GDS International - Next - Generation - Healthcare - Payers - Summit - US - 9


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Sybase Solutions for the Healthcare Industry

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GDS International - Next - Generation - Healthcare - Payers - Summit - US - 9

  1. 1. solutions brochureSybase® Solutions for theHealthcare Industry Optional Photos Here (fill space)
  2. 2. Sybase technology enables healthcare organizations to manage, analyze, and mobilize data more effectively, resulting in greater efficiencies, collaboration, and improved quality of care.
  3. 3. OVERVIEW Healthcare organizations are under heavy pressure from both consumers and government to controlescalating healthcare costs, reduce the ranks of the uninsured, improve quality of care and supportinnovative clinical research. Meaningful improvements in healthcare efficiency and quality will rely heavilyon technologies that can improve the flow, availability, as well as the integration and interpretation ofstructured and unstructured data, across the continuum of care. Manage. Sybase is making it more feasible for health plans and providers to consolidate and analyzelarge amounts of data to speed research, improve care and reduce costs. Analyze. Changes in the amounts and types of data healthcare organizations rely on are alreadyunderway. It’s not enough anymore to understand what has taken place in the past; in order to staycompetitive, organizations need to be able to predict what will occur. Predictive analytics involves theextensive use of data mining, statistical analysis, forecasting, predictive modeling, and optimizationtechniques to drive your strategic and operational decisions and actions. Mobilize. Sybase is enabling healthcare organizations worldwide to mobilize information at the pointof care, secure access to clinical data and accelerate innovation and research. We enable real-time eligibilityverification at admission, and give clinicians and physicians secure access to patients’ clinical information viathe Web. Our technology solutions make it possible for healthcare organizations to plan for the future, improvecollaboration with industry partners, streamline business processes, and improve the bottom line. Bydelivering enhancements such as improved decision support for medical personnel via systems integration,Sybase solutions can also increase customer satisfaction with providers and payers.
  4. 4. ANALYZE ANALYZING INFORMATION FOR SMARTER DECISIONS Validating coverage and processing claims is complex. Payer organizations need solid, scalable solutions that will give them an advantage over their competition while at the same time, enable them to maintain strong relationships with their healthcare partners. Sybase solutions for healthcare payers and managed care companies focus on providing more comprehensive and accurate enterprise reporting and analytics. Our high performance analytics solutions provide payers with ease and flexibility in analyzing claims and other medical and personal data to improve utilization, develop new services, eliminate waste and prevent fraud. While traditional business intelligence systems deal with data access and reporting and help answer questions such as what happened, what exactly is the problem, and what actions are needed; Sybase’s predictive analytics capabilities go further, enabling you to understand why events are happening, predict what will happen next, and identify the most optimal course of action. AOK Hessen — accelerating insight into data patterns What are the typical evolutionary patterns of certain diseases? Which therapies are most successful to avoid inpatient treatment? Are there any billing peculiarities, such as unusual ratios of diagnoses to prescriptions? These were the questions that AOK Hessen — the largest statutory health insurance company of the German state of Hesse, responsible for 1.6 million insured individuals — needed to find the answers to. To obtain truly meaningful insight, it was necessary to consider all existing information simultaneously. This meant that data on medication and outpatient care had to be compared with other benefit-related data (such as hospitalization) in a single analysis. As a result of this broad-ranging view, the data volumes involved are extremely large.“Sybase’s predictive analytics Andreas Seibert, head of the IT-Business department, describes how this affected the users, “For eachcapabilities go further, enabling individual analytical query, our divisions had to submit a formal request to our IT department and then waityou to understand why events for IT to deliver the report. In addition, the operational OLTP database often took an extremely long time toare happening, predict what will run a query and return the results. We wanted to enable our divisional users to run queries by themselves andhappen next, and identify the customize those queries as necessary. To accomplish this, we needed a system that was easy to understand,most optimal course of action.” flexible, and above all, very fast.” By probing its voluminous data assets covering treatment protocols and invoices submitted by doctors, hospitals, pharmacists and other partners, a health insurance company can gain valuable insight. AOK Hessen therefore decided to establish a centralized data warehouse and deploy an ETL process to load it with data from various operational systems. Two years ago, AOK Hessen generated a profit of USD $136 million. The insurance company attributes this result to its commitment to a strong membership and performance management strategy. Sybase