Cognizant eHealth Portal Case Study

Managed Healthcare Provider Takes Internet Self-service Concept to New Heights

Cognizant IT and Healthcare Domain Expertise Help Transform Client Website into a Competitive Advantage.Nobody builds a secure, interactive HIPAA-compliant Internet portal serving 40,000 providers, one million members, and countless business trading partners in a mere six months – unless you combine Cognizant Technology Solutions’ IT and Healthcare domain expertise on the project, as one major managed healthcare provider did in May 2005.

The client operates a group of managed healthcare Medicaid companies in California, serving patients who have traditionally faced barriers to quality healthcare – including low-income families and individuals covered under Medicaid, the Healthy Families Program, the State Children’s Health Insurance Program (SCHIP) and other government-sponsored health insurance programs.

A Website Ripe for Improvement.Prior to engaging Cognizant, the client operated a corporate website that presented only static information to healthcare providers, plan members and various trading partners visiting the site. With operations in eight states, the company’s regional offices linked to the national site, adding state-specific information to the bulk content. As a result, the various web pages and sections were not well organized or easily searchable. Communication channels were limited to e-mail, and without secure personalized login capabilities, the online experience was uniform for all visitors. Additionally, many areas of the website lacked brand consistency; a more cohesive brand experience - was desired.

Creating a More Dynamic Website Experience.The client’s newly hired VP/CIO of Information Services was familiar with Cognizant’s work, having collaborated on projects with Cognizant in the past. He valued Cognizant’s consultative approach to developing effective business solutions and hired the firm to address a myriad of issues centering on IT reengineering and building a dependable ePortal platform.

To achieve true online B2B and B2C information and transaction exchange capabilities, a major redesign of the site was in order. The primary objective of the assignment was to create a secure bidirectional website personalized to the needs of the client’s visiting healthcare providers, members and trading partners. In addition, the existing website needed to be reorganized to facilitate a more user-friendly online experience. Thus linked databases would have to be restructured, and access would have to be improved. The overall goal was to develop a dynamic, real-time bidirectional data flow, facilitating interactive business communications, reduced paperwork and automated processes, minimizing clerical interdiction. Analysis Leading to a Microsoft Solution.Working closely with the client, Cognizant’s Microsoft Center of Excellence and technology team completed a wall-to-wall audit of the company website within two months. The analysis included recommendations on improving usability, a proposed architecture for the new site, and a technology designed to improve interactivity.

The client had written its existing website in Visual Basic, with a SQL 2000 database and ASP.NET front end. Cognizant recommended that that the new site be developed using .NET framework and hosted in IIS6.0 on a Windows server, as .NET codes are compiled in Common Language Runtime (CLR) and are run as Just-In-Time (JIT) compiled native codes which run seamlessly in a Windows environment. Cognizant was confident that it could leverage Microsoft’s finest Interface Development Environment for easier development and better maintainability of the codes. This way, the client would minimize disruption and maximize the use of in-house resources for a trouble-free transformation.

Next, a prototype was presented, featuring the desired navigation and information features as well as a secured bidirectional data platform. The prototype demonstrated the robust architecture and simplified development process inherent in a Microsoft solution, and the client signed off on the plan.

As a certified gold Microsoft service partner, Cognizant engaged its Microsoft Center of Excellence to seamlessly integrate the client’s new website into the existing corporate Microsoft solution.

In Six Months, the Client Achieved Operational Efficiency and Added Brand Value.With project documentation, coding, implementation and testing complete, the client’s new ePortal launched in less than six months, on January 31, 2006, incorporating the following prominent user functionalities (below in a tabular format): Provider Self-Services Secure login Detailed claim reviews Member eligibility status reviews Online authorization requests

Member Self-Services Detailed EOB reviews Change-of-address capabilities Primary Care Physician (PCP) changes ID request and print capabilities

File Exchange Services Download files Upload files File history reviews Exchange views

Based on Microsoft-recommended layered architecture, which simplifies maintenance and enhancement without affecting parallel layers, the website was deployed on a server farm to maintain manageable traffic loads.

