Medical innovation is saving lives. Since 2000, the average global lifespan has increased from 66 to 71 years. This longevity means international healthcare systems are managing more patients and procedures. To accommodate growth, minimize subscriber costs, reduce fraud, and still provide excellent coverage, insurance companies are revamping policies and processes. However, achieving real transformation—such as compensating clinicians based on patient outcomes—requires greater business insight.

Daman speeds business insight by 5X and improves agility by migrating from Sybase IQ to SQL Server 2016

“We’ve realized the dramatic performance improvements we saw in our proof of concept just by moving our Sybase data warehouse—which had three years of optimization—to a vanilla installation of SQL Server 2016 with Columnstore indexes. And we can keep our very granular data sets.”

Andrew Rigby, Data and Information Enterprise Architect at Daman

Customer Name: DamanIndustry: HealthCountry or Region: United Arab Emirates Customer Website: www.damanhealth.aeEmployee Size: 1,600Partner Name: D | ONE

Customer Profile: National Health Insurance Company – Daman is the region’s leading specialized health insurer, providing comprehensive health insurance solutions to more than 2.8 million members in the United Arab Emirates. technologies, and production print solutions.

The National Health Insurance Company – Daman is the leading provider of health insurance for individuals and companies in the United Arab Emirates (UAE). It combines healthcare-related expertise with innovative technology to deliver policies that have earned international awards and quality-focused certifications. To create innovative solutions for managing evolving requirements, Daman sought to increase insight into more than 3TB of service data. Peter Bauer, Chief Information Officer at Daman, says, “Our world is changing massively. We need to be able to observe these changes and make decisions faster. For example, we need to understand current inflation rates and how medical costs relate to this inflation. We’re also looking to deepen insight into the medical supply chain so we can help our providers with capacity planning.”

Slow business insight impeded efficiencySeveral years ago, Daman implemented a data warehouse with a star schema model to expand and accelerate data analytics. An application called SAS Enterprise Guide extracts data from the warehouse and presents it in reports that employees view with Microsoft Excel. Although initially successful, over time the warehouse was unable to scale to deliver the performance and flexibility that Daman required. Weekly reports took 28 hours to run. The more complex monthly reports took two days. “Speed is extremely

important for user acceptance,” says Bauer. “People are accustomed to getting answers on a website in a few seconds. Our previous solution was too slow.”

SQL Server outperforms the competitors by as much as 98 percent Because Daman’s databases are only getting bigger, the company engaged third-party D | ONE for help. “To improve the performance of our Sybase data warehouse and the level of detail provided to applications for analytics, we needed to aggregate data or consolidate it into smaller sets,” says Marco Roehrle, Manager of the Intelligence Department at Daman. “But we didn’t necessarily want to go down that road because we’d have data split into different areas.”

At the same time, Sybase created another challenge. It lacked a built-in tool to control and track which users and applications accessed what information in database tables. Because the company already used Active Directory for enterprise-wide access control, it made sense to use it with the data warehouse. Andrew Rigby, Data and Information Architect at Daman, says, “But integrating Active Directory with our Sybase IQ solution was going to require a one-time cost of $250,000 and then a yearly maintenance charge after that.”

“Managing security is smoother with SQL Server. It interoperates with our existing Active Directory to control and maintain proper access. Overall, it reduces time and effort without us needing an additional solution.“

Peter Bauer, Chief Information Officer, Daman

Accelerates performance by 64% without aggregation and compresses data by 85%Given the drawbacks of its existing data warehouse, Daman decided to look at alternative options. Working with third-party D | ONE, Daman compared the performance of Sybase IQ 16.0 with SQL Server 2014, SQL Server 2016, Oracle 12c, and SAP HANA. The SQL Server 2016 data warehouse with clustered in-memory Columnstore indexes delivered the best performance, completing queries 64 percent faster than Sybase, 98 percent faster than Oracle, and 13 percent faster than SAP HANA.

Over the next three months, D | ONE migrated Daman’s data warehouse to SQL Server 2016, taking advantage of clustered in-memory Columnstore indexes and SQL Server Always On to reduce the effort required to maintain high availability. The warehouse runs on a Pure Storage array with solid-state drives, 16 virtual cores, and 150GB of memory. “I didn’t necessarily believe the numbers, but we’ve realized the dramatic performance improvements we saw in our proof of concept just by moving our Sybase data warehouse—which had three years of optimization—to a vanilla installation of SQL Server 2016 with Columnstore indexes,” says Rigby. “And we can keep our very granular data sets because SQL Server has the performance needed to

analyze our massive tables. This reduces future risk by not having data replicated in different tables. We can also use commodity hardware with SQL Server, which is something we can’t do with SAP HANA because it’s an appliance.”

