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Sybase® Solutions for the Healthcare Industry

Sybase technology enables healthcare organizations to manage, analyze, and mobilize data more effectively, resulting in greater efficiencies,

collaboration, and improved quality of care.

oVerVieWHealthcare organizations are under heavy pressure from both consumers and government to control

escalating healthcare costs, reduce the ranks of the uninsured, improve quality of care and support innovative clinical research. Meaningful improvements in healthcare efficiency and quality will rely heavily on technologies that can improve the flow, availability, as well as the integration and interpretation of structured and unstructured data, across the continuum of care.

Manage. Sybase is making it more feasible for health plans and providers to consolidate and analyze large amounts of data to speed research, improve care and reduce costs.

analyze. Changes in the amounts and types of data healthcare organizations rely on are already underway. It’s not enough anymore to understand what has taken place in the past; in order to stay competitive, organizations need to be able to predict what will occur. Predictive analytics involves the extensive use of data mining, statistical analysis, forecasting, predictive modeling, and optimization techniques to drive your strategic and operational decisions and actions.

MobIlIze. Sybase is enabling healthcare organizations worldwide to mobilize information at the point of care, secure access to clinical data and accelerate innovation and research. We enable real-time eligibility verification at admission, and give clinicians and physicians secure access to patients’ clinical information via the Web.

our technology solutions make it possible for healthcare organizations to plan for the future, improve collaboration with industry partners, streamline business processes, and improve the bottom line. by delivering enhancements such as improved decision support for medical personnel via systems integration, Sybase solutions can also increase customer satisfaction with providers and payers.

AnAlYZinG inForMAtion For sMArter DecisionsValidating coverage and processing claims is complex. Payer organizations need solid, scalable solutions

that will give them an advantage over their competition while at the same time, enable them to maintain strong relationships with their healthcare partners. Sybase solutions for healthcare payers and managed care companies focus on providing more comprehensive and accurate enterprise reporting and analytics.

Our high performance analytics solutions provide payers with ease and flexibility in analyzing claims and other medical and personal data to improve utilization, develop new services, eliminate waste and prevent fraud. While traditional business intelligence systems deal with data access and reporting and help answer questions such as what happened, what exactly is the problem, and what actions are needed; Sybase’s predictive analytics capabilities go further, enabling you to understand why events are happening, predict what will happen next, and identify the most optimal course of action.

aoK Hessen — accelerating insight into data patternsWhat are the typical evolutionary patterns of certain diseases? Which therapies are most successful to avoid

inpatient treatment? Are there any billing peculiarities, such as unusual ratios of diagnoses to prescriptions? These were the questions that AOK Hessen — the largest statutory health insurance company of the German state of Hesse, responsible for 1.6 million insured individuals — needed to find the answers to.

To obtain truly meaningful insight, it was necessary to consider all existing information simultaneously. This meant that data on medication and outpatient care had to be compared with other benefit-related data (such as hospitalization) in a single analysis. As a result of this broad-ranging view, the data volumes involved are extremely large.

Andreas Seibert, head of the IT-Business department, describes how this affected the users, “For each individual analytical query, our divisions had to submit a formal request to our IT department and then wait for IT to deliver the report. In addition, the operational OLTP database often took an extremely long time to run a query and return the results. We wanted to enable our divisional users to run queries by themselves and customize those queries as necessary. To accomplish this, we needed a system that was easy to understand, flexible, and above all, very fast.”

By probing its voluminous data assets covering treatment protocols and invoices submitted by doctors, hospitals, pharmacists and other partners, a health insurance company can gain valuable insight. AOK Hessen therefore decided to establish a centralized data warehouse and deploy an ETL process to load it with data from various operational systems. Two years ago, AOK Hessen generated a profit of USD $136 million. The insurance company attributes this result to its commitment to a strong membership and performance management strategy.

Sybase IQ was part of their strategy. Hessen implemented Sybase IQ, integrated with Sybase partner Qyte’s RayQ data mining tool. As a result, AOK Hessen created the first analytical data warehouse on the market capable of running direct, end-user initiated artificial intelligence (AI) evaluations.

