4-page Case Study
Posted: 6/28/2011
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Landkreis Passau Gesundheitseinrichtungen German Medical Network Implements Cost-Effective Quality Management with Hosted Services

Landkreis Passau Gesundheitseinrichtungen (LPG) is a service company made up of hospitals and medical institutions that provide emergency and ongoing care for the Passau region of Germany. It treats a total of 44,000 patients per year, and employs 1,000 people. LPG must meet quality standards set by the German government and the international medical community to maintain operations. LPG wanted to implement a cost-effective quality management solution that would provide visibility and secure access for interested parties, without additional burden on its IT staff. It turned to Microsoft Gold Certified Partner Business Systemhaus AG, who used Microsoft SharePoint Online, a cloud-based document management service offered as part of Microsoft Office 365. With this solution, LPG can provide a highly secure platform with anywhere access to help maintain standards.

Founded in 1994, Landkreis Passau Gesundheitseinrichtungen (LPG) provides emergency and ongoing care for the people of the Passau region of Germany. With headquarters in Vilshofen, Germany, LPG consists of four city hospitals, two medical schools, and a regional medical care center. The hospitals and medical care center treat more than 44,000 patients every year. In 2010, LPG was named one of the “Great Places to Work” by the Institute Deutschland.

* With SharePoint Online, we can much more easily see how processes are working, where there are gaps, and what we need to change so we can make improvements over time. *

Joachim Eger
Head of IT, Landkreis Passau Gesundheitseinrichtungen

To maintain quality requirements set forth by the German government and the international medical community, LPG sought and achieved certification from the International Organization for Standardization (ISO). To achieve ISO 9001:2008 certification, organizations must document processes according to guidelines set by ISO to maintain consistency. External institutions frequently review and recertify these processes to ensure standards are upheld.

To help meet the ISO standards, LPG had a quality management system in place, but several challenges existed with it. The original system had been developed by a doctor who no longer worked for LPG, so it was a challenge to update the system. The system was also developed before the regional hospitals had merged into the LPG network, so it was not built to maintain quality documents for several institutions at one time. Finally, it was difficult to grant access to external parties who needed to regularly review process documents to ensure LPG was meeting standards.

LPG wanted to introduce a standard quality management system for all the hospitals to use, but it also faced several challenges in providing a new system. “Our main focus in IT is maintaining technology solutions for surgery and patient care,” explains Joachim Eger, Head of IT at Landkreis Passau Gesundheitseinrichtungen. “Our team members have to travel around the region to provide support for the medical equipment and our other systems, so we did not want a solution that would require more administration.” It also did not want to hire additional people to support a new system.

Another challenge LPG faced was how to provide a system where employees at all of the region’s hospitals and other institutions could access the forms and process documents they needed. The hospitals’ infrastructures were not networked, so employees at one hospital had no visibility into another hospital’s network file shares. Additionally, each hospital maintained its own Active Directory service structure. “To reconstruct a new Active Directory structure for all the hospitals would be an additional burden for the IT team, especially because many of the medical machines in each hospital have user accounts and we cannot risk any of them going offline,” says Eger.

Providing access for different types of users was also a challenge. It believed security issues existed around opening the IT infrastructure to allow access to external parties who needed to review process documents. It also wanted to provide different levels of access for employees, so that people who simply needed to print forms or view processes could not alter process documents in any way, even accidentally.

To help create its new quality management system, LPG worked with Business Systemhaus AG (BSH AG), a Microsoft Certified Gold Partner. Founded in 1995, BSH AG has 40 employees who provide consulting, infrastructure planning, development, and support for businesses of all sizes that implement solutions such as Microsoft Dynamics, Microsoft SharePoint Server, Microsoft Online Services, and other Microsoft server solutions. BSH AG also helps businesses that want to transition to hosted services to help reduce IT costs or ease administration.

At first, LPG considered deploying Microsoft SharePoint Server 2010 on-premises, but through BSH AG it learned about Microsoft Office 365, which brings together trusted business productivity, collaboration, and communications products as cloud-based services.

