Horizon Case Study - Leveraging the Web and Mobile to Deliver Personalized Healthcare Services

© 2013 IBM Corporation
Horizon Case Study: Leveraging the Web and Mobile to
Deliver Personalized Healthcare Services
Jack Quigley | Director of Portals, Web Services and Middleware | Horizon
Healthcare Services
Niral Jhaveri | Vice President, User Experience | Prolifics.

22 © 2013 IBM Corporation© 2013 IBM Corporation
Agenda
 About Horizon Healthcare Services
 System Strategy – The 5 year Journey
 Member Portal – Strategy in Action
 Lessons
 Where Are We?
 What’s Next?
 About Prolifics

33 © 2013 IBM Corporation© 2013 IBM Corporation
About Horizon Healthcare Services, Inc.
• Horizon is New Jersey’s oldest and largest health insurer.
• Horizon traces its history back to 1932, when Associated Hospitals of
Essex County, Inc. began selling multi-hospital pre-payment plans for $10
a year covering 21 days of in-patient care.
• The company was one of the first health insurance companies in the nation
and also one of the first Blue Cross Plans.
• Today, it serves more than 3.6 million members.
• The company has more than 4,800 employees and is headquartered in
Newark, NJ with offices in Wall Township, Mt. Laurel, and West Trenton, all
in NJ.

44 © 2013 IBM Corporation
• Horizon is executing a 5 year Systems Strategy Roadmap
‒ 14 Strategic Business Capabilities led to Systems Strategy Roadmap
• eBusiness Strategy and Member Portal are driven by Top 5 Strategic
Capabilities
Horizon Systems Strategy
The 5 Year Journey
Low Cost and Highly Efficient Operations and Administration
Self-Service Everywhere
Stable and Simplified IT Infrastructure
Integrated and Trusted Source of Truth of Core Business Information
Near-Time Medical Cost Quality, Analytics and Insights

Horizon eBusiness Strategic Objectives
KEY STAKEHOLDERS
Members
Consumers
Providers
Employer Groups
Employees
Increase Membership
Increased Sales Focus
Feedback &
Measurement
Affordable Health Care Models
Optimize
Customer
Interaction

Horizon Systems Strategy
Member Portal – Strategy in Action
 System Strategy provided focus on 4 key areas for eBusiness and the
Portal
Portals
W W W
Portal Infrastructure Integration Services
Portals
W W W
Portal Infrastructure Integration Services

Low Cost, Efficient Ops & Admin
Simplified IT InfrastructureSimplified IT Infrastructure
Portal Infrastructure
 Needed to replace aging technology of Member Portal
─ Limited ability to render content and transactions on a
single pane
─ UI unable to support our interactive design goals
─ Incompatible with modern day web browsers
─ Lacked sophisticated content management platform
 Build a Foundational Portal Platform
─ First step to building next generation Horizon Portals
─ IBM Websphere Portal 7
─ IBM Websphere Content Management 7
─ IBM AIX on P-Series blade servers
─ ESB built using IBM DataPower Xi52 for web services
─ IBM WSRR as Service Registry
Portal Infrastructure
Source of Truth
Medical Cost Quality Analytics

Simplified IT Infrastructure
Feature Management
 Feature Management
─ Previous Member Portal had no ability to control visibility of content or
transactions
─ Needed capability to delegate administration to an Employer’s Group
Administrator
─ Needed capability to control access to features and feature sets by a Group
 Member Portal Group Administration
─ Leveraged Websphere Portal to build Administrative Console
─ Group Feature Management provides toggle on/off of a feature/feature sets
 Supports multiple user audiences
─ Employer Group Administrator
─ Service Desk Agents
─ Account Teams
Portals
W W W
Source of Truth

Portals
W W W

Source of Truth
 Builds a better informed membership base
 Allows members to make better-informed decisions
about the cost of their health
 Provides estimated cost data for commonly billed
elective inpatient, outpatient and diagnostic procedures
 Integrates data via ESB (DataPower), combining legacy
data source and third-party web service
Source of Truth
Treatment Cost Estimator
Integration Services

hip

The Technology behind the Features…
 Feature Management & Treatment Cost Estimator was
developed using IBM’s Web Experience Factory
 Uses producer-consumer design pattern where the service
producers can be reused
 Personalization  PZN rules.
 Segmentation  User Profile
 Caching  DynaCache
 Apps built via RAD and use
an MVC design pattern
 ALL portlets are built
to the JSR 286 spec
Consumer
Consumer Common
Service Provider

Source of Truth
 Multi-channel approach to delivering our strategy
 Bundles key member online services into a mobile app
 View Benefits
 View and Search Claims
 View Authorizations / Referrals
 Request an ID Card
 Update Additional Insurance
 Dedicated team specialized in mobile development
 App due in the stores (iTunes & Android) February
Source of Truth
Mobile Member Portal

Member Portal – Strategy in Action Lessons…
• Do not underestimate the time and effort required to set up your infrastructure
• Over-communicate your program
‒ Ensure you have a blueprint and that everyone on the project understands it
‒ Identify and engage teams you depend on as early as possible
• Horizon leverages Partnerships to execute most development. No one partner
can solve all of your development and support needs
‒ Start with multiple partners that have specialty in specific areas – Websphere
Portal, Websphere Content Management, mobile, etc.
‒ Leverage your direct experience as each work streams mature
‒ Choose your top few partners for the long haul and get them to have skin in the game
• Experience matters, but not just in your development partners
‒ Trust your instincts as an experienced manager – experts are often only as good as
their last project, especially if their last project was their first in that technology
‒ Institutional knowledge is often underestimated in technology heavy projects – No one
knows your business better than your people
‒ Never stop asking questions
• mix of specialty and generalists to ensure your top partners

Horizon Systems Strategy - Where Are We?
 New Member Portal launched in early 2011
 2011  490K active members
 2012  650K active members (validation in progress)
– 8 new features introduced to our members, Mobile Website launch
 2013  Target 900K active members
– 5 new features, Updated mobile app and website

Horizon Systems Strategy - Where Are We?
While member portal transactions continue to increase at a fast pace only a
percentage of those increased transactions are leading to reduced calls.
100,000
150,000
200,000
50,000
0
Month / Year
Jul-11 Jul-12 Oct-12 Jan-13Apr-12Jan-12Oct-11
300,000
350,000
250,000
NumberofCalls/Transactions
Apr-11Jan-11
+92%
-19%
Member Portal Transactions
Calls Handled Member
 Member portal transaction have grown at a CAGR of 92% from Jan
2011 through December 2012.
 During this same period Calls handled by the call center have
decreased at a CAGR of 19%.

Horizon Systems Strategy - What’s Next?
 Rebuilding Horizon Broker Portal on the new Portal Platform
 Building a Horizon Consumer Portal integrated with Websphere
Commerce 7
 Launching storefronts for our Brokers on Websphere Commerce
 Upgrading Web Security Layer by implementing WebSeal, TAM and
TDS
 Continue enhancing Member Portal and Mobile Member App

Horizon Case Study - Leveraging the Web and Mobile to Deliver Personalized Healthcare Services

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