Software AG > Case Studies > Medical Service Innovation Through Process Integration

Medical Service Innovation Through Process Integration

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Customer Company Size
Large Corporate
Product
  • webMethods Integration Platform
  • webMethods BPMS
  • ApplinX
  • webMethods Insight
Tech Stack
  • Service-oriented architecture
  • Business Process Management
  • Rules engine
  • Legacy systems integration
Implementation Scale
  • Enterprise-wide Deployment
Impact Metrics
  • Productivity Improvements
  • Customer Satisfaction
  • Digital Expertise
Technology Category
  • Application Infrastructure & Middleware - API Integration & Management
  • Application Infrastructure & Middleware - Data Exchange & Integration
Applicable Industries
  • Healthcare & Hospitals
Applicable Functions
  • Logistics & Transportation
  • Quality Assurance
Use Cases
  • Predictive Maintenance
  • Remote Asset Management
  • Remote Patient Monitoring
Services
  • System Integration
  • Software Design & Engineering Services
About The Customer
The customer is a Health Maintenance Organization (HMO) founded in the 1940s. It is the most advanced healthcare service organization in its country, serving more than 2 million people. The company operates about 300 medical clinics throughout the country, as well as 20 medical diagnostic and therapeutic centers, 100 pharmacies and several hospitals. It is the fastest-growing HMO in its country, facilitating 80 percent of the health services for its members through independent nurses, doctors and other health services professionals. As a result, digital service demand has grown dramatically—with 1.5 million members online and 500,000 using mobile apps.
The Challenge
The Health Maintenance Organization (HMO) was facing growing challenges in internal communication and knowledge management due to its rapid growth and innovation-backed success. Siloed applications and a lack of end-to-end process management and control made oversight difficult and put data integrity at risk. For instance, provider fee-payment systems had become so complex to maintain that it took extra manpower and time to process charges to members and payments to providers. The organization needed to make patient medical records quickly and readily available, increase auditing and monitoring of transaction and data movement, improve back-end IT systems and process efficiency, and open 25 years of custom legacy applications and data to all platforms, including a new digital business platform.
The Solution
In late 2013, the organization embarked on a journey to unify all of its existing investments in a managed and controlled process landscape. It used the webMethods Integration Platform to create a service-oriented architecture and implemented Business Process Management (BPM) capabilities based on webMethods. The organization used webMethods to model and analyze business processes and KPIs, and then integrate them. This allowed the HMO to use webMethods BPMS to execute and monitor processes, a rules engine to enable flexibility, ApplinX to connect and expose legacy systems, as well as webMethods Insight to monitor services. The organization replaced its 20-year-old UNIX® system with a new eligibility system. It launched an innovative Children’s World service, connecting patients and family doctors over streaming video. And it seamlessly aligned surgery and consultant practices with new Ministry of Health regulations.
Operational Impact
  • Removed legacy system constraints
  • Enabled real-time, life-saving services innovations
  • Made member medical records instantly available to doctors
  • Every patient transaction is computerized, and every health care provider is connected to the HMO’s Electronic Medical Records (EMR) system
  • Doctors, pharmacists and patients get alerts and reminders automatically

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