IQ was part of their strategy. Hessen implemented Sybase IQ, integrated with Sybase partner Qyte’s RayQ data mining tool. As a result, AOK Hessen created the first analytical data warehouse on the market capable of running direct, end-user initiated artificial intelligence (AI) evaluations. “Our ability to provide the most comprehensive and reliable business solutions to our clients relies on constantly evolving new and innovative technologies to enhance our operational efficiency. The rapid growth of our business has seen claims records grow nearly 500 percent in five years, and our ability to manage this burgeoning data effectively and drill down into it for greater business insight links directly to risk management, cost containment and the enhanced quality of service we provide our clients. Sybase is the bedrock of our data management capabilities and an important contributor to our business success.” – Pierre Robertson, head of decision support systems at MHG
  5. 5. Garvan Institute — using data to improve patient care and reduce costs Analytics Accelerator for To maintain its standing as an internationally-recognized leader in gene-based medical research, Garvan Healthcare PayersInstitute needed to generate detailed reports that merge lab research with information on patients suffering Faster Reporting and In-Depth Analyticsfrom a variety of diseases such as cancer, diabetes and osteoporosis. The institute also needed an information for your TriZetto® Facets® Platformarchitecture that would allow researchers to easily query databases — providing data for published journal The payer industry is moving toward a newarticles. To solve the challenge, Garvan Institute turned to Sybase Adaptive Server® Enterprise 15 (ASE), serving model of healthcare, Integrated Healthcareas a reliable platform for more than 30 separate databases. Garvan researchers now easily build research Management (IHM). TriZetto’s innovativereports from ASE-generated data to author journal articles with information that helps relieve human solutions in core administration, caresuffering and improve quality of life. management and constituent engagement are essential to the achievement of the IHM model. Sybase and TriZetto haveMIQS — improving patient-treatment accuracy and efficiency been working together since 1993, when Founded in 1990, MIQS is the premier provider of electronic medical record and financial management the Facets Solution was designed aroundsoftware for kidney dialysis and offers the only integrated, patient-centric, unified clinical and financial the Sybase ASE database to power thesoftware solution. MIQS relies on Sybase ASE as the database platform for Disease Manager Plus, a healthcare automation of payer’s core business functions—over 60% of Facets customersinformation-management solution serving healthcare service providers and payers that manage costly chronic run their business on Sybase ASE today!illnesses over time. Primarily used to manage patients with end-stage renal disease requiring dialysis, thesolution unifies daily activities by combining electronic medical records, practice management, and decision- With the Sybase Analytics Accelerator forsupport functions within a completely integrated and analyzable application infrastructure. Using Sybase Healthcare Payers solution, you can now gain deeper and faster insight into yourASE, MIQS has improved patient-treatment accuracy and efficiency while also improving healthcare billing claims and other operational data. Byprocesses and simplifying regulatory compliance. accelerating and simplifying your analytics capabilities, you can get a more refinedMetropolitan Health Group — reducing risk and containing costs picture of the cost of care, detect subtle but actionable changes in outcomes, When Metropolitan Health Group (MHG) learned its legacy database system was being discontinued, it cost, and payment trends, and developseized the opportunity to migrate its legacy applications and client information to Sybase ASE and Sybase IQ the metrics needed to support pay-for-to enable it to continue serving its clients and meet its strict service level agreements. performance initiatives. MHG provides medical scheme administration and managed healthcare to more than 600,000 individuals This solution, provided in partnership withcovered by 21 medical schemes in South Africa. Their administrative services include management of Project Performance Corporation (PPC),membership information, medical claims processing (150,000 to 200,000 claims per day), premium uses a unique high-performance analyticsmanagement, marketing and communication, financial and actuarial services. They also include reporting on engine to support complex queries and reporting. It is designed specifically tomembership, financial and other trends to provide medical schemes with the business insights they require to work with Facets and other common datamaintain their viability. sources to give you a consolidated source To meet its analytic and reporting responsibilities to its clients and provide them with the insights they of data for up-to-the-moment analysis and decision-making.need to mitigate risk, understand healthcare utilization patterns and detect fraud, MHG implemented SybaseIQ to power a data warehouse. In addition, they needed to be mindful of the sensitivity of the informationthey process and the reliability of their IT systems. In particular, they havevery strict service level agreements (SLAs) with their clients they mustmeet, as they are linked to financial penalties that may be levied againstMHG should they fall short.
