APN Consulting, Inc. has been supporting the healthcare vertical for over 15 years.  Our clients include mid-sized to large-sized healthcare payers, health-tech companies, and provider organizations.  Our close association with this industry has allowed us to be part of the transformational journey, navigating the forces shaping the healthcare industry.   Through a keen focus on critical success factors, our teams have helped develop solutions that aid our clients to attain market and thought leadership positions.   APN works with client teams in a flexible delivery model that leverages the advantages of onsite, near-shore, and offshore resources.  These can be rapidly deployed to augment an existing team or work on fixed-bid, fixed-deliverable projects. 

Here are some strategic initiatives where our teams contributed -

Challenge: Due to the pandemic, Healthcare is shifting from inpatient to outpatient settings. While the Provider organizations build capacity and infrastructure for outpatient services, the Payer organizations need to make system and process changes to accommodate the new delivery mechanism.
Solution: APN teams have been working with their clients to build new functionality that can accommodate ambulatory surgery centers, primary care clinics, retail clinics, and patient homes into the business process workflows. Clinical innovations, patient preferences, financial incentives, clinical health records, telemedicine, and an increased focus on improving the quality of care and clinical outcomes are bringing about a sea change in the systems that support these business processes. We provide experienced Solution Architects, Subject Matter Experts, Business Analysts, Project Managers, and Developers that help enhance the functionality of the existing systems.
Challenge: Healthcare entities continue to merge. Even with the number of entities available for mergers is shrinking, the trend continues because smaller entities are being targeted for consolidation. This trend has been forcing healthcare organizations to consolidate their platforms and business processes.
Solution: APN has been part of two initiatives where mergers required systems, infrastructure, and processes to be brought on to a single platform. The consolidation trend is seen as necessary due to ACA that drives the paradigm that value-based care requires unified entities as opposed to contractual-based ventures. While the consolidation efforts were either carried out by our client teams or large systems integrators, APN played a crucial role in providing Enterprise Architects, Infrastructure talent, Testers, and Business Analysts with a staff augmentation model. Our teams help clients develop systems and processes that optimize economies of scale to reduce costs and identifying the best partners to effectively manage population health.
Challenge: Patient Data privacy has been a critical focus for a long time. However, new laws at the Federal and State levels are introducing additional regulatory requirements. The California Consumer Protection Act (CCPA) enhances privacy rights and consumer protection with a renewed focus since 2020. Healthcare organizations are obligated to interpret HIPAA guidelines accurately and provide the right amount of transparency that protects patient data while absolving doubts about unfair profiteering.
Solution: APN has a strong network of some of the best Subject Matter Experts (SMEs) who are well-versed in patient data privacy laws and regulations. They have been critical in guiding the business stakeholders on the most current requirements and helping build the right checks and balances in their systems. This has helped our clients avoid penalties for non-compliance. In one particular instance, several business process changes had to be redefined to adequately protect patient data. Our SMEs were a critical component of that initiative.
Challenge: The consumerization of Healthcare has increased the financial burden on patients because they are now paying higher premiums, co-pays, co-insurance, and deductibles. Patients are now demanding improved access to healthcare networks, clearer benefits and billing information, and more consumer-friendly services. Developing systems that accommodate these changes is critical to maintain and grow market share. Solution: APN has been working with Health-Tech as well as Healthcare Payer organizations to transform their systems to improve the patient experience. Our projects in this area have ranged from redesigning patient portals, service portals, and payer portals. We have been involved in digital transformation and migration projects to cloud-based platforms. APN has been involved in these projects for upwards of five years and has built a significant amount of expertise in the domain and technologies that support these initiatives.
Challenge: Organizations that are slow to adopt new technologies will find it challenging to compete for market share. They are finding that it is critical to deliver more personalized services, facilitate better clinical outcomes, and improve patient experience and quality of life. Organizations have seen a rapid defection rate to organizations that offer all these benefits.
Solution: APN is working closely with Health-Tech providers to build better systems that address the above challenges. There is a radical shift in the Healthcare payer market where instead of building systems from the ground-up, they are leaning more towards the Health-Tech companies that have already solved the process and technology challenges. This has led to projects where SaaS platforms are being deployed and APN is helping deploy professional services teams that configure, customize and deploy these SaaS platforms.
Challenge: Strong Business Reporting is a critical success factor in the healthcare industry. However, several challenges continue to slow down the speed and effectiveness of business. One of the challenges is that the proper staging of data takes time. Solution: APN teams have helped identify and review the bottlenecks in integration. We analyze and suggest data grouping for optimal performance. By eliminating redundancies, optimizing data loads and refreshes, and leveraging cloud-based services, we have been able to make significant improvements in this area.
Challenge: Another challenge in Business Reporting has been the inconsistency of data and metrics used in reports. This can often lead to incorrect business indicators which affect the business decisions negatively.
Solution: We address this business challenge through data standardization, machine learning, and artificial intelligence. The challenge can be effectively mitigated by identifying all the key performance indicators across the organization and standardizing the underlying business rules. Our teams then centralize the data sources for all reporting purposes, inventory all the reports and dashboards that need to be used, and establish a data governance that monitors the standardization. We then do an impact analysis on the changes and ensure that all the business results are being delivered as desired.
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