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Customer Experience and Design

Member-Centric Care: Are we working on the correct priorities?

In my previous blogs, I asked if we were missing a key player in member-centric care and then provided my opinion. Here is a recap of questions and answers I discussed, as well as some new points:

Are we, business and information technology professionals, clinicians, and non-clinicians, working on the correct priorities for member-centric care that are facing our core team (i.e., payers, providers, facilities, third-party vendor, regulatory agencies, and members)?

  • It Depends — I love this one, don’t you?
  • The priorities have not been ranked by the business for IT. Every priority seems to be #1, because they are #1. As consultants, we need to assist the business in ranking their priorities based on the slightest variations of cost and SPEED TO MARKET.
  • We need to complete IT Transformation without the chains of traditional SDLC to meet SPEED TO MARKET: The solution should be Agile w/ iRise for BPM.
    • See Perficient BPM Blog https://blogs.perficient.com/bpm/2012/03/08/agile-process-diagram-using-irise-enterprise-visualization/
    • At my most recent engagement, we worked within the client’s IT SDLC that did include Agile with a huge approval process and formal training. I’m not sure how iRise can be implemented within a big Payer without going through a tedious SDLC review committee, formal training for the team, etc. (i.e., there goes 6 months before the first kick-off meeting). The client will continue to be Traditional SDLC unless the CTO/CIO/CEO bypasses the formal process and prototype Agile w/iRise following a formal BPM methodology.
      • Rapid changes and re-prioritization with monthly implementations are required NOW for the business to transform to Member-Centric Care. IT must also transform as the business transforms. One cannot happen without the other.
      • For the successful Payer and Provider to work on the correct Member-Centric Transformation Priorities, they must make IT SDLC transformation a #1 priority.
      • The successful Payer and Providers will be working to correct changing priorities in build if they allow IT to transform its SDLC to support BPM with the RIGHT tools.
      • What are your thoughts and experience of working within a traditional Payer and/or Provider to Agile w/iRise?
      • How do you add many off shoot links to a traditional SDLC?
        • I am familiar with the solution and experience of working with Payers and Providers to achieve rapid development once the links are set in the client’s traditional chain.
        • HINT: The only way for the above to be implemented is through knowledge transfer from the consultant to the client’s team members and leadership and support the client in their adoption from top down. Employees are the stars that align and make HUGE transformation from in traditional environment
        • If you are a CTO/CIO/CEO for a payer or provider, what is your experience? Is it possible? How did you set consultants and employees to be successful?
        • If you are a Payer or Provider that is on the business and/or IT team leading the transformation to Member-centric care, how is it going? What are your lessons learned?

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Christel Kellogg

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