Allegheny HealthChoices streamlines information sharing

Behavioral health data is incredibly sensitive, and Allegheny HealthChoices, Inc. (AHCI) processes a lot of it. The non-profit corporation was formed in 1999 by Allegheny County, Pennsylvania, to monitor the transition of Medicaid-funded behavioral health services to a managed care environment, but over the years its role evolved. Today is oversees, monitors, and manages the flow of Medicaid data between stakeholders, including a variety of downstream insurance companies and government agencies. 

As they contemplated that new role, members of the AHCI IT team realized that the firm would need a data infrastructure better designed to ingest the large, complex EDI files containing user claim and program data. The information in these files needed to be filtered into AHCI’s data warehouse and then made available to the insurance companies and agencies that needed it. AHCI receives more than 100 EDI files every day from multiple sources, all of which need to be processed quickly, accurately, and securely. The task had grown too large to be managed manually, so AHCI needed to find a way to automate procedures.

Automating with Actian
Actian DataConnect has been at the core of running AHCI’s day-to-day business operations since its inception. DataConnect offers a hybrid integration solution that enables an organization to quickly and easily design, deploy, and manage integrations on-premises, in the cloud, or in hybrid 

environments with no limits on data type or volume. With its emphasis on reuse and adaptability, DataConnect is engineered to help cost-effectively integrate diverse data and applications from numerous endpoints.

At AHCI, Actian DataConnect automates and streamlines the entire EDI ingestion and transformation process by collecting and transforming the EDI files at scale and loading them quickly into the AHCI data warehouse, thus making it available for distribution to downstream stakeholders. DataConnect helps eliminate the enormous labor costs that this would entail if it were to be done manually. Additionally, it streamlines AHCI’s process, enabling the firm to be more innovative and facilitate the delivery of better patient experiences.

Focusing resources where they can do the most good
Early on, IT leaders at AHCI estimated that it would take as many as five people working full-time to transform and load the incoming EDI files manually–not a good use of the non-profit’s limited resources. Instead, they decided to use Actian DataConnect to automate these file transformations. This would enable the firm’s IT personnel to focus on more innovative projects aimed at improving healthcare services. 

“We receive more than 100 EDI files each day, which we need to process quickly, accurately, and securely,” says Jody P. Wright, Manager of Applications and Data Systems at AHCI. “We wanted to automate the whole process from the start, and Actian DataConnect provided the critical functionality we needed. It enables us to transform EDI data quickly and load it into our own data warehouse seamlessly.”