Metropolitan Health Group (MHG) provides medical scheme administration and managed healthcare to more than 600,000 individuals covered by 21 medical schemes in South Africa. Among MHG’s medical scheme clients are four of the country’s largest – the Government Employees Medical Scheme (GEMS), Bankmed, the Transmed Medical Fund and Polmed.
“Essentially,” explains Rod Russell, MHG’s Infrastructure Manager, “our clients outsource components of their medical claims processing and managed healthcare delivery to us. In doing so, both they and we are mindful of the sensitivity of the information we process as well as the need for accuracy and the reliability of our IT systems. In particular, we have very strict service level agreements (SLAs) with our clients that we must meet, as they are linked to financial penalties that may be levied against MHG should we fall short.”
MHG’s 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.
MHG also provides disease and wellness programs to medical scheme members. These programs, which focus on health risk and benefit management, include Hospital Benefit Management, Chronic Medicine Management, HIV/AIDS Management, Pharmaceutical Benefit Management, Dental, Optical and Pathology Benefit Management, Oncology Management and Maternity Management.
To deliver this multitude of services and meet its SLAs, MHG relied on its legacy data management system – consisting of an Image database running on an HP 3000 server. So, when HP announced the end of service for the HP 3000, MHG was understandably concerned.
Product End of Life Creates Critical Business Challenges
“The discontinuation of the HP 3000,” recalls Russell, “presented us with a number of challenges that we had to address quickly, transparently and successfully. Failure was absolutely not an option. If we had made the wrong technology choices there could have been disastrous results for both MHG and our clients.”
In addition to needing to move to a new hardware platform, MHG had to port and migrate its legacy applications and identify and implement a new relational data management system, as its Image database system was also no longer available.
“Our applications had been written in Cobol and Powerhouse and the Image database was a proprietary and outdated technology,” says John Everitt, MHG’s Database Manager. “So, while these developments created a number of immediate challenges for us, they also presented opportunities for us to make the move to the current generation of technology.”
Sybase Chosen for Performance, Reliability, Scalability and Low TCO
Having decided to stay with HP hardware, MHG’s IT team evaluated a number of data management systems and quickly produced a short list of candidates that included Oracle and Sybase. Additional research and evaluation led the company to select Sybase Adaptive Server Enterprise (ASE) as the operational data management system that best met its business-critical requirements. “Sybase simply delivered the best price/performance,” says Everitt. “ASE’s reliability, scalability and ability to handle high transaction volumes with great performance and a low total cost of ownership (TCO) were compelling factors in our selection. The fact that we can maintain our entire database infrastructure with only 2 DBAs is of huge benefit to us.”
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.
Sybase IQ was chosen, again over Oracle, because of its unsurpassed query performance and low total cost of ownership. “Sybase IQ,” explains Everitt, “delivers data access, query performance and data loading that are up to 100 times faster than traditional relational databases. Additionally, it has the ability to compress terabytes of indexed data by as much as three to five times, which minimizes storage costs. And it does not require laborious tuning.”
Recalling the proof of concept Sybase created for MHG during the evaluation process, Bryn Davies, Sybase Regional Manager for the Business Intelligence practice recalls, “In one instance involving a particular report that historically had taken MHG 12 hours to complete, we were able to slash that to 12 minutes with Sybase IQ.”
Additionally, using Sybase IQ in combination with Cognos, MHG users at virtually every technical skill level can perform their own multi-dimensional analyses and create reports to help clients make the best possible business decisions.
MHG’s new, comprehensive data management system includes:
- a consolidated operational ASE database 500GB running at MHG headquarters on an HP Itanium server,
- the Sybase IQ-powered data warehouse 500GB running at MHG headquarters on HP Itanium Server
- ASE Small Business Edition databases 5.5TB running on HP Proliant ML350 Servers running RHEL Linux at MHG’s 6 satellite offices, and
- Sybase Replication Server, which manages the synchronization of data between MHG’s central and satellite offices.
MHG has recently upgraded its installations at its satellite offices to Sybase ASE 15 to take advantage of key new features including on-disk encryption, partitioning and improved query processing performance. Due to the success of this upgrade, it is now in the process of upgrading its core servers at its head office.
“Sybase…An Important Contributor to Our Business Success”
“Our data management systems are as mission-critical as you can get,” says Russell. “If they’re not up and running, we’re not up and running and neither are our clients. Ultimately, it’s the individuals covered by the medical schemes who would be negatively impacted, if our systems weren’t as robust and reliable as they are thanks to Sybase.”
"MHG has built a strong reputation over the years for matching our proven operational methodologies with cutting-edge technologies,” adds Pierre Robertson, head of decision support systems at MHG. “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.”