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BROCHURE Informatica B2B Data Exchange for Healthcare: Improving Patient Care Ilan Yacoby CTO, IT and Computing Division Clalit Health Services “The deployment time savings and efficiency of application integration engendered by Informatica have provided Clalit with much faster implementation and significantly lower costs: 2-3 years work of four programmers was saved, and we are now able to rapidly incorporate new formats into our environment.” The healthcare industry faces growing scrutiny an
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  BROCHURE “Te deployment time savings and ef ciency o application integrationengendered by Inormatica have provided Clalit with much asterimplementation and signicantly lower costs: 2-3 years work o our programmers was saved, and we are now able to rapidly incorporate newormats into our environment.”  The healthcare industry aces growing scrutiny and pressure. On the one hand, healthcareorganizations are expected to improve the quality o patient care, while on the other, theyace demands to decrease the escalation o health care costs. Add to the mix increasing regulatory mandates or patient data security and escalating volumes o electronicinormation.Due to the evolution to electronic ormats o patient data, the amount o inormation that is being exchanged is exploding. Virtually every encounter between patient and healthcareprovider creates data on health, treatment protocols, insurance eligibility and claims, billing and payment, etc. This in turn triggers a wide range o healthcare community membersbeyond the patient and doctor: benefts administrators, insurance claims reviewers, payment processors, etc.A signifcant advantage can be gained in meeting these challenges by automating themanagement o inormation and transactions. Inormatica B2B Exchange oers thisadvantage. Informatica B2B Data Exchange for Healthcare: Improving Patient Care BUSINESS CHALLENGE Control the cost o providing  ã healthcareIncrease patient service and quality ã Adjust to standards and mandates ã by regulatory agencies  Technology Challenge Manage an exploding volume o  ã inormation issuesManage an exploding variety o  ã patient data in varying ormats,protocols, and standardsIntegrate high volumes o  ã ragmented, non-standard datapassing through multiple healthcarenetworksComply with mandates or  ã transparency, privacy, disclosure, anddocumentation.  Technology Strategy   A centralized hub that provides visibility, integration, management,and orchestration of all data within the walls of the healthcare network and beyond to patients, providers, andhealthcare community partners. Ilan Yacoby CTO, IT and Computing DivisionClalit Health Services  Informatica B2B DataExchange for HealthcareSolution Inormatica B2B Exchange or Healthcare isa amily o sotware products that enableshealthcare enterprises to optimize andautomate their relationships with their partners. It addresses global, multi-enterprisehealthcare data transaction needs suchas healthcare claims, claim payment andremittance advice, healthcare claim status,coordination o benefts, and enrollment. The Inormatica B2B Data Exchange amilyincludes two products:Inormatica B2B Data Transormation ã transorms unstructured and semi-structured ormats into any structuredormat.Inormatica B2B Data Exchange connects ã the enterprise with business partners andcustomers. It provides partner management and on-boarding, event monitoring,and a ull range o security and controleatures. It includes Inormatica B2B Data Transormation. Universal Healthcare Data Transformations Healthcare networks must support manytypes o business processes, data ormats,and communication protocols to addressthe specifc needs o each o their providers,insurers, and patients in a scalable and cost eective manner. By supporting any-to-anydata ormat transormations or structured,semi-structured, and unstructured data,Inormatica B2B Data Transormationreduces the IT costs o custom development,validation, and error identifcation byautomating access to all orms o data andthus streamlining intra- and inter-healthcarenetwork collaboration and integration. Dynamic Healthcare Partner Network Management Inormatica B2B Data Exchange or Healthcaremanages all aspects o communicationsbetween parties in a healthcare network– Including the patients, healthcareand insurance network partners, thirdparty administrators, Pharmacy Beneft Management (PBM), Centers or Medicare andMedicaid (CMS), and government agencies.It allows the capability to create, edit, andmanage all partner profles and defne thespecifc data ows particular to a partner to accommodate the diverse and dynamicnature o all the providers and payers withina healthcare network to promote operationalefciencies and collaboration. Healthcare Industry and Technology Standards Library  Inormatica B2B Data Transormation supportstransormations and mappings, via XML, o most healthcare industry standards including HIPAA 275, HL7, ASTM, ASC X12, EDIFACT,UB92 claim orms, and NCPDP transactions.Inormatica