Fighting dementia; the Alzheimer's Society takes the cloud route

Salesforce Logo on wall of office Reception

As a UK charity coming into increasing national focus, the Alzheimer’s Society has used cloud computing based technologies from to transform its IT infrastructure and position it for a future where increased demand for its services is a certainty.

Starting life as a community-based organisation and now a fully networked national body, the Alzheimer’s Society has worked with the non-profit Salesforce Foundation division to create a technology stack to help support the needs of the 800,000 people in the UK who have a form of dementia. With more than half of that figure diagnosed with Alzheimer's disease, the total number of dementia patients is further projected to soar to 1.7 million people by 2051.

Faced with this huge challenge in terms of increasing growth, the Alzheimer’s Society first adopted Salesforce as a tactical platform to address a direct need for data management. Onward from this point Salesforce has markedly evolved to become a strategic platform for future operations managed by a ‘Computerised Record System’ known internally as a CRS.

The UK’s move to encourage a process of "personalisation" where individuals (and families) take control of their mental health recovery has imposed yet further change upon the Alzheimer’s Society.

In effect this has meant that in some areas the organisation has had to think about changing itself from being a business-to-business entity, to what is essentially a business-to-consumer body. This transformation, matched with the need to form a more technically integrated national operation, meant that not only would new technology need to be deployed, but a new base of user skills would also have to be developed.

In terms of its technical shopping list, the Alzheimer’s Society used’s own Platform-as-a-Service (Paas) to build its Computerised Record System. The CRS was also tailored with and integrated to the central cloud and application portfolio using the firm’s Java-like programming language Apex - and the Visualforce XML-style syntax for building graphical user interfaces in HTML or Flex.

To skill up to its new system the Alzheimer’s Society used a dedicated training professional who went around the country performing tuition and learning services. With 300 sites and over 2000 users (some with comparatively limited technical skills) this was deemed as a necessary expense thrown up by the move to Salesforce. There was also a massive data import task to undertake in order to bring 100,000 somewhat ‘fragmented’ patient records over from Microsoft Excel and other local systems.

Cloud data responsibility

"Looking after 100,000 patient records and protecting that data as it moved to a cloud computing based environment was a big responsibility and we faced a lot of scepticism from many quarters. So there was a strict process of due diligence where we spoke to the Information Commissioner’s Office and undertook an internal formal risk assessment before even an initial move to could be considered," said Phil Shoesmith, head of corporate infrastructure, Alzheimer’s Society.

The society confirms that one of the central functions it uses for is to control individual 'service user' tracking. With a remit to cover a wider spectrum of dementia than just those suffering from Alzheimer’s disease alone, the society needs to record who has been given what care and advice, where it has been given and what an individual’s timeline of engagement with the charity is as a whole. Customised assessment forms were developed using Apex from Salesforce so that staff could record every individuals’ needs and state of being at any one time.

"Training was very critical so we produced a number of videos using a screen capture tool with overlays and soundtracks to show users how to use the system,” said Shoesmith. "A key factor for us was usability. Where our staff do have IT experience they use Facebook and other similar applications - and Salesforce really is about as straightforward as these apps to pick up. Salesforce CEO Marc Benioff once described Facebook as something like ‘500 million users with no training courses’ - and he has a point."

Dementia doesn’t centralise around cities or transport networks; it is spread around the entire country, so this is where the Alzheimer’s Society carries out its work. Due to its nationwide footprint, the society knew that it needed a cloud-based system as it didn't want to install software on its 1500 PCs spread right across the UK.

Shoesmith’s group started off by using the free 10-user licence and worked upward to expand in 2009 to the 200 user system. In 2010 they then moved to put out a tender for a 2500 user system, which Salesforce won beating Microsoft and others.

"On we found many good technologies but some challenges in terms of change management. We found that there were some manual steps that were frustrating when taking sandbox development through to live production. Plus, the licence options seem to be ever-expanding and increasingly complex. I would also say that there are some reporting limitations,” said Shoesmith. “We would also like see the development and construction of an EU-located data centre for Salesforce,” he added.

On the plus side, Shoesmith confirms that up-time has been superb and it's not a huge “quantity” of software to install, so it’s an easy mountain to approach. Also on the positive side of the equation, the society says that it recognises how keeps on constantly developing with every new version bringing new technologies.

"The cloud model has worked particularly for us and this is largely down to its major defining characteristics ie we were able to focus on the application rather than the underlying infrastructure throughout the build and deployment process. The cloud’s web-based architecture also of course supports an extremely geographically distributed user base – and the PaaS model also allows us control our pricing payment as we expand usage throughout the organisation," said Shoesmith.

Shoesmith also confirms that the deployment scenario his organisation has worked with should and could be suitable for any other similar charity due to cost control considerations in the face of what is always limited funding. “’s foundation-level pricing means we can get hold of software with cutting edge features an affordable price point,” he added.

Looking beyond 2012 and onward, the Alzheimer’s Society is now looking to expand and build programme management tools into its IT framework using’s AppExchange app portal - some of these tools are free.

The organisation also wants to build in mobile usage options based on HTML5 and also see how we can make some of its data available externally.

The overall experience appears to be positive and having been purchased via the non-profit Salesforce foundation, there is clearly a strong philanthropy message here that is benefitting real people with real dementia challenges in their life.

In light of PM David Cameron’s recent Challenge on Dementia, moves to tackle mental health via any route are arguably now in greater focus than ever before. Although the Alzheimer’s Society has had to work hard to pass a US-based cloud solution through its due diligence procedures, the reality of the installation that has been executed is surely testimony to the cloud model’s applicability and usefulness.