  6. 6. MANAGE STREAMLINING PROCESSES TO IMPROVE EFFICIENCIES Health systems, hospitals, clinical researchers and other care providers face the dual challenge of delivering the highest quality of care while finding ways to operate as efficiently as possible to survive in today’s competitive healthcare climate. In fact, as providers automate more of their processes, many are finding that they need better tools for capturing, consolidating, analyzing and simplifying the movement of information. Sybase understands these issues and offers multi-functional technology solutions that enable providers to maximize their investment and streamline their workflow. BJC HealthCare — timely and accurate information at the point of care For most healthcare organizations, providing clinicians with timely and accurate critical-care information is a goal. For BJC Healthcare, it’s a reality. BJC HealthCare is one of the largest nonprofit healthcare organizations in the United States. Through its 13 hospitals and multiple community health locations, it provides inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long- term care and hospice. For programs designed to ensure patient safety and maintain optimal standards of care, BJC HealthCare uses Sybase Adaptive Server Enterprise 15, Replication Server and Sybase Professional Services. In particular, BJC HealthCare’s Medical Informatics division concentrates on improving health care by implementing innovative, effective information technology applications. The division’s mission is to improve care by “translating data into effective interventions.” Their data-driven expert systems assist clinicians and protect patients. BJC pharmacy expert systems check for potentially dangerous drug combinations, verify that the proper laboratory tests associated with specific drugs are run at the right times, and monitor patient prescriptions to ensure patients with particular diagnoses receive the proper medications before being discharged. These expert systems have proven to be a very efficient and potentially life-saving framework. In 2008, these systems generated alerts to clinicians resulting in approximately 18 patient care interventions per day.
  7. 7. BlueCross BlueShield Tennessee — improving efficiencies BlueCross BlueShield is a national system of 58 independent plans and the nation’s largest health insurer,providing coverage to one out of every four Americans. When it came time for BlueCross BlueShield Tennessee(BCBST) to overhaul its business model and IT systems in an effort control skyrocketing health care costs, theyturned to Sybase. Using Sybase technology, BCBST was able to increase claims processing throughput, improvecash flow, reduce training time, increase scalability and functionality, expand rapidly into the managed carebusiness and quickly introduce and manage new product while experiencing these results: • Increase in claims processing throughput by 25 percent • Handle two million members and process 25,000 claims per day • Provide ad hoc query responses up to 500 times fasterISOH — single view of patient history ISOH is the largest oral health service provider in Australia. Before ISOH, access to public dental clinics inNew South Wales, Australia’s most populous state, was on a first-come, first-served basis, irrespective of clinicalneed or whose tooth ached the most. The paper-based system was ineffective, inefficient, and inconsistent. Using Sybase technology, SQL Anywhere, PowerBuilder and PowerDesigner, ISOH was the first system inAustralia to provide a single view of a patient’s oral health treatment history provided by any public healthfacility across NSW. The system allows telephone triage that geographically distant patients can access fromtheir own homes. It’s possible with ISOH to search any appointment book anywhere, anytime to reservean appointment. It’s also scalable to accommodate dental services from a small two-chair clinic to a large200-plus-chair dental hospital.Leeds Teaching Hospital NHS Trust — comprehensive e-procurement The largest trust in the United Kingdom, providing acute services for the City of Leeds — needed to developan e-procurement system based on a common item catalog that would work with its existing purchasingand finance systems. Using Sybase technology, it developed a comprehensive e-procurement, managementinformation and purchasing control system. Employing more than 15,000 staff across eight sites and treating 125,000 inpatients, 65,000 day cases "Using Sybase technology,and 700,000 outpatients each year, Leeds Teaching Hospitals NHS Trust annual budget is more than USD $1 BlueCross BlueShieldbillion. Prior to this project, Leeds’ procurement environment was a tangle of inflexible, disconnected systems Tennessee was able to(some electronic, some manual), a vast number of suppliers, and centrally and locally negotiated contracts. In increase claims processingaddition, Leeds had no catalog management capability. throughput, improve cash flow, reduce training The Sybase solution slashed the total cost per order by 92 percent, dramatically improved staff productivity, time, increase scalabilityincreased