Mid-sized Regional Health Insurer

Technology’s human impact: Better care coordination, better patient experience

Technology’s human impact: Better care coordination, better patient experience

What We Did

When a regional health insurer and a local health system teamed up to build a new clinic and related health plan, they sought a partner who could navigate the complexities of both healthcare and technology. That’s where we came in.

We partnered with the health insurer to design a new member portal and build a platform that could integrate the necessary data. Together, we paved the way for data sharing, enabling better care coordination and laying the foundation of a better member experience.

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Integrated platform uniting clinical and non-clinical data—the groundwork for a shift away from legacy technology

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New member portal with a reusable set of APIs facilitating data movement across 6 business domains and 35 endpoints, all to support an improved member experience

Project Timeline

Requirements gathering and analysis
Portal and integration architecture design
Integration platform build
Test and deploy new platform

The Challenge

In a rapidly changing healthcare landscape, a regional health insurer partnered with a local health system to create a forward-looking approach to care. Together, they built a free-standing clinic and related health plan to provide certain services for zero out-of-pocket charges.

All involved—the insurer, the health plan, and the members—needed to access the right information and right services, simply and securely, at the right time. The next step? To integrate the data and create a streamlined experience for members.

As technology experts who know the complexities of healthcare, West Monroe offered the right multidisciplinary expertise to create an integrated platform and new member portal.

Together, we got to work.

An Undeniable Approach

To power the partnership and elevate the care experience, we built an integration platform to marry health plan data with clinical data. We designed a micro-service architecture that enabled access to real-time data, and, for the growing and dynamic plan, provided flexibility for product enhancement. To drive optimization, the team also developed an automated QA solution.

Technology is only as successful as people’s ability to use it—so we needed to bring the customer experience to life. We worked closely with the client to determine the optimal customer experience and core functions needed to drive that experience. Next came the new member portal—keeping the end user, the member, top of mind. To develop the portal as a seamless and intuitive experience, we leveraged a component architecture and modern web framework.

The collective West Monroe and client team built out analytics and processes that would further enhance patient engagement and elevate care outcomes.

Returns You Can Measure

The platform and the portal were far more than pieces of technology; they had real human impact. The digital experience laid the foundation for better care coordination and an enhanced patient experience.

For the health insurer, the capability to integrate real-time data translated to more accurate and precise care coordination. For the consumer, the seamless and intuitive member portal meant it was easier to get—and stay—engaged in one’s own care.

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