Connected Health Framework for Health Plans

Connected Health Framework for Health Payers

If you're a health payer executive in today's increasingly complex and competitive health care marketplace, success will be determined by your ability to meet a number of critical challenges.

There are a number of challenges facing health payer organizations. From empowering consumers to take better care of their health and bringing new consumer-focused products to market to improving the responsiveness of customer self-service channels and connecting people, processes, and legacy systems the work can seem insurmountable within a complicated technology environment.

By modernizing legacy information and communications technology (ICT) systems you can not only achieve these goals but, also, make improvements across your business.

Helping you respond to changing business needs

The Microsoft Connected Health Framework extends the life of your current application and legacy system investments by enabling you to connect people, information, processes, systems, and devices, regardless of the platform or the original programming language. It's a simple and pragmatic approach to service, enabling the critical capabilities that you need to exploit new business opportunities and respond quickly to changing business needs.

The Connected Health Framework is a next-generation platform to support direct-to-consumer connections, delivery of actionable information within the context of existing workflow and digital lifestyles, and end-to-end collaboration with healthcare providers and trading partners.

Microsoft's approach to service-oriented architecture

  • An incremental approach accelerates time-to-value: Central to our real-world approach is time-to-value. In the business world, time-to-value is a critical value measurement and service-oriented architecture (SOA) helps drive more immediate returns in that area. In trying to achieve faster time-to-value in the real world, big top-down approaches do not work and bottom-up approaches don't tend to be manageable. In contrast, Microsoft's real-world SOA takes a middle-out approach, allowing you to focus on immediate business problems and apply ICT solutions in incremental steps to deliver near-term business results. By starting small with a focused business problem, you can achieve a focused business solution that then becomes the basis of broader SOA implementations.
  • Agility to quickly respond to changing business needs: The Connected Health Framework enables you to transform your business into one that is capable of turning information into actions that improve the health of members, better the quality of care and customer experience, and control rising medical costs. The Connected Health Framework can help you do what legacy claims-based insurance and customer relationship management (CRM) applications were never designed to do - support the ad hoc, unstructured, collaborative interactions and exception-handling that enable a customer-centric, highly collaborative, and knowledge-driven health payer enterprise.
  • Extensibility - it works with what you have: The Connected Health Framework unlocks valuable ICT resources from their application silos and makes functionality broadly available across the organization to promote business process optimization and organizational agility. Based on open industry standards, the Connected Health Framework gives you a standards-based means of integrating diverse systems and applications across a heterogeneous environment. This results in a loosely-coupled means of achieving integration so the underlying infrastructure promotes further change as business needs evolve.
  • Familiarity and broad platform support make service orientation mainstream: The Microsoft Office Business Application (OBA) strategy, made possible by new platform capabilities in the Microsoft Office system, allows you to bridge the legacy world of structured, transactional processes with the new world of non-routine, unstructured, and people-driven processes. Health plans can realize the "real-world" value and make service orientation mainstream faster and with fewer resources than their competitors by using the already familiar Office system and Microsoft Office SharePoint Server environments to access services and interact with business applications that connect them to existing legacy and line-of-business systems.

Connected Health

Benefits for health plans

Rapid gains in productivity and operational efficiency

  • Enable employees and partners to use the familiar Office and SharePoint Server environments with Microsoft's Office Business Application (OBA) strategy.
  • Leverage, extend, and optimize your current IT infrastructure.
  • Leverage your Microsoft investment to extend and optimize your new and legacy application portfolio with rich and intuitive forms, reports, spreadsheets, and other user-friendly documents.

Ecosystem-wide collaboration, communication, workflow, and compliance

  • Support internal and external collaboration and workflow
  • Embrace a heterogeneous healthcare ecosystem with support for open-standards such as web services, JAVA, XML, and other messaging technologies such as MQSeries, WebSphere, and SeeBeyond to provide interoperability and integration across the health plans your internal applications and external trading partners.
  • Simplify information access and usage protections making it easier and less time consuming for employees, partners, and consumers to work together and share information with less risk.

Consumer engagement reference architecture pack

  • Go where consumers go with direct-to-consumer connectivity and personal interactions within the context of the consumer's digital lifestyle. Technology-generated "moments of participation" enable consumers to proactively manage their health and their finances across the home, the workplace, and connected devices.
  • Simplify cross-entity consumer and provider authentication by using a standards-based web service built with off-the-shelf Microsoft technologies to plug-n-play with the existing consumer authentication system of any employer or partner.

Opportunities for implementation

Here are some ways you can integrate the Microsoft Connected Health Framework in your organization.

  • Consolidate and synchronize multiple provider data files and Network Provider Identification (NPID)-related processes.
  • Develop and launch new products and processes.
  • Consolidate acquired systems and data.
  • Provide superior customer services across multiple products and channels.
  • Extend functionality and agility on top of an aging portfolio of core transaction, care management, and customer service systems.
  • Participate in health information exchange networks.
  • Extend and virtualize processes and workflows internally and externally.