MCS improves business-critical applications for faster patient care with replication and reporting in Azure

Fast data for patient services 

Through its subsidiaries, Medical Card Systems (MCS) serves the Medicare Advantage commercial market segment and sells several insurance products through its general insurance agency. Founded 37 years ago, it is one of the largest managed-care organizations in Puerto Rico. MCS shows its unwavering commitment to its customers’ health through innovative products based on a service delivery model that considers all aspects of human health.

Healthcare needs can arise at any moment and are often time sensitive. MCS customers have access to a variety of hospitals, emergency rooms, and clinics to receive a wide range of services, including visiting a primary care doctor or specialist, getting a screening, or filling a prescription. As a holding company in the healthcare insurance industry, MCS needs to ensure that its customers can find out right away whether or not their services would be covered and by how much. Likewise, providers need to relay crucial information to clinicians and administrators concerning patients’ medical history and surgery approvals.

Also, MCS has approximately 500 employees across its 11 service centers that need reliable access to patient and policy data to serve the customers’ needs. All these needs make it critical for MCS to maintain highly available platforms where staff, customers, and providers can access data quickly, at any time.

MCS’s core system ran on AS/400, but the company found that it couldn’t scale its data replication as easily as it needed to. The company had to replicate more than 130 tables every hour to keep up with processing information for its 386,000 customers. Not only scale but also lack of expertise from its legacy cloud provider posed problems for MCS, which struggled to find local experts who could work directly with MCS staff to support and optimize the company’s cloud environment. 

“We could have layered very expensive services on top of our existing solution to get the real-time data we needed,” says Juan José Díaz Goitía, Senior Vice President of Information Technology at MCS. “But we knew it would be easier and more cost effective to replicate our data into a warehouse both for reporting and connecting it to other services in our ecosystem.”

Expert guidance, advanced analytics

MCS set out to change its environment to get more out of its database, minimize IT maintenance, and gain more technical support. Attracted by the selection and interoperability of Microsoft Azure services, the company adopted Azure Data Factory, a data integration solution, to replicate data from the AS/400. It added Azure SQL Managed Instance as an operational database and for reporting and data analytics. MCS now conducts live replication of the AS/400 tables in its production environment and connects that data to SQL Managed Instance for a modern, cloud-based database experience with minimal IT burden.

MCS initially hesitated to make this change. The company worked closely with Microsoft to complete a proof of concept in two months and moved into full production three months after that. MCS received strong support from data scientists and AI specialists on the Microsoft Data SQL Engineering team around best practices and change management, and this trusted relationship factored heavily into the company’s decision to fully implement the Azure services.

“At the beginning, I was a bit skeptical that maybe this was just a sales pitch,” says Sigfredo García Irizarry, Assistant Executive Vice President of IT Administration at MCS. “But when the Microsoft team showed us the AS/400 emulator and how we could transform data in minutes in Azure, that was the ‘wow’ factor for me.”

Adds Díaz Goitía, “The Microsoft team was always available, provided expert guidance, and showed us a better, faster way to accomplish our goals with Azure.”

MCS gained new capabilities by using SQL Managed Instance as a reporting platform along with Microsoft Power BI to create dashboards and enhance its business intelligence. As the next step in the company’s analytics journey, MCS plans to adopt Azure Synapse Analytics in the future to fine-tune its capabilities.

Easier maintenance, faster operations

Because SQL Managed Instance is a platform as a service (PaaS) offering, MCS performs much less back-end database management now. The company minimized issues with patching, and Microsoft handles most of the maintenance and optimizes the database. And the IT team saves time and headaches by replicating data in Data Factory.

“Maintaining and adding new fields and tables into the legacy platform was very cumbersome and time consuming,” says Díaz Goitía. “But now we can maintain our platform and enhance it going forward with far more speed and agility thanks to Azure.”

Delivering patient services quickly

As a holding company in the healthcare industry, MCS wants to give its customers—often patients—the answers they need, whether related to a claim approval or a clinical decision, as fast as possible. “We used Azure to meet our business goals for a more flexible database, more operational efficiency, and improved ability to deliver the healthcare information our customers need as quickly as they deserve,” says García Irizarry.

MCS considers its initial Azure implementation as laying the groundwork for continued scaling and improvement of its services. “With Azure SQL Managed Instance and Azure Data Factory, we can now serve more customers at the same time, helping us to grow in the future,” concludes García Irizarry.

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The information provided represents MCS’s experience using Microsoft Azure. It does not constitute architectural advice or an endorsement.