Business Intelligence & Analytics: The Case for the Healthcare Industry

Marketing Team - Wednesday, September 24, 2014

Healthcare is data abundant.  It is in every medical practice, every hospital and every healthcare managing entity such as HMO’s, PPO’s, Medicare, MediCal, ACO, IPA’s and more.   In this blog you will be introduced to a real life example of making meaningful use of data and systems to optimize patient care and healthcare services overall.

Recently, Western Integrated Systems installed our Extract, Transform, & Load (ETL) solution with a major Independent Practice Association (IPA) in Northern California.    The challenge the IPA faced was delivering sustained high quality healthcare service levels in a paper intensive work environment.   The IPA sought a new solution to automate their business processes in terms of patient qualification, insurance verification, billing and elimination of excess paper work.

Using the ETL solution from Western Integrated Systems, the IPA has been able to achieve distinct benefits which improved their delivery of services and ability to provide quality care at all levels of their organization.    Specifically the ETL solution has allowed them to do the following:

1. Set up automated procedures, called robots, which identify and extract patient records from a leading primary data source.  These patients are specifically at risk and need further support and follow-up.   Formerly, this process required the completion and print out of PDF documents which were then transmitted to nine separate patient clinics.

2. A second procedure and robot was set up within the ETL solution to process insurance verifications.   The ETL solution was able to identify whether the patient was currently insured, their deductibles, and the time period the insurance policy was in force.  

3. Prior to the ETL, the process was completely manual and paper-based.  Now knowledge workers are freed up to provide more productive and meaningful work to improve the patient experience.  

4. The final step of the verification process is to make available the actual benefits to the qualified patient. 

The Results

Thanks to remarkable productivity gains using automated robots, the IPA has eliminated manual website downloads and they have reclaimed 90% to 95% of an analyst’s time for higher-value work.  The automation provided by the ETL has eliminated 100% of the cost of routine portal downloads, and costly transcription errors have been eliminated. 

The Future

The IPA’s success automating their partner web integration activities has validated their plan to review, automate, and streamline web-based business processes across the organization.

The use of key productivity tools such as ETL solutions are on the critical path, towards successfully implementing effective patient care strategies within the overall healthcare community.

Joe Ferrera

Business Intelligence & Analytics / Team Leader

Office: (916) 736-2191

Cell: (916) 792-4101





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