This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

  Today in Health It Launching your development project. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping health IT staff current. And engaged. I just wanna ask you real quick, have you signed up for clip notes?

CliffNotes is a service we offer to at this week in Health IT to keep you and your staff current. We know you don't have time to listen to every episode, so we developed CliffNotes to keep you informed. It's an email that goes out 24 hours after each show airs on the channel with a summary, bullet points, and two to four short video clips.

Great way to stay current, see what's on the channel, and see if you can listen to the whole episode, subscribe on our website. This week, health.com. Just click on the subscribe button or have your team subscribe and get the discussion started on the right foot. All right, here's today's story. This comes from healthcare finance news, Anthem and Humana.

Enter into multimillion dollar agreement with SS and C for API cloud platform. Domini Rx is an API driven claims adjudication platform representing . The next generation of ppms. I, I'm not sure I'm saying that exactly correctly. It's D-O-M-A-N-I-R-X, so that's how it's spelled, that's how I'm reading it.

Lemme give you some excerpts. The parties have committed to an agreement of approximately 925 million in the form of cash property. So that's the deal that's coming together. The amount includes 138 million in initial cash to get this thing off the ground. There's a non-exclusive license to a claims processing platform called RX Nova, an assignment to a service agreement the company has with Humana.

And up to approximately 400 million in cash and other property interests and or services. So it's a big gnarly kind of deal. What are they doing upon completion? The cloud native, API Driven claims adjudication platform will represent the next generation in PBMs. SSNC said in announcing the deal on July 21st, it will harmonize the payer and provider management user experience.

SSNC said, we are committed to building the next generation claim adjudication and PBM platform said CEO Bill Stone. In a statement, Dom and I Rx will give end-to-end transparency in data analytics while adhering to the changing government regulations. The company said, here are all those requirements and promises right there in the uh, release to better address the complexity of the claims adjudication industry-wide.

As healthcare organizations compete and grow Domini Rx, we'll build a unified user experience leveraging plug and play technology to provide an affordable, transparent solution. S. S and C said, insights will be drawn from hundreds of millions of claims transactions powered by Domini Rx. Advanced processing platform will provide participating members, flexible tools, advanced analytics, and customizable programs, all while increasing transparency, accessibility, and service quality for members and pharmacies.

Healthcare, finance news has this section called the Larger Trend. Let me give you some of that. It's pretty interesting. ppms. Receive and store massive amounts of data in their function of claims adjudication. The use of an API application programming interface allows applications to talk to each other for faster seamless process.

Otherwise, I think we would still be looking at pretty archaic systems and I. Starting July 1st, payers were required to give patients access to their data through open APIs, subject to the provisions of hipaa, Medicaid, chip, and individual market qualified health plans, payers needed to build, implement, and maintain APIs that enabled provider access to their patient's data.

They were also required to streamline the prior authorization process. AHIP pushed back against the rule earlier this year saying it was hastily constructed requiring insurers to build these technologies without the necessary instructions. All that may be true, but this is a big win for patients in the long run.

All right. Where am I gonna go with this? I, I'm not really gonna comment on this all too much. What I'd like to do is talk about development projects in general. There are more development projects taking off in healthcare. Every day. Uh, this is a big one. Obviously, big doesn't mean successful, it just means big.

Let's explore what successful development projects have in common. I, I think they start with a proper mission. With good user stories, with good requirements. All those things are just basic foundations to good programming to really understand what is going to be developed and how it's going to be utilized.

I think the architecture is becoming more and more important. We need internet architectures, cloud providers, long-term, multi-cloud strategy. We need to be able to be agile, . To plug things in. We don't know what the future's gonna hold. It's moving very rapidly. We don't know where we're gonna get the data or what types of data we're gonna get.

So these need to be highly flexible, internet scalable type solutions. So the architecture very much matters. You have to be aware of costs. There's a lot of costs when you go into these cloud platforms. So. Open source platforms tend to be less expensive on the front end, potentially more expensive on the support on the backend.

You have to be very careful with that, but just understand the cost structure that you're getting into. I. The next thing on a development project is you have to have a good data model, good data standards, and good data practices. You have to understand how you're going to use the data. Very key in how you're gonna design the application.

So you're gonna collect the data. Are you gonna normalize the data? If you are collecting new data, how are you going to create that user experience and user interface to collect the data in a way? That is going to be usable. You have to understand that data supply chain and how it's gonna be used throughout the entire ecosystem.

Your algorithms, how are you going to evaluate your algorithms? How are you gonna provide transparency into your algorithms? How are you gonna prove the efficacy of your algorithms? These are all important things to consider when you're developing applications. You need to have a really good work plan and project practices.

Uh, one of the things we look at a lot when we're looking at these projects. Is, what's your structure and what's your governance structure is really key. Do you have a group looking at new requirements, the adding of of new data elements, the adding of new functionality? What is the governance structure, and then what are the key roles and how are they designed?

I find a lot of these projects kick off with silos from the get go, which makes no sense whatsoever. You need to connect the user community to the development community, make sure that there's a robust conversation going on throughout the entire thing. The tools and practices are pretty well known these days, but you have to take a look at those with the future in mind.

The software isn't gonna be complete the day it rolls out. It's just gonna be starting. You're gonna have to have a release framework, you're gonna have to have repositories and all those things are gonna be very important. Your security framework. When I say the word architecture, I'm thinking about

Security from the get go, but I want to call it out here that the security framework is important, especially in healthcare projects and privacy framework is also important when with regards to healthcare projects. So make sure you have a plan. Make sure that if you have a development partner, they're providing you.

That's information. I think it's important also to understand the adoption strategy, the integration into clinical workflows, especially in healthcare systems and provider applications. We have to ensure that the products aren't made in a vacuum. If you're creating a consumer application, you need the consumers at the table.

If you're creating a B2B application, it's important to have the business providers at the table as well and also determine your project methodology, right? Agile waterfall. Agile is the preferred method these days. It's my preferred method as well, but we still have waterfall projects happening in in healthcare.

One of the biggest challenges with Waterfall versus an Agile project is . One of my success factors that I look in early on in these development projects is how quickly am I seeing code? You should see code early and often in these large projects if if you don't, that is a huge red flag. And if you haven't done this before, don't accept promises and PowerPoints.

You should be seeing working code all along the way. You don't want a monolithic software platform anyway, so when somebody's telling you, well, it all comes together at the end. . Or it all comes together in in these big phases. That's a mistake. Even if they're showing you bits and pieces of the code working, the login module is working.

The initial screen, the reporting, I mean, they're breaking it out. That's what internet architecture looks like anyway. They should be developing it in blocks in a modular format, so. Again, I am a huge proponent of C code early and often in these projects. If you're not seeing code, huge red flag, your project's probably behind schedule and you may not know it yet.

That's all for today. If you know someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, health.com, or wherever you listen to podcasts. Apple, Google, overcast, Spotify, Stitcher, you get the picture. We are everywhere. We wanna thank our channel sponsors who are investing in our mission to develop the next generation of health leaders.

VMware Hillrom, Starbridge Advisors, McAfee and Aruba Networks. Thanks for listening. That's all for now.