Marts make healthcare more efficient

Heart of data warehousing comes from extracts for Amisys sites

Differences between the power of IMAGE databases and others in the IT world are prompting companies to start data warehouses, and a long-time HP 3000 data tool provider has opened up a new line of business to help.

M.B. Foster Associates (800.ANSWERS, www.mbfoster.com) is extending its tools business to services with the design and implementation of data marts, starting with the Amisys healthcare customers already using MBFA’s products. At the heart of warehouses are marts, extractions from production-level databases running on HP e3000s.

MBFA Founder Birket Foster calls data marts “a fishing pond for data, organized by line of business, departments or geography. They’re pre-built for decision support systems.” The marts’ ponds are fed by IMAGE/SQL databases hosted in the e3000 world, relying on intelligent extracts performed on a regular basis.

Data marts exist to answer questions about companies’ business practices. In the case of healthcare providers using Amisys software, some want to reduce claims fraud. Looking at fraudulent claims helps the HMO or insurance firm locate a pattern to spot future frauds, or even catch fraud in the act — but only if the claims data can be analyzed in a decision support database.

While it’s possible that database could be hosted on an HP 3000, these days it’s often not there. More decision support tools are available for NT systems running SQL Server databases, the kind that MBFA has already integrated with marts at a few healthcare companies. Putting the rich data of the 3000 into other platforms’ databases gives users a way to find those answers to questions.

“End-user computing requires navigation to make it possible to see how a business’s data works,” Foster said. “You have to build small islands of information to help someone make a particular decision. You also have to figure out the database update strategy.”

Data marts require design based on an understanding of the topic matter. Cross-platform marts like those in the e3000 world also need common data definitions, key fields such as area code or ZIP code, as well as synchronization points like ends of quarters or months.

Marts also rely on views. These are throw-away fields not relevant to the database’s production use, manufactured tables that don’t exist anywhere else. The views, common definitions, and synch points make up the elements of a template, the design’s heart. Foster said his company’s new practice utilizes consultants with experience at Amisys sites that have been using DataExpress software, the solution MBFA has installed around the world.

That solution uses SQL Server on NT systems as the decision support database, connected to the Amisys IMAGE/SQL database through DataExpress. The MBFA data marts for Amisys users provide analysis on claims and membership life cycle data. “There are other areas, but those two at a minimum end up being key ones,” Foster said.

The fraud detection works to catch “companies that are in the business of submitting fraudulent claims to HMOs across America,” he added. “We talk to customers about how to look for patterns.”

Finding fraud is just one way to improve member service by holding down costs, but it’s an obvious one. Reminding customers to have the annual physicals which are a part of their plan is another benefit. “On a life cycle of a member, it’s better for them to have regular checkups than to get really sick after a few years,” Foster said.

To engage the MBFA consultants in data mart design, customers need to buy or own DataExpress, and sign on for 15 to 20 days of consulting. The software summarizes data for use in marts, a process it can do in batch in off-hours.

MBFA then uses Distributed Transaction Services (DTS), a Microsoft component included in NT servers to load the SQL Server database. DataExpress triggers the DTS loading after its summarization is complete.

“It improves the way that people can look at their data,” Foster said. “You add more value for the customer, and the first of our marts is in the Amisys space.” MANMAN and MM II and Exegesys sites are also in the works.

Templates used for one customer can be leveraged for others in the same industry, but flexibility is important to success. “It’s a process of discovery, when they get in there and look at the data,” Foster said. “Some of the questions that you come up with are ones you didn’t know you were going to ask. They learn a lot about their business in the process.”