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Unifying Data and Streamlining Service Delivery for a Health Benefits Administrator 

Challenge

Our client, a full-service Third-Party Administrator (TPA), serving a significant number of lives across multiple employer groups, faced a series of operational and technological challenges. Their growth strategy, involving the acquisition of multiple TPAs, led to a decentralized and siloed IT landscape, resulting in increased operational costs and complex data management. Their outdated legacy web portal for population health management was inefficient, leading to missed performance benchmarks in clinical case management and quality outcomes.

Moreover, the disparate systems and data structures across TPAs resulted in scalability issues, lengthy data load times, and relied heavily on manual processes. This resulted in non-uniform models and structures, thereby affecting data quality and trust.

Solution

To solve these challenges, we partnered with the client to undertake a series of transformative initiatives aimed at improving operational efficiency and service delivery.

Unified Data Platform (UDP)

Recognizing the difficulties posed by data management across multiple TPAs, we embarked on a project to create a unified data platform. The goal was to consolidate, rationalize and standardize data assets, effectively creating a single, comprehensive source of truth for business intelligence and analytics. The process involved careful planning, design and development, ensuring that the new platform could seamlessly integrate data from the various systems and formats previously in use.

Population Preventive Care (PPC)

To improve the efficiency and effectiveness of the client’s disease management processes, we developed a new product offering named PPC. This initiative was based on the existing Disease Management (DM) care gaps addressal process but aimed to provide a more robust and comprehensive solution. A critical part of this project was the development of a new multi-tenant clinical portal. Built using Design Led Engineering, this portal integrated all necessary member data in a single, user-friendly interface, greatly enhancing the efficiency of case managers and nurses.

Online Portal 2.0

Alongside these specific projects, we also recognized the need for a comprehensive, unified platform for various client services. We worked closely with the client to understand their specific needs and goals, leading to the development of a new portal integrated with the UDP. This platform, dubbed “Online Portal 2.0”, was designed to be highly intuitive and user-friendly, providing a seamless experience for both the client and their customers.

Payment Gateway Integration

Recognizing the importance of a seamless payment process, we integrated the client’s online platform with a payment processing solution. This project required careful coordination with various stakeholders and thorough testing to ensure secure, reliable operation. The result was a significantly improved user experience, empowering patients and members to make payments easily and securely.

Throughout these initiatives, we provided staffing services and implemented Agile project management methodologies. This approach ensured efficient project planning, tracking and reporting, and it allowed us to adapt and respond to any challenges or changes that arose during the projects.

Outcomes

The partnership led to significant positive outcomes. The creation of the Unified Data Platform resulted in a single, trustworthy source of data for all TPAs. This improved scalability and significantly reduced data load times, thereby overcoming one of the major challenges the client was facing. The new PPC product offering and the development of a clinical portal increased the productivity of case managers and nurses. By providing comprehensive member data in a single location, it became easier to identify care gaps, conduct screenings and provide preventative care.

The user experience was also enhanced by integrating the payment gateway, which facilitated easier and more streamlined payment processes. The engagement showed steady growth, starting with a small team and expanding to a large team with a high retention rate. This growth was accompanied by multiple successful releases, including the rollout of the new online portal, improved messaging and other feature enhancements.

This engagement exemplifies a comprehensive digital transformation journey, highlighting the immense value that strategic partnerships can deliver in overcoming complex operational and technological challenges.

Understanding the Challenges of Data Migration

emids delivered a GUI-based ETL middleware tool which leveraged Microsoft SQLServer, Snaplogic and a .Net interface. 

Overview

One of the main reasons many organizations, especially at the enterprise level, continue to use older or legacy systems is the challenge of updating all of the “jobs” or interfaces which move data into and out of those systems. From years of work and work-arounds, these interfaces become complex and patched with custom coding. Much of the cost, time and risk in any digital transformation is found in this area making data migration one of the greatest challenges. The underlying process is called Extract Transform and Load or ETL.

At the same time, interface work is often thought of as basic blocking and tackling work in many IT departments and is often not considered as prominently as other parts of the system modernization.  This is combined with the reluctance of data trading partners to change the incoming feeds or doing so at a cost for many of the same reasons. The basic work of ETL can often become a drag on implementations due to the effort involved in both documenting and accommodating clients who also are slow to change.