* We were concerned about opening our IT infrastructure to external users, but with the SharePoint Online service in the cloud, we can provide them with access to everything they need in a secure way. *

Joachim Eger
Head of IT, Landkreis Passau Gesundheitseinrichtungen

BSH AG offers solutions built in Microsoft SharePoint Online, a hosted document management service that offers the same robust capabilities as SharePoint Server 2010. LPG joined the Microsoft Rapid Deployment Program to pilot SharePoint Online. LPG was interested in hosted services because they would not require an additional server infrastructure for the IT team to manage.

As the first step, BSH AG held workshops with LPG to outline its requirements for the system. BSH AG customized team sites in SharePoint Online to build a prototype of the quality management system and used the Microsoft Word Web App to create the forms and process documents. With input from doctors and staff at the hospital, BSH AG also created the necessary document management workflows and helped LPG develop a document governance strategy to classify documents for each hospital, each department, and so on.

Because chief physicians at LPG must sign off on all processes to ensure any changes are correct and will not disrupt or adversely affect the organization or even patients’ medical care, BSH AG also created a feedback and approval workflow for all new or modified documents. “Every time staff members access the system or open Microsoft Outlook, they can see who has created new drafts, approved, or published documents,” explains Michael Zettl, Consultant at Business Systemhaus AG. “Because they have visibility into the system, they can more easily ensure they are maintaining the ISO compliance standards.”

To provide access to the quality management system for physicians, nurses, and staff workers, LPG worked with BSH AG to set up user accounts so that people only had the necessary levels of access they needed to do their jobs. LPG created all user accounts through the central administration portal for Office 365. All of the accounts are for online access and are separate from the Active Directory accounts employees have to access the hospitals’ networks.

LPG has 300 kiosk computers throughout the hospital network that different workers access to view processes and forms. Before, employees could easily change a document without realizing it. “With Office 365, we can set different subscription levels for different users,” says Eger. “Our kiosk users have read-only access to processes and forms, and they can easily see what has been changed or updated—but they cannot change anything themselves.” About 70 employees have full permission to access and change documents to maintain standards. In addition, with the help of the versioning feature in SharePoint Online, employees have just one quality document to maintain, instead of the multiple versions that caused people confusion in the past. Only a few people have access to a draft before it is final; the rest of staff only sees the final published version.

With the cloud-based solution, LPG can give external reviewers access to the quality management system in highly secure way by providing them with online accounts that enable them to view workflows, process documents, and forms in SharePoint Online, rather than allowing them access to the hospitals’ networks. “By using the Word Web App included with Office 365, LPG knows that its employees can easily view and share their documents online from almost anywhere,” explains Zettl.

Beyond the quality management system, BSH AG also created team sites for LPG to track meeting information. Staff members can capture and track action items, assign responsibilities and deadlines for tasks, and create status reports. LPG also uses team calendars to help manage schedules for emergency doctors and specialists, or to manage vacation schedules for staff. Finally, LPG plans to continue to look for ways to use SharePoint Online to help improve efficiency and collaboration.

With Office 365 cloud-based services and the help of BSH AG, LPG can provide a cost-effective quality management system that offers visibility to employees across the region and makes it easier for them to do their jobs well, all without increasing the burden on IT. LPG can also provide access to external reviewers to ensure it maintains ISO compliance standards.

Created a Highly Secure Platform with Anywhere Access
By using SharePoint Online to create its quality management system, LPG can ensure that employees at all its regional institutions can access the documents they need by signing on to Office 365 at kiosk machines. Because employees with kiosk user accounts have only been granted the permissions they need to access process documents and forms, LPG does not have to worry that employees will accidentally alter documents in a way that affects processes or medical care for patients.

* The low cost of Office 365 was a key consideration for LPG. They can define exactly how many people should have access and what type of access they need, and then pay subscription fees only for what they need. *

Michael Zettl
Consultant, Business Systemhaus AG

It can also provide access to the quality management system for external reviewers without giving them access to internal hospital networks. “We were concerned about opening our IT infrastructure to external users, but with the SharePoint Online service in the cloud, we can provide them with access to everything they need in a secure way,” says Eger.

