A US-based healthcare company gets ahead of a growing claims volume
Company Size
1,000+
Region
- America
Country
- United States
Product
- IBM® CICS® Configuration Manager for z/OS®
- IBM CICS Interdependency Analyzer for z/OS
- IBM CICS Performance Analyzer for z/OS
- IBM CICS Transaction Server for z/OS
- IBM CICSPlex® System Manager
- IBM Enterprise COBOL for z/OS
- IBM Operational Decision Manager
Tech Stack
- IBM System z® servers
- IBM zEnterprise® EC12
Implementation Scale
- Enterprise-wide Deployment
Impact Metrics
- Cost Savings
- Productivity Improvements
Technology Category
- Application Infrastructure & Middleware - API Integration & Management
- Application Infrastructure & Middleware - Data Exchange & Integration
- Application Infrastructure & Middleware - Middleware, SDKs & Libraries
Applicable Industries
- Healthcare & Hospitals
Applicable Functions
- Business Operation
Use Cases
- Process Control & Optimization
- Root Cause Analysis & Diagnosis
Services
- Software Design & Engineering Services
- System Integration
About The Customer
The customer is a US-based company that provides a diverse portfolio of health and well-being services. It relies heavily on a claims processing application to support its operations. The company was facing a challenge of accommodating a growing volume of healthcare claims due to changes within the healthcare marketplace, particularly around government healthcare initiatives. The company's existing claims processing application was handling the current volume, but the company needed to optimize and modernize its application workloads on its IBM System z® servers to accommodate the expected increase in claims volume.
The Challenge
The US-based healthcare company was facing a challenge of accommodating a growing volume of healthcare claims. The company's existing claims processing application was handling the current volume, but changes within the healthcare marketplace, particularly around government healthcare initiatives, were expected to drive up that volume. The technology manager within the organization anticipated the growing demands on the company’s claims processing systems and took action. He created a modernization strategy for the organization’s two IBM zEnterprise® EC12 servers running IBM CICS-based application workloads to improve application performance and help accommodate the growing claims volume.
The Solution
The company worked with IBM to analyze its systems and create a roadmap of incremental enhancements, starting with simple, low-risk actions and progressing to more complex activities. The team used IBM software, including the IBM CICS Interdependency Analyzer for z/OS® and IBM CICS Performance Analyzer for z/OS applications, to better understand the company’s environment and obtain performance metrics. The roadmap began with low-risk activities, such as recompiling COBOL programs with the latest compiler and implementing CICS Thread Safety methods, and progressed to more complex solutions. These included using IBM CICSPlex® System Manager software for greater resiliency and using the rules decision tool to promote greater flexibility and business logic reuse. The IBM team also deployed IBM Operational Decision Manager software to help automate business rules processes.
Operational Impact
Quantitative Benefit
Case Study missing?
Start adding your own!
Register with your work email and create a new case study profile for your business.
Related Case Studies.
Case Study
Hospital Inventory Management
The hospital supply chain team is responsible for ensuring that the right medical supplies are readily available to clinicians when and where needed, and to do so in the most efficient manner possible. However, many of the systems and processes in use at the cancer center for supply chain management were not best suited to support these goals. Barcoding technology, a commonly used method for inventory management of medical supplies, is labor intensive, time consuming, does not provide real-time visibility into inventory levels and can be prone to error. Consequently, the lack of accurate and real-time visibility into inventory levels across multiple supply rooms in multiple hospital facilities creates additional inefficiency in the system causing over-ordering, hoarding, and wasted supplies. Other sources of waste and cost were also identified as candidates for improvement. Existing systems and processes did not provide adequate security for high-cost inventory within the hospital, which was another driver of cost. A lack of visibility into expiration dates for supplies resulted in supplies being wasted due to past expiry dates. Storage of supplies was also a key consideration given the location of the cancer center’s facilities in a dense urban setting, where space is always at a premium. In order to address the challenges outlined above, the hospital sought a solution that would provide real-time inventory information with high levels of accuracy, reduce the level of manual effort required and enable data driven decision making to ensure that the right supplies were readily available to clinicians in the right location at the right time.
Case Study
Gas Pipeline Monitoring System for Hospitals
This system integrator focuses on providing centralized gas pipeline monitoring systems for hospitals. The service they provide makes it possible for hospitals to reduce both maintenance and labor costs. Since hospitals may not have an existing network suitable for this type of system, GPRS communication provides an easy and ready-to-use solution for remote, distributed monitoring systems System Requirements - GPRS communication - Seamless connection with SCADA software - Simple, front-end control capability - Expandable I/O channels - Combine AI, DI, and DO channels
Case Study
Driving Digital Transformations for Vitro Diagnostic Medical Devices
Diagnostic devices play a vital role in helping to improve healthcare delivery. In fact, an estimated 60 percent of the world’s medical decisions are made with support from in vitrodiagnostics (IVD) solutions, such as those provided by Roche Diagnostics, an industry leader. As the demand for medical diagnostic services grows rapidly in hospitals and clinics across China, so does the market for IVD solutions. In addition, the typically high cost of these diagnostic devices means that comprehensive post-sales services are needed. Wanteed to improve three portions of thr IVD:1. Remotely monitor and manage IVD devices as fixed assets.2. Optimizing device availability with predictive maintenance.3. Recommending the best IVD solution for a customer’s needs.
Case Study
HaemoCloud Global Blood Management System
1) Deliver a connected digital product system to protect and increase the differentiated value of Haemonetics blood and plasma solutions. 2) Improve patient outcomes by increasing the efficiency of blood supply flows. 3) Navigate and satisfy a complex web of global regulatory compliance requirements. 4) Reduce costly and labor-intensive maintenance procedures.
Case Study
Harnessing real-time data to give a holistic picture of patient health
Every day, vast quantities of data are collected about patients as they pass through health service organizations—from operational data such as treatment history and medications to physiological data captured by medical devices. The insights hidden within this treasure trove of data can be used to support more personalized treatments, more accurate diagnosis and more advanced preparative care. But since the information is generated faster than most organizations can consume it, unlocking the power of this big data can be a struggle. This type of predictive approach not only improves patient care—it also helps to reduce costs, because in the healthcare industry, prevention is almost always more cost-effective than treatment. However, collecting, analyzing and presenting these data-streams in a way that clinicians can easily understand can pose a significant technical challenge.
