Healthcare Solutions

 

Healthcare is a broad category and covers operations as diverse as care delivery organizations, health plans, pharmaceutical manufacturers, and nonprofit advocacy groups.

Ten2Eleven understands the healthcare space and works with clients at multiple points along the care delivery spectrum. We understand the unique organizational and operational challenges in healthcare and have a wide variety of tools, techniques, and approaches to help our healthcare clients succeed.

Health Plan System Integration

Ten2Eleven provides assistance to Health Plans to resolve issues related to siloed, standalone systems. These clients often come to Ten2Eleven with similar pain points:

  • Staff spend time doing double entry and resolving differences between systems, instead of customer-facing high value activities
  • Data quality issues related to siloed systems result in a degraded member, group, or broker experience
  • Key processes, such as group setup, renewals, claims management, etc. take much longer than desired, and require extensive manual intervention

Ten2Eleven works with clients to identify a desired future state process, with focus on key data elements and how they flow through the organization. Ten2Eleven uses a multi-disciplinary team of Business Analysts, Data Architects, and Systems Analysts to understand the current environment and the gaps towards achieving consistent data across systems.

Every client is different and Ten2Eleven identifies ideal solutions based on the specifics of each engagement. In some cases, setting up a Master Data Management solution such as a patient or provider registry is the first step. In other cases, clients have de facto Systems of Record and need to improve the rigor and maturity of their data management practices. Ten2Eleven often supports client staff in setting up data governance programs and in measuring the efficacy of data improvement activities.  As part of these initiatives, Ten2Eleven assists in productionalizing integrations between systems to ensure that data flows consistently and reliably.

Ten2Eleven helps clients set up ongoing data quality measurement to support the business case of such initiatives and to help maintain the gains that are realized. This includes identifying data quality metrics and goals, and installing reporting solutions (such as Ten2Eleven’s proprietary Validator tool) to easily and visually track progress towards these goals.
Case Studies

Claims Analytics

Healthcare analytics projects are often constrained by the quality and availability of the underlying data. Many times claims data is the only available source of information for utilization and encounter analytics.

Ten2Eleven has extensive experience in deriving actionable information from claims data and has developed a number of claims analytic systems for healthcare clients. Ten2Eleven approaches these projects by first understanding the business rules and edits imposed by the source systems (typically claims capture or adjudication systems). This is followed by assessing the data quality and consistency of the available claims data, and confirming that project goals can be met with the available data.

Depending on project goals and the client environment, Ten2Eleven will then develop algorithms or statistical models to derive metrics from the claims data. These metrics will be validated with client and business partner staff who are familiar with the underlying data capture process.

Finally, Ten2Eleven will develop interactive dashboards which allow client staff to receive data via push notifications and to interact with the data in order to gain insights into key areas of the business such as operational performance, financial performance, or compliance with therapeutic guidelines.

Case Studies