REVIEWER: Mary Doyle, associate CIO at Community Care Behavioral Health Organization.

BACKGROUND: We are a Pittsburgh-based organization managing behavioral health coverage for Pennsylvania Medicaid, Medicare and commercial members. We are attentive to coordination of care with medical insurers and social service agencies because behavioral health often affects physical illness and vice versa.

PLATFORMS: The SAS data integration application resides on a Windows NT server. The Oracle 10g database is on a Hewlett-Packard UNIX system.

PROBLEM SOLVED: Community Care previously used an outside vendor to assist with data processing, but we felt it was time to bring the process in house and blend the data with additional sources to help truly coordinate care. The goal was to have one source for all data reporting. Community Care manages data obtained from claim processing, internal clinical transactions, member eligibility, and financial and pharmaceutical data. Since deploying SAS Data Integration and DataFlux Data Quality solutions, we reduced processing time by two-thirds, despite data volume increasing by 50 percent yearly. With this technology, Community Care is better able to provide cost-effective services for our 1 million members while meeting regulatory obligations.

PRODUCT FUNCTIONALITY: We used SAS DI, along with DataFlux Data Quality software, as a starting point. We also started with SAS Analytics and Reporting. We are looking to add a SAS predictive analytics component in the near future. Community Care has joint projects with an affiliated physical health insurance plan serving Pennsylvania residents enrolled in Medicare or Medicaid. We need to understand how physical diseases affect behavioral health and vice versa, and to use data to help consumers with all aspects of their health care. Once insurers understand use patterns, they can team with medical personnel to develop methods to address the problems. We’ve been able to move our side of this analysis much quicker using SAS as an analytical tool. We’re looking at being able to structure some data to help better answer public health sector questions. 

STRENGTHS: SAS Data Integration Studio, with its point-and-click interface, is much more straightforward than competitive products. Programming is also much simpler with SAS DI, and processing takes much less time. Reducing processing time is very important to Community Care because we have 60GB of claims data and expect growth of another 30 to 40GB over the next year. The DataFlux solution allows our business and IT users more control over data quality, from data cleansing to applying business rules to the data being processed.

WEAKNESSES: The introduction of new tools with extensive functionality requires some ramp-up time to get the most impact. We underestimated the power of the quality module and how many of our processes could benefit from it. Overall, the development cycle was extended as the power of the quality module produced several indications where our data could be improved.

SELECTION CRITERIA: Our contracted data vendor strongly encouraged us to consider SAS when we were planning to bring the project in house. Community Care’s IT department was not a SAS shop, and we were not familiar with the scope of SAS products and those of its DataFlux subsidiary. We invited both SAS and DataFlux, and another vendor, to demonstrate their technologies. The SAS and DataFlux team were the unanimous choice – even among technical staff that had no prior knowledge of the two companies. The key to choosing the SAS and DataFlux solution was strong data quality and data cleansing abilities.

DELIVERABLES: Because runtimes have decreased dramatically with SAS, Community Care can now run reports weekly instead of monthly. This allows us to make better data-driven decisions, a key focus of our CEO. For instance, we can now measure clinical interventions, such as: Does a patient released from the hospital need six follow-up services to maintain the discharge plan, or is eight the preferred number? More importantly, staff quickly sees which members aren’t following post-hospitalization protocols.

VENDOR SUPPORT: Community Care used SAS consulting services to get the DI and the DataFlux data quality implementation up and running quickly, a decision we consider key to the project’s success. By partnering with SAS, we were able to apply best practices in our data warehouse work, thus reducing the trial and error that we might have otherwise endured. The project even came in under budget, a benefit I’ve never experienced with consultants.

DOCUMENTATION: The SAS and DataFlux documentation is complete and fully meets our needs.

SAS Data Integration Server

SAS

100 SAS Campus Drive

Cary, NC 27513

(800) 727-0025

www.sas.com

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