MSDN Industry Center - Health Plans - Microsoft Connected Health Framework for Health Plans

Abstract

Microsoft’s Connected Health Framework for Health Plans is a is a free, open, and extensible reference architecture that enables partners and health plans to accelerate new business opportunities and meet complex and changing business demands  by reducing the cost and complexities of managing processes and connecting core systems, service channels, new applications, consumers, and business partners. The framework combines Microsoft’s comprehensive SOA offering with partner solutions and applications to provide Health Plans with tools, technologies, guidance, and reusable artifacts for building and maintaining SOA solutions.  These SOA solutions enable business users to streamline and optimize business processes to increase productivity, drive out costs and complexity, and promote organizational agility.

Click here to download the full White Paper and explore the concepts and components that make Microsoft’s Connected Health Framework for Health Plans a simplified and pragmatic approach to service-enabling the critical capabilities health plans need to accelerate new business opportunities and to respond quickly to changing business needs.  Following Microsoft’s Real World SOA approach, and interoperable by design, the Connected Health Framework extends the life of current application and legacy system investments by connecting people, information, processes, systems, and devices, regardless of the platform or the original programming language.  The Connected Health Framework is the next generation platform to support direct-to-consumer connections, delivery of actionable information within the context of existing workflow and digital lifestyles, and end-to-end collaboration with providers and business partners.

Executive Summary

Beyond their core business of underwriting health and paying claims, health plan organizations are under unprecedented pressure to 1) improve the health of their members, 2) improve quality of care and member experience, and 3) control rising medical costs.  The challenge that health plans face is that the attainment of these three key goals is underpinned by two core imperatives: 

1.    Quickly seize new business opportunities that create competitive advantage, enable new revenue streams, increase margins, incent and engage consumers to improve their health habits and self-manage their conditions, and support cross-organizational collaborative processes to promote a safer, more effective, and interconnected health care system.

2.    Reduce the cost and complexities of managing processes and connecting core systems, service  channels, consumers and business partners

To execute on these imperatives, the Health Plan’s IT organization must establish a standards-based means of integrating diverse systems and applications across a heterogeneous environment.  Microsoft’s solution to these imperatives begins with Microsoft’s Connected Health Framework for Health Plans (CHF).  The CHF is a Real World, service oriented architecture (SOA) solution that enables health plans to align their business goals and imperatives with the IT organization.  The CHF enables health plan IT organizations to quickly respond to changing business demands by reducing the complexities of managing processes and connecting core systems, service channels, new applications, consumers, and business partners.

Microsoft’s CHF takes a different, Real World, approach that quickly unlocks valuable IT resources from existing application silos and makes functionality broadly available to promote business process optimization and organizational agility.   The CHF employs SOA design and technology standards that have been proven to reduce application development and maintenance costs by 30 percent or more [1].  For example, Horizon Healthcare was able to reduce overall complexity, increase productivity by over 45% and reduce costs by 50% [2] using Microsoft’s platform.  Other technology standards and concepts employed by the CHF include web services, Software as a Service (SaaS), Business Process Management (BPM), composite applications, and Web 2.0.

The overall advantages that the CHF provides to Health Plans include:

-      Rapid gains in productivity and operational efficiency

-      Ecosystem wide collaboration, communication, workflow and compliance

-      Simplified identity management

-      Microsoft’s Consumer Engagement Reference Architecture, a stand-alone companion module to help health plans “go where consumers go” by supporting direct-to-consumer connectivity and personal interactions within the context of the consumer’s digital lifestyle, home and devices. 

The whitepaper offers guidance and practical next steps for Health Plans to get started quickly by successfully laying the foundation for a service oriented solution environment. It provides guidance and testimony on how SOA enables Health Plan IT organizations to leverage existing IT assets to respond to evolving business demands using a stable and predictable technical infrastructure. The whitepaper outlines Microsoft's recommended Real World "Middle Out" approach for building an SOA. Cases of Health Plan clients that have successfully followed this approach are exemplified throughout.  The whitepaper also identifies the core SOA components, architectural patterns, and artifacts available from Microsoft, and Microsoft partners, to help Microsoft health plan customers and partners quickly realize success with the Connected Health Framework for Health Plans.

Top of page