This is the 4th blog in our series “From data diffusion to insights with enterprise-wide data strategy”
An interview with Francois Charette, Senior Vice President of Product Engineering, Optum
Health plan organizations have a short window of opportunity to become true orchestrators of care by capitalizing on the data locked in their systems. Francois Charette is senior vice president of Product Engineering. He suggests that in the age of big data and analytics, amid the din of consumer demand for a better system (and a better interface), it’s time to shift data to the cloud. Cloud is the only technology that will overcome legacy silos and move health plans to a higher purpose.
Q1: What has prevented health plans from using member data more effectively?
Historically, health care vendors offered payer products and services that responded to specific, high-volume transactional business needs. Implementations were point-to-point and data sets focused on supporting operations. For example, a software product might require claims, membership and provider data to power certain capabilities. If new functionality or data were requested, a new point-to-point integration was required — often demanding coding, long implementation time and maintenance challenges. These solutions typically offer weak reporting and analytics.
To derive business intelligence, payers often rely on data warehouses for analysis and reporting. But there are issues there as well. A data warehouse provides a snapshot of data and is used in data analysis and reporting as part of a business intelligence function. It has a predefined set of attributes and does not accommodate evolving data sources.
Plans that move their data stores to a single cloud platform, purpose-built for data sharing, analytics and reporting will have the capability to:
- Understand members and populations
- Predict and prescribe the next right move in the health care continuum
Those who don’t will conduct business as usual and lose relevance in the continuum.
Francois Charette talks about how an EDP addresses the lack of effective data usage.
Q2: Is an enterprise data platform the foundation for analytics?
An enterprise data platform enables sharing data between applications and application services within the ecosystem. Technologists who have been in health care a long time know that achieving this kind of sharing with legacy technology would be:
- Problematic and costly
- Require an extremely large data warehouse
- Difficult to build, secure and maintain
The reality is we can enable big data with technology that didn’t exist ten years ago. It’s a paradigm shift that CIOs aren’t necessarily seeking when they are looking to provision new capabilities. Take the example of a payer seeking fraud, waste and abuse analytics who has already established a quality and risk solution. That payer is likely to look for a consulting relationship or a specific solution to reveal anomalies in the provider network. They soon realize that these “services” can sit on top of a cloud-based enterprise data platform (EDP). The EDP is capable of sorting information from a single source, and provisioning a new application — without going back to the original provider in question. Their search for a specific solution leads them to EDP technology that supports new data streams, new analytical “instruments” and new services.
Hear how Optum is using its EDP as an enabler for the business.
Q3: What are the key attributes the CIO should seek in achieving a digital transformation?
It’s important to partner with a company that understands health care. That partner should also bring domain expertise, standard EDI file transfer, HL7 engines and analytical services that help you rapidly commission the EDP. A generic platform will require integration points for solutions purchased separately rather than enable components and solutions.
With the right EDP technology and active response to new data coming in, organizations can really push their data to the edge. They have an opportunity to identify markers they’ve never thought about, reduce costs, and improve client satisfaction and net promoter scores.
Why Optum for your EDP? Francois Charette explains.
Q4: How does the CIO justify the cost of an EDP?
First of all, the cost of entry is relatively low. And storage and computing is delivered in a service model, eliminating infrastructure maintenance and capex challenges. An enterprise data platform built in the public cloud liberates data. You can turn it on and off as needed.
Second, the ROI of a single data platform will be quickly recaptured as the organization:
- Decommissions legacy warehouses and redundant operations
- Decreases medical spend
- Identifies and addresses gaps in the care continuum
We can bring dark data to light where it can be used to make transformative changes. Deliver end-to-end member information at the point of care. This is possible with big-data tools such as machine learning and artificial intelligence, together with digital collaboration channels.
The other consideration is purely competitive. Failure to deliver analytics that improve the orchestration of health care will rapidly lead a payer organization to be obsolete. If you follow what’s happening in the marketplace, many organizations are moving infrastructure to market-leading public clouds. The level of investment in public cloud technology cannot be mimicked or matched — but can be affordably leveraged.
Q5: What can the CIO do to help the business transform culturally?
The payer business is vulnerable to disruption by tech-enabled newcomers with viable schemes for improving the health care system. Innovation has to be a cultural value and the talent pool, diverse. Health plans need technologists with end-to-end, full stack, public cloud development expertise. What’s happening is happening fast and you’ll want to have cloud-savvy partners at your side.
Visit Optum.com/CIO to learn more about how cloud enables storage and powerful analytics across the enterprise and populations.
Catch up now on the entire series: From data diffusion to insights with enterprise-wide data strategy
About the Author:
Francois Charette is senior vice president of Product Engineering at Optum. He has more than 20 years’ experience helping organizations align business and customer needs with technology innovation and change management. His team partners across Optum to define and execute technology strategy to meet current and future needs in the payer, provider, life sciences and government markets.