Digital Transformation in the Healthcare Industry

One of the oldest and largest independent physicians associations had an opportunity to simplify and automate key member services to lower costs and improve revenue. The credentialing process, a core product offering, entailed recurring background checks and credentials verification for each physician member.

Time-consuming, labor-intensive manual processes for auditing and managing vital paper documents created excessive data quality and data duplication issues as well as lengthy and arduous output and reporting processes. The challenging input/output processes also limited insight into marketing opportunities and inhibited organizational growth. Specific challenges included:

• Ability to grow efficiently and with confidence.
• High cost of credentialing and onboarding operations.
• Linear costs associated with growth.

Pinnacle’s initial effort was to develop a comprehensive enterprise data warehouse and related analytics site. This initiative was critical to supporting an efficient and enjoyable online customer experience and in enabling company leadership to gain visibility into emerging trends, opportunities, and root causes of critical business issues.

Thereafter, Pinnacle executed a cloud migration strategy leveraging Cloud SaaS and PaaS solutions. The cloud-based infrastructure facilitated ongoing and future growth for both business and data applications.

• Improved quality of services
• Better product offerings with perceived value to members
• Single patient record
• Shorter opt in and onboarding timelines
• More efficient processes which in turn lower operating costs
• Fewer payor issues
• Fewer incoming support calls and fewer escalations
• Ability to grow without exponential costs
• Lower costs & increased quality of care