GOALS

• Enhance the health plan's data analytics capabilities to identify high-risk members and develop targeted interventions that improve health outcomes and reduce costs, enabling proactive care management and personalized health interventions
• Improve member engagement and satisfaction by implementing a user-friendly patient portal that provides easy access to health records, appointment scheduling, and communication with providers, empowering members to actively participate in their healthcare
• Streamline claims processing and reduce administrative burdens by leveraging automation and data exchange standards like FHIR, improving operational efficiency and reducing costs associated with manual processes.

Frustrations

• Facing challenges with data interoperability between disparate systems within the health plan and across external providers, hindering efforts to gain a comprehensive view of member health and care utilization
• Dealing with increasing pressure from government regulators to improve health outcomes and reduce costs, while navigating complex compliance requirements and reporting mandates
• Struggling to keep pace with rapid technological advancements in healthcare IT and finding the right solutions that meet the specific needs and budget constraints of the health plan.

GOALS

• Modernize the agency's case management system to enable mobile access for caseworkers in the field, improving real-time data entry, collaboration, and responsiveness to children and families
• Implement data-driven tools to assess risk factors and predict child welfare outcomes, enabling proactive interventions and allocation of resources to prevent child abuse and neglect
• Improve communication and collaboration with other agencies involved in child welfare cases, such as healthcare providers and law enforcement, to ensure coordinated services and timely information sharing.

Frustrations

• Working with outdated technology that is slow, prone to errors, and lacks essential features for effective case management, hindering the ability to provide timely and efficient services
• Experiencing high caseloads and administrative burdens, leaving limited time for caseworkers to focus on direct interaction and support for children and families, potentially compromising the quality of care
• Facing challenges in securely sharing sensitive data between agencies due to privacy concerns and technological limitations, creating barriers to effective collaboration and integrated service delivery.