Cognizant Business and Technology Teams Develp a Plan. To achieve the objectives efficiently, Cognizant usability engineers revised the static pages of the client’s website as Cognizant’s healthcare and technology experts addressed the bidirectional design. The first step was to provide a secured site where providers, members and trading partners could log in and perform private, personalized transactions. Getting the providers on board early set the stage for user acceptance in subsequent developments, as access to the providers would be the main reason for visitors to traffic the website. The second step was to enhance the current corporate website by improving its usability, incorporating the dynamic exchange of integrated data, and building on corporate branding. The work would be performed in waves. Bidirectional activities focused on refining provider self-services, member self-services and file exchange services, respectively. Usability activities focused on website enhancement.

A Coordinated Effort Provides Speed and Efficiency.Before the engagement, the client had never considered the advantages of offshoring its development work. Based on prior experiences, the company was prepared to bear the cost of a two-year development cycle in completing its ambitious undertaking. However, as the initial relationship blossomed, Cognizant effectively proved the cost- and time-saving benefits of offshoring the work, and the client agreed to the approach. Cognizant’s account-management team collected all project specifications and collaborated with Microsoft for technical and helpdesk issues onsite. The client business managers in eight states were contacted to ensure that standardized procedures met local needs. Technology managers at each office also weighed in to communicate special needs and that facilitate a seamless data exchange. Throughout the process, the client’s “HIPPA” administrators and Cognizant healthcare domain experts were consulted to ensure proper wording and format compliance. Regionally and nationally, Cognizant worked closely with the client’s business and technology teams at the local level to ensure that compliance standards and corporate requirements remained consistent, leading to the central gateway that would ultimately become the company’s new web portal. As work progressed, Cognizant’s offshore development team provided the coding, testing, system integration and proof-of-concept work, controlling costs and taking advantage of a “follow the sun” work schedule. The resulting efficiencies effectively cut 18 months off the client’s anticipated expectations, saving substantial in company resources.

Corporate Website Revamp, B2: Content regrouped by state and subject Branded theme, structure look, and feel Improved usability

Technology Healthcare system: QMACS 4.1 and QNXT 2.6 Programming languages: VB.NET, XML, ASP.NET, Java Script Database: SQL 2000 Utilities: .NET Framework

Impressive Results Confirm the Client’s Decision to Hire Cognizant.The client is now seeing the benefits of an integrated ePortal serving providers, members and business partners. The website branding is prominent, and, most important, the dynamic data exchange has created a highly transparent business environment over which all parties can communicate efficiently and effectively and in compliance with government regulations. In short, the new ePortal provides unprecedented performance, scalability, maintenance ease and automation capabilities for improved cost savings, user satisfaction and an improved competitive advantage. Reduced operations overtime cost: 80% reduction in EDI-related work. The Provider Registration grew an average of 46% every month in just five months of implementation.

Upon implementation of Online Authorization Submission and realtime, UM Productivity has improved by 53%.

Provider and Member service calls were reduced from 9.3 per 100 members to 8.1 in just three months of ePortal implementation.

Using the Microsoft platform helped cut application maintenance cost and reduce hardware and server utilization. Usability: GUI interface for easy navigation.

Ambitious Plans Extend the Cognizant-Client Relationship.What began in the summer of 2005 will continue moving forward as the client awards Cognizant more work based on sterling results. Ongoing aspects of the engagement will focus on implementing several major enhancements, including, but not limited to, real-time transaction capabilities and online claim submission.

Start TodayIn a time when companies are relentlessly pushing to compete better, move faster and fight harder, Cognizant is the global technology partner with a single-minded passion: dedicating our systems expertise, industry intelligence and global resources to make your business stronger.

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For more information on how Cognizant can improve your presence on the web, contact us at inquiry@cognizant.com, or visit our website at www.cognizant.com.