Thud! That's the sound an overstuffed three-ring binder makes when dropped on a boardroom table, and it echoes in trustee meetings around the country. But last March, it sent a clear message to the trustees and leaders of Dartmouth-Hitchcock, an academic medical center in New Hampshire: To lead transformational cultural and technological change throughout the organization, they needed to show by example how to conduct business. This required effective and efficient communications facilitated by new methods and tools to advance their work as a board.

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The paper packets were costly and labor-intensive, and the ever-growing volume of pages made them cumbersome to carry and increasingly difficult to navigate and comprehend. The trustees challenged leadership to provide access to their board materials anywhere, anytime. Equally important, they wanted only the most essential information to prepare them for each board and committee meeting.

The directive was set. First, replace paper packets with a fully integrated electronic board packet. Second, reduce the volume and communicate priorities clearly and succinctly. The timeline? Go paperless before the next quarterly meeting in June. Reduce the volume and better organize packet content by September.

The directive immediately raised a number of questions. Who will lead the transformation? How can we get all our source materials into a common electronic format? Which file format? What is the best method for distributing the electronic document? Which areas of the document can be eliminated? Which areas can be reduced?

A development team was formed, consisting of a member of administration and a member of the D-H Web team. They quickly identified key factors essential to the project's success:

  • An electronic version of the board packet that worked equally well on the Web, a user's machine or a portable device
  • A central, secure and widely accessible access point for packet distribution and archiving and easy access to supporting materials
  • A streamlined packet that contains only must-read material
  • A cost-effective solution over the long term

Eliminating Paper

In November 2009, the team launched a secure extranet website to act as a central repository for trustee-related content. With proper authentication, trustees could log onto the site and gain access to meeting schedules, board directories, news alerts, internal communication notices, committee definitions and charters, as well as a resource library containing board documents and committee-specific documents. This website was the first step toward better communication, but this new initiative would have greater impact than anyone could have anticipated.

The first priority was to get the packet into a usable, indexed, easy-to-navigate electronic format. Historically, many D-H staff members spent an entire day copying and collating hundreds of documents and assembling them into binders, before rushing off to ship and distribute them.

Converting the packets to an effective electronic format posed a technical challenge because the source materials are extremely diverse. There is a section of general board information, as well as sections for eight committees. Each section may include several source documents in various formats including Microsoft Word, Excel and PowerPoint, plus third-party PDF (portable document format) files and scanned images and text. To add to the complexity, the available production time to compile all section documents is just a few hours. The luxury of having days to assemble the final product just isn't realistic with this type of communication.

Before making a final decision on the electronic format, the team considered how the document ultimately would be delivered and read. Storing the packet strictly as Web-based content meant that trustees needed Internet access at all times, and that they could not personalize it with notes and comments. Delivering the document to their personal computers posed other problems. D-H had no oversight on these personal devices, and therefore no way to ensure security or provide technical support. A different delivery tool would be needed.

Choosing a Device

As the team continued to research the best file format, it ramped up the search for a delivery device. These were parallel initiatives, each with its own set of must-have criteria, and they needed to be compatible.

The team decided that D-H would issue each trustee a device for the duration of his term. This eliminated the concern about device oversight and gave the team a standardized delivery platform. But which type of device was right for the job? Laptops or netbooks were ruled out early on. Placing a vertical screen in front of a trustee during a board meeting was seen as contrary to a collaborative environment. E-reader devices like Amazon's Kindle and Barnes & Noble's Nook ultimately were ruled out because it would take considerable production time to convert the packet into e-book formats, and there was no good delivery channel to "push" it to the remote devices unless we wanted to post the confidential packet on Amazon.com.

The focus shifted to emerging tablet technology, most notably the Apple iPad. Its small form would be less obtrusive in the boardroom, and the wide range of applications available made it much more versatile than the e-readers. The iPad also provided a platform for other more efficient, interactive means to communicate, such as video streams and Web browsing. Plus, it wasn't just a reader; it would allow trustees to explore and use other applications, such as e-mail, calendar and contacts. The iPad also satisfied another key requirement—any device issued to this diverse group needed to be powerful enough to satisfy the tech-savvy user, and intuitive enough for nontechnical users.

With an extensive library of applications available, the team could select the best possible file format for the board packet, which was the PDF. The team could assemble the packets quickly from a wide range of source documents and create a table of contents to ease navigation. In addition, it could be read on almost any platform, which was important for non-iPad users who needed to access their packets from their PC, Mac or other mobile device.

