highlights the impact that consistent content structure can have within or among organizations. Well-structured content – that is, information that’s organized and labeled consistently and strategically – is not a nicety. It’s a business issue with bottom-line repercussions.

Here are some key takeaways:

  • Inconsistent content structure costs organizations money. Those costs are generally unseen until someone (enter, the content strategist) does the hard work of analyzing the costs and opportunities.
  • Analyzing content structure incurs its own costs. Determining which structural changes will pay off requires an investment of time and money – and an appropriate skill set. It’s no accident that Intel representatives, with their deep knowledge of information systems, helped facilitate the discussions among the hospitals.
  • Making structure-related decisions requires collaboration. No one can simply issue a memo directing every hospital (or every organization in a consortium, or every department in a company) to start using a new, consistent approach to structuring and labeling content. Inconsistencies need to be discussed and evaluated so that the changes solve the right problems, create no new problems, and get the support they need.
  • Processes and information systems may need to change, too. To change content structures in business-critical ways, you must understand existing processes and information systems. Before you can align content structures, you may have to align processes or systems.

For more on the Portland hospitals’ community-based efforts, see the Intel white paper.

Title image courtesy of Joseph Kalinowski, Content Marketing Institute