Business rules, or the Transformation component of ETL, can end up in multiple IT systems and either lost in layers or trapped in legacy systems. Because they are built over time, there is a tendency to either add on to a very long and complex “rule” or to create a new “purpose-driven” task each time. Either path adds to the complexity and creates a process dilemma. The skills and the knowledge for transformation work are often split between the technical IT and business analysts. This often leads to having purpose-driven interfaces as the analyst attempts to replicate IT functions and use the technical tools directly, or the IT resource creates rules on the analyst’s behalf over and over via individual requests.

Our client, an enterprise healthcare payer/provider, was one of the organizations going through the process of modernization of their IT infrastructure and clinical delivery systems. The UM platform was replaced and interfaces had to be migrated. A new interface management and ETL tool, Snaplogic, was also implemented across the enterprise. As part of those efforts, they recognized that there was an opportunity to not repeat the past, and a need for a tool to migrate the interfaces to the new platform without repeating the process dilemma of purpose-driven interfaces. The purpose of the tool was to create a method for analysts to onboard customers and set up file transfers, or interfaces, without the need for purpose-driven coding.

Solution

We were engaged to build a GUI-based ETL middleware tool which leveraged Microsoft SQLServer, Snaplogic and a .Net interface. Middleware, in this context, is software that operates between the data source and the target system and allows communication that is not dependent on the two systems having a common structure. The middleware solution acts as a translator between the two systems and transformations are typically applied as the data moves from system to system. Middleware solutions can also be made available to the analyst to apply their contextual knowledge without having the overhead of ETL and IT administration.

We started by examining the capabilities of Snaplogic and the existing processes to discover the business context and the actual rules. We then looked into applying a master set of rules globally but instead opted to design a framework so that, by entering configuration details into the application, complex and custom rules were applied to any incoming feed in a generic fashion. We also designed the capability of using MDM-governed or core tables to consolidate multiple, independent incoming feeds into a single stream to the target UM system. The configuration also includes steps to validate the incoming records and diverting potential errors to a path for correction.

Results

By using the application framework we developed, analysts are now able to set up new customer feeds and connect to sources, move and archive files, apply transformation rules, validate data, load to targets and manage job scheduling without manipulating the underlying infrastructure. The resulting tool is a significant reduction in both development resource cost and time to implement new, and eventually change existing, customers.

This innovative no/low-code approach keeps the technical delivery in the framework, which reduced the IT support load, and allowed analysts to create and manage the process without assistance in all but the most difficult scenarios. By consolidating the rules within the framework, auditing and reporting of the specifics was simplified and could be more readily understood by both technical and business users.  This was accomplished by applying a generic approach to the process while still allowing individual customizations to be applied in a standardized format.

The engagement entailed extensive development, testing and component integration between the application, database and Snaplogic. This tool was not only delivered on time and on budget, but also met all functional requirements and attained all goals and objectives initially established by the client.

Contact us to learn more about partnering opportunities.

Creating a Provider Portal with Longitudinal Patient Medical History Using Data from Multiple Sources

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Top Healthcare Software Developer Creates Interoperable Portal to Help Physicians Make Timely, Informed Decisions for Patient Care

Overview

The client is a provider of the healthcare industry’s most comprehensive suite of consumer experience platforms. Its integrated software is used by payers and providers to positively impact consumer decision-making and health behaviors beyond the care setting through personalized, interactive engagement across multiple channels. Its products include a healthcare customer relationship management system, an enterprise health content management system, an enterprise patient portal and comprehensive care management technology. The company has helped more than 1,100 provider organizations influence consumers in a way that transforms financial and quality of care outcomes.

Business Opportunity

One of the client’s signature products is a web-based clinical portal used by physicians to access vital patient information stored across disparate, federated health information systems. Timely access to this data provides physicians with the insight they need to make faster, more informed decisions about how to diagnose and treat individual patients.

One of the selling points of the platform is its single sign-in that allows physicians to log into the portal and obtain a secure, comprehensive and real-time view of a patient’s health records, including information on allergies, medications, past hospitalizations, blood banks and more.

To retrieve this data, which is geographically dispersed between multiple electronic health records (EHRs), laboratory systems and other backend systems, and provide physicians with a unified view of the disparate information, the client needed to integrate patient records in the portal with more than 30 HIS systems. The multiple integration points and EHRs vendors that existed across these systems complicated this process, hampering the free flow of information and resulting in inconsistencies in the data exchanged. This caused patient records to be marred by missing data, duplicate records, gaps in treatment plans and inaccuracies—all of which had the potential to put patients at even greater risk if not corrected.

