BI & Data Warehousing for PBMs and Medical Centers

BI and Data Warehouse prompt healthcare sector to go in line with the latest trends. On its heels is the prescription benefit management IT solutions.

BI and data warehousing are important for healthcare industries. But the healthcare sector faced obstacles in implementing BI tools, analytics, and data warehousing. The reason: data were diversely distributed by independent stakeholders who acted independently. This called for integrated data warehousing with BI.

According to Colin White, founder of BI Research business transaction databases had the following problems:

• Data is unsuitable for reporting
• Data lacked historical information
• Data had quality issues

Data Warehouse could solve all the above mentioned problems. In Data Warehousing data can be stored and maintained in many different ways. Data Warehousing tools can help in mining, processing data into valuable analysis, besides can do functions like personalization of data for patient care and track trends to move with market dynamics. Healthcare sector can also align business objectives with Data Warehouse. These data are organized to facilitate population-based queries as well as for the analysis. Today, hospitals and medical centers have invested a great deal in Data Warehousing to support data loads from a variety of sources such as HMOs, Pharmacy Claims Processors and metadata vendors.

Data Warehouse to Deliver Actionable BI

Patient health data can be integrated to med claims where millions of claims are generated daily. These claims need to be processed and routed to the appropriate payer. The clearing houses which process these claims sit on a huge amount of data need a data warehouse a central repository to provide invaluable intelligence on: prevalence of diseases, preferred drugs for them, info on patient population, physicians and drug prescription information. It is at this stage BI comes to picture.

BI plays a larger role in patient care, disease management, prescription management, devising health plans, and meeting strategic goals; hence require moving from business transaction data bases to data warehouse. PBM, hospitals and medical centers are using data warehouse to deliver actionable BI. This will enable the executives to arrive at actionable insights and resultant data driven decision making. The solution is through single view of data with graphical interface, a dashboard for users with financial, operational, and patient care data.

Next challenge is in paying for prescription. As a solution to this Prescription Benefit Management IT vendors are providing Prescription Benefits Plans (PBP) software that embraces Rx4, Rx4 + and Deductible plans. For high deductible wellness programs/health plans, prescription benefits are incorporated with the medical plan. Smart solutions for the optimum benefit of healthcare stakeholders.

Prime Technology Group, LLC is a global, technology services company with innovation at the core of our business engagements. For more Information visit http://www.PrimeTGI.com