Three things to check to make sure your engineers have their estimates right

Engineers have admirable analytical skills, but they tend to minimize the importance of project elements that aren’t related to the code itself.

That’s why it’s your job as the executive to reality-check the project timeline estimate once it’s delivered to your desk. Otherwise, you risk downtime, headaches, broken agreements, revenue loss, and bad business reputation.

  • Have you considered the time we’ll need to integrate with partners?

    Healthcare SaaS solutions are much less valuable in isolation. They need to connect to the entire ecosystem to be functional for the end user. What I often see is that engineers think in terms of code, forgetting that it takes time to connect with EHRs, health plans, clearinghouses, PBMs, and other partners.

  • Do you have a thorough launch and testing plan?

    The project should begin with a precise itinerary, even though it might change based on different circumstances. Without a structured approach, a delayed launch is the least of your concerns — we’ve seen legal overlooks that can pause company operations for up to a year.

  • Did you outline all the risks and ways we can deal with them?

    Perfect planning for every possible scenario is impossible, but it pays to try to predict potential pitfalls. Get your team to document all conceivable risks and reasons the release might be delayed, and then devise ways to prevent or fix these issues.

Would you like to hear about these three checks in more detail? I’ll dive deeper into each in the coming weeks, but you can also schedule a call and talk to me one-on-one.

How Troy Medicare Built Secure, Real-Time HIPAA-Compliant Data Warehouse Leveraging Vitamin Software

Troy Medicare's Journey to a Secure, Real-Time HIPAA-Compliant Data Warehouse with Vitamin Software

Troy Medicare, a distinguished HMO Medicare Advantage Plan, partnered with Vitamin Software to optimize its data capabilities. Troy Medicare strives to achieve its goal of transparent and fair pricing with the help of data by monitoring, reviewing, and tracking information from numerous sources about beneficiaries, care providers, and pharmacies. Recently, they aimed to upgrade their data management system to monitor better and improve healthcare delivery, ensuring members receive optimal care at reduced medication costs.

The Challenge of Complex Data Management in Healthcare

Troy Medicare faced a complex challenge: needing a secure, HIPAA-compliant data infrastructure that enhanced the beneficiary experience while maintaining a strict 15% profit margin. Troy’s collaboration with various entities, including providers and pharmacies, is centered on delivering quality healthcare while adhering to HIPAA and federal reporting requirements. They required a system capable of processing diverse data types from multiple partners under stringent regulatory standards. Any lapse in achieving these goals could compromise their operational efficiency and quality of service.

 

Why Troy Medicare Chose Vitamin Software

Troy Medicare needed someone who understood the complexities of HIPAA compliance and was an expert in building secure data warehouses using AWS services. Vitamin Software team prides itself on secure data management in healthcare. It is a certified AWS Partner, specialized in data cleaning and processing using EDI data format standards like X12 - 834, FHIR, and HL7v2 for fixed format data files like DTRR, FEFD, HCCMODD, PDE, and P2P.

How Vitamin Software Responded 

In response to Troy Medicare's requirements, Vitamin Software architected a robust, user-centric data warehouse, leveraging the robust capabilities of Amazon RDS and AWS Elastic Beanstalk. This advanced solution adhered to stringent U.S. data residency and HIPAA compliance mandates, providing a secure, scalable environment for data storage and processing. Implementing the BOTS framework, a versatile EDI translator, Vitamin Software seamlessly integrated diverse data formats into Troy Medicare’s internal dashboards, optimizing data accessibility and utility for enhanced decision-making processes.

The Results

Vitamin Software, a consultative and reliable partner, provided expertise in secure data management and specialized data processing. Their solution ensured capital efficiency and helped Troy adhere to the Medical Loss Ratio (MLR) requirements, maintaining a regulated margin of 15%. The successful partnership allowed Troy Medicare to successfully navigate its initial operational phase, including the first open enrollment period. The new system enabled Troy Medicare to monitor partner activities efficiently, reducing the time spent on data management and enhancing healthcare delivery quality.

Need Help Keeping Complex Data in Compliance?  

Discover how a secure and scalable data solution can benefit your healthcare organization. Contact our sales team at sales@vitaminsoftware.com for a consultation on achieving operational excellence and compliance.

For more details, you can read the full case study at Vitamin Software's website. Further insights on MLR requirements are available in the Brookings article: Profits, medical loss ratios, and the ownership structure of Medicare Advantage plans.

Revolutionizing Healthcare Efficiency: Aventi's Success with AWS and Vitamin Software in 340B TPA Data Management

Aventi's AWS-Powered Leap in Healthcare Efficiency with Vitamin Software

Discover how Aventi, a 340B TPA, leveraged AWS, and Vitamin Software to revolutionize their data capabilities within a year. The focus was streamlining data connections, ensuring accuracy, and enhancing financial visibility.

Aventi faced the challenge of securely connecting to multiple partners—hospitals, pharmacies, and wholesalers. The issue required leveraging SFTP services and meeting stringent traceability and accuracy standards to begin untangling. The more complicated part was ingesting data according to the data standards set by multiple partners.

 

The Challenge of Automated Drug Distribution

As a crucial player in the 340B program, Aventi facilitates revenue generation for hospitals in low-income areas. Collaborating with Vitamin Software, Aventi aimed to create a system that automated drug distribution and ensured precise financial reporting.

Why Aventi Decided on Vitamin Software’s Expertise 

Aventi chose AWS for its scalability, compliance measures, and secure connectivity options. Vitamin Software's technical expertise in complex data architecture was pivotal in designing a robust system with Amazon RDS at its core.

How Vitamin Software Responded 

AWS services, including EC2, VPCs, and ELBs, were deployed to secure SFTP connections. Advanced backup policies of Amazon EBS and RDS ensured information availability in disaster recovery scenarios. Amazon RDS scaled seamlessly, handling both write-heavy and read-heavy workloads.

The Results

Aventi's adoption of AWS and Vitamin Software's expertise accelerated business operations, enabling faster client onboarding. The secure web app deployed on Amazon RDS facilitated accurate 340B reports. AWS's support for EDI, especially X12 messages, streamlined communication with wholesalers, ensuring precise drug delivery.

Click here to read the entire case study with the intricate tech details. 

Achieve Efficiency in Healthcare Data Management

Explore how your healthcare organization can achieve capital efficiency in software development through best practices in compliant data warehousing.



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