If you want a tip on selecting technologies that will enable your company to achieve its business goals, here's a good one from Stephen Wiggins, CIO of Blue Cross Blue Shield of South Carolina: Don't chase it. Let the business tell you what to do."We do not develop technology for technology's sake here," Wiggins says. "Our basic philosophy is leverage what you have. As long as what you have is flexible enough to meet your business needs, then build on it-because it retains knowledge from the past."
Following this fundamental strategy, the Columbia, S.C.-based health insurance company developed an award-winning Web site that enables providers, agents and employers to access real-time information-such as eligibility, claims status, referrals, authorizations, rates and more-from the carrier's legacy systems.
Operating since late 1999, www.SouthCaroliaBlues.com has garnered a growing user population and seven national awards-including one from the Chicago-based Blue Cross Blue Shield Association for a "Best of Blues" award for electronic media and interactive programs.
As of June, 24,000 of BCBSSC's 1.3 million members in South Carolina, along with nearly 5,000 providers, had registered on the "My Insurance Manager" portion of the site-where the secure, real-time transactions occur. And although the Web site is being hailed as exemplary in the industry, Wiggins shuns the role of visionary, claiming that common business sense drove the largest health insurer in South Carolina to the Internet.
"A lot of people talked about the New Economy, or the e-economy or the dot- com economy, and we didn't know what that was," he says. "We just knew there was this additional channel that people were beginning to use, and we needed to be there for them."
Despite his pragmatic approach, Wiggins does have the ability to imagine the possibilities for information technology. "There are not a lot of people in technology who see the big picture anymore," he says. "It's very specialized. It's hard to see how it all hooks together."
At BCBSSC, it will all hook together with a single user interface across the organization, from the front office to the back office, according to Wiggins.
"The goal we have now is for everything we do to be 100% self-service," he says. "The customer comes in and is able to do everything they need to do without talking to a person. But that's just a goal," he admits. "We know we will never achieve that."
For those customers who require full-service assistance, BCBSSC's customer service representatives are equipped with an intuitive platform that's integrated with the same back-office systems customers access through the self- service Web site.
With computer-telephony integration technology coming this month, CSRs' desktops will automatically display pertinent data about a customer who has been routed to them via the phone system.
"What's significant about our system is there is one common database where a record is kept of every interaction with a customer, whether it is through the phone, the Web site or a CSR," Wiggins says.
At times, CSRs also need to consult with people throughout the organization- in claims, managed care, provider maintenance, billing or membership-for what Wiggins calls "deep help." For that to occur, the back office needs to have the same intuitive interface that customers and customer service representatives have, he says.
Finally, Wiggins describes what he calls "E2B-employee-to-business" technology-the method by which BCBSSC plans to integrate its platforms with platforms of the future.
"We're developing a portal called 'My E-Work,'" he explains. "It's a single Web page for our employees to do all their work through the browser, and it will interface with all our systems and everything else that may be available through the Internet."
By the end of the year, My E-Work will be deployed with limited functionality, such as e-mail and human resources capabilities, to all employees. Additional capabilities will be rolled out as they become available.
"My E-Work will be the launching pad that we will continue to refine for the employees-in the same way we refine (the Web site) for our different constituents who are customers," Wiggins says.
Currently, only a handful of Wiggins' 1,000-person IT staff are developing the user interface for My E-Work. They're utilizing the same tools the company used to develop the corporate Web site-specifically, ClientSoft's WebPack, a screen-scraping technology that captures data from the OS/390 CICS Sysplex mainframe, and OpenNetwork Technologies' DirectorySmart, a role-based Web security platform.
"We wrote very few new transactions for the Web site," Wiggins says. "We're really leveraging our existing transactions-the same ones the customer service representatives use. Our philosophy is: We've already written the applications over many years. This is just a channel."
A fortunate decision
BCBSSC is also leveraging its claims system, which handles 200 million claims per year. Unlike many other health insurers in the industry that built separate systems for different claims, BCBSSC made the decision when it developed the system 20 years ago to build a single, file-driven system that could process all types of claims.
Although the original claims system has been modified significantly over the years, its basic design turned out to be a good one when the Internet emerged and BCBSSC decided to offer customer self-service transactional capability via its Web site. "We're doing what we do more easily than others because we're just interfacing our big engine into the Internet, whereas many other businesses run many systems," Wiggins says.
In addition to making it easier to provide real-time data online, Wiggins believes that the broad functionality of BCBSSC's claims system has enabled the company to adapt more easily than competitors to changes in the military TRICARE business-as it evolved over the years from a simple, single contract to a multi- benefit, multi-structured program.
To illustrate his point, Wiggins notes that at least 25 companies processed CHAMPUS/TRICARE claims back in the early 1980s when BCBSSC first entered the business. Today, as a subcontractor, BCBSSC processes 82% of that business-with only one competitor.
As effortless as BCBSSC's technology decisions appear in hindsight, choosing technologies that can be so well leveraged in the future isn't easy.
"Let's face it. The promise of technology is a wonderful thing," Wiggins says. "And as a technologist, I'm always faced with: 'Oh, don't worry, it will all be integrated with a simple push of a button.'
"But, in reality, that isn't true," he says. "The easier we try to make it, the more complex it is."
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