The medical scheme, Medihelp, has installed a sophisticated data warehousing solution that will also form the foundation of its customer relationship management initiative (CRM). Set to roll out in the second half of 2000, the system will mainly be supporting Medihelp`s managed care, product development, financial and marketing functions.
Established in 1905, Medihelp processes more than one million claims, 90 000 telephone calls and pays out in excess of R200 million per month to providers of health care services. Medihelp is one of the five largest medical schemes in South Africa today. "We had to refocus our strategy and operations since we privatised in 1994. We rewrote all our core systems in 1997 and implemented them in 1999," says Anton Rijnen, General Manager of Medihelp.
Traditionally the OLTP system runs on a mainframe, where claim and membership details are captured and processed. "As the scope of the enterprise grew, it became clearer that the large volume of transactions required a powerful data warehouse solution," says Rijnen.
Bearing in mind the demands of a CRM campaign, Medihelp opted for a complete data warehousing solution provided by JSE-listed Datacentrix.
"The package consisted of an HP multi-processor with eight processors, combined with a Microsoft NT and SQL enterprise solution. In addition to this, Medihelp uses the Cognos toolset for the warehousing application," explains Datacentrix marketing director, Klaas Lammers.
"For Datacentrix, the provision of the entire solution - from hardware to software - is significant because it shows that we are able to provide a complete integrated hardware and software package, tailored to the requirements of individual customers," Lammers says.
"A major factor in Medihelp`s decision was the need to move towards open systems", says Rijnen.
"Cognos is compatible with all other Microsoft products and provides the functionality of a full data mining query tool," he continues. "All in all, the whole system provides great scoping potential. The platform and infrastructure we have established can accommodate other applications should the need arise".
Medihelp now has a more efficient system to track the treatment members receive and ensure that the best treatment is provided at the most cost-efficient rate. Rijnen says "The system also enables us to engage in efficient medicine management where we can ensure that our members are getting the right medicines and that, where applicable, they are getting cost-efficient generics. We can now measure disease management from the medicine usage side, which can result in a host of cost savings."
Greater effectiveness in the administration of a medical scheme directly affects the members, as inflated running costs will immediately affect members` premiums. "The new system also assists us in managing hospitalisation more efficiently," continues Rijnen. "
On the marketing side, the benefits are also enormous. "In order for Medihelp to offer consumers the desired products and benefits, we need insight into our members` usage patterns to determine what benefits on services are required and how often. Usage patterns are easily extracted from the data warehouse and assist in determining areas where savings can be effected.
"We are confident that our new system will assist us in ensuring good client relations, increased responsiveness to client needs and market-oriented benefit options", says Rijnen.
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