“Sybase’s predictive analytics

capabilities go further, enabling

you to understand why events

are happening, predict what will

happen next, and identify the

most optimal course of action.”

ANALYZE

“Our ability to provide the most comprehensive and reliable business solutions to our clients relies on constantly

evolving new and innovative technologies to enhance our operational efficiency. The rapid growth of our business

has seen claims records grow nearly 500 percent in five years, and our ability to manage this burgeoning data

effectively and drill down into it for greater business insight links directly to risk management, cost containment

and the enhanced quality of service we provide our clients. Sybase is the bedrock of our data management

capabilities and an important contributor to our business success.”

– Pierre Robertson, head of decision support systems at MHG

garvan Institute — using data to improve patient care and reduce costsTo maintain its standing as an internationally-recognized leader in gene-based medical research, Garvan

Institute needed to generate detailed reports that merge lab research with information on patients suffering from a variety of diseases such as cancer, diabetes and osteoporosis. The institute also needed an information architecture that would allow researchers to easily query databases — providing data for published journal articles. To solve the challenge, Garvan Institute turned to Sybase Adaptive Server® Enterprise 15 (ASE), serving as a reliable platform for more than 30 separate databases. Garvan researchers now easily build research reports from ASE-generated data to author journal articles with information that helps relieve human suffering and improve quality of life.

MIQS — improving patient-treatment accuracy and efficiencyFounded in 1990, MIQS is the premier provider of electronic medical record and financial management

software for kidney dialysis and offers the only integrated, patient-centric, unified clinical and financial software solution. MIQS relies on Sybase ASE as the database platform for Disease Manager Plus, a healthcare information-management solution serving healthcare service providers and payers that manage costly chronic illnesses over time. Primarily used to manage patients with end-stage renal disease requiring dialysis, the solution unifies daily activities by combining electronic medical records, practice management, and decision-support functions within a completely integrated and analyzable application infrastructure. Using Sybase ASE, MIQS has improved patient-treatment accuracy and efficiency while also improving healthcare billing processes and simplifying regulatory compliance.

Metropolitan Health group — reducing risk and containing costsWhen Metropolitan Health Group (MHG) learned its legacy database system was being discontinued, it

seized the opportunity to migrate its legacy applications and client information to Sybase ASE and Sybase IQ to enable it to continue serving its clients and meet its strict service level agreements.

MHG provides medical scheme administration and managed healthcare to more than 600,000 individuals covered by 21 medical schemes in South Africa. Their administrative services include management of membership information, medical claims processing (150,000 to 200,000 claims per day), premium management, marketing and communication, financial and actuarial services. They also include reporting on membership, financial and other trends to provide medical schemes with the business insights they require to maintain their viability.

To meet its analytic and reporting responsibilities to its clients and provide them with the insights they need to mitigate risk, understand healthcare utilization patterns and detect fraud, MHG implemented Sybase IQ to power a data warehouse. In addition, they needed to be mindful of the sensitivity of the information they process and the reliability of their IT systems. In particular, they have very strict service level agreements (SLAs) with their clients they must meet, as they are linked to financial penalties that may be levied against MHG should they fall short.

analytICS aCCelerator for

HealtHCare PayerS

faster reporting and In-Depth analytics

for your trizetto® facets® Platform

The payer industry is moving toward a new

model of healthcare, Integrated Healthcare

Management (IHM). TriZetto’s innovative

solutions in core administration, care

management and constituent engagement

are essential to the achievement of the

IHM model. Sybase and TriZetto have

been working together since 1993, when

the Facets Solution was designed around

the Sybase ASE database to power the

automation of payer’s core business

functions—over 60% of Facets customers

run their business on Sybase ASE today!

With the Sybase Analytics Accelerator for

Healthcare Payers solution, you can now

gain deeper and faster insight into your

claims and other operational data. By

accelerating and simplifying your analytics

capabilities, you can get a more refined

picture of the cost of care, detect subtle

but actionable changes in outcomes,

cost, and payment trends, and develop

the metrics needed to support pay-for-

performance initiatives.

