|
CASE STUDIES: Healthcare Insurance Sector
Case Study #1: Independence Blue Cross - IBC-Highmark, Unified View Business Objective - The advance planning for 2008/2009’s potential merger between Independence Blue Cross (IBC) and Highmark was extensive and thorough - organized around several themes: business processes, information technology, business intelligence and analytics, etc. Solution - The “Unified View” initiative was tasked with (a) identifying commonalities and differences in the capabilities, approaches, and architectures of the “Informatics” environments within both IBC and Highmark, and (b) rapidly designing, building and deploying set of new and extensible Informatics capabilities that would support reporting and analysis services across a logical physical and/or physical view of unified foundational data assets of both companies – combined for true cross-company reporting. A2C provided overall technical leadership for this initiative. This included organizing and designing due diligence tasks to identify and quantify commonalities and gaps between the organizations’ informatics capabilities, and mentoring and driving the design of a new and contemporary “Unified View” data warehouse architecture that would combine the strengths of IBC and Highmark’s independent legacy data warehouse environments, while preserving some measure of organizational autonomy, and supporting a complex and iterative multi-year conversion / migration process. Benefits Realized - The following key objectives and goals were accomplished: ► IBC / Highmark were able to identify commonalities and gaps in their Informatics technical architectures – including Server, DBMS, ETL, SAN, and reporting technology stacks. ► IBC / Highmark were able to architect a new DW that retained the strengths of each organization’s legacy DWs, while addressing shortcomings and positioning the new DW for graceful extension of functionality over time. ► IBC / Highmark was able to prioritize the new DW’s deliverables, and create a roadmap of continuous delivery of business value and insight to the new organization.
Case Study #2: Independence Blue Cross - Member ID Cards
Case Study #3: Independence Blue Cross - M&A Project Management Office Business Objective - Implement a Project Management Office for the potential merger between Independence Blue Cross (IBC) and Highmark to facilitate: workstream progress, issues and risks, and expedite communications through the workstream to the leadership team. Solution - The Project Management Office was the hub for all progress using the latest project management tools: M/S Project and a Microsoft Sharepoint site/repository developed by A2C. In addition A2C created a “Clean Room” environment for sharing of information between the parties and provided over 20 personnel to assist with project management, business analysis and process re-engineering. Benefits Realized - The following key objectives and goals were accomplished: ►IBC / Highmark were able to plan and estimate providing a dynamic view of the project schedule, costs and resources.
Case Study #4: Independence Blue Cross - Member Benefits Information Exchange Business Objective - As a member of the Blue Cross Blue Shield Association (BCBSA), IBC is required to respond to requests for member data from other BCBSA member companies through the Blue Exchange hub. The BCBSA continually releases iterations of new requirements for these transactions. Enhanced Eligibility Iteration 4 (EEI4) required all BCBSA member companies to provide member benefit information for eligibility transactions. IBC elected to re-architect the system to leverage a Service Oriented Architecture, allowing common access to member benefit information which would then be available for any consumer within the organization.Business Objective - Implement a Project Management Office for the potential merger between Independence Blue Cross (IBC) and Highmark to facilitate: workstream progress, issues and risks, and expedite communications through the workstream to the leadership team. Solution - As part of the Member Benefits SOA Enablement engagement, the following key objectives and goals were accomplished: ►Integrated multiple benefits COTS systems and mainframe systems to provide a consolidated view of the data ►Developed a standard Canonical Model for benefits information. ►IBC was able to exchange Member Benefits information seamlessly across the Blue Exchange network with its peer organizations ►Multiple IBC initiatives and mandates were able to utilize the Member Benefits Web Services providing quicker implementation time and data quality IBC engaged A2C to architect the Member Benefits Web Services to provide a standard way in retrieving a member’s coverage and utilization against individual benefits. These web services would serve to provide the integration to IBC’s numerous benefit’s data-stores, removing that requirement from consumers and a standard Canonical Model for reporting coverage and utilization for a member’s deductible, co-pay, co-insurance, out of pocket maximums, benefit limitations, and penalties. Benefits Realized - IBC was able to meet the BCBSA requirements for Blue Exchange, while simultaneously providing a common infrastructure for retrieving member benefit information, resulting in reduced implementation costs, improved data quality and quicker implementation times for multiple projects and initiatives.