Daman can also reduce its storage costs going forward. The data-compression capabilities built into Columnstore indexes in SQL Server 2016 reduce its data footprint by 85 percent compared with Sybase IQ. “Thanks to impressive performance of the Microsoft SQL Server 2016 Columnstore technology, we are now able to run business-critical analyses that were previously not possible,” says Roehrle. “Further, the high-end storage

requirements are massively cut back due to Columnstore compression.”

Reports are generated up to 5 times faster Today, 400 employees use the solution, and Daman expects adoption to broaden over time. “Even though we haven’t fully optimized our solution, it’s easily exceeded our Sybase solution in terms of speed,” says Bauer. “Today, a user can perform a simple query that involves tables with billions of rows and get an answer in 3 seconds instead of 20 seconds. This will make a big difference in our service levels.” Monthly reports are also 5 times faster. They used to take 48 hours to generate using Sybase but with SQL Server, they’re ready in 10 hours. IT staff can also generate weekly reports 64 percent faster, in 10 hours versus the 28 that Sybase required. And Daman expects these delivery time frames to improve even more as IT staff tune the solution. “We have a lot of things on the roadmap that we want to test,” says Roehrle. “Temporal tables and other capabilities that exist in SQL Server 2016 can further increase performance.”

Boosts security, saves time, and avoids more than $250,000 in expensesBecause SQL Server works seamlessly with Active Directory, Daman avoids paying for $250,000 for more software licenses and it minimizes complexity by

using one solution for authentication and access control. “Managing security is smoother with SQL Server,” says Bauer. “It interoperates with our existing Active Directory to control and maintain proper access. Overall, it reduces time and effort without us needing an additional solution. And now that we can easily apply security at an application and database level, no one has to enter extra passwords and people still access only the data they are authorized to see according to their Active Directory credentials.”

In addition, when a user views a report in Excel, the data is not stored on disk, which is critical for meeting new security requirements. “Report data stays in the users’ cache and it’s automatically deleted when they go offline,” says Bauer. “This wasn’t the case with our previous solution. It would have taken us a lot of effort to update it to achieve the same results.”

Staff have a practical tool for improving services and detecting fraudNow that it takes less time to analyze large volumes of data with SQL Server, Daman can compare services, providers, fees, outcomes, and other variables to gain the insight needed to improve decision making and move toward adopting a compensation model based on patient outcomes.

“When we work with a provider to discuss or establish service fees, having almost instant answers to business inquiries with

“Having almost instant answers to business inquiries with our SQL Server data warehouse can drive discussions and negotiations in a more direct and dynamic way. This includes being able to quickly detect patterns indicative of waste, abuse, or even fraud.”

Peter Bauer, Chief Information Officer, Daman

our SQL Server data warehouse can drive discussions and negotiations in a more direct and dynamic way,” Bauer explains. “This includes being able to quickly detect patterns indicative of waste, abuse, or even fraud, such as a provider who always bills for severe or complicated medical cases. We can also see when people are not following guidelines, such as physicians who prescribe antibiotics or authorize MRIs unnecessarily.”

The employers who engage Daman for healthcare plans are also benefiting from new insight. “In the yearly contract renewals, we now give corporate customers information about how they can optimize the use of our products and show them in which areas they have unexpectedly high costs—and why,” says Bauer. “By giving our clients performance reports, we improve their business insight, which enriches our relationships.”

Facilitating innovation Pleased with its outcomes, Daman is currently analyzing options for migrating some of its existing Oracle databases to SQL Server 2016. Microsoft Consulting and Premier Services is also working with the infrastructure and operations unit within Daman to build a mission-critical Microsoft SQL Server database as a service (DBaaS) solution to simplify operations, management, monitoring, and deployment of SQL databases. The

company is also evaluating Microsoft Power BI, Microsoft R Services, and Azure Machine Learning for advanced analytics.

Commenting on why it’s using the Microsoft platform for so many projects rather than incumbent technologies, Bauer says, “Usually, if you make such a big technology switch, you hit new problems, which are difficult to solve. But we have not. The smooth transition from Sybase to SQL Server 2016 has been amazing. We like how Microsoft is investing in its database, analytics, and cloud products so they interoperate with other technologies. For example, we’re interested in using the R language to develop complex scripts and, maybe, deep learning. SQL Server 2016 already supports the R language. Microsoft is also much more supportive in helping us with our transformation and business targets. For me, that kind of strategic partnership is a sound investment, because it can contribute to the growth of our company and help us provide better services.”

Software• Active Directory• Microsoft SQL Server 2016

- SQL Server Always On - Columnstore indexes

This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, INTHIS SUMMARY. Document published December 2016