Companies that base their business on the effective management of large volumes of data are increasingly turning to business intelligence systems to provide rapid insight into the complex relationships between information resources.
One such company is Metropolitan Health Group (MHG), which is using Cognos PowerPlay and ReportNet, supplied by Synergy Computing, to gain rapid insight into information for better risk profiling and management of patient information.
MHG is one of SA's leading providers of medical scheme administration and managed care solutions to the employer groups and medical schemes of blue-chip and multinational corporations, public enterprises and government departments. MHG's solutions include fully outsourced administration, system licensing options and integration of standalone health risk management solutions.
"Creating a single version of the truth with coordinated, consistent and timely information can help companies deal effectively with large volumes of data and help them to improve decision-making," notes Christo Bredenkamp, account manager at Synergy Computing.
Pierre Robertson, Head, Decision Support System (DSS) at MHG, says the organisation has a full department dedicated to information management and analysis. "Business intelligence is probably one of the fastest growing areas of IT in our organisation owing to the value that it can deliver," he comments.
From humble beginnings as a rudimentary system, Robertson says the company has grown to appreciate the value that is hidden within the large volumes of data that it collects through the process of claims administration and management.
"The reporting system started on a rudimentary base with structured reporting to trustees; however, this was a laborious task, with numerous problems encountered in the reporting chain. This evolved as there was a specific report that was required by one of the medical schemes calling for data classifications that did not exist on the MHG data warehouse; furthermore, the business started to use the claims that were received on the administrative side of the business to identify risk," he continues.
Noting how BI tools can improve manual reporting systems, Bredenkamp notes: "Consistent data across OLAP [online analytical processing] and reporting capabilities allow users to analyse and report on performance from any perspective with complete accuracy, replacing outdated manual processes with information at the click of a button."
In terms of the company's business model, risk is defined as the cost of patient management - it is in the interests of the company as well as the patient to identify any health problems as early as possible in order to reduce the cost of managing the ailment. By keeping the patient out of hospital or critical care, the cost to the medical schemes is reduced, allowing it to offer reduced medical aid premiums to members - while also resulting in better quality of life for the patient.
"The data that was collected in claims clearly presented an opportunity to begin analysing specific ailments and their treatment to profile and manage risk - but the way that claims arose and were handled was not clearly defined, and while they contained a lot of data, most of this required manual identification and cross-checking to get any value from it," says Robertson - in essence, the organisation had data but it was worthless, until value was added to it.
He responded to this situation by building a hospital data mart that would collate information in a structured manner, allowing for proper analysis and rapid access. "That thinking was then cloned; we created various data marts such as for medicines used, doctors and specialists visited by patients and more - allowing for drilling down and analysis of risk in our customer databases. The network of cubes that we created on top of the data marts eventually resulted in a complete Risk Analysis System (RAS). Using the RAS, underlying issues that may result in any given medical condition can be identified, detailing the likelihood and the causes of cost escalation," explains Robertson.
Cognos business intelligence (BI) software plays an important role in enabling the company to create its RAS solution, he continues. "Historically, MHG had Cognos BI software in the business; what triggered extended use of the software was the increased need for reporting that we had to satisfy. While we had used Impromptu Web Reports, this proved to be unsuitable for our needs. With the introduction of ReportNet, though, we had access to a solution that far better addresses our specific requirements."
Bringing all reporting requirements together under one solution is a breakthrough in reporting solutions, says Bredenkamp. "ReportNet brings reporting closer to the needs of everyday users and negates the requirement to understand database logic and computer languages. This makes reporting far more accessible - even to non-computer experts."
Using ReportNet, the company can isolate specific risk groups and drill down into considerable detail. Says Robertson: "ReportNet allows us to link directly into the data mart, delineate a population and then extract detail. It's a collaborative effort between the clinical team - they know which data is relevant - the data warehouse department, and analytics department. The result is reports that deliver real business value, providing insight into risk profiles associated with different medical trends, treatments and ailments," he says.
Since MHG's analytics department had a clear vision of what it sought from BI, Robertson says Synergy Computing played an important role in providing the appropriate tools to enable that vision.
As to how its Cognos-enabled solution improves the business, he says reporting takes place far more rapidly and is likely to be extended further into the organisation. "We want to empower users to access and create their own reports. We're moving from an ad hoc system, where reports are requested from the DSS department - and which can take up to two days for delivery - to a system where the user has the ability to draw a report when they want it," explains Robertson.
The growing importance of BI to the organisation is resulting in increased demand on the systems department - as Robertson notes, once you give people information they can use, they want more. "As such, we expect the department to continue growing as there is no doubt as to the value that BI is delivering to our organisation," he concludes.
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