Case Study

 

Transforming Healthcare Operations

Health Partners 

HealthPartners, a leading healthcare and insurance organization, partnered with SDG to modernize critical business workflows using a cost-effective low-code solution.

Challenges

Manual data input and output

Siloed information

Limited tracking and reporting

SDG Solutions

Solution analysis and design
Low-code development
Microsoft Power Platform suite
Training, documentation and upskilling

Maximizing efficiency

HealthPartners is an integrated, non-profit healthcare provider and health insurance organization serving more than 1.8 million medical and dental health plan members nationwide.

The HealthPartners Pharmacy Programs team is responsible for overseeing a complex fee schedule and labor-intensive drug price coding process. To ensure accurate claim adjudication and reimbursement to their contracted specialty pharmacies, this team manages records of over 3,500 national drug codes (NDCs), which they associate with unique pricing parameters based on an individual pharmacy’s business rules.

Historically, the Pharmacy Programs team has managed this data and these business rules using carefully maintained spreadsheets and manual workflows. As their network expanded, HealthPartners encountered serious challenges with maintenance, accuracy, and reporting. Additionally, the team wasn’t able to easily integrate drug and pharmacy data with other HealthPartners systems, resulting in information silos that threatened efficiency and accuracy.

Embracing low code solutions

To address these problems, HealthPartners turned to custom enterprise software development consultancy SDG. After analyzing the HealthPartners team’s workflows, document structure, and collaboration tools, SDG recommended a low-code solution using Microsoft’s Power Platform suite of low-code applications. This architecture meant a new application could be implemented with minimal custom code – which would contain costs, accelerate development time, and ease the burden of long-term maintenance.

An architecture built for lasting success

SDG’s team of analysts, engineers, and designers then collaborated closely with the HealthPartners’ team to design and implement the Power Platform solution. They centralized information in a cloud-based Dataverse data platform, enabled new insights through PowerBI reporting and analytics, and quickly built new workflows and interfaces using the Power Apps drag-and-drop web interface and prebuilt components.

Success in weeks

The Pharmacy Programs team was up and running on the new system within weeks, quickly realizing the benefits of the new solution’s modernized architecture, cloud-based integrations, and a user-friendly interface. The members of the HealthPartners Pharmacy Programs team were especially impressed by the project team’s speed and collaboration.

Throughout the project, SDG made sure to equip the HealthPartners team with documentation, training, and new skills. Because of the smooth handover and thoughtful implementation, the HealthPartners Pharmacy Programs team is confident and excited that they’ll be able to extend the new system themselves through the Power Platform suite, without needing to engage costly custom development services.

“This project was amazing! I’ve never seen an application of this complexity get built so fast. A legacy project would have taken at least a year or more to roll out something like this.”

Liz Fuller – Information Technology Manager at HealthPartners

Low code in motion

By implementing a low-code solution, the HealthPartners team has streamlined processes that once took hours into mere minutes. They’re communicating more effectively, they’ve dramatically reduced claim adjudication issues, and they’ve improved their ability to serve their customers – all with fewer technical limitations.

 

 

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