Integration architecture first for health payers
If the landscape of a health payer’s IT system were compared to a city’s buildings and skyscrapers, then system integrations and the flow of data would be analogous to the infrastructure of roads, electrical grid, water system and sewage system of that city.
A city landscape is filled with buildings of all shapes and sizes – custom-developed solutions, packaged solutions and third-party service providers. Some of the buildings are being continually modified, while others are torn up and new buildings are erected. The only constant is the changing skyline.
The same is true with the landscape of a health payer’s IT system. As healthcare goes through transformations triggered by changing government regulations and the need to curtail rising healthcare costs, the only constant is the changing skyline.
Unlike actual cities, very little attention is given and investments are made in the infrastructure that supports the buildings in a health payer IT landscape. Systems and solutions can go up fast, but if the infrastructure is nonexistent, inadequate or inflexible, the bottleneck to change will be the time and cost spent in integrating the solution to the rest of the system landscape. For health payers, continuously investing to improve integration architecture and capabilities is the key to keeping up with the changing system landscape.