This solution, provided in partnership with

Project Performance Corporation (PPC),

uses a unique high-performance analytics

engine to support complex queries and

reporting. It is designed specifically to

work with Facets and other common data

sources to give you a consolidated source

of data for up-to-the-moment analysis and

decision-making.

streAMlininG Processes to iMProVe eFFicienciesHealth systems, hospitals, clinical researchers and other care providers face the dual challenge of delivering

the highest quality of care while finding ways to operate as efficiently as possible to survive in today’s competitive healthcare climate. In fact, as providers automate more of their processes, many are finding that they need better tools for capturing, consolidating, analyzing and simplifying the movement of information. Sybase understands these issues and offers multi-functional technology solutions that enable providers to maximize their investment and streamline their workflow.

bJC HealthCare — timely and accurate information at the point of careFor most healthcare organizations, providing clinicians with timely and accurate critical-care information is

a goal. For BJC Healthcare, it’s a reality.

BJC HealthCare is one of the largest nonprofit healthcare organizations in the United States. Through its 13 hospitals and multiple community health locations, it provides inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. For programs designed to ensure patient safety and maintain optimal standards of care, BJC HealthCare uses Sybase Adaptive Server Enterprise 15, Replication Server and Sybase Professional Services.

In particular, BJC HealthCare’s Medical Informatics division concentrates on improving health care by implementing innovative, effective information technology applications. The division’s mission is to improve care by “translating data into effective interventions.” Their data-driven expert systems assist clinicians and protect patients.

BJC pharmacy expert systems check for potentially dangerous drug combinations, verify that the proper laboratory tests associated with specific drugs are run at the right times, and monitor patient prescriptions to ensure patients with particular diagnoses receive the proper medications before being discharged. These expert systems have proven to be a very efficient and potentially life-saving framework. In 2008, these systems generated alerts to clinicians resulting in approximately 18 patient care interventions per day.

MAN

AGE

blueCross blueShield tennessee — improving efficienciesBlueCross BlueShield is a national system of 58 independent plans and the nation’s largest health insurer,

providing coverage to one out of every four Americans. When it came time for BlueCross BlueShield Tennessee (BCBST) to overhaul its business model and IT systems in an effort control skyrocketing health care costs, they turned to Sybase. Using Sybase technology, BCBST was able to increase claims processing throughput, improve cash flow, reduce training time, increase scalability and functionality, expand rapidly into the managed care business and quickly introduce and manage new product while experiencing these results:

• Increase in claims processing throughput by 25 percent • Handle two million members and process 25,000 claims per day • Provide ad hoc query responses up to 500 times faster

ISoH — single view of patient history ISOH is the largest oral health service provider in Australia. Before ISOH, access to public dental clinics in

New South Wales, Australia’s most populous state, was on a first-come, first-served basis, irrespective of clinical need or whose tooth ached the most. The paper-based system was ineffective, inefficient, and inconsistent.

Using Sybase technology, SQL Anywhere, PowerBuilder and PowerDesigner, ISOH was the first system in Australia to provide a single view of a patient’s oral health treatment history provided by any public health facility across NSW. The system allows telephone triage that geographically distant patients can access from their own homes. It’s possible with ISOH to search any appointment book anywhere, anytime to reserve an appointment. It’s also scalable to accommodate dental services from a small two-chair clinic to a large 200-plus-chair dental hospital.

leeds teaching Hospital nHS trust — comprehensive e-procurement The largest trust in the United Kingdom, providing acute services for the City of Leeds — needed to develop

an e-procurement system based on a common item catalog that would work with its existing purchasing and finance systems. Using Sybase technology, it developed a comprehensive e-procurement, management information and purchasing control system.

Employing more than 15,000 staff across eight sites and treating 125,000 inpatients, 65,000 day cases and 700,000 outpatients each year, Leeds Teaching Hospitals NHS Trust annual budget is more than USD $1 billion. Prior to this project, Leeds’ procurement environment was a tangle of inflexible, disconnected systems (some electronic, some manual), a vast number of suppliers, and centrally and locally negotiated contracts. In addition, Leeds had no catalog management capability.

