An Award-Winning Healthcare System Serving the Greater Boston, Massachusetts, Region, Cambridge

Situation

An award-winning healthcare system serving the greater Boston, Massachusetts, region, Cambridge Health Alliance (CHA) includes three hospitals, more than 20 primary care practices, and the Cambridge Public Health Department. Public health, clinical care, academics, and research are some of the domains of the organization, whose mission is to improve the health of individuals. CHA employs nearly 5,000 people.

By the beginning of 2005, CHA was just completing some widespread improvements to its technology infrastructure. It had upgraded from Microsoft® Exchange Server version 5.5 to Exchange Server 2003, and adopted the Microsoft Office Outlook® 2003 messaging and collaboration client. It had consolidated from four server computers to one, while providing improved scalability—CHA could grow to 6,000 users without adding additional hardware. Also, Exchange ActiveSync® technology in Exchange Server 2003 enabled employees to be more productive when away from their desks. Using mobile devices, they could now access their inbox, calendars, and contacts within Exchange Server from afar.

However, as 2005 wore on, unsolicited commercial e-mail became an increasing problem. At the time, CHA had no antispam software in place, because there hadn’t been a strong need for it. Senior Technical Architect Dan Cameron says, “Spam wasn’t a major problem for us prior to 2005.”

However, as the volume of spam and the sophistication of spam tactics continued to grow, says Cameron, “We began to be plagued with spam on a daily basis—to the point where e-mail was becoming unproductive. About 60 to 70 percent of messages that employees were receiving were spam.”

Besides the nuisance factor associated with spam, the problem introduced prohibitive costs throughout the organization. Employees were spending a lot of time trying to rid their inboxes of junk e-mail. And the IT organization incurred costs related to resources: It needed greater bandwidth and storage space, as well as administrator labor hours, to deal with the problem.

CHA needed a cutting-edge antispam solution that would effectively eliminate spam messages now and in the future.

Solution

Before evaluating third-party technologies, the IT department at Cambridge Health Alliance decided to deploy the Microsoft Exchange Server Intelligent Message Filter, available as a download at no extra cost to users of Exchange Server 2003. After determining the effectiveness of the filter, CHA would decide whether to retain it or pursue another solution.

The fact that the technology was provided as a cost-free add-on did not make the solution more or less potentially viable in the eyes of CHA. “We implement technology based on how effective it is, not who owns it or how much it costs,” says Cameron. That an antispam solution might be fully integrated with the organization’s communication and collaboration server was seen as promising. Says Cameron, “Most companies base their technology decisions on functionality, support, total cost of ownership, ease of management, and so on—and that’s what we based our decision on.”

The Intelligent Message Filter provides advanced server-side message filtering to combat the influx of spam. Used in conjunction with Outlook 2003, it helps significantly reduce the volume of spam that users receive. The filter employs SmartScreen™ technology from Microsoft Research to track more than 500,000 e-mail characteristics to classify a message as legitimate or spam.

The Intelligent Message Filter is installed on an e-mail gateway server at the Internet perimeter. When external users send e-mail, the filter evaluates the message content and assigns a rating based on the probability that it is spam. The rating is stored as a message property called a spam confidence level (SCL) within the message itself. Administrators set thresholds to determine how to handle messages with given SCL ratings.

On the client side, Outlook 2003 and Outlook Web Access users can create a list of safe senders from whom they always want to accept e-mail messages and a list of blocked senders from whom they always want to reject e-mail messages.

In addition to safe and blocked senders lists, CHA uses sender and inbound recipient filtering to identify and block spam, and global deny and accept lists. These lists help to reduce the amount of false positives, or messages incorrectly categorized as spam, by specifying IP addresses from which to always accept or deny messages. CHA relies on twice-monthly filter updates to stay guarded against spam in the future.

Cambridge Health Alliance began testing the Intelligent Message Filter add-on in November 2005. For about a month, CHA recorded the spam confidence levels of both spam e-mail messages and non-spam e-mail messages of several employees. This helped determine where to set threshold sensitivity levels and see whether messages were being incorrectly categorized as spam. “Healthcare receives a lot of e-mail messages containing terms usually associated with spam—for example, Viagra,” says Cameron. “We needed a solution that could distinguish between these messages and actual spam.”

In December 2005, the IT department rolled out the solution to the entire organization. “The results were impressive,” says Cameron. “There were virtually no false positives, and we immediately saw about a 95 percent reduction in spam.”

In February 2005, CHA applied Exchange Server 2003 Service Pack 2 (SP2), which included enhancements to the Intelligent Message Filter, now fully incorporated into Exchange Server 2003.

Benefits

CHA has achieved a 95 percent reduction in spam messages. Employee productivity and workflow have greatly improved, and the organization is seeing significant savings in IT resources. CHA is able to implement and administer the antispam solution easily and keep the organization guarded against spam in the future through twice-monthly filter updates.

95 Percent Reduction in Spam

CHA’s IT department has been impressed with the effectiveness and flexibility of the antispam solution. Cameron says, “We implement best-of-breed technologies, whether from a startup or a major vendor. Based on our results with the Intelligent Message Filter, Microsoft has done its homework. The technology stacks up well against the competition.”

The global deny and accept lists have proved especially helpful for CHA. These lists specify Sending IP addresses from which to always accept or deny messages. Prior to using the lists, internal CHA e-mail messages sent using Simple Mail Transfer Protocol (SMTP) were occasionally mistaken as external messages, or spam. “Once we began using the global deny and accept lists, this was no longer an issue.”

Before use of the Intelligent Message Filter, nearly 70 percent of e-mail messages received by CHA were spam. Now, says Cameron, “We’re blocking nearly 95 percent of the spam coming into the organization, if not more.”

Increased Productivity and IT Resources

Previous to implementing the new solution, employees returning from vacation would need to wade through thousands of spam messages. “That doesn’t happen anymore,” says Cameron. “We have received countless messages from our doctors thanking us for using such effective technology.”

The new lack of spam has benefited both attitudes and workflow. “Doctors’ time is at a premium, so spam is especially expensive for them,” says Cameron. “The improvements that the filter has made to their workflow have had a positive impact on productivity, which benefits everyone.”

The IT department has also seen significant savings in IT resources through conserved storage space and labor hours.

Easy Implementation and Administration

For CHA, the solution was easy to install, test, and configure. “Check a few boxes and decide on your settings, and you’re in business,” Cameron says. “It’s the easiest thing I’ve ever implemented. It integrates well with our other technology, so things tend to be easy to support going forward. The total cost of ownership is very low.”

Long-Term, Dynamic Spam Protection

Because spammers constantly change tactics to find new ways to penetrate antispam defenses, CHA applies twice-monthly updates to the Intelligent Message Filter as soon as they become available. The frequency of updates gives the organization long-term peace of mind. Going forward, CHA plans to implement new features of the filter as they become available. Says Cameron, “I honestly think that Microsoft is very focused on security and that across the board the company will continue to provide some of the best protection around.”

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