monitors and updates thesestandards as necessary to ensure thelatest changes are always incorporated. This allows networks to utilize immediatelythe latest standards and specifcationsand lowers the cost to maintain changes or updates. Additionally, Inormatica B2B Data Transormation provides pre-built rameworksor HL7, EDI (e.g., ASC X12, EDIFACT)that enable mappings between multipleversions o standards (e.g., HL7 versions2.1, 2.2, 2.3, 2.4, 2.5, 3.0, MLLP, ASTM andsite-specifc variations). An easy-to-useinterace assists non-IT business users inmaking customizations to the standards andtransormations. System Interoperability and Integration with Informatica Data IntegrationPlatform Inrastructure design o Inormatica B2B DataExchange or Healthcare is based on a servicecomponent architecture or interoperabilitywith any major connectivity, business processmanagement, and messaging system. Theproduct is also integrated with the entireInormatica Data Integration Platorm.Providers and payers can access their unstructured or structured data in batch or real time, search and profle all their datasources via Inormatica Data Explorer®,ensure the data is clean with Inormatica DataQuality™, and with Inormatica PowerCenter®,integrate and deliver the right data at theright time. In conjunction with PowerCenter,capabilities such as importing mappingsrom PowerCenter and extracting data owparameters rom the mapping ensuresthe data is transormed, reconciled, andexchanged across any platorm.In this way, Inormatica oers a commonplatorm or data integration and B2Binterchange initiatives. The advantage o thisapproach is a common repository with sharedmetadata, common tools and services, andnear universal connectivity or structured,semi-structured, and unstructured dataormats. This enables a single, trusted patient record across multiple channels, provider networks, and diverse internal systems that manage patient and service inormation.It allows a consolidated view o member benefts across multiple member products- such as medical, detail, behavioral health,pharmacy, exible spending accounts, healthsavings accounts, and beneft spending cards– and multiple healthcare applications.  Healthcare Data Flow Orchestrationand Flow Library  Inormatica B2B Data Exchange or Healthcare provides advanced visual dataow orchestration. The graphical modeling environment with Business Process Modeling Notation (BPMN) allows rapid representationand automation o provider and payer business processes; the visual nature o themodel also ensures that the most efcient and streamlined processes are ollowedwithin and across the network. These canbe customized as needed based upon thespecifc requirements o benefts providers,administrators, insurance claims reviewers,payment processors, and others. Healthcare Event Monitoring  One o the ways to ensure that transactionscomply with business needs is via event management. This involves deploying thenecessary controls to view and monitor, notiy,reconcile, analyze, and manage exceptionsto enable business process ows within andacross the healthcare network.Inormatica B2B Data Exchange or Healthcareprovides the ollowing business event monitoring capabilities:Event Viewer to see a list o events, search ã on a specifc event o interest, and drilldown to obtain inormation such asevent type, status, history, and any errorsassociated with it.Event Monitoring to centrally manage ã transactions, reconcile issues, and defnethe flters and triggers used to send alerts.Web-based Business Dashboard and ã Analytics to provide diagnostics andanalyses o business transactions.Event monitoring ensures that all health-related transactions are conducted in anappropriate and timely manner. It streamlinesclaims processing and billing with real-time patient inormation by interconnecting patients, payers, and providers and it providesvisibility and transparency into medicaland healthcare processes, ensuring theearly detection o potential problems, andestablishes the highest possible controlover all transactions, which is mandated or compliance with regulatory requirements. These capabilities also increase customer satisaction by meeting or exceeding current Sotware License Agreements (SLA) contractsto resolve delayed or inaccurately paid claimsto Health Net providers while decreasing costlypenalties associated with ailing to meet SLAs. Security  Inormatica B2B Data Exchange or Healthcareeatures integrated authentication, fne grainedaccess control, dual authorization, and ullaudit trail capability with beore and ater datacapture. Authentication can be integrated withany JAS-compliant enterprise authenticationand identity management products such asWindows (NTLM) and Oracle Oblix to ensureconsistent application o security policies. This ensures that the integrity o data remainsintact and also provides assurance that patient data can be trusted. Connectivity  Due to the many ways a healthcare networkmust communicate with its providers, payers,and patients, Inormatica B2B Data Exchangeor Healthcare provides inter- and