If you're a health plan executive in today's increasingly complex and competitive healthcare marketplace, success will be determined by your ability to meet a number of critical challenges, including:
•
Empowering consumers to take better care of their health and finances
•
Bringing new consumer-focused products to market
•
Addressing complex and rapidly changing business demands
•
Connecting people to people, workflow processes, and legacy systems
•
Improving the responsiveness of customer self-service channels
These goals often cannot be achieved unless you reorganize your business. And that often means modernizing legacy information technology (IT) systems.
Microsoft's Connected Health Framework extends the life of your current application and legacy system investments by enabling health plans 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 the 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 providers and trading partners.
An incremental approach accelerates time-to-value: Central to this 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 IT 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: Microsoft's 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 plan enterprise.
•
Extensibility—it works with what you have: Microsoft's Connected Health Framework unlocks valuable IT 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 2007 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 Microsoft 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.
The service-oriented reference architecture enables health plans to exploit new business opportunities.
Rapid gains in productivity and operational efficiency Microsoft's Office Business Application (OBA) strategy enables health plan employees and partners to reuse the familiar and broadly used Microsoft Office and Office SharePoint Server environments Leverages, extends, and optimizes 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 Supports internal & external collaboration & workflow across organizational boundaries Embraces a heterogeneous healthcare ecosystem with support for open-standards such as Web Services, JAVA, XML, HIPAA, HL7 and other messaging technologies such as MQSeries, WebSphere, SeeBeyond to provide interoperability and integration across the health plans internal applications and external trading partners.
Case Study: Horizon Blue Cross Blue Shield
Horizon Blue Cross Blue Shield of NJ is the state's largest health insurer with over 4,400 employees and 3.2 million members. These members depend on Horizon to make health care work by improving the health care experience for members and the communities served. With this in mind, Horizon created a SOA that focused on enabling member self-service processes that reduced the cycle time of real-time transactions such as primary care physician changes and enhanced eligibility inquiries.
Once implemented, Horizon experienced increased timeliness, self-service, data quality, and user satisfaction while reducing development costs by 50% and increasing IT productivity by over 45%. For these innovations Horizon was named one of the top 100 companies by CMP Media, LLC in its InformationWeek 500, a prestigious listing of the most innovative users of information technology in the United States. Horizon was one of only three health insurers to make the top 100.
"Meeting our customers' rising service expectations is our paramount concern and our award-winning Microsoft-based services oriented architecture gives us the organizational agility we need to get the job done. Microsoft's standards-based technologies have made it increasingly easier and cost effective for us to integrate our mainframe and Unix systems for better results." Anthony Thomas, CTO Horizon BlueCross BlueShield
Simplified information access and usage protections make it easier and less time consuming for employees, partners, and consumers to work together and share more information with less risk –even across company boundaries.
•
Consumer engagement reference architecture pack Architectural guidance is available to help health plans "go where consumers go" by supporting 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.
Simplified cross entity consumer and provider authentication. Use 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.
Evaluate the Microsoft ESB/SOA solution using the free ESB/SOA guidance kit. This kit is available by working with Microsoft or a Microsoft certified partner. The evaluation process is free of charge.
4.
Download and evaluate the free Microsoft BizTalk Services Internet Service Bus (ISB) SDK. The "BizTalk Services" ISB, complements the capability available in on-premise deployments of Windows Server, the .NET Framework, and BizTalk Server.
5.
For additional information contact Microsoft Health Plans team at hlthplan@microsoft.com
6.
Contact your local Microsoft representative and ask to arrange a detailed briefing on the Microsoft Connected Health Framework for Health Plans
7.
Contact Microsoft or one of its partners to evaluate what architecture maturity level your company has reached. The APIO and BPIO models provide questions that span the capabilities and help you identify your organization's current architecture maturity level.
