Thank you for choosing mobileLACE for your innovative digital transformation journey. Our Case Studies will show that Transformation Constraints can be mitigated by using our tested and now proprietary, innovation solutions for technology and business provided inside our mobileLACE Digital Transformation Platform.
This case study was executed over three years – in 2013 I was a consultant embedded in a Big 5 consulting team – the other was as a consultant turned FTE working inside the L.A.C.E in 2015-2016. The proper ingestion and streamline of the data input process with accurate and logical usage of the shared data – to help create sustainable healthcare value, occurred during my first point of entree into this enterprise – wide healthcare digitization transformation. The effort that followed was big – it encompassed infrastructure, process, tools, policy and mindset shift needed to support the shifting industry model from volume-based to value-focused patient care with an eye on fluidity, portability and transparency, in order to yield whole patient health care into higher quality health results for the patient.
My business and technology transformation experiences really started in 1994 – you can listen to earlier case studies for Telecommunication: MCI WORLDCOM, and International Real Estate for Eco-Tourism on the Placencia Peninsula of Belize, CA – on our “Digital Alchemists” podcast. As an Enterprise Business Analyst, Enterprise Transformation Coach and now CEO, I have strategized solutions from the 90’s until 2019 – when I took my collective collated experiences over 25+ years and strategized the mobileLACE model; then with the mobileLACE team it was developed in 2020-2021.
From 2013 thru 2016 CIGNA was facing huge constraints around:
* DATA INTEGRITY
* MEDICAL FRAMEWORK MODEL CHANGES – THAT REQUIRED SOCIAL & CULTURAL SHIFTS
* GOVERNMENT ENTRY INTO THE HEALTHCARE SPACE
Cigna began to respond and change systems immediately to move from volume to value; starting with their Intake Workflow and moving into many other processes, systems and products that were limiting due to the old model philosophy.
Shifting cultural intelligence in order to institute the social awareness needed for the mandated change – as with many other company transformations going on today to catch-up to digitization, proved to be most challenging – internally. Yet, Cigna strategically determined that the best impetus for their external solution was working to assist HCP’s in the Cigna networks. So they did!
I believe their effort created a superior and ethically intelligent model that any healthcare insurance company could follow. Leadership made the decision to begin rewarding healthcare professionals – whose health metrics rose due to using new managed care methods resulting in higher levels of wellness – less clinical testing, and more collaboration. However, like other large companies in different spaces – also evolving into digital – shifting the architecture already in place requires herculean efforts.
Data inflow, retention, storage and reporting integrity – a challenge during technological change, was adjusting first and the workflow change to accomodate the system with clean, accurate and safe data was underway.
The V to V model shift was more integral and interdependent; it needed to be mapped out horizontally – across orgs – quickly, but it ended up difficult to deliver effectively and with speed due to organizational processes in place (that often plague many transforming companies) such as: financial budgeting, resource sharing rules, platform architecture and political shadow cultures. All of these – put in place over the ten years since a major merger created Cigna ended up to young to be wrong, but to brittle to withstand the new constant – dynamic change!
Again, like all other businesses facing digitization Cigna wanted to change, but found the holistic approach foreign and antithetical to its in place organizational structure. The differentiator for Cigna – was relative to people in the healthcare business; because these processes dealt with life changing access or denial to procedures that human beings needed – due to chronically impairing or acutely malignant illnesses that presented life and or death situations the people at Cigna – the company with heart – the people who care, catapulted into persistent action.
Large companies – with no effective leader to evangelize the digital cultural shift – in this case the use of the hero-mental model, out of processes needed to move agility across the enterprise, always experience slow and painful change. Without the leader who started the agile journey – and his high level recognition and knowledge around decisions for transformational success, an incongruent ride occurred too early on to smooth the bigger waves that would come as time passed and processes changed. The many external market challenges were keeping Cigna leaders in a constant state of pivot and this demanded a high use of consultants. By virtue of that model this sends an enterprise into a revolving door flow, with a flavor of the month pattern that does and undoes more than not.
Intake Workflow Data Integrity:
Intake of data in healthcare has many integration points for the insurer. Healthcare professionals, clinical support from blood-work to major surgical procedures, the equipment that goes along with that care, and the legal stats from providers of the care, as well as the members who use the care products with the affiliated HCP’s. Data is key to quality health care.
Streamline the data input, scrub the data – keep the data clean, and then report it in the correct place; creating ease of use for both insurance members and healthcare providers. Secondarily, use data gathered – in other ways, to further assist with holistic healthcare reform.
Medical Framework Changing Required Social Shift:
The foundation of value economics and value based models, over volume based approaches required changing one’s social view from the initial point of service for insurance members within the HCP’s networks and the HCP’s themselves. The tri – metric re-calibration around healthcare systems for the new emerging quality around delivery of care required collaborative systems, processes and the application of cultural intelligence into the workflow. It seemed likely – that this would take some time to institute – perhaps, several decades. Yet, the mandate for this shift was to start – now.
Re-access what was deemed “necessary for change” according to reform. Organize it – adding understanding around architectural obsolescence and dependencies between orgs. A large integrative effort was needed – to create real systemic changes that could meet the V to V policy mandate. Upon my arrival changes were already underway – the goal was to get it done in the least amount of time – with the highest quality. However, architectural change in a hybrid bi-modal process without a leader orchestrating strategy was rough.