Solution

In 2015, the client enlisted emids’ help to solve these integration-related challenges. We brought broad clinical and technical expertise to the engagement, including knowledge in:

We conducted an in-depth study of the databases, schemas and data semantics used by the two primary EHR systems used—to deepen our understanding how to extract data from these systems. Then we built customized connectivity adapters for each HIS system, which included lab, pharmacy, radiology, transcription, imaging and admissions systems, to aggregate, normalize and harmonize clinical and patient data flowing between each source system and the portal. Adapters were both batch and real-time as well as bi-directional, sending out data as JSON and XML.

Interface engines, built on a Java/Spring/Hibernate framework that could be quickly configured and extended, provided secure exchange points between adapters, routing data back and forth between each HIS system and the portal as indicated in Figure 1.

 

Technologies Used

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Results

While our work with both of these engagements are ongoing, we have helped the client meet their initial deadlines for bringing these projects to fruition and transforming them from concepts into viable technologies ready for the first phase of internal testing. Our team of healthcare experience technologists, which included 50 people at peak, jumped into both projects quickly and have added value uniformly and quickly.

We understood what needed to be built to execute the projects and assembled teams with deep healthcare knowledge to help drive their development. With the population health project, we worked closely with the client to flesh out the engineering for the product and set its direction. We helped anticipate and resolve issues before they became problems, even taking the initiative to collaborate with the third-party analytics provider that came on board to keep the engagement proceeding smoothly. The client still raves about how the initial prototype of the product matched their vision and met their needs right out of the gate.

We have continued to deliver new functionality for these projects, overseeing production releases every two weeks. The NLP tool we are developing for the client has enabled them to quickly explore the impact of different scenarios for coding by changing the rules for the automatic capture of clinical data. This process used to take days, but we have helped the client shorten the turnaround to few hours.[/vc_column_text][/vc_column][/vc_row]

Streamlining Data Collection and Metrics

Leading Global Medical Research Provider Advances Data Collection and Quality Reporting for Surgical Registries

Overview

A multinational Fortune 500 company and the world’s largest provider of biopharmaceutical development and Contract Research Organization (CRO) had contracted with the largest organization of surgeons in the world to improve data collection and reporting for all of their clinical registries.

The registries portals are web applications maintained by research organizations and healthcare providers, which store detailed, anonymized information about patients’ surgical procedure or post-surgery condition. Surgeons affiliated with the organization hire registrars to input the data relevant to patients’ surgical procedure and post-surgical conditions assimilating from various hospital information systems using registry portals.

Making use of the registry data is critical in the national movement to deliver clinical and quality measures across core practice areas, such as surgery. This allows clinicians to improve patient care and, ideally, outcomes. The CRO was charged with the task of combining patient registries with other research organizations and providers, such as hospitals, to provide the organization with comprehensive and accurate reports.

While integration is always challenging when merging disparate data sources, the registries have unique data structure and formats. This made the process of data extraction and transformation highly complex. Currently, much of the reporting is done manually. Finally, the lack of a unified data warehouse at the organization further hindered reporting goals.

Business Opportunity

emids conducted a three-day workshop with the CRO to understand the basics of the systems used in its data storage platform and its overall architecture, along with the functionality and infrastructure of each component. During the process, emids and the CRO determined the need to build a scalable, secure and dynamic platform to store and manage the clinical registry data for the organization of surgeons.

We explored the requirements for migrating historical data from existing registries to the new platform and keeping the clinical data of individuals private for development and quality assurance purposes. We also examined the current challenges of the reporting structure and requirements for achieving future reporting initiatives.

Solution

The platform in development has two components: a unified operational data store (ODS) and a data warehouse. The ODS is used for integrating disparate data from multiple sources, while the data warehouse is needed for long-term storage.

Services We Provided

Platform Infrastructure

Results

The new unified, clinical data warehouse and portal provides a more efficient, comprehensive system for capturing, merging and delivering quality metrics to the surgical community, with the goal of improving patient care. Along with giving the organization and third-party registrars a single, standard system for submitting data, the new platform provides surgeons and other clinical users with a web-based system for accessing data and running reports, improving their analytics and insight.