What the IT leaders at managed healthcare plans are doing in terms of optimizing their organizations’ IT reliability, scalability, and flexibility is an area that IT leaders at patient care organizations would be wise to keep an eye on. While there are some IT fundamentals that are different at provider organizations and health plans, there are a surprising number of areas of similarity and overlap. One of these has to do with the struggles on the parts of both health plan and provider leaders to create greater usability, reliability, and scale to support their efforts at population health management, including both population health risk assessment and care management; as well as the acceleration in the ingress of massive amounts of raw data these days, with data coming from everywhere and needing to be managed intelligently.
It is in that context that the executives at the Long Beach, California-based Molina Healthcare—whose main areas of coverage and focus are Medicaid managed care, Medicare Advantage plans, and the coverage of dual-eligibles (those eligible for both Medicare and Medicaid coverage), made a major infrastructure-related announcement last month. On Feb. 21, during the annual HIMSS Conference, executives at Molina Healthcare, which covers 4.2 million individuals and families across the United States and Puerto Rico, announced that they were working with the San Francisco-based Splunk, to improve their capabilities. As the Feb. 21 press release stated, “Splunk Inc. (NASDAQ: SPLK), provider of the leading software platform for real-time Operational Intelligence, today announced Molina Healthcare Inc. uses Splunk® IT Service Intelligence (Splunk ITSI) to help provide faster, more reliable healthcare services for its customers. The analytics capabilities and visualizations in Splunk ITSI enable Molina to streamline stakeholder communication across the organization. Molina’s leadership team uses the insights provided by ITSI to make data-driven decisions about its IT services infrastructure, ensuring prioritization of innovative solution delivery and resulting in a reduction of IT incidents by 500 percent and mean time to resolution by 150 percent.”
The press release quoted Ben Gordon, Molina Healthcare’s vice president of enterprise infrastructure services, as stating that, “With Splunk ITSI, our IT team now effortlessly helps our members receive access to more customized services to better meet their health care needs. We can do this by quickly troubleshooting and collaborating to analyze actionable data that is easily visualized, classified and applied back to our members. The health care industry has experienced an explosion of data,” Gordon emphasized. “With the powerful analytics built into Splunk ITSI, we have more insight than ever before into our members’ preferences. Splunk ITSI helps simplify the way we run the organization.”
The press release went on to note that “Service outages and performance issues in health care have a significant negative impact on customer experience, service delivery and patient satisfaction. Molina Healthcare’s legacy monitoring tools lacked the capabilities to effectively monitor and troubleshoot its critical services, resulting in the team having to spend valuable time and resources dealing with issues. Molina Healthcare uses the innovative Glass Table feature in Splunk ITSI to visualize the flow of key business processes including user interactions as well as the real-time performance and health of critical systems. The Glass Table visualizations provide a custom view of Molina Healthcare’s business processes and IT infrastructure mapped to enterprise critical KPIs, enabling employees around the company to share the same view and use the same vocabulary for IT management and troubleshooting.”
Last month, Gordon, who leads a team of about 250 IT professionals, spoke with Healthcare Informatics Editor-in-Chief Mark Hagland about this set of innovations, and its implications for healthcare IT more broadly. Below are excerpts from that interview.
Tell me a bit about what led you and your colleagues to purchase a commercial solution in order to help you ramp up on your core infrastructure and analytics capabilities going forward?
We’ve been growing rapidly for the last four or five years, and with that rapid growth, we’ve been trying to keep up with the business, and part of the strategy is to modernize our infrastructure, and put the right tools and strategy in place that allows us to scale. So we’ve built a metrics aggregation platform, where we’re talking all the tools we use to monitor all our technologies, and aggregate it into a central repository, and we use that repository to monitor how things are behaving and performing. Splunk was chosen to be that aggregator: it pulls in tools, and we’re building in end-to-end views of our services, such as member claims. It really helps with our operations center in terms of those resources understanding what’s important, and cuts down on the mean times to resolving the issues that pop up, as they pop up. Since Splunk has come in, they’re reduced dramatically the number of IT incidents.
How do you define IT “incidents”?
An IT incident is something that is either not behaving properly or has an issue. It’s alerting or alarming that something that needs to be addressed.
And that can refer to any kind of IT issue?
Yes, that’s correct?
Is this connected to data analytics?