Case Study #7: THOMSON REUTERS - Dynamic Data Center Reference Architecture Business Objective - As a leading provider of decision support solutions that promote informed healthcare decisions affecting more than 150 million U.S. lives, Thomson Reuters Healthcare (TRH) experienced a rapid expansion of their Product Portfolio in a short period of time. The accelerated growth both caused them to respond quickly by adding incremental infrastructure to accommodate new clients and needed product enhancements. This continual expansion of their infrastructure footprint has caused their annual capital expenses to increase year over year, which then translates into higher operational expenses that are impacting their profitability. Solution - A2C’s Enterprise Architecture group was brought in to formulate a reference architecture for their product platform that would leverage “Cloud” Technology“ and “Dynamic Data Center” concepts to reduce their Capital and Operating expenses and shorten their provisioning times. As part of the engagement, the following objectives were accomplished: Benefits Realized - TRH was able to significantly reduce the footprint of its infrastructure environments within their Data Center and free up resources that would have been required during the provisioning processes. This not only reduced its capital spend by over 30% a year, but it also reduced its operating expenses by 18%. In addition, they shortened their minimum environment provisioning time from 60 days to approximately 3hrs including additional functionality to handle occasional performance peaks and “State Roll-Back” for advanced troubleshooting capabilities..
Case Study #8: Reed Elsevier - Pinpoint Quality® Suite Data Platform Business Objective - Elsevier is a leading publisher of science and health information serving more than 30 million scientists, students and health and information professionals worldwide. They develop online information solutions that help healthcare professionals achieve better outcomes. Pinpoint Quality® application, identifies and improves clinical performance in hospitals or a group of hospitals. It incorporates severity adjustment and artificial intelligence with evidence-based guidelines and benchmarks. Pinpoint Quality® offers a systematic approach to improving care outcomes, patient satisfaction and operational efficiency. It provides desktop access to clinical, quality and cost indicators for disease categories, provides coverage of 100% of the inpatient population and allows for immediate identification of cost savings opportunities and improvements in clinical quality, safety, and service. Solution - A2C’s Information Services practice implemented a Multi-Dimensional Data Warehouse repository utilizing Oracle’s 11G platform with OLAP services and OBIEE integration. This solution enabled Reed Elsevier to achieve the following: - which will dramatically streamline and simplify Reed’s key product delivery platform and operations Benefits Realized - Reed Elsevier was able to increase revenues and take advantage of market opportunities by decreasing their customer onboarding times, and being able to react immediately to market conditions and adhering to federal healthcare mandates.
Case Study #9: Saint Vincent Medical Center - Electronic Medical Record Business Objective - Saint Vincent Medical Centers of New York (SVMC) serves as a major healthcare resource for the greater New York Metropolitan area. SVMC is currently in the planning process for building a new “All Digital, All Green” hospital which will utilize state-of-the-art technology to serve and provide the highest quality care to its patients. As part of this transformation, SVMC needed to implement an Electronic Medical Record strategy, in order to be compliant with the upcoming regulatory legislation and take advantage of the federal economical stimulus bill for Healthcare Information Technology. Solution - SVMC engaged A2C to formulate an appropriate EMR Roadmap , that would include the implementation of a digital repository, comprised of patient information, that would be digitally converted from their historical, paper-based medical chart and forms data. As part of the EMR Digital Transformation engagement, the following key objectives and goals were accomplished: ►Instituted a classification schema for all patient information and medical data which included bar code identification to virtually eliminate any human error Benefits Realized - SVMC was able to establish a strong foundation for their Electronic Health Record strategy that will not only enable them to provide the highest quality of care to its patients but they will be eligible to receive several million dollars in reimbursement from the federal economic stimulus plan under the American Recovery & Reinvestment Act of 2009
Case Study #10: Saint Vincent Medical Center - Server Virtualization Business Objective: Saint Vincent Catholic Medical Center (SVCMC), a large multi location healthcare provider in Manhattan NY, was faced by many of the issues that most hospitals these days are faced with. SVCMC engaged A2C to perform a virtualization assessment for their environment and then to implement the proposed solution. A2C was also tasked with developing an enterprise backup solution for their current environment. ► Obsolete, unsupported server hardware and an overcrowded data center Solution - As part of the Virtualization and Enterprise Backup Project, the following key objectives and goals were accomplished: ► A2C delivered a virtualization assessment report
|