contract compliance and management, and provided better control over spending. Specifically, it: and functionality, expand • Lowered the total cost per order by 92 percent rapidly into the managed • Reduced time spent on supply issues from 20 percent to less than five percent care business and quickly • Improved contract compliance and management by 30 percent introduce and manage new product…"ADDRESSING COMPLIANCE, NOW AND IN THE FUTURE As you prepare your organization to succeed in the next phase of the healthcare industry, it’s importantthat you choose a technology solution that’s truly open, and a partner who’s both committed to the changingworld of HIPAA requirements and thoroughly experienced in business process integration. Sybase excels in these areas and is uniquely qualified to help you transition smoothly from your currentposition to full HIPAA compliance and full business process integration. Our HIPAA transaction tools are easyto use and platform independent. They greatly reduce the time needed for data integration efforts, enabling youto focus less on “getting to the data” and more on strategically using the data to improve business performance.
  8. 8. “Sybase believes that the By combining HIPAA-compliance efforts with steps to integrate all of your business processes andhealthcare market leaders of communicate better with your trading partners, your healthcare organization will become more competitive.tomorrow will be those with Sybase believes that the healthcare market leaders of tomorrow will be those with streamlined, end-to-end,streamlined, end-to-end, processes integrated with their trading partners. Sybase offers solutions to:processes integrated with • Migrate HIPAA based transactions from the 4010 standard to the 5010 standard and utilize concurrenttheir trading partners.” 4010 and 5010 processing to reduce processing and maintenance overhead • Enable healthcare payers to comply with HIPAA regulations and CMS mandates while providing fully- featured EDI translation tailored to your company’s internal processing requirements • Address HIPAA regulations and Centers for Medicare and Medicaid Services (CMS) mandates for providersSybase Solutions for MedicalDevice Integration MOBILIZING CAREMore and more, medical devices and It is no surprise that the healthcare industry has rapidly and enthusiastically adopted mobile technology.medical software vendors are being This is an industry that, while steeped in tradition, is driven by discovery and innovation. Healthcaredriven to provide connectivity and professionals are routinely and increasingly using mobile devices to access and review patient records andmobile solutions to their customers. test results, enter diagnosis and billing information during patient visits, consult drug formularies and otherSybase integration software provides reference material, and synchronize information with their organizations’ centralized systems, all without theout-of-the-box solutions for medicaldevice connectivity and rapid need for wired network connections.development of mobile applications Gartner has placed Sybase in the Leaders Quadrant of their Magic Quadrant for Mobile Enterprisefor software solutions including: Application Platforms1. Sybase’s mobility platform addresses the converging IT requirements of healthcare• EMR (Electronic Medical Records)• HIS (Hospital Information System) organizations today. By combining application development tools, mobile device management and security,• LIS (Laboratory Information System) and email/messaging, the Sybase Unwired Platform enables healthcare organizations to empower caregivers• POL (Physician Outpatient Laboratory) to work anywhere, at anytime, on any device.• PMS (Physician Management System) Backed by more than 20 years of expertise, Sybase technology has been selected by 81 Fortune 100Contact us to see how we can help make companies to solve mobile, distributed and remote enterprise computing challenges. Our mobile technologythe integration of your devices easier. solutions can enable caregivers to review patient records, see test results in real-time, access drug formularies from anywhere, or enter data during homecare visits. Sybase’s mobility platform provides the core integration, synchronization, messaging and mobile data management capabilities required to exchange informationSybase Integration Options for between caregivers and enterprise systems, enabling better decision making, improved efficiency and ultimately better care. SQL Anywhere provides data management and exchange technologies designed for database-powered applications that operate in frontline environments without onsite IT support. It offersPoint of Care Data Management System enterprise-caliber features in a database that is easily embedded and widely deployed in server, desktop,Sybase is the exclusive partner remote office and mobile applications.for Abbott’s Point of Care deviceinterfacing. Our open connectivityplatform together with Abbott’sPrecision Web data managementplatform provides a vendor neutralsystem for the managementand interfacing of point-of-care,laboratory, and other