HCL Healthcare: Meeting Reform Challenges Pradep Nair Senior Vice President Healthcare Practice pnair@hcl.com
Agenda Healthcare Industry: Drivers of Change HCL Healthcare Overview Healthcare Sub-Verticals Pharmaceuticals Payer Provider Success Stories Orlando Health, Inc. Merck & Co., Inc. 2
Healthcare Industry: Drivers of Change Continued Governmental Regulations and Reporting Requirements Business Owners, Stakeholders, Shareholders h Demand to Drive Out Costs Emerging Technologies Changing the Face of Customer Interaction Could Computing, Mobility, Social Media, SaaS etc. Demand for Real-Time Information EMRs, bio-information, personalized medicine, wellness, etc. Standards: One Language for All User Information as an asset 3
HCL Definition of Healthcare Industry Pharm maceutical Drug Discovery Drug Development Sales & Marketing Manufacturing Enterprise IT Analytics Core Adjudication Systems Compliance Sales Automation Lines of Businesses Clinical Management Payer Regulatory Compliance Foundational Clinical CRM Revenue Cycle HIE Provider 4
HCL Healthcare Growth Strategy 5
Excellence in Service Delivery through investments for the future The Business Analyst Academy Service Delivery Excellence A strong panel of Business Analysts and product specialists in the Healthcare Services domain, functions and technologies 1 2 3 Product Specialists in Drug Discovery, CMS, LIMS, Manufacturing, Sales & Marketing, ICD 9-10, EMR, HIE, Compliance, Meaningful Use Strong Domain and Functional knowledge across the Pharma, Payer, & Provider Landscape Deep Business, Technology and soft skills 6
Healthcare Partnerships Pharma Payer Provider 7
HCL Life Sciences: Select Customers Drug Discovery Merck & Co., Inc Pfizer, Inc. Drug Development Merck & Co., Inc Manufacturing & SCM IT Pfizer, Inc. Sales & Marketing Merck & Co. Distribution/ Enterprise IT Merck & Co., Inc 8
HCL Life Sciences: Investment in Domain Expertise Somnath Mukherjee Masters in Biotech and BioInformatics and Over 15 years experience in LIMS and Lab Automation Extensive experience in LIMS, ELN, SDMS, Interface Technologies, LIMS Analytics and Product Development Core Strength in Program Management and Offshoring Lab automation implementation Navaneeth Expert in Regulatory Compliance Pharmaceuticals 17 years of experience in multiple functional areas such as Quality Control, Quality Assurance, Regulatory Affairs & Analytical Research and Development of Pharmaceutical Industry. Dr. Gowri Balani Over 14 years experience in the Clinical Domain with an Ivy league Education Extensive experience in Clinical Research and Drug Safety and Domain Consulting for various Pharmaceutical and Technology companies. Core Strength in off shoring and outsourcing clinical and drug safety space Stuart Pyle 20+ years of Healthcare & Pharma experience and has held various leadership positions Leads HCL Pharma Analytical Services CoE Extensive functional knowledge of Clinical Trials, Drug Development, Medical Devices, Commercialization, Compliance & Validation spaces Lakshmipathi Raju 20+ of Pharma and IT experience Expertise include Software Design, Development and implementation in regulated environment, PoC in e- Submissions, e-lab notebook, LIMS support, validation of Infra, COTS, data migration Vijay Kumar Mallavarapu 16+ years of Pharmaceutical and IT experience Extensive experience in performing Computer System Validation and Equipment/Instrument validation Strong management skills of leading teams successfully in audits of USFDA/ MHRA Krishna Das SM 21 years of Pharmaceuticals experience in Sales & Marketing Previous experience include Astra Zeneca and Dr.Reddy s Labs Bachelor s degree in Life Sciences Deborah A. Cenci 19 years of Global Regulatory Affairs and Quality 15 years of Regulatory Submissions 14 years of Drug Safety Reporting & CRO Management. 12 years of experience in Research & Development to Commercial Launches 9
Life Sciences: Emerging Services & Customer Trends New offerings Regulatory Affairs and Compliance Officer Universal Content Manager LIMS Information Ontology for R&D e-pedigree Customer Interest in Drug Safety & Clinical Operations Multi Channel Marketing Discovery Services in China Cloud computing for SaS Mobile Technologies Expanded Partnerships and Alliances Deloitte and Booz Pistoia 10
HCL Payers & Providers: Select Customers 11
