Perficient is at the forefront of managing and developing applications for numerous clients in the healthcare sector. This article focuses on pharmacy benefits management (PBM) organizations, including:
- Challenges faced by PBMs
- Value PBMs provide
- How Perficient leverages its talent pool of business analysts, developers, architects, and process managers to provide technical solutions to address industry needs
PBMs collaborate with various government entities, employers, and insurance companies to manage, administer, and execute prescription drug benefits within health plans. Their primary goal is to optimize the management of prescription drugs, bring in cost efficiency, and pass the benefit downstream to the end-users, the patients.
We are currently supporting a prominent PBM that manages prescription benefits for millions of individuals across various segments.
Complex, Vast Volumes of Data Pose Major Challenges
Challenge: Managing complex data
Collating data from disparate sources like pharmacy systems, healthcare providers, insurance claims, patient records, and clinical trials is a formidable task. Integrating such diverse data requires robust systems to maintain its accuracy, completeness and consistency.
Challenge: Gathering meaningful insights
To get insights from such vast and diverse data sets, an appropriate analytical tool is essential. Ensuring that crisp information reaches the users is of utmost importance.
Challenge: Scaling to support the business
As the volume of data grows, the systems have to handle & manage the data without compromising on performance.
Challenge: Satisfying regulatory requirements
Healthcare must comply with various laws and regulations, for example, HIPAA, which makes it essential that the systems, vendors, and processes managing the sensitive data are also compliant.
Overcoming Challenges With AWS ETL Services
AWS extract, transform, and load (ETL) services offer powerful solutions to tackle such challenges. Let us walk through the challenges and services in brief.
Solution: Managing complex data
- Unified data cataloging: For the disparate sources, AWS Glue Crawlers creates a searchable catalog of datasets, tables, and their associated schemas. This helps in organizing the data in a logical structure and provides data access controls.
- Organized data storage: AWS S3 (simple storage service) stores the structured, unstructured, or semi-structured data. The data is organized and stored based on source, date, or some relevant criteria. S3 provides availability, security, and scalability, all of which come at a significantly low cost.
- Transformation using PySpark: Employing PySpark within AWS Glue jobs helps in creating transformations to clean, enrich, and customize data as required. PySpark helps in performing fast distributed transformations on large data sets. AWS DMS (data migration service) also facilitates moving data into Redshift with ease.
- Automated ETL trigger: AWS EventBridge triggers the AWS Lambda based on events, which in turn initiates a job. This ensures timely processing of data and avoids manual errors.
Solution: Gathering meaningful insights
- Data analytics: Amazon Redshift stores the enriched data, which facilitates high-performance analytics and querying. Various analytical tools like AWS QuickSight connect to Redshift to bring out user insights.
Solution: Scaling to support the business
- Scalability: AWS provides EC2 instances that can be scaled up or down. Elastic load balancing (ELB) ensures dynamic scaling to manage varying levels of traffic, enhancing app availability. AWS Lambda provides serverless computing & scales based on the number of requests. Amazon Redshift supports on-demand scaling to enhance performance, storage, and computing.
- Performance monitoring on the cloud: AWS CloudWatch serves as a vigilant monitoring tool that provides alarms and logs for tracking and analysis of ETL job performance metrics, ensuring efficient and optimized workflows.
Solution: Satisfying regulatory requirements
- Regulatory compliance: AWS provides security features, encryption & access controls, audit and monitoring tools, and physical and environmental controls. Such AWS features, in combination with policies & procedures followed at Perficient, ensure strict adherence to the regulatory framework of the healthcare sector.
Perficient + Healthcare Data
Our diverse, global team of experts deliver crucial skillsets to support our clients’ success. This ensures seamless implementations, enhanced data integrations for efficient management of crucial information, continuous optimization of code, flexible scalability based on business needs, cost optimizations, and improved processes around planning and implementation, ultimately empowering the PBM organization with better data insights.
- Discovery process
- Crafting robust data models
- Creating design and defining architectures
- Developing AWS data pipelines & infrastructure on AWS
- Generating BI reports for comprehensive reporting
- Efficient testing of the pipelines
- Automated deployment methods
- Process teams that follow Agile methodology
Explore our AWS and healthcare expertise. Or contact us to discuss your specific business data needs.
