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Appian World 2012 Business Track: Self-Service Case Management - Benenden Healthcare Society

Alena Davis, Appian
April 17, 2012

Once again, attendees at Appian World 2012 split up into three tracks - beginner, developer and business. Developers are learning about best practices in mobile BPM from Appian's Christine Hutchison. Beginners are enjoying a Government Solutions Panel featuring US Marine Corps, Horizon Industries, Collabralink, and Amazon Web Services. For the business track, Tim Clarke, head of applications for Benenden Healthcare Society, presented on Self-Service Case Management software.

The organization that is now Benenden Healthcare was founded in 1905 to help Post Office workers suffering from tuberculosis (TB). Charles Garland, a Post Office clerk himself, decided to create a mutual self-help organization so that the less well off could get access to the healthcare they so desperately needed. Everyone would contribute a small weekly amount into a fund which would be used to help those who contracted TB. In the early days, it was known as The Post Office Sanatorium Society. Today, the Benenden Healthcare Society retains its values and ethos of mutuality. One member, one price - £1.50 per week. They currently serve 1 million members.

Benenden defined its 3 year IT Strategy in 2008 to shape the way its systems would grow and interact. The project kicked off in early 2008, selecting Appian BPM. In mid 2008, process mapping was completed, and system development began later that year. Benenden wanted to use BPM for the following functions:

    • Contact Centre ñ initial point of contact for all medical benefit claims and membership administration

    • Administration ñ processing of case related paperwork; medical referral documents, invoices

    • Finance ñ invoice authorization and query, supplier administration

    • Hospital Administration ñ querying and acceptance of medical referrals direct into hospital PAS

Clarke talked about Benenden's business challenges. The Society relied on legacy COTS Packages. Multiple systems required synchronized copies of data, which negatively impacted performance. The systems had few rules and even fewer restrictions on user actions. Workarounds became the norm, which diluted the data. The Society was beholden to expert users for essential business process work. Training took a long time (4 week buddy system for major apps). Users were working in unintentional but unavoidable silos. There was no through life process or continuity, which was bad for the customer experience.

The traditional BPM approach of process by process design and build was an unfamiliar methodology for most in the room. Case Management required big bang delivery, providing functionality to the whole business from day 1.

Clarke talked about why the Society chose Appian BPM. While they felt most vendors could meet the technical requirements, Appian was the only one to fully understand their position in the Healthcare market and the service they wished to deliver. Appian's toolset provided the functionality and adaptability to meet the immediate requirements and incorporate their long term objectives.

Benenden deployed their first Appian BPM solution in August 2010. It was a big bang delivery with multiple through life case management processes covering finance management, member disputes, and provider issues. The case management UI features an interactive clickable body for intuitive, speedy recording of details. AJAX calls directly into RDBMS DoSS records containing thousands of permutations. For task management, they created a report mechanism which drives reports and analysis around the business.

The Society's roadmap for self-service case management includes a social community to allow direct interaction with the business and each other ñ this has the potential for 1 million users across the UK. Members delivering self-service will allow the business to direct more efforts to customer satisfaction and equality. Appian will be at the hub of all data and information shared within the Society and to its external partners. Benenden will also take advantage of Appian's mobile BPM capabilities for online/mobile healthcare consultations.

Clarke wrapped up his talk with a discussion of lessons learned.

    • Understand your architecture and what Appian BPM can do

      • Content

      • Rules/Constants

      • Tasks

    • User engagement from the earliest stage will help to traverse skeptics and those adverse to change

    • Prepare and design dynamic management of Appian's vast BPM resources

The potential for self-service case management in healthcare is huge, and Benenden's roadmap is very impressive.