This month I have been working with a client who wants to evolve from a traditional healthcare payer into a provider of health management services. This is a growing trend as insurance companies and other healthcare payers move from traditional services such as processing claims to providing more preventive and wellness services to clients and subscribers.
These types of companies face a challenge seen by many healthcare organizations: how can they quickly, electronically enable a business processes without a long development lifecycle to deal with situations like flu epidemics and natural disasters?
Currently, healthcare is deeply entrenched around processes, which often get in the way of providing quality care, as well as increasing the cost of providing services. Being able to quickly adapt IT systems to deal with changes in processes can allow companies to react quicker to changing situations and find ways to reduce costs by optimizing processes.
As IT consultants, we need to enable these companies by advocating solutions that use dynamic process assembly. Several companies provide tools to automate assembly of new processes, or the modification of existing ones with minimal impact on IT. Tools such as IBM’s Business Services Fabric and Oracle’s BPEL Process Manager allow companies to model processes and build components that can be assembled dynamically using a rules engine, or by hand using web 2.0 user interfaces.
A key advantage of these tools to healthcare clients is that they often include pre-built assets or components that can speed up the time it takes for companies to see value. These assets often cover common functions such as eligibility and claims submission. Having assets either pre-built or purchased allows organizations to share and re-use them to meet different business needs and can reduce the time it takes to enable a process electronically.
These assets also help to mitigate risk. Purchasing or building a set of pre-tested assets and dynamically assembling them provides increased confidence in the solution and reduces the testing need for new business processes.
Another value to our clients is improved process optimization. Modeling processes allows us to identify areas where we can provide automation and reduce the time and cost associated with a process. This can result in improved customer service and reduce the amount of staff time associated with a given process.
A common theme to my earlier blog posts has been around innovation, by providing business process management solutions which allow clients to model, assemble, and deploy processes in a dynamic way, we can foster the type of innovation that our clients need to meet today’s healthcare challenges. I encourage all of you to look into this type of technology.
Don Sheppard is a Delivery Manager at Prolifics, responsible for ensuring the health and success of key projects. Don is a Master Certified I/T Architect with the Open Group and has over 18 years of experience, including 13 years at IBM as CTO for the National Portal Services Practice. Don has designed large, complex web and portal architecture, including web 2.0 sites and rich Internet applications in numerous industries, including healthcare.
