This year’s Gartner IT Symposium/Xpo theme of “Unleash Possibility” was fitting as all of us in IT collectively rebound from an intense few years and recalibrate for what’s next. No industry knows this better than the healthcare sector, which has faced rapid digital transformation and tight budgets, all while striving to improve patient outcomes.
More Timely, Transparent Healthcare Financial Processes
HealthEdge’s HealthRules Payer platform enables customers to automate the complex medical claims adjudication process, which determines how much and how quickly healthcare providers are reimbursed for medical services.
HealthRules Payer customers regularly achieve auto-adjudication rates up to and over 90%, supporting timely reimbursement for providers and saving significant administrative costs for health plans. By providing accurate, real-time claims information, HealthEdge customers increase provider satisfaction, strengthening relationships with provider organizations. Timely claims payment and more transparent information give health plan members a smoother experience and a clearer view of their financial responsibilities for care.
“Our customers’ data is at the heart of life-changing decisions, such as whether a parent can access cancer medication for their child,” said Kendra McCormick, Senior Manager of Datacenter and Network Operations for the HealthRules Payer division of HealthEdge. “If the data isn’t available, people have to make care decisions that are at best a minor inconvenience, or at worst harmful to their wellbeing.”
By investing in a modern data architecture for its flagship claims adjudication offering, HealthEdge has gained flexibility and operational agility, freeing up personnel and budget to accelerate technology innovation.
HealthEdge’s Data Architecture for Better Provider and Consumer Experiences
Growing data from HealthRules Payer users was taxing the business unit’s infrastructure, with considerable costs required to add more storage.
To improve cost and operational efficiency, the business unit re-architected its data platform. The team prioritized simplicity and on-demand consumption for all of their data, spanning traditional applications to persistent containers and Kubernetes, all with a commitment to intrinsic security. Kendra shared her enthusiasm with all that has been accomplished but reiterated that HealthEdge is early in its journey, and that flash storage is a critical accelerant of their growth. Beyond cost and efficiency, the benefits of flash drive faster access to insights along with reliability, scalability, and uptime.
Future-proofing Possibility in the Cloud
Kendra stressed that “the cloud is an operating model, not a destination.” She explained the importance of workload portability and data portability as an enabler to both this cloud operating model and an on-demand consumption model.
Releasing the operational burden of storage has enabled Kendra’s team to spend less time managing boxes and more time innovating their platform. HealthEdge engineering teams are pursuing new projects, accelerating innovative capabilities, and exploring a microservices architecture with Kubernetes.
To simplify data services in Kubernetes, the HealthEdge team leverages Portworx® by Pure Storage. Portworx has empowered the team to drive efficiency in their container environment, allowing them to deploy one cluster for each customer’s applications. That means one—not 55—copies of that data, saving disk space and compute, while bringing simplicity to the team and the customer.
“We could not be doing containerization without it [Pure Storage]. Portworx really gives us the flexibility to support that deployment, with limited engineering.”
As Kendra shared: “We could not be doing the containerization without it [Pure Storage]. It 100% enables our ability to work with containerization, which has a number of benefits that we’re getting by using Portworx. And Portworx really gives us the flexibility to support that deployment, with limited engineering.”
While the cloud operating model is pivotal to future growth, it will take a combination of public and private cloud to satisfy HealthEdge customers’ requirements for governance and compliance. Evergreen//One has allowed HealthEdge all of the flexibility of the cloud while consuming assets on premises.
Addressing Security with Surgical Precision
There’s perhaps no other industry with higher security concerns than healthcare. The paralyzing cyberattack on Change Healthcare underscores how any downtime or disruption can have real-world, real-life implications on human lives. According to Kendra: “It’s not just our customer’s data, it’s your data, it’s patient data. It’s you, me, and our families. That’s a really big responsibility for us.”
Digital transformation can be uncharted territory, but HealthEdge has found a way to embrace it with more certainty. As Kendra outlined, “We’re trying to innovate, but the conundrum with trying new things is you’re not always sure what you’ll need from a tech perspective. With storage, it’s one less thing we have to do the math on up front.”
Now, when Kendra’s team is tapped with big new ideas they need the infrastructure to support, they have the scalability to say yes to new, exciting innovation. Flexible, as-a-service consumption from Evergreen//One gives the HealthEdge team the agility to only pay for what they use, avoiding big capital expenditures.
The upshot: HealthEdge controls cost to its customers, customers can control the cost to their customers, and the cost of healthcare is reduced. According to Kendra: “With the economy the way it is and inflation, Pure allows us to really limit that cost and only pay for what we’re using at any given time, so we don’t have to pass off that extra cost to the customer.”
Learn more about how HeathEdge leverages Evergreen//One to scale storage quickly and cost effectively.
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How Healthcare Payers Succeed with Cloud
Discover payers’ success strategies for cloud cost-savings and effectiveness in this webinar featuring IDC and Pure Storage healthcare experts.