In response to a dramatic rise in the cost of cancer treatment in the early 2000s, insurance companies implemented systems that required doctors and patients to wait up to two weeks for approval of even the most basic treatment.
There had to be a better way. That’s why Dr. Marc Fishman, a hematologist, oncologist, and patient advocate, founded Oncology Analytics in 2008. “Our goal was to improve the quality of cancer treatment and reduce administrative burdens on the treating physicians while reducing unnecessary costs,” Fishman says. The company works with health plans and physicians to ensure cancer treatment plans keep up with ever-improving protocols and are tailored to an individual patient’s needs.
Also, Oncology Analytics is lightning-fast. Fishman and his team created an online system where physicians could receive treatment approval for basic, high-quality care that was cost-effective in about five minutes. More complex treatments can be approved in minutes to hours. Based on data entered by the treating physician’s office, the company’s software evaluates chemotherapy treatment requests for efficacy, toxicity, and cost. Treatments that are of high quality and high value are automatically processed and approved by the software. Treatments that don’t fall under those rubrics are forwarded to the clinical team for further review.
The company grew fast, jumping from 100,000 members under contract to millions over just a few years. Fishman hired more people to handle the increasing load, but his software was stretched to the breaking point. “The more we grew, the harder it was to get analytics data from the system,” he says. “The information was there, we just couldn’t access it efficiently.”
That’s why he turned to OZ Wizards, a global consulting, services and solutions company that specializes in helping its clients use digital innovations to improve their customer service and improve data collection and analytics.
Data is vital to a company like OA because it’s used to improve the approval process. More importantly, it also can be used to help physicians discover which treatments and pharmaceuticals work for large numbers of patients, so the OA clinical team can focus its resources where they can provide the most impact.
One major problem was that a lot of critical information was stored outside the software’s database in email chains between the company and physicians or health plans, where it couldn’t be accessed by the software. So if a health plan wanted data about treatments for the previous 1,000 patients with stage 3 breast cancer, Fishman had to manually go through 1,000 email chains — plus any attachments — to capture the information and generate a report.
“It simply became undoable,” he says.
The legacy system, which had various additions tacked on as the company grew, was becoming ever more fragile as it was tweaked. It also required employees to manually enter some information, increasing the potential for mistakes and wasting a lot of time.
The decision was made to upgrade the software, and OA initially attempted to do it internally. That was a $500,000 mistake, Fishman says. “It was around the same time they were rolling out the Affordable Care Act website, which cost tens of millions and wasn’t working properly, so that saved my sanity,” Fishman jokes. “I could tell myself, ‘At least I didn’t throw away millions of dollars.’ ”
That’s when he called in OZ, which assessed OA’s existing processes and software infrastructure, then collaborated with OA employees to make sure their needs also would be addressed by the new system. OZ developed a reliable, web-based application for the company that makes it significantly easier and faster for OA to search and pull data. In the course of its initial review, OZ also identified several other problems that needed fixing, as well as numerous areas where it could help OA develop new features to help both its employees and clients.
The most important change was eliminating all the data silos and creating a fully integrated system. OZ used data services, analytics, and Intelligent Automation (IA) tools to create a single, centralized system, so Fishman and his team no longer have to search for email chains to gather 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 correspondence in a single, easily accessible — and searchable — database. For OA employees, OZ created a similar dashboard to make it easier for them to monitor case progress.
“Our new, robust solution increases data accuracy and security,” says Amjad Shamim, CEO of OZ. “Most importantly, by improving overall quality and speed, we’ve helped improve patient care.”
Fishman said the day they flipped the switch to the OZ application, “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. The other two were people who were confused about whether they had the correct site. No one complained. No customers or employees had any trouble learning the new system.
“It’s very intuitive,” Fishman says. “And there’s been no downtime because the software just doesn’t crash.”
The part Fishman likes best? The new system’s speed and flexibility. “I asked for a report, and told (an assistant) it wasn’t urgent, she could get it to me next week,” he says. “About an hour later, she had 20 columns and tens of thousands of rows of data. That would have taken us weeks to put together before.”
OA also can now easily supplement reports with additional data. “Before, if you asked to add more data, it would be ‘Uh-oh,’ ” Fishman says.
It’s not just employees who have benefited from the increased speed. The OZ solution sped up the approval process even more: Those five-minute approvals can now be processed in 90 seconds.
OZ is a leading global consulting company whose services and solutions enhance Customer Experience through digital innovation.