connected 1 Magic Quadrant for Mobile Enterprise Application Platforms, Publication Date: 16 December 2009, by William Clark and Michael J.medical devices. King, ID Number: G00172728. The Magic Quadrant is copyrighted 2009 by Gartner, Inc. and is reused with permission. The Magic Quadrant is a graphical representation of a marketplace at and for a specific time period. It depicts Gartner’s analysis of how certain vendors measure against criteria for that marketplace, as defined by Gartner. Gartner does not endorse any vendor, product or service depicted in the Magic Quadrant, and does not advise technology users to select only those vendors placed in the “Leaders” quadrant. The Magic Quadrant is intended solely as a research tool, and is not meant to be a specific guide to action. Gartner disclaims all warranties, express or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose. mobilize
  9. 9. Caremark — wireless prescriptions reduce errors Of the three billion prescriptions filled every year in the United States, as many as 40 percent requiretime-consuming rework and calls between pharmacists and physicians. Caremark needed to improve theefficiency and accuracy of prescription writing while overcoming the limitations of PC-based point-of-caresystems. To accomplish this, Caremark created the iScribe Suite, an innovative handheld, wireless prescribingand formulary reference system powered by SQL Anywhere Studio. Thanks to this solution the vast majority oferrors such as illegible handwriting can now be eliminated, medication errors have been reduced by 80% anddoctors can spend more time with their patients.Cerner BeyondNow — mobilizing point-of-care in the home For over 26 years, Cerner has focused on developing healthcare information technology solutions. CernerBeyondNow helps to improve patient care by integrating all three facets of the homecare business: clinicalactivities, billing/financials, and management decisions. Cerner created a mobile point-of-care applicationbased on SQL Anywhere to enable home healthcare providers to have access to patient charts, profiles andhistories in order to make the most effective decisions, and to allow home healthcare organizations to reduceadministrative paperwork and expedite third-party reimbursements. “The most important benefitOchsner Clinic Foundation — eliminating backlog for test results is that our mobile system Ochsner Clinic Foundation, the largest private health care institution in Louisiana, needed a solution has eliminated the need forthat would help it overcome a persistent three-week backlog for cardiovascular test results. Using Sybase therapists to spend hourstechnology, Ochsner developed and deployed a mobile application that solves its backlog and generates more each week re-entering theircomprehensive reports in seconds. time-keeping and treatment information into desktop Built with Sybase PowerBuilder, Ochsner’s Cardiovascular Information System (CVIS) allows clinicians PCs for transmission toto enter test and procedure results directly into a patient’s record — solving the problem with dictation, our centralized systems.generating reports in seconds and eliminating the laboratory’s backlog. Clinicians are assisted by procedure- This allows them to treatspecific modules with decision-making intelligence, and information is immediately received by physicians more patients and/or spendwherever they are. Ochsner also uses Sybase PocketBuilder™ to deploy an “e-bill” application, and plans to use more time with each patient,it to deploy CVIS to handheld devices. which is critical when your • Saves $400,000 annually through more accurate billing focus is producing the best • Reduces transcription costs by $60,000 per year possible clinical outcomes.” • Tripled the cardiology business in seven years – Keith Bickett, Project Manager, PeoplefirstKindred Healthcare — replacing paper-based billing systems Kindred Healthcare, Inc. is a healthcare services company that through its subsidiaries operates hospitals,nursing centers and a contract rehabilitation services business across the United States. The contractrehabilitation services business — Peoplefirst — is the nation’s second largest contract therapy company,employing over 8,000 individuals the majority of whom work directly with patients at over 600 locationsacross the country In the course of a typical day, a therapist might work with 10 patients. Historically, the therapists (or asecretary) had to spend an hour at the end of each day at a desktop PC keying their handwritten patienttreatment notes — patients seen, time spent with each patient, and other treatment related information —into the company’s centralized billing system. This paper-based system created problems for Peoplefirst. The time spent keying information into thesystem was time that could have been better spent working with patients. Additionally, as with any paper-based system that requires re-entry into a computer system, errors were inevitable. This could cause problemswith reimbursements from the healthcare facilities that are responsible for billing services to insurancecompanies and Medicare.
