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GE Healthcare is a unit of General Electric Company (NYSE: GE). GE Healthcare is focused on innovations designed to reduce costs, increase access and improve quality around the world. Sunder Bharadwajan is GE Healthcare’s Centricity EDI Services Software Manager.
Bharadwajan’s group provides critical services to GE Healthcare’s EDI Services customers, handling electronic data interchange (EDI) for healthcare in a B2B setting. The group deals with three types of core data, the sum of which amounts to 1B transactions per year: healthcare claims, healthcare remits, healthcare eligibility.
Ensuring prompt customer service for claims processingFor years, GE Healthcare had been using the eGate integration engine – until it was notified by Oracle that the solution was being put on Oracle’s “end of life” list, forcing GE Healthcare (and other IT vendors) to seek alternatives - alternatives that have the potential to become huge, expensive headaches for organizations.
The team knew it had to make a change, so it sent out an RFP to many vendors. According to Bharadwajan, EDI data must conform to critical SLAs and certifications that govern electronic transmission of patient information. “For example, you have eligibility transactions with a turnaround time defined by the CAQH CORE® – a certification agency in the U.S. To be CORE-certified you need to meet many standards, including turning around transactions end to end in 20 seconds or less, with an internal processing time of 4 seconds or less.”
In cases where there is no industry standard,
and certifications and regulations don’t govern data, GE Healthcare has set SLAs to ensure prompt customer service – for claims processing, for example, the organization strives to acknowledge every claim submitted by healthcare organizations within 24 hours.
Why Talend?Bharadwajan says, “We decided to go with Talend, primarily because it is open source and Talend gave us the control that we needed to support our existing architecture, but it began as an existential issue – eGate was at the end of life, and we wanted to go with a platform that would set us up for future growth.”
During the POC, members of Talend’s Professional Services team worked closely with GE Healthcare’s core group of engineers. Talend was onsite to train the team, and GE Healthcare purchased a block of consulting time to help them understand more about escalations and design reviews. “We learned straight from the Talend people who created these open source technologies. To have access to these folks is very, very beneficial. They worked through use cases about how to work on a target platform, get the design validated, and work with them to get defects resolved.”
Today, GE Healthcare is in the process of moving its data from eGate to Talend Data Services/ESB, and in particular, the Talend Data Mapper (TDM). So far, the transition has been smooth, and Talend has been able to support GE’s X12 and proprietary data formats – with support from Talend’s consulting teams.
According to Bharadwajan, “TDM is very easy to deploy and we’ve been happy with the use cases that we want TDM to solve. We are a Java shop, so all of the scripts we wrote for eGate are very easy to transfer to a different
Discovering new life for claim data
“With Talend, we can ensure prompt customer service for claims processing, exceeding SLAs for turnaround times and compliance standards.
CA S E S T U DY
INDUSTRY
• Healthcare
INFORMATION• HQ: USA
• 10,001 employees
USE CASE• Claims management
CHALLENGE• Ensuring prompt customer service for claims processing
TALEND PRODUCT USED • Talend Data Services/ESB
RESULTS
• 1 billion transactions per year processed via EDI for healthcare
• From 40,000 to 80,000 transactions per hour
Talend helping data center handle more volume
• 126 payers on the system. Their transactions now processed faster
”Sunder Bharadwajan, EDI Services Software Manager, GE Healthcare.
container. Talend Data Services/ESB lends itself well to that role. One of the benefits of eGate was its built-in X12 parsing and data transformation capability, and that’s where TDM is coming in. The way we wrote some of the data transformation scripts in eGate was not very amenable smooth porting.” Following a set pattern of data transfer, the GE Healthcare team has had success. One example of the data transfer challenges for GE Healthcare is that while its customers should be on ASC X12 version 5010, (a HIPAA mandate) some are still on X12 4010, and most payers don’t understand or support 4010 anymore. Bharadwajan says. “We had to look at the monolithic scripts we had, establish patterns on how to solve them with TDM and slowly move things over. By and large, TDM supports standard formats, and the Talend consulting team helped us come up with TDM structures for our proprietary formats.”
Exceeding claims turnaround timesFrom the beginning of the re-platforming project to Talend Data Services/ESB, the team at GE Healthcare has had 3 main goals in mind, all of which have been realized:
1. Zero disruption to existing customers. Bharadwajan says, “We designed a way to make the transition almost invisible to customers. Currently both platforms are running and we do an “enablement process” - progressing through multiple rounds of testing to ensure a particular customer or payer can be moved over to Talend. If there is a problem, we move the organization back to eGate while we correct the issue.”
2. Turnaround times/compliance. GE Healthcare has been able to consistently meet and exceed internal SLAs regarding turnaround times and external industry compliance standards.
3. Growth. GE Healthcare is striving to expand its EDI footprint, catering to practice management systems outside of the GE Healthcare portfolio. Currently, the data center processes 40K transactions an hour at peak volume, and Bharadwajan is exploring how their systems could handle double that volume (80K transactions/ hour), uncovering bottlenecks and learning how to scale with more elasticity.
With Talend Data Services/ESB in place, Bharadwajan and his team are working towards more specific KPIs: “We cater to Practice Management system software for various sectors, from small (5-10 physicians) practices to massive hospitals and health systems. One goal after we finish this replatforming effort is to increase our market share.”
”We are using an Agile methodology to smoothly transition all payers over to the Talend solution” says Bharadwajan.
Bharadwajan and his team have been pleased with their decision to move to Talend Data Services/ ESB, and more specifically, Talend TDM, and look forward to getting all 126 payers on the system by early 2016. Once that is completed, GE Healthcare might consider a move to Talend DI, followed by Big Data, but for now, the team is focused on migrating all of the data to the ESB system.
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