Automating Healthcare
Solving business problems with savvy automation

E-mail Distribution Lists

Business problem
Despite its abuse and shortcomings, e-mail remains a vital communication tool for the enterprise. Designed correctly, it allows messages to be sent to precisely targeted segments of the workforce. Having invested the time and effort in distribution group design, we also wanted to help staff visualize and understand the structure and easily use it for messaging.

A picture is worth 1,000 words
Kevin, one of our physician informaticists, saw the importance of having a highly structured approach to e-mail distribution groups and voluntarily assumed ownership of the process. He also recognized that it was not enough to just impose order on the process; it was equally important to clearly communicate the design logic to everyone. Understanding the logic would help people:

  • more effectively use the distribution lists; and,
  • be more amenable to the centrally-imposed structure instead of insisting on their own design.

Kevin created and maintains a graphical representation of each major branch of the e-mail distribution group tree (click the image below to see a full-size image). Shown below is one of the "communication maps," for the emergency medicine department. As can be seen, the groups are designed to segment workers by:

  • geographic work location (hospital); and,
  • type of worker (e.g., MDs, RNs, etc.)

[Click the partial image above to see the full-size image]

We created a tool for the intranet that leveraged Kevin's work and made it as easy as possible to understand and use the e-mail distribution groups — not only for e-mail, but also for paging.

An automated process extracts a list of all distribution groups from the Exchange e-mail server into a database, and then compiles a hierarchy of groups. Each service line or department has its own hierarchy and communication map (see example above). Each subgroup is named using a numbering scheme:

  • EMD1
    • EMD2
      • EMD21
        • EMD21A
        • EMD21B
      • EMD22
    • EMD3
    • etc.

Selecting a top-level group, such as EMD1 (shown above), displays the next level of groups (shown below).

Note: there are no individuals in these groups. Only the lowest-level groups actually contain any names; the higher-level groups are only containers for lower-level groups.

Selecting one of the second-level groups displays the next level (shown below).

Selecting one of the third-level groups displays the next level (shown below).

Selecting one of the fourth-level groups displays the next level (shown below), which in this case happens to be the final level, containing a list of people. Once the final level has been reached, links are offered to either send an e-mail address to the group or any member of the group, or to send a page to all members of the group who have a corporate pager. (Note: an e-mail may be sent to any of the higher-level groups by selecting that group in Outlook.)

If sending a page, the screen shown below is displayed, listing all members of the group who have pagers, and the standard intranet paging tool. Up to 110 alphanumeric characters may be sent, either using a preselected message or any other message.

Two other tools are offered, based on the distribution group data. The first is a list of all distribution group owners and the groups that they own.

The second tool is a list of all the groups (if any) to which the current user belongs (my list is shown below), and a quick way to look up the groups to which any other individual belongs.


  • The intranet tool helps staff understand the e-mail distribution group hierarchy and the logic behind the design.
  • The ability to directly page everyone in a group (a recent addition) may prove valuable in the event of an emergency.

Lessons learned

  • Finding multiple ways to leverage existing resources offers a sort of exponential return on the original investment: not only does the organization obtain a greater return on the investment, but new uses for the original resource increase its perceived value and the frequency of all related uses. The whole (total return from all uses) really is greater than the sum of the parts (return from each use in isolation).

Posted 29 June 2008


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