  10. 10. To increase the productivity of its rehabilitation therapists, improve the accuracy of data required for billingand other business purposes, and generate the best possible patient outcomes, Peoplefirst rehabilitationreplaced paper-based processes with a mobile application powered by Afaria from Sybase. “Moving from paper to Point-of-Care-Mobile has produced important benefits for Peoplefirst and for ourpatients,” says Keith Bickett, Project Manager, Peoplefirst. “The most important benefit is that our mobilesystem has eliminated the need for therapists to spend hours each week re-entering their time-keeping andtreatment information into desktop PCs for transmission to our centralized systems. This allows them to treatmore patients and/or spend more time with each patient, which is critical when your focus is producing thebest possible clinical outcomes.” “In addition,” Bickett continues, “the information we capture now is more timely and accurate, which allowsus to generate more accurate invoices and improve our cash flow. Management also benefits by being able toview information in near real-time, which allows them to optimize scheduling, monitor treatment plans andprogress, and meet compliance requirements more efficiently and effectively.”Sybase brings a full spectrum of support and services to healthcare organizationswith professional services and education services. Sybase offers a full spectrum of support and services for our products. When it comes to Sybase products andunderstanding how to manage, analyze and mobilize information; Sybase’s professional services groups arethe leaders. We offer a wide variety of services to match your technology and business requirements; lookingat where you are today and where you want to go, and charting a course with our proven project managementmethods, and work that is compliant with our ISO 9001/TickIT-certified quality management system. To further support the skills development of our customers, Sybase provides world-class learning solutionsincluding: technology skills assessments, certification preparation and focused training. Our comprehensive,certification-based curricula are delivered by our Certified Sybase Instructors at your site, a convenientlylocated Learning Center, over the web using SyberLearning LIVE™, or through our anytime, anywhereSyberLearning OnDemand.™ Sybase’s rich 25-year history as a technologyleader and innovator includes creatingtechnology that powers the world’s mostcritical data in commerce, finance, governmenthealthcare and defense — let us know how wecan help you.
  11. 11. Healthcare unwired Manage ANALYZE MOBILIZE • Consolidate data • Report and analysis • Electronic health delivery • Streamline operations • Predictive analytics • Mobile access to clinical data • Enhance decision support • Optimize utilization • Real-time patient monitoring • Regulatory compliance • Detect & prevent fraud –– Afaria, PocketBuilder, –– Sybase ASE, Replication –– Sybase IQ, Industry SQL Anywhere, Sybase Server, e-Biz Impact, Warehouse Studio for Unwired Platform EDI Server Healthcare, Infomaker, PowerBuilder, PowerDesigner
  12. 12. CONTACT INFORMATIONFor Europe, Middle East,or Africa inquiries:+(31) 34 658 2999For Asia-Pacific inquiries:+852 2506 8900 (Hong Kong)For Latin America inquiries:+770 777 3131 (Atlanta, GA)Sybase, Inc.Worldwide HeadquartersOne Sybase DriveDublin, CA 94568-7902U.S.A1 800 8 sybase Copyright © 2010 Sybase, Inc. All rights reserved. Unpublished rights reserved under U.S. copyright laws. Sybase, the Sybase logo, Sybase Adaptive Server Enterprise, Sybase PocketBuilder, Sybase PowerBuilder, Sybase IQ, SyberLearning LIVE, and SyberLearning LIVE OnDemand are trademarks of Sybase, Inc. or its subsidiaries. All other trademarks are the property of their respective owners. ® indicates registration in the United States. Specifications are subject change without notice. 04/10 L03269