Benenden Healthcare Society BPM case study #appianforum

Ian Grant of Benenden Healthcare Society, a UK not-for-profit, user-pay healthcare provider with almost a million members. They had a need to improve their business agility, and identified that they needed a new case management system as well as better auditability of the decisions made within processes. They reengineered their processes first, then had their three short-listed vendors build out those processes to see how quickly (and well) it could be done; Appian was the unanimous choice of the selection panel.

They created Service Management System (SMS) to document and manage all interactions with members. Typically, when a member calls in, the service rep accesses all previous case data for this member, gathers some information about what is wrong with the member in layman’s terms – so that the service rep doesn’t have to be a clinical expert – then the rules and processes built into SMS present the services available to that member, and generates the necessary paperwork and follow-on processes. When they go live (soon), they expect to reduce their service rep training time from months to three weeks, and improve their customer satisfaction rating from 95% to 99%. They’ve created some lightly-customized user interfaces that allow for fast information gathering and problem resolution.

During implementation, they completely ignored the current state, and only considered the to-be processes and functionality. Although they had a waterfall requirements process up front with formal signoff, they moved into a more iterative prototype development cycle (although one that seems to have taken a year, so not so agile).

They’ve already achieved two million GBP in savings through renegotiations with their service providers based on their expected future-state process, as well as seeing some improvements across all processes. This is fairly common, since the act of examining and reengineering a business process almost always has the effect of improving it since many of the inefficiencies will be exposed and resolved even before any technology is brought to bear on the processes.

They have involved 85% of the entire user base in some way in the creation of the new system, which has resulted in a high degree of user buy-in since they developed the requirements themselves. They’ve already identified their requirements for the next phase, and are creating the development plan now to deliver that by the end of next year.

I’m left with the impression that there is still a lot of waterfall methodology at Benenden; whether that hinders their efforts will be seen once they’ve rolled out the first version.

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