The Sybase solution slashed the total cost per order by 92 percent, dramatically improved staff productivity, increased contract compliance and management, and provided better control over spending. Specifically, it:

• Lowered the total cost per order by 92 percent • Reduced time spent on supply issues from 20 percent to less than five percent • Improved contract compliance and management by 30 percent

ADDressinG coMPliAnce, noW AnD in the FutureAs you prepare your organization to succeed in the next phase of the healthcare industry, it’s important

that you choose a technology solution that’s truly open, and a partner who’s both committed to the changing world of HIPAA requirements and thoroughly experienced in business process integration.

Sybase excels in these areas and is uniquely qualified to help you transition smoothly from your current position to full HIPAA compliance and full business process integration. Our HIPAA transaction tools are easy to use and platform independent. They greatly reduce the time needed for data integration efforts, enabling you to focus less on “getting to the data” and more on strategically using the data to improve business performance.

"Using Sybase technology,

BlueCross BlueShield

Tennessee was able to

increase claims processing

throughput, improve cash

flow, reduce training

time, increase scalability

and functionality, expand

rapidly into the managed

care business and quickly

introduce and manage

new product…"

By combining HIPAA-compliance efforts with steps to integrate all of your business processes and communicate better with your trading partners, your healthcare organization will become more competitive. Sybase believes that the healthcare market leaders of tomorrow will be those with streamlined, end-to-end, processes integrated with their trading partners. Sybase offers solutions to:

• Migrate HIPAA based transactions from the 4010 standard to the 5010 standard and utilize concurrent 4010 and 5010 processing to reduce processing and maintenance overhead

• Enable healthcare payers to comply with HIPAA regulations and CMS mandates while providing fully-featured EDI translation tailored to your company’s internal processing requirements

• Address HIPAA regulations and Centers for Medicare and Medicaid Services (CMS) mandates for providers

MobiliZinG cAreIt is no surprise that the healthcare industry has rapidly and enthusiastically adopted mobile technology.

This is an industry that, while steeped in tradition, is driven by discovery and innovation. Healthcare professionals are routinely and increasingly using mobile devices to access and review patient records and test results, enter diagnosis and billing information during patient visits, consult drug formularies and other reference material, and synchronize information with their organizations’ centralized systems, all without the need for wired network connections.

Gartner has placed Sybase in the Leaders Quadrant of their Magic Quadrant for Mobile Enterprise Application Platforms1. Sybase’s mobility platform addresses the converging IT requirements of healthcare organizations today. By combining application development tools, mobile device management and security, and email/messaging, the Sybase Unwired Platform enables healthcare organizations to empower caregivers to work anywhere, at anytime, on any device.

Backed by more than 20 years of expertise, Sybase technology has been selected by 81 Fortune 100 companies to solve mobile, distributed and remote enterprise computing challenges. Our mobile technology solutions can enable caregivers to review patient records, see test results in real-time, access drug formularies from anywhere, or enter data during homecare visits. Sybase’s mobility platform provides the core integration, synchronization, messaging and mobile data management capabilities required to exchange information between caregivers and enterprise systems, enabling better decision making, improved efficiency and ultimately better care. SQL Anywhere provides data management and exchange technologies designed for database-powered applications that operate in frontline environments without onsite IT support. It offers enterprise-caliber features in a database that is easily embedded and widely deployed in server, desktop, remote office and mobile applications.

“Sybase believes that the

healthcare market leaders of

tomorrow will be those with

streamlined, end-to-end,

processes integrated with

their trading partners.”

SybaSe SolutIonS for MeDICal

DevICe IntegratIon

More and more, medical devices and

medical software vendors are being

driven to provide connectivity and

mobile solutions to their customers.

Sybase integration software provides

out-of-the-box solutions for medical

device connectivity and rapid

development of mobile applications

for software solutions including:

• EMR (Electronic Medical Records)

• HIS (Hospital Information System)

• LIS (Laboratory Information System)

• POL (Physician Outpatient Laboratory)

• PMS (Physician Management System)

Contact us to see how we can help make

the integration of your devices easier.