It is. The platform views analytics. It isn’t being used for patient outcomes or insights at the moment. Think of the platform as, regardless of what you’re doing from a business standpoint, all of the applications and systems have to run properly to be able to provide those services. Splunk is providing the visibility and transparency into those systems, and allowing the teams to respond more rapidly, and be able to clear out the noise, and really focus on the optimal things, on things that matter.
What has been the single biggest challenge in optimizing your systems?
Systems are becoming more complex every day. We collect over 64 billion data points a month from all of our systems; it can really be overwhelming for our technology teams. So the challenge is figuring out what matters. So having a system like Splunk can help you filter out the noise from the important things—especially in this day and age of distributed systems, using the cloud and distributed architectures, you have to have systems like this to help you filter out the noise.
What kinds of qualities and characteristics were you looking for from a prospective vendor partner in this area?
Ease of integration with other tool sets and technologies is absolutely essential. Splunk is very easy to integrate; they have a robust user community, almost like an Apple store. People post widgets and things all the time. Also, the tool itself is very smart. In traditional tools, there’s a tremendous amount of configuration that you have to have in house. We wanted to adopt the next generation of tools, that don’t require the same amount of configuration to run them effectively. That’s what’s most important. We didn’t want to have to hire a bunch of people to manage our tools; we wanted the tools to do the work.
What should provider IT people understand about engaging in this kind of work?
It’s all about patient care and member outcomes, regardless of whether you’re a payer or provider. So making sure that the technologies across healthcare, the administrators and other folks helping members having good experiences with tools, that they’re always up and stable and performing well.
So the performance of your systems speaks to the quality of consumer experience that you can provide, then?
Yes, absolutely, there’s a cascading effect, in that regard Imagine if someone couldn’t send an email, or the technology were slow. The experience is a bad one, and the member suffers, or they go somewhere else.
What commonalities or differences might there be around scale, between health plans and providers?
Well, we’re certainly larger than a provider, but regardless of the scale, the technology is the same, regardless of the magnitude. The concepts, problems, and issues are the same. So tools like this can start small and scale up. This isn’t something applicable only to an extremely large set of data. It’s really about the tools to manage your data.
What data governance lessons have you and your colleagues learned so far, in all this?
One of the biggest things that’s come out of this exercise—most shops have an operations center that responds to issues and keeps systems running. When you’re hiring new people and bringing them in, there’s a learning curve. But you can build visual representations in Splunk. So if I say to you as a new staffer, go work on claims, you have to figure that out, and it can be very confusing. What we’ve built in Spelunk with the help for the network administrators and developers, we’ve built a visual view of claims, and it shows you the entire service, the flow of a claim. And imagine if you’re a new staff member here in IT, you can get a general view of how the claims process works, and that’s worth its weight in gold. And the mean time to resolving an IT issue has gone down. And regardless of whether you’re a provider or a payer, your operations center is such a key place in the organization. And data visualization has helped tremendously. New guys come in, and they can see how things work, and that’s big.
So the data visualization aspect of this is huge, then?
Yes, it absolutely is. And the real-time reporting. You can find out where a fax went that was sent from a doctor’s office, we can go in and find out where something a process, is.
Where is all this headed, do you think?
My personal feeling is that this is all about information in healthcare now. I think you’ll see more adoption of the cloud and third-party services. And that actually makes tracking of data and processes even harder. So I think you’ll see the tools becoming more intelligent, and there will be fewer of them. So tools like Splunk, data aggregation tools, will become more important. And there’s a lot of analyzing of patient outcomes, but are they really looking at processes form end to end? So instead of just looking at claims and outcomes, we’ll all be looking more and more at the entire process, and at the member experience as well.
Do you have any explicit advice, based on what we’ve talked about, for our readers, especially for CIOs, CMIOs, and CTOs in patient care organizations?
I would just say, for folks who are adopting the tool, that getting the involvement and collaboration across all tiers of IT as you work to visualize data and process, is critical. When we built these visual views, we had the developers, all the infrastructure people, too, in the room at the same time. So it really helped to have the developers and infrastructure people together. And in dev ops—developmental operations—a movement that’s been going on for speed of delivery and agile operations, dev ops bring the infrastructure guys c loser to the development cycles and have them work hand in hand together—that’s a key piece of this. In my past, you always had developers who had a view of their applications, and the infrastructure guys had their view, and you never had a common understanding. Now you have a common language now.
There’s a potential for acceleration of the optimization of systems, then, right?
Yes, that’s right. There really is great potential here going forward.