CATEGORY: CRM Analytics

REVIEWER: Steve Albrecht, data manager, Health Economics Department for Emerald Health Network.

BACKGROUND: Based in Cleveland, Ohio, Emerald Health Network is the state's premier independent PPO (preferred provider organization) and an industry leader in the use of information technology. Emerald Health works closely with more than 175 hospitals, 1,800 ancillary providers and 22,000 physician locations throughout Ohio, western Pennsylvania, northern Kentucky and eastern Indiana. Clients include more than 800 employer groups and 150 payors.

PLATFORMS: The data warehouse is running in SQL Server 2000 (Windows 2000 Server) on Dual Xeon 933MHz processors with 2GB of RAM and 136GB of disk space. Analysis Services is running on NT Server 4.0 on a single Pentium III 800MHz processor with 2GB of RAM and 100GB of disk space.

PROBLEM SOLVED: Emerald Health's constant challenge is negotiating, documenting, monitoring and maintaining millions of complex relationships between payors (employers), providers (such as hospitals and physicians) and consumers (employees and their dependents). "Our challenge is not just to maintain data on all these relationships, but to transform that data into valuable information. We use that information to strengthen our partnering relationships with payors and providers in our communities so that jointly we can provide our network members with a superior healthcare product," says Peter Osenar, president and CEO. Success is driven by what we do with our data, and ProClarity is revolutionizing the way Emerald Health does business.

PRODUCT FUNCTIONALITY: We very quickly learned that ProClarity could improve our internal management by giving us more quantifiable metrics than we had before. By quickly and accurately tracking expenses and margins, Emerald Health has been able to manage the business with more precision than ever before. ProClarity's incredible speed allows us to respond to pricing issues very rapidly. As a result, we know exactly which type of business to pursue and which to avoid.

STRENGTHS: ProClarity's tremendous power enables us to understand and improve our business in ways that were previously unthinkable. We are able to delve into analysis that we couldn't have touched prior to our use of ProClarity. In half an hour, ProClarity garners the information it would have taken us days or even weeks to garner before. ProClarity is also very simple to deploy. We were up and running with a QuickStart solution within two weeks.

WEAKNESSES: The development is done in Analysis Services. An indirect weakness is the dependency on the ability to create effective cubes in Analysis Services. Without a resource that can perform the back-end development, ProClarity will not be a success in your organization.

SELECTION CRITERIA: One of the main reasons we selected ProClarity was its flexibility. We found that other vendors were more difficult to work with, even in the evaluation stage. We were looking at several types of solutions, including an ASP model, and we liked the fact that we could own the ProClarity solution and our data. The combined Analysis Services and ProClarity solution was perfect for our needs. ProClarity was easier to evaluate and ultimately implement than other solutions we were considering.

DELIVERABLES: With ProClarity, we are able to further differentiate our product offering and demonstrate increased value for our customers. ProClarity allows us to access the data at each hospital, for example, so we can better determine utilization patterns and see where dollars are being driven. Then we negotiate with those facilities in ways that most appropriately address their concerns regarding reimbursement, while giving our clients and their employees the best economic packages possible. While many competitors require a week or even a month to process claims, "Two days is our commitment," says Osenar, "and we're very much on target."

VENDOR SUPPORT: The QuickStart program was the key to our success. The time that Emerald Health spent with the consultant ­ only two weeks ­ was invaluable. The process of working on an initial application area with a ProClarity expert is a great way to develop a usable base application and transfer the knowledge in a very timely and efficient manner. The best part of working with ProClarity is the service. Any problems or questions are addressed immediately.

DOCUMENTATION: The product has been so easy to use that we have not looked at the documentation since the first week of implementation.

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