SybaSe IntegratIon oPtIonS for

Sybase is the exclusive partner

for Abbott’s Point of Care device

interfacing. Our open connectivity

platform together with Abbott’s

Precision Web data management

platform provides a vendor neutral

system for the management

and interfacing of point-of-care,

laboratory, and other connected

medical devices.

mobilize

1 Magic Quadrant for Mobile Enterprise Application Platforms, Publication Date: 16 December 2009, by William Clark and Michael J. King, ID Number: G00172728. The Magic Quadrant is copyrighted 2009 by Gartner, Inc. and is reused with permission. The Magic Quadrant is a graphical representation of a marketplace at and for a specific time period. It depicts Gartner’s analysis of how certain vendors measure against criteria for that marketplace, as defined by Gartner. Gartner does not endorse any vendor, product or service depicted in the Magic Quadrant, and does not advise technology users to select only those vendors placed in the “Leaders” quadrant. The Magic Quadrant is intended solely as a research tool, and is not meant to be a specific guide to action. Gartner disclaims all warranties, express or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

Point of Care Data Management System

Caremark — wireless prescriptions reduce errorsOf the three billion prescriptions filled every year in the United States, as many as 40 percent require

time-consuming rework and calls between pharmacists and physicians. Caremark needed to improve the efficiency and accuracy of prescription writing while overcoming the limitations of PC-based point-of-care systems. To accomplish this, Caremark created the iScribe Suite, an innovative handheld, wireless prescribing and formulary reference system powered by SQL Anywhere Studio. Thanks to this solution the vast majority of errors such as illegible handwriting can now be eliminated, medication errors have been reduced by 80% and doctors can spend more time with their patients.

Cerner beyondnow — mobilizing point-of-care in the homeFor over 26 years, Cerner has focused on developing healthcare information technology solutions. Cerner

BeyondNow helps to improve patient care by integrating all three facets of the homecare business: clinical activities, billing/financials, and management decisions. Cerner created a mobile point-of-care application based on SQL Anywhere to enable home healthcare providers to have access to patient charts, profiles and histories in order to make the most effective decisions, and to allow home healthcare organizations to reduce administrative paperwork and expedite third-party reimbursements.

ochsner Clinic foundation — eliminating backlog for test resultsOchsner Clinic Foundation, the largest private health care institution in Louisiana, needed a solution

that would help it overcome a persistent three-week backlog for cardiovascular test results. Using Sybase technology, Ochsner developed and deployed a mobile application that solves its backlog and generates more comprehensive reports in seconds.

Built with Sybase PowerBuilder, Ochsner’s Cardiovascular Information System (CVIS) allows clinicians to enter test and procedure results directly into a patient’s record — solving the problem with dictation, generating reports in seconds and eliminating the laboratory’s backlog. Clinicians are assisted by procedure-specific modules with decision-making intelligence, and information is immediately received by physicians wherever they are. Ochsner also uses Sybase PocketBuilder™ to deploy an “e-bill” application, and plans to use it to deploy CVIS to handheld devices.

• Saves $400,000 annually through more accurate billing • Reduces transcription costs by $60,000 per year • Tripled the cardiology business in seven years

Kindred Healthcare — replacing paper-based billing systemsKindred Healthcare, Inc. is a healthcare services company that through its subsidiaries operates hospitals,

nursing centers and a contract rehabilitation services business across the United States. The contract rehabilitation services business — Peoplefirst — is the nation’s second largest contract therapy company, employing over 8,000 individuals the majority of whom work directly with patients at over 600 locations across the country

In the course of a typical day, a therapist might work with 10 patients. Historically, the therapists (or a secretary) had to spend an hour at the end of each day at a desktop PC keying their handwritten patient treatment notes — patients seen, time spent with each patient, and other treatment related information — into the company’s centralized billing system.

This paper-based system created problems for Peoplefirst. The time spent keying information into the system was time that could have been better spent working with patients. Additionally, as with any paper-based system that requires re-entry into a computer system, errors were inevitable. This could cause problems with reimbursements from the healthcare facilities that are responsible for billing services to insurance companies and Medicare.

