Large US healthcare provider improves operational efficiency by optimizing legacy application

TCS helped re-engineer the existing processes of a large US healthcare provider and optimize the application and database design, helping the company simplify its day-to-day processes and respond faster to customers.

About the Client:
TCS' client is one of the largest not-for-profit healthcare providers in the US, serving over nine million people across several states. It is an integrated managed care consortium providing high-quality, affordable health care services through its many hospitals and more than 500 medical offices.

Business Challenge:
A healthcare provider in the US managed its Regional Outpatient Appointment Management using a legacy mainframe based application. This system interacted with various customer management channels such as the internet, Interactive Voice Response (IVR) and call center through a CICS Transaction Gateway (CTG). The system posed many challenges to the company. For example, the logging of business-critical message database tables that were needed to troubleshoot business or technical issues, was not complete across channels. Thus, these could not be accessed by the technical team to research business or technical issues.

TCS’ Solution:
We conducted an in-depth analysis of the processes and proposed reengineering the system to meet the current and future needs of the business.

We re-architected the existing database design by creating additional mirror tables and new indexes to improve the access efficiency of the database tables. Mirror tables were used to store data older than the current date, thereby allowing for additional indexes to be created if needed. We then introduced an automated batch process to move the data from the primary tables to the mirror tables. The capacity of the tables was increased to hold older messages and to minimize the wait time that was being encountered in accessing such messages. The actual capacity of the tables was made customizable and could be modified using an online screen.

We replaced the archival and purging process with one that required no downtime. This ensured that no transactions would result in errors because of a delay in the archival process. To fetch messages from the archived files, we recommended an automated process that could be customized. This allowed any critical messages to be quickly accessed by the business team without any assistance from the technical team.

Our solution enhanced the consortium's appointment system by improving patient access and increasing process efficiency. Our recommendations have helped simplify its day-to-day processes, improve performance and achieve operational efficiency. Customer satisfaction has improved, as the healthcare provider can address and resolve business
and technical issues faster than before. Other benefits include:

  • Significant improvement in the average response time in retrieving message logs. Messages less than four days old can be retrieved 10-24 percent faster while messages older than four days can be retrieved 99 percent faster. By eliminating delays in accessing older message to investigate the cause of problems, the re-engineered and automated process allows log messages to be retrieved at any time of the day.
  • Optimization of the database design allowed additional channels, that were not logged earlier, to also be streamlined into the system. Within two years, twice as many channels are expected to be captured.
  • The technical team receives around 15-20 tickets each month: Each of these tickets required manual investigation earlier. With elimination of this manual effort, the average time spent on individual tickets has gone down from 5-8 hours to a few seconds.
  • The company has improved operational efficiency due to the new features available in the latest database version; for example, the performance of SQL queries has improved.

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