Developing a “single source of truth” for health plan member data

Sohail Malik_Elixir Technolgoies_New

Sohail Malik, Vice President, Solution Architecture, Elixir Technologies

Like organizations in every customer-centric industry, healthcare payers struggle to manage the volume and variation of member data available to them. Typically, relevant data resides in siloed systems, inhibiting easy access which significantly diminishes its value for gaining insight into how members interact with a payer organization, what products and services they are looking for, their communication preferences and other critical information. Moreover, when departments rely on different data sources, siloed systems can inhibit collaboration, resulting in errors and slower time-to-market for new products or services.

To unlock the value of this customer intelligence, many payers and other health care organizations are now establishing a strategy to achieve the equivalent of what has been called “a single source of truth” for their data – an easy and accessible means for the right people in the organization to gather and use reliable, essential data.

While in theory a single source of truth would require an information structure in which every data element is stored only once, in reality this isn’t feasible for most organizations. Typically, healthcare organizations have an infrastructure that includes numerous legacy systems, each of which stores health plan data relevant to that system’s purpose. This on-premise technology is typically difficult to customize or scale, requiring IT resources and unanticipated costs or tedious manual workarounds to add functionality or integrate with other systems. As a result, a choice is often made to purchase additional systems to handle new tasks, such as addressing a new customer communication channel. This only serves to further complicate the organization’s infrastructure.

SaaS offers a holistic alternative

Software as a Service (SaaS) cloud-based solutions, affordable and secure, offer another, more holistic approach to overcoming data silos. With no local install required, access to data and collaboration for business users at any location, from any device and across lines of business is greatly improved. SaaS platforms for applications such as member communications have a distinct advantage over legacy systems. Rather than pulling data from disparate parts of the organization, the SaaS solution houses assets in a consolidated content library. The ability to access assets from a centralized source supports a “create once and use everywhere” approach.

For example, having a centralized content library for member data can empower the customer support team with real-time access to all communications sent to a member. Moreover, business users creating member communications would have the ability to access needed data from portals that are pre-configured for user permissions and specific workflows. Rather than being trapped in print-centric systems, member data is available for use in print or electronic communications according to member preferences. For communications subject to regulatory requirements, the centralized content library combined with automated rules and processes can help ensure compliance.

Harnessing new and existing data sources with a SaaS cloud-based solution will enable business users to take actions based on all relevant member data, not just what is available in one standalone system or line of business. Employing this approach to attain a “single source of truth” for member data holds the potential to significantly improve responsiveness to members and their overall experience with your health plan.

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