“The most important benefit

is that our mobile system

has eliminated the need for

therapists to spend hours

each week re-entering their

time-keeping and treatment

information into desktop

PCs for transmission to

our centralized systems.

This allows them to treat

more patients and/or spend

more time with each patient,

which is critical when your

focus is producing the best

possible clinical outcomes.”

– Keith Bickett, Project Manager,

Peoplefirst

To increase the productivity of its rehabilitation therapists, improve the accuracy of data required for billing and other business purposes, and generate the best possible patient outcomes, Peoplefirst rehabilitation replaced paper-based processes with a mobile application powered by Afaria from Sybase.

“Moving from paper to Point-of-Care-Mobile has produced important benefits for Peoplefirst and for our patients,” says Keith Bickett, Project Manager, Peoplefirst. “The most important benefit is that our mobile system has eliminated the need for therapists to spend hours each week re-entering their time-keeping and treatment information into desktop PCs for transmission to our centralized systems. This allows them to treat more patients and/or spend more time with each patient, which is critical when your focus is producing the best possible clinical outcomes.”

“In addition,” Bickett continues, “the information we capture now is more timely and accurate, which allows us to generate more accurate invoices and improve our cash flow. Management also benefits by being able to view information in near real-time, which allows them to optimize scheduling, monitor treatment plans and progress, and meet compliance requirements more efficiently and effectively.”

sYbAse brinGs A Full sPectruM oF suPPort AnD serVices to heAlthcAre orGAniZAtions With ProFessionAl serVices AnD eDucAtion serVices.

Sybase offers a full spectrum of support and services for our products. When it comes to Sybase products and understanding how to manage, analyze and mobilize information; Sybase’s professional services groups are the leaders. We offer a wide variety of services to match your technology and business requirements; looking at where you are today and where you want to go, and charting a course with our proven project management methods, and work that is compliant with our ISO 9001/TickIT-certified quality management system.

To further support the skills development of our customers, Sybase provides world-class learning solutions including: technology skills assessments, certification preparation and focused training. Our comprehensive, certification-based curricula are delivered by our Certified Sybase Instructors at your site, a conveniently located Learning Center, over the web using SyberLearning LIVE™, or through our anytime, anywhere SyberLearning OnDemand.™

Sybase’s rich 25-year history as a technology leader and innovator includes creating technology that powers the world’s most critical data in commerce, finance, government healthcare and defense — let us know how we can help you.

heAlthcAre unWireD

Manage anaLYZe MOBILIZe

• Consolidate data• Streamline operations• Enhance decision support• Regulatory compliance

– Sybase ASE, Replication Server, e-Biz Impact, EDI Server

• Report and analysis• Predictive analytics• Optimize utilization• Detect & prevent fraud

– Sybase IQ, Industry Warehouse Studio for Healthcare, Infomaker, PowerBuilder, PowerDesigner

• Electronic health delivery• Mobile access to clinical data• Real-time patient monitoring

– Afaria, PocketBuilder, SQL Anywhere, Sybase Unwired Platform

ContaCt InforMatIon

For Europe, Middle East, or Africa inquiries: +(31) 34 658 2999

For Asia-Pacific inquiries: +852 2506 8900 (Hong Kong)

For Latin America inquiries: +770 777 3131 (Atlanta, GA)

www.sybase.com

Sybase, Inc. Worldwide HeadquartersOne Sybase DriveDublin, CA 94568-7902U.S.A1 800 8 sybase

Copyright © 2010 Sybase, Inc. All rights reserved. Unpublished rights reserved under U.S. copyright laws. Sybase, the Sybase logo, Sybase Adaptive Server Enterprise, Sybase PocketBuilder, Sybase PowerBuilder, Sybase IQ, SyberLearning LIVE, and SyberLearning LIVE OnDemand are trademarks of Sybase, Inc. or its subsidiaries. All other trademarks are the property of their respective owners. ® indicates registration in the United States. Specifications are subject to change without notice. 04/10 L03269