Payer: Investment in Domain Expertise Frank Balco Over 30 years of experience in running payer operations. Held various senior management positions including COO for BCBS. Recognized by the industry as a thought leader Mahesh Vijayaraghavan 18+ Years of experience in IT industry 6+ years of Healthcare IT experience Expert in creating CoE for Payer Products Played Key roles in Product Implementations, Program Management, IP and Solutions Development Sanjay Logabiraman 18 years of IT and Healthcare Payer experience MBA, PMP, Six Sigma Green Belt certified Managed Business Integrations related to M&A for UnitedHealth group (UHG) Heading the group that builds solutions for Payer business pain points Dr. Vishal Tahiliani Qualified Physician with 15 years of Healthcare (Clinical and IT) experience Member of IMA, MCGP and certified Healthcare Quality Auditor for NABH Accreditation Experience include Clinical Trials and large Healthcare IT application development and implementation projects Rajesh Krishnamurthy 1 years experience in the Healthcare Domain Certified HIPAA consultant with expertise in Healthcare Integration Standards: HIPAA, X12, HL7 Worked with large payers and clearing houses to implement innovative solutions for transaction processing Anirban Mukherjee 10+ Years of Payer IT industry experience Expertise in the operational areas for payers including claims administration Played key roles in solution development, competency building and business analysis Worked with leading payers including BCBS and regional health plans 12
Payer: Emerging Services & Customer Trends New offerings ICD 9 to 10 Transition: Migration & Testing Member Management from Quote to Card and change management control Automate Prescription Drug prior authorization and medical management processing to meet compliance mandates Provider Data Base Management HIPAA Partner Enablement Program Customer Interest in Pega solutions Independent Testing services PBM compliance related to prior authorizations of prescription drugs Reform: Open Enrollment, i.e. Quote to Card automation including application of Underwriting and early Risk Assessment rules Expanded Partnerships and Alliances Deloitte Alphapoint Foresight 13
HCL Provider: Investment in Domain Expertise Anil Kumar 25+ years in IT services and 16+ years in healthcare industry Deep domain knowledge in healthcare standards, regulations and business processes; product companies and providers to plan, select and implement their electronic health records (EHR) Mike Martinez 20 + years of IT executive management experience in acute care, specialty care, long term care and physician organizations Implementation experience with major HIT vendor applications (inpatient and outpatient) Focus areas: ICD-10, HIE, CPOE, and Meaningful Use Michelle Mercer 20+ years executive healthcare leadership in hospital, health plan and corporate settings Ground floor development for two start-up healthcare companies. Registered Nurse. Certified R.N. Coder. Focus areas: Quality Measures and Meaningful Use. Zena Jacobi 20+ years experience in the Healthcare Domain Expert in Healthcare Integration Standards: HIPAA, X12, HL7 Worked with large provider and standards organizations Dr. Varsha Mishra 7+ years of experience in healthcare provider industry Focusing Meaningful use of EMR, CPOE, & Quality measures Certified professional in Hospital Information System Extensive functional knowledge of hospital clinical workflows, EMR, Diagnostic Dr. Vinod Sanjay 14+ years of experience in the Healthcare Provider Industry with specialization in Clinical Systems, Laboratory Information Systems, HL7 integration and Health Intelligence Experience in Healthcare Product companies serving the US, UK, German and Australian markets 14
HCL Provider: Emerging Services and Customer Trends New Offerings Standards transformation and quality compliance Enterprise performance improvement (Quality improvements) Financial performance (top line and bottom line impact) Customer Interest In Federal mandates for standards transformations: 5010 EDI transformation ICD 10 conversion Quality compliance and reporting initiatives comprising: ARRA led MU incentive programs for EHR adoption, utilization and care measures Prospective payment systems across LOB and clinical settings under reform Sustained Quality impact beyond reform Quality based healthcare purchasing model Expanded Partnerships & Alliances Health Language Wellogic 15
Provider: Emerging Services Active Care Excellence - ACE Solutions Suite A set of solutions that improves 1. Standards transformation and quality compliance 2. Financial i performance (top line and bottom line impact) 3. Enterprise performance improvement (Quality improvements) ACE Standards Transformation Solutions ACE Management Solutions ACE Quality Compliance Solutions ACE Executive Intelligence Solutions ACE 5010 X Conversion ACE Organization Advisor ACE Quality Manager ACE Communicator ACE ICDX Toolset ACE Technology Advisor ACE Care Messenger ACE Provider Analytics 16