A leading healthcare IT system based out of the US desired to enhance their core platform that would help them navigate complexities of the healthcare industry and ensure better health outcomes and enhanced experiences for their members. They were looking for a tech partner who could improve their efficiency by digitally transforming their offerings. HCLTech, being the most preferred tech partner, crafted new-age solutions specific to the client's needs.
The Challenge
Overcoming legacy constraints in healthcare
Given the complex nature of the healthcare industry, the client wanted to move from the traditional to the next-generation digital healthcare platforms. Retaining the market share was a challenge and hence, it was necessary to enhance the end-user experience by transforming the delivery models to drive collaboration, speed and quality. The key challenges were:
- The need to focus on increasing efficiency and achieving cost-effectiveness
- Managing the complexity of a core administrative platform for healthcare payers
- Lack of customer-centric health management solutions
- The need to adhere to CMS regulatory changes and industry compliances like HIPAA and HITRUST
- Accelerating adoption of SAFe and DevOps through a roadmap
- The need to enable L2 and L3 support to 30+ payers by providing application maintenance services
The Objective
Switch from legacy to new-age solutions
The client wanted to move from the traditional to the next-generation digital healthcare platforms. The ask was to make operations agile, error-free and smooth. We intended to drive a focused and strategic change toward a managed and optimized model for the client that could:
- Operate in a managed services model and defect prevention leading to backlog prevention
- Identify and implement process improvement initiatives to improve productivity and optimize costs
- Reduce customer escalations and improve customer experience
The Solution
Strategic change for effective optimization
HCLTech intended to drive a focused and strategic change towards a managed and optimized model for the client. The client’s requirements were addressed in four stages.
- In the first stage, the intricacies of the Core Admin Services (CAS) platform on-prem and the system’s expectations on the Cloud were identified
- The second stage was about interaction with product owners, product architects and end-payer customers to derive business architected solution blueprint
- Secondary research on the robustness and capabilities of other core administration platforms was conducted in the third stage
- Finally, an engineering team was formed to successfully drive technical architect solutions
The Impact
Enhanced the market share and reduced costs
The client experienced a 20% faster feature rollout across product portfolios and customers. Moreover, HITRUST certification was endorsed across platforms.
- Over 30% reduction in costs
- 30% faster issue resolution during the open enrollment period
- 40% productivity savings over a period of 3 years
