In response to rising cancer treatment costs, insurance companies introduced systems that delayed approval of even the most basic treatment by up to two weeks. Dr. Marc Fishman, a hematologist, oncologist, and patient advocate, founded OncoHealth to improve the quality of treatment, reduce administrative burdens on the providers, and cut costs. Through the platform, approvals for treatments are given within five minutes. However, more complex treatments took hours as they got forwarded to the clinical team for review. As the company grew from 100,000 members to millions in a few years, the software struggled to handle the load. “The more we grew, the harder it was to get analytics data from the system,” Dr. Marc Fishman says. “The information was there; we just couldn’t access it efficiently.”
“It was all hands on deck. We had everyone standing by to cope with whatever problems came up. Except, there weren’t any. The company received three calls about the new system, one of which was a compliment.”
Critical information was stored outside the database in email chains between the company and physicians or health plans. Retrieving data like cancer treatments for the previous 1,000 patients with stage 3 breast cancer involved manually going through 1,000 email chains—plus any attachments—to capture the information and generate a report.
The legacy system, which had various additions tacked on became unwieldy. The manual process became unmanageable, increasing the potential for mistakes and wasted time.
OZ assessed existing processes and infrastructure and then developed a reliable, web-based application to retrieve data faster. Data silos were replaced with a fully integrated system that leveraged Intelligent Automation (IA) tools and data & analytics to create a single, centralized system for collecting and storing data. It built a new user interface, as well, including an integrated, real-time dashboard used for claims and payment processing that allows providers to access up-to-date eligibility information. The new system stores all information in a single, easily accessible—and searchable—database. For employees, OZ created a similar dashboard to make it easier for them to monitor case progress.
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