Overcoming Healthcare’s Digital Transformation Gaps

By Tim Jones, Managing Director of Application Modernization at Advanced

Imagine a patient doing everything right and still being denied medical benefits because of a “preprogrammed glitch.” This situation became the reality for a Missouri resident applying for Medicaid, according to a NPR story earlier this year. Unfortunately, she’s not alone. 

Technological problems aren’t just playing out at the federal agency level, they’re hitting other healthcare organizations, especially insurers, that still rely on outdated legacy technology to manage high volumes of users, transactions, and data. 

The pandemic’s acceleration of modernization and digital transformation had a particularly massive impact on the health insurance industry. And, thanks to healthcare startups entering the marketplace, as well as the newly embraced telehealth trend, the pressure is on for everyone, from traditional providers (i.e., UnitedHealthcare, Blue Cross Blue Shield, Aetna, etc.) to Medicare and Medicaid to digitize faster.

Embracing modernization and accelerating business growth are becoming top priorities for CIOs at health insurance organizations, yet there are still billions of linesof outdated, decades-old COBOL code used in production today, revealing the massive disconnect between the goals and current practices.

That gap will only grow wider in 2022 and beyond if traditional providers don’t accelerate digitization efforts now to compete with startups and other businesses that offer new solutions and sidestep recent technology pitfalls with modernized mechanizations.

Opportunity awaits, but challenges still exist. Here are five steps you can take to move in the right direction.

Make life easier for your members 

In less than a decade, we’ve seen rapid adoption of patient portals that allow patients to access records and take action in their healthcare. The health insurance market is experiencing a wave of innovation, requiring insurers to innovate and embrace emerging tech to scale, offer new digital features and solutions and give consumers the level of transparency they expect. New companies are creating more user-friendly pathways for digitally adept consumers looking for alternatives. They’re providing customization options and personalized products to help patients find plans that work for them.

Newer healthcare insurance technologies provide more options, and legacy companies refusing to adapt will continue to get left behind.

Enable data as a service

Modernization projects take time. They’re sometimes multi-year initiatives that involve development, quality assurance, training, and more to complete. Meanwhile, there is a constant need to move data back and forth across project environments. 

Moving large datasets across application landscapes can bog down IT teams and take days to weeks of coordinated effort. It doesn’t have to.

Emerging technologies can virtualize application data and wipe out a large chunk of the infrastructure and operational overhead in data management. These solutions enable data as a service (DaaS) and can increase the pace of modernization initiatives while also doing two key things: cutting cost and risk.

Address compliance requirements

It’s healthcare after all, and compliance issues will always be top of mind for insurance providers.

Aging application infrastructure can be handled quite easily, but underlying data may need to be preserved for an extended period. The good news, however, is there are ways to archive and restore entire application stacks in minutes and taking advantage of those capabilities means you can accelerate modernization projects and eliminate push back from legal and compliance teams.

Refactor your old code

Legacy companies continue to use legacy technology in backend systems.

Take, for example, a company using asdministrative tools that were developed to run on mainframe and AS/400 platforms. In recent years, organizations deploying these administrative systems have encountered difficulties due to high licensing costs and an outdated user experience. Revamping through modernization offers a path to the future.

Millions of lines of code in COBOL, RPG, and COBOL/400 needed to be made available in web-enabled, platform-neutral applications for two main reasons: increasing volumes of interaction between hospitals, their patients, and external collaborators (doctors, insurance companies, etc.) is creating demand for simple, scalable internet-friendly integrations; and increasing pressure from healthcare providers to adopt a platform-neutral approach to ease integration and avoid the expensive proprietary costs of the AS/400 systems.

Modernization can be a daunting process, but partnering with an application modernization solutions organization to refactor code to Java, modernize your user experience, and optimize your applications to enable integrations is an efficient and cost-effective way to do it.

Seek an outside MSP with legacy and new technology expertise

Chances are the solution for long-term modernization success isn’t in house. If it was, you probably wouldn’t have modernization issues.

A post-modernization application management service provider that provides 24/7 monitoring and support of both the application and infrastructure will make sure your modernization effort is built to last.

Like digitization, taking these steps to update your practices won’t happen overnight. Every step you take will not only make your organization more efficient and ready for growth, but also save your patients from the kinds of errors and glitches that keep them from care. 

Bio: Tim Jones is Managing Director of Application Modernization at Advanced. With more than 20 years’ IT experience, Tim has a strong track record in business growth and developing high performing teams who are positioned to succeed. He is a specialist in delivering transformative technological solutions to enterprise and SME markets that span both private and public sectors.