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Data Management


APH gives self-insured healthcare employers data they can trust


In-house integration helps APH take control of data quality and accelerate revenue by 50 percent. By Matt Cheatham


dvanced Plan for Health (APH) creates custom plans for self-insured healthcare em- ployers by building and analyzing longitudinal claims-based patient records to fi nd patterns and healthcare trends that can cut costs, improve pa- tient health and improve spending effi ciency. In order to do this effectively, APH exchanges data with its clients’ past and current third-party administra- tors, pharmacy-benefi t managers, laboratories, workers’ compensation and biometric companies. All of that data comes to APH in different formats that must be translated into a single standard format for processing. To accomplish this, the organization used an integra- tion solution based on an outsourced ETL provider and custom-coded SQL scripts, but this solution frequently broke down. Often, to get a new customer up and run- ning took 20 weeks – and even longer if the outsourcer encountered issues. In addition, data quality wasn’t under APH’s control. Frequently, problems were only discovered after the fact, causing even more delays.


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Pervasive consultants architected the high-level processes for the initial APH migration, including profi ling and analytics to make sure that only clean, valid data went into APH’s data warehouse.


Chris Andrews, managing director of information, says, “The outsource provider was taking about fi ve months or so to get a client onboard. The model for APH is a PEPM basis, so we charge per employee, per month. And, we can’t start charging until companies and their employees are live in the system.” As APH’s business and product offerings grew


18 January 2011


(270,000 patients currently), the company also needed more effective reporting and analysis. To that end, APH management planned a data warehouse for business intelligence and monthly fi le validation, as well as to house customer data.


Selecting the software APH experts evaluated four different integration companies


on 25 criteria, including ease of mapping, metadata management, data validation, scalability and fi nancial stability of the vendor. In the end, only two of the four — Informatica and Pervasive — offered the tools with the necessary capabilities. “We chose the one that demonstrated whose rep- resentatives knew what we were going through, and how we needed to get rid of the problems in our area,” Andrews says. “It was a pretty easy choice going with Pervasive, especially when we considered just the over- all costs compared to other integration suites. Some of the quotes that we saw were almost laughable. How could anyone justify ROI for those?”


Building the solution Pervasive consultants architected the high-level processes for the initial APH migration, including profi ling and analytics to make sure that only clean, valid data went into APH’s data warehouse. APH staff attended data training, working alongside the Pervasive services staff at its headquarters, completing the work in tandem. Initially, the plan was to use Pervasive Data Pro-


fi ler to check only the data against business rules and provide detailed audit reports. However, Pervasive’s


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