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COLLABORATIVE HEALTHCARE
SUMMIT 2012
Transforming Healthcare –
The Future is Now!
Wednesday | October 24, 2012 | Boston, MA
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COLLABORATIVE HEALTHCARE
SUMMIT 2012
How Leading Organizations
Optimize the Customer Experience
and Automate Operations
Alan Trefler
CEO and Founder
October 24, 2012
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Unsustainable
Cost Increases
Benefit - Shifting
Models
Government
Regulations
Consumers
More Educated
Customers More
Demanding
Healthcare
Reform
Aging Population
New Payment
Models
New Delivery
Models
Social Media
Legacy System
Limitations
Tough Economy
Tsunami of Changes in Healthcare
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RAISED CUSTOMER SATISFACTION 40%
SAVED $25M & IMPROVED CUSTOMER SATISFACTION
RETAINED ADDITIONAL 4% OF MOST VALUABLE CUSTOMERS
IMPROVED SERVICE LEVELS TO INCREASE CUSTOMER LOYALTY
Optimize Customer Experience
Automate Operations
DRAMATICALLY IMPROVED SUPPLY CHAIN EFFICIENCY
CONSOLIDATED FIVE CALL CENTERS INTO ONE
CREATED ONE CLAIMS PROCESS AROUND THE GLOBE
ENABLED AGILE ENTERPRISE ORDER ORCHESTRATION
STREAMLINED ACCOUNT OPENING AND ON-BOARDING
DOUBLED MARKET SHARE IN ONE YEAR
ENABLED MULTI-CHANNEL CROSS-SELL, UP-SELL
ENROLLED 1 MILLION CITIZENS IN 6 MONTHS
DRIVE REVENUE
30% REVENUE GROWTH
ENHANCE EFFICIENCY
40% PRODUCTIVITY GAIN
ENGAGE CUSTOMERS
5 POINT RETENTION
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360°
Who Why/What When/Where/How
Intent Data Process + +
360° 360°
Automate Operations
Optimize Customer Experience
1080° 720° High Definition
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SERVICE ORIENTED ARCHITECTURE (SOA) LEGACY
APPLICATIONS Infrastructure (App Server, Database, etc.)
Execution Gaps
“Make it easy!” “Meet my needs” “Understand me”
Oriented ArchitectureTM (COA)
EFFICIENCY
CROSS-SILO
CROSS-CHANNEL
Customer
Archaic
Development
Chaotic
Processes
Ineffective
Systems
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Directly Capture Objectives Empower Change & Collaboration
Familiar business metaphors accessed through a web browser
Easy forms guide & protect users
Working models replace paper specs & requirements
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SERVICE ORIENTED ARCHITECTURE (SOA) Infrastructure (App Server, Database, etc.)
Execution Gaps
Archaic
Development
Chaotic
Processes
Ineffective
Systems
Customer Oriented ArchitectureTM (COA)
DIRECTLY CAPTURE
OBJECTIVES
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CROSS-SILO
CROSS-CHANNEL
EFFICIENCY
LEGACY
APPLICATIONS
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Request Modify care programs to cover more visits
in New York for Commercial Members Modify care programs to cover more visits
in New York
for Commercial Members
Situational Layer Cake Align Customer and Business Intent
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SERVICE ORIENTED ARCHITECTURE (SOA) Infrastructure (App Server, Database, etc.)
Execution Gaps
Archaic
Development
Chaotic
Processes
Ineffective
Systems
Customer Oriented
DIRECTLY CAPTURE
OBJECTIVES
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LEGACY
APPLICATIONS
SITUATIONAL
LAYER CAKE
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Architecture (COA)
CROSS-SILO
CROSS-CHANNEL
EFFICIENCY
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6R Case Automation Drive Work to Done
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Anticipatory Retrieval
Adaptive Analytics Open Database
Productivity & Quality Alerts
Model & Simulate
Priority
Cases & Folders
Skill Based Routing Tailored
Interactions
Next Best Action
Multi-Channel
Imaging
Web Services
Telephony System-Driven
Processing
Guided Processing
Automated Transactions
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SERVICE ORIENTED ARCHITECTURE (SOA) Infrastructure (App Server, Database, etc.)
Execution Gaps
Archaic
Development
Chaotic
Processes
Ineffective
Systems
Customer Oriented Architecture (COA)
6R CASE
AUTOMATION
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Anticipatory Retrieval
Adaptive Analytics Open Database
Productivity & Quality Alerts
Model & Simulate
Priority
Cases & Folders
Skill Based Routing
Tailored Interactions
Next Best Action
Multi-Channel
Imaging
W eb Services
Telephony
System-Driven Processing
Guided Processing
Automated Transactions
DIRECTLY CAPTURE
OBJECTIVES
1
SITUATIONAL
LAYER CAKE
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HEALTHCARE PROCESSES
CROSS-SILO
CROSS-CHANNEL
EFFICIENCY
LEGACY
APPLICATIONS
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1080°
Who Why/What When/Where/How
Intent Data Process + +
Automate Operations
Optimize Customer Experience
High Definition
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$100 MILLION IN SAVINGS AND 20 POINTS AHEAD OF INDUSTRY IN CUSTOMER SERVICE
“CHATS represents a major step forward…to boost
customer and member satisfaction and raise the service,
quality, affordability and work environment of Kaiser’s
contact centers.”
BUSINESS GOALS
FIRST CALL resolution rate
Improve operational efficiency to
enhance customer satisfaction and
reduce costs
Streamline workflow and provide user
guidance
Support real-time personalized
healthcare
Integrate and deliver critical
information to improve member
interaction
RESULTS
Trenita R. Ward
VP California Member Service, Call Centers
FOR HEALTHCARE CUSTOMER SERVICE
by J.D. Power and Forrester Research
90% 20% IMPROVEMENT in Call Handling Time
20% REDUCTION in training time $100M SAVINGS
#1
over 10 years
16 16 © 2012 Pegasystems Inc. COLLABORATIVE HEALTHCARE SUMMIT 2012
Leadership Through Client Success
Revenue in $M
Multiple patents and awards for software innovation
Growing global alliance partners network
Over 2,000 staff worldwide
$100 $126
$162
$212
$264
$337
$416
2005 2006 2007 2008 2009 2010 2011
6 YEARS OF
REVENUE GROWTH >25%
PEGA
PEGA
#1 IN BPM BY GARTNER AND FORRESTER
IN CASE MANAGEMENT
PEGA
#1 BY FORRESTER
PEGA PEGA
LEADER IN CRM BY GARTNER AND FORRESTER
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Execution Gaps
CASE MANAGEMENT
AUTOMATION
Real Business Value in 90 Days Enablement & Partners Drive Fast Results
SERVICE ORIENTED ARCHITECTURE LEGACY
APPLICATIONS Infrastructure (App Server, Database, etc.)
EFFICIENCY
CROSS-SILO
CROSS-CHANNEL
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