intra-enterprise connectivity or many types o datainputs and outputs – at fles, messages,databases, Web Services – without anyadditional middleware skills or integrationproducts. This supports interoperability withinany environment through streamlined cross-network collaboration or any type o datatransormations regardless o the data type,application, or inrastructure. The connectivityacilitates the collection o diverse patient and healthcare data rom disparate systemsand allows it to be shared electronically via asecure connection across multiple systems. System Management Multiple and distributed computer systemsplay into virtually all healthcare networks. Toaccommodate this act, Inormatica B2B DataExchange or Healthcare allows management o items such as hardware inventories,server availability, sotware inventory andinstallations, storage management, networkcapacity, and any other monitoring o systems.File import, export, saving, loading, andlogging can be highly customized to complywith ormat requirements o various systemmanagement monitoring agents and can alsobe specifed in accordance to the defnedsecurity policy. Many common management activities, such as data archiving andrestoring, are provided through a command-line interace. Scripts or clustering sotwaresuch as Veritas are provided or start, stop,and quiescence, and determine node health. Universal Healthcare Data Transformations ã Dynamic Healthcare Partner Network  ã ManagementHealthcare Industry and Technology  ã Standards Library Healthcare Data Flow Orchestration and ã Flow Library System Interoperability and Integration ã  with Informatica Data Integration PlatformStore-and-Forward ã Monitoring Event Management ã Security  ã Connectivity  ã System Management ã INFORMATICA B2B EXCHANGE FOR HEALTHCARE FEATURES:  Worldwide Headquarters, 100 Cardinal Way, Redwood City, CA 94063, USAphone: 650.385.5000 ax: 650.385.5500 toll-ree in the US: 1.800.653.3871 www.inormatica.com Inormatica Ofces Around The Globe: Australia ã Belgium ã Canada ã China ã France ã Germany ã Ireland ã Japan ã Korea ã the Netherlands ã Singapore ã Switzerland ã United Kingdom ã USA © 2008 Inormatica Corporation. All rights reserved. Printed in the U.S.A. Inormatica, the Inormatica logo, Inormatica B2B Data Exchange, Inormatica PowerCenter, Inormatica Data Explorer, and Inormatica Data Quality are trademarksor registered trademarks o Inormatica Corporation in the United States and in jurisdictions throughout the world. All other company and product names may be trade names or trademarks o their respective owners. 6831 (08/27/2008) Clalit Ensures Trusted Patient Data and ReducesManagement Costs Clalit, the largest public health network in Israel covering 1,300 clinics and 3.8 million patients,successully tackled one o the greatest data management challenges acing the healthcareindustry with Inormatica. Clalit deployed Inormatica B2B Data Exchange or Healthcare to access,transorm, and consolidate - in real time - patient records dispersed across 189 applications inmore than 300 disparate and complex ormats, including the industry-specifc Health Level 7(HL7), Adobe PDF, Microsot Word, and other unstructured data types. The Inormatica solution or non-relational data enabled Clalit to improve patient care by generating standard sets o accurate,up-to-date, XML-based patient records that could be displayed in hundreds o legacy applications.Inormatica provided Clalit with both an easy-to-use development environment and a powerultransormation engine to automate and streamline the ull data integration liecycle. As a result,Clalit avoided what would have been an extremely costly, time-consuming, and error-prone manualdevelopment eort. With Inormatica B2B Data Exchange or Healthcare, Clalit achieved:An immediate 140% ROI and ongoing low maintenance costs ã Reduced transormation development time rom weeks to hours ã Saved 2-3 years work by our developers ã  ABOUT INFORMATICA Inormatica Corporation is a leading provider o enterprise data integration sotware. Using Inormatica products, companies can access, discover, integrate, and deliver enterprise dataacross systems, processes, and people to reduce complexity, ensure consistency, and empower thebusiness. STRATEGIC BUSINESS VALUE Deliver higher quality patient care and ã improve patient health and saetyIncrease patient service and satisaction ã Provide consistent patient channel delivery ã and communicationIncrease efciency and transparency o  ã customer interactionsReduce the risk o medical errors by ã increasing patient record accuracy andtimeliness o inormationIncrease coordination between healthcare ã providers and payer networksStreamline claims processing and billing  ã with real-time patient inormationReduce the cost o medical care by driving  ã process efciencyAdhere to medical best practices ã Improve compliance with government and ã industry mandates by better visibility o data transactionsAccelerate on-boarding o medical practices ã Optimize the value o existing systems ã
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