The iPads were configured with a number of crucial security features: file encryption, pass-code access, automatic wipe in the event of repeated attempts to login with an incorrect pass code, and remote wipe capability in the event that an iPad is lost or stolen. (Automatic wiping erases all data files and personal information and resets the device to factory defaults.) Policies were established that addressed device and information security, branding and a specialized user's agreement for each trustee.

Paperless Packets Debut

For the June 2010 meeting, the trustees received their electronic board packets via e-mail to their personal computers. The new PDF version of the board packet was designed with extensive linking capabilities for ease of navigation, along with updated branding and formatting standards.

But it was still 680 pages long. While the project team received very positive feedback, the need to reduce the volume of content was clear. At the closing session of the June meeting, trustees were given a glimpse of the future: the June packet was presented as a fully functional electronic packet on the iPad device. The response was overwhelmingly positive.

Cutting the Bulk

As with many large organizations, the quarterly board packets had grown in size and complexity. A desire to ensure that the trustees had all the information they could possibly need also had driven this growth. The project team established a framework of five guiding principles for refining future meeting materials:

  • Standardize the methods used to assemble packet content
  • Highlight the most important content (top five priorities)
  • Use new formats to present packet information (video, online reporting or others)
  • Navigate areas of packet content and supporting materials
  • Eliminate unnecessary content

Over the next two months, the team worked closely with those staffing the boards and their committees to address the quantity, quality and type of materials previously distributed. The goal was to create an electronic packet containing the most important information within an executive summary under each section. This would be the must-read material, with links to background content available on the trustees' secure website. If a trustee only had time to read the executive summaries, he would be adequately prepared for the upcoming meetings, but access to detailed background information was immediately available.

Deploying the Devices

A pilot group of five trustees began testing and providing feedback on various components of the project, while also learning to be superusers of the iPad and relevant applications to help train their peers. Each member of the pilot group received an iPad and draft of the trustee user guide. Over a four-week period, they used the iPad to test the trustee website for ease of navigation and access to its online resource library and other areas of interest. Some researched other iPad applications that might be useful. The pilot group provided feedback to the project team regarding the content of the redesigned board packet, identifying pertinent and essential components to keep, while recommending that other material be relocated to the online resource library.

It was important to deploy devices that were ready to use right out of the box. Each iPad was set up with the necessary accounts (such as iTunes and YouTube) and specialized application buttons were created so that trustees would have effortless access to their board material, the secure trustee website, as well as preloading access to the D-H YouTube Channel and other key D-H sites.

Before the iPads were mailed to the full board, each trustee received a personalized electronic user guide and policies of use. Then the iPads were mailed to the trustees, ready to use and preloaded with their September board packet. The September meeting kicked off with a one-hour iPad orientation and training session. Trustees were able to receive one-on-one assistance with either a member of the project team or a member of the pilot group. This transition was essential to the success of the project.

The positive feedback was tremendous. The intuitive interface and interactive functionality made it easier to read and understand board material, increasing trustees' effectiveness and productivity during meetings. They appreciated the ease of accessing information from anywhere at any time. And they did not miss carrying heavy notebooks.

Despite the sizeable cash outlay for the procurement of the iPad devices, D-H projects a savings of more than $4,000 per year. The project also saved a significant number of man-hours used to assemble and distribute the paper-based packets. Now just one person sitting behind a desk for a few hours compiles all the documents in Adobe Acrobat. Distribution is accomplished with the simple push of a button. The metric that may be the most difficult to quantify is the improved efficiency in communication with the trustees, and their resulting increase in productivity.

Next Steps

As the initiative moves forward, the team is committed to continually improving both the board materials and the tools used to deliver them. Time is reserved at the end of each board and committee meeting for evaluation and feedback about the meeting materials. This is an opportunity for those who staff the board's committees to hear directly from trustees and help the staff take ownership of the new format. In addition, trustees complete an electronic meeting evaluation using the iPad after each meeting.

As technology continues to evolve, so will the ways we use it to support and engage our trustees. Some future plans include deploying an expanded set of business productivity applications for the iPad, access to personalized schedules and board materials, and a method for trustees to submit comments and questions to committee chairs in advance of meetings.

Dartmouth College and Tuck School of Business are following Dartmouth-Hitchcock's lead. Both organizations' boards have plans to make a transition to electronic board packets. The organizations will collaborate on future development of the technology and methods for the best possible communication and productivity, further demonstrating their commitment to continual improvement.

Kimberley A. Gibbs (kimberley.a.gibbs@hitchcock.org) is a manager for the Office of the Presidents, and Michael Zellweger (mz@hitchcock.org) is a Web development analyst at Dartmouth-Hitchcock , Lebanon, N. H.