With team calendars, doctors can view or change their schedules from any location in the world, and specialists who travel between hospitals can show when they will be available at different locations in the region.

Provided Insight for Change Management
LPG will use its new quality management system to understand overall processes and implement change management. “With SharePoint Online, we can much more easily see how processes are working, where there are gaps, and what we need to change so we can make improvements over time,” says Eger.

Hospitals also have better visibility into what is happening throughout the region, because they all have access to view the same system. Management can worry less about tracking process changes across individual institutions because all changes are recorded and tracked in one system. “Because everyone has access to the system in the cloud, they can all see who has edited or signed off on a new process,” says Eger.

Provided a Cost-Effective Solution
With Office 365, LPG has implemented a quality management solution with predictable costs. To deploy SharePoint Server 2010 on-premises, LPG could have paid as much as EUR€20,000 (U.S.$28,500) for hardware and software. Additional IT staff to maintain the solution and effort to network the hospitals and recreate the Active Directory infrastructure would also have cost LPG thousands of euros. “The low cost of Office 365 was a key consideration for LPG,” explains Zettl. “They can define exactly how many people should have access and what type of access they need, and then pay subscription fees only for what they need.”

Avoided Additional IT Burden
Because LPG can rely on Microsoft to manage the infrastructure and daily maintenance for its cloud-based services, it avoided placing more administrative burdens on its IT team. To implement the solution, it did not have to worry about deploying additional hardware, networking the hospitals, or restructuring the Active Directory service to handle user accounts. In terms of daily maintenance, it does not have to worry about tasks such as installing service packs and updates for existing systems, nor will it have to worry about future upgrades for the solution. “With Microsoft managing this solution behind the scenes, our IT staff can remain focused on ensuring the medical equipment works the way it should, which ensures we can provide quality care,” explains Eger.

Microsoft Office 365
Microsoft Office 365 brings together cloud versions of our most trusted communications and collaboration products—Microsoft SharePoint Online, Exchange Online, and Lync Online—with the latest version of our Office desktop suite and companion web applications for businesses of all sizes.

Office 365 helps save time and money, and it frees up valued resources. Simple to use and easy to administer, it is financially backed by a service level agreement that guarantees 99 percent reliability. Office 365 features robust security, IT-level phone support, geo-redundancy, disaster recovery, and the business-class privacy controls and standards that you expect from a world-class service provider.

For more information about Microsoft Office 365, go to:

For More Information
For more information about Microsoft products and services, call the Microsoft Sales Information Center at (800) 426-9400. In Canada, call the Microsoft Canada Information Centre at (877) 568-2495. Customers in the United States and Canada who are deaf or hard-of-hearing can reach Microsoft text telephone (TTY/TDD) services at (800) 892-5234. Outside the 50 United States and Canada, please contact your local Microsoft subsidiary. To access information using the World Wide Web, go to:

For more information about Business Systemhaus AG products and services, call (49) (0) 921 5 95 0 or visit the website at:

For more information about Landkreis Passau Gesundheitseinrichtungen products and services, call 0 85 41 206 342 or visit the website at:

Solution Overview

Organization Size: 1000 employees

Organization Profile

Landkreis Passau Gesundheitseinrichtungen (LPG) is a regional healthcare network that serves 44,000 patients annually in the Passau region of Germany. It employs 1,000 people.

Business Situation

LPG wanted to provide a standard quality management system across the network to help it maintain ISO 9001:2008 standards.


With the help of partner Business Systemhaus AG, LPG implemented a quality management system based on Microsoft SharePoint Online, a cloud-based service for sharing and managing documents and information.


  • Created a highly secure platform with anywhere access
  • Provided insight for change management
  • Provided a cost-effective solution
  • Avoided additional IT burden

Software and Services
  • Microsoft Office 365
  • Microsoft Word Web App
  • SharePoint Online

Vertical Industries