CATEGORY: Enterprise Portals

REVIEWER: R. Robert LaGalia, senior vice president of strategy and development for RadMD.

BACKGROUND: National Imaging Associates (NIA) is the leading provider of diagnostic radiology management services to healthcare payers in the United States. In 1999, NIA first began testing and refining RadMD, a Web-based radiology medical management application service that enables healthcare organizations to cost-effectively automate the radiology medical management process. NIA's services allow managed care organizations (MCOs) and other healthcare payers to manage the cost and utilization of diagnostic radiology, assure regulatory compliance, enhance system-wide productivity, improve quality of care and increase physician and member satisfaction. NIA's services carry the accreditation of the American Healthcare Accreditation Commission (URAC). URAC is the standard for best practices and processes to promote high quality care in the managed care industry.

PLATFORMS: RadMD is the front-end application to NIA's medically staffed call center operations or can be private-labeled via an application service provider (ASP) model with user-defined criteria on a hosted basis.

PROBLEM SOLVED: NIA has had success with its offline radiology benefits management platform and saw an online version of this proven suite of products as a natural step in the evolution of the company. The RadMD application combines clinical domain expertise with Web-based technologies on a secure Enterprise Portal (EP) computing architecture to drive system-wide improvements in cost and quality. Sybase has worked with RadMD closely on implementation of their Sybase Enterprise Portal product. The EP computing model provides for cost-effective, secure and untethered access to proprietary clinical decision support criteria, patient history and expert content, and facilitates the physicians' clinical decision-making process. Participant connectivity is enhanced through EP, encouraging providers and consumers to collaborate together in the medical management process.

PRODUCT FUNCTIONALITY: RadMD offers clients seamless integration with client legacy systems to assure error-free data transfer and claims adjudication, and includes tools to assess network performance and ROI.

STRENGTHS: For physicians, the advantages of a Web- based approach over traditional utilization management exemplify the main strengths of Sybases's offering. These advantages include 24x7 availability, user-defined personalization criteria, delivery of clinical and administrative information to improve practice management, online benefits management tools (e.g., patient eligibility, referral), low-cost, efficient and secure connectivity, efficient and rapid navigation through an easy-to-use graphical user interface and assured data integrity for prompt and accurate reimbursement.

WEAKNESSES: Working with a beta version of Sybase EP, we ran into some integration issues among different components. However, we worked with the technical resources at Sybase and the existing professional services group to correct the problem. Sybase responded quickly to our needs and we consequently completed our application development on EP.

SELECTION CRITERIA: We needed a personalized, single gateway that can integrate into our existing legacy applications and support our call center functionality. While "shopping around" we quickly discovered that Sybase was the only partner which could optimize our radiology expertise and leverage it using an enterprise class technology platform, key portal services and proven consulting resources. That was where we saw the main advantage in the Sybase EP. As such, RadMD was selected by Sybase as the first customer to be enrolled in its early adopter program for Sybase EP.

DELIVERABLES: With Sybase EP, NIA has expanded its business processes to the Web without having to completely reengineer existing legacy applications. The RadMD application is integrated into our proprietorial developed call center client application, where we process approximately one million business transactions through the system on an annual basis. The addition of the Web-based application into our existing call center management system improves not only efficiency for the users, but also internal productivity and thus our ability to cost-effectively scale the business. In short, Sybase EP is how RadMD has solved integrating a Web- based medical management application with their existing offline clinical call center.

VENDOR SUPPORT: Throughout the project, we worked with a team of between four and six software engineers and network experts from Sybase to implement EP and assist with application development. Sybase certainly supported their product well.

DOCUMENTATION: Because we participated in the early adopter program, rather than relying on written documentation we had access to Sybase representatives to resolve any questions that arose during implementation.

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