MIS Plan Concentra Health Services

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INTRODUCTION
Concentra Health Services, Inc. is a Dallas, Texas based company. Our primary business is that of providing healthcare solutions to employees, via operations that are based in relationship to employer facilities.
The primary model of our services is to be contracted by an employer to set up, operate and manage a health center on the employer's premises. These clinics can involve treatment of occupational injuries and illnesses, occupational with urgent care issues that are non-work related and occupational issues as well as primary care issues. A contract pharmacy can be added to any of these models. The value of these services is many. For some it is solely to reduce the cost of Workers' Compensation, for others it has to do with keeping their workforce more health and productive, or offering a benefit of healthcare services, which are directly sponsored thus avoiding the costly health insurance premiums of providing similar levels of care. The pharmacy piece provides pharmacy services without the markup of retail pharmacies. This allows the employers to provide a higher level of healthcare services to their employees, without having it underwritten by traditional third party insurance companies.
Concentra has 250 companies that they are providing services for in the United States. (Company Overview, 2006) This illustrates the first of the many IS issues for this company. With 250 separate and physically disconnected sites, sharing information with each other poses an issue. There is an added difficulty in providing privacy, as the company deals with private healthcare information protected by the Health Insurance Portability and Accountability Act of 1996.
Concentra employs a staff of 12 IT professionals, 3 of which are responsible for help desk operations, the remainder are made up of management personnel, programmers and hardware specialists.

IT BACKGROUND INFORMATION
Concentra has employed the Citrix Metaframe server technology, to alleviate the issues of portability of connections and security to meet the demands of the privacy laws. The Citrix Metaframe presentation server provides "a secure, single point of access to applications and information on demand, while ensuring a consistent user experience anywhere, anytime, using any device, over any connection". (Citrix Can Help You, 2006) The Citrix platform is stable enough, and secure enough to use remotely for long periods, and under demanding database operations. This has allowed Concentra to take full advantage of requiring the customer to supply the Concentra staff with PC's and internet connection, which alleviates the problem of supplying IT equipment in an unknown, or unsupervised environment. It also keeps all proprietary information on the Concentra systems, and allows employees to work from anyplace they may be, even at home which is becoming a more popular choice.
Concentra does not perform typical 'third party billing'. That is they do not charge a fee for service for the care given in their clinics. They do however, track those services, keep medical records for each patient, and provide software solutions to audiometric evaluation programs, as well as many other biological monitoring programs. For this Concentra employs the expertise of Unique Software.
Unique Software offers a product named Occupational Health Manager (OHM). OHM is a large customizable software product, that is based on a backend database, which can be housed in Oracle, Btrieve or SQL. Concentra utilizes an SQL server to warehouse the data from OHM. OHM requires approximately 2 gigabytes of hard drive space for every 50,000 records. (Occupational Health, 2006) In addition, the cost of operating and maintaining the database is passed on to the customers. Concentra has worked extensively with Unique Software to develop the product, and change it considerably from the 'off the shelf' version. This has developed a relatively unique application that is unique to Concentra.
Concentra has a small number of programmers who are able to develop SQL reports customized for individuals, and to make changes to the data structure, or population tables. There is a significant level of expertise needed to maintain this software product. In addition the licensing fee for this product is between $15,000 and $20,000 for each site that it is place at. This cost is passed on to the customer. Concentra obligates each customer to purchase this software option. It is the only option that is offered by Concentra currently.
With this background, I want to point out the key issues surrounding the IS needs in delivery of service to uphold the mission and values of Concentra.
1. There is a significant human capital needed to maintain the SQL database.
2. It is not web accessible, necessitating the Citrix Metaframe server, with no alternatives to access.
3. There is a significant cost that is passed on to the customer, however does not generate operating income for the company.
4. The Citrix Metaframe server is adequate for secure access to the database
5. There is significant training required by the end user for the OHM Software
6. Because employees use Citrix, Concentra is required to purchase a license for Microsoft Office to allow access to these products.
7. Concentra is reliant on Unique Software and their development of the product.
8. Concentra is providing Unique Software with product upgrade ideas, which they can then sell to competing companies.

In conclusion, I would like to recommend the following steps to augment the IS structure that is in place currently:
Concentra can take the human capital that they have invested in supporting the OHM product and begin transitioning them to working with a similar SQL language database. We can then develop a completely web based product, that provides the levels of security that we need. By doing this, the Citrix applications will no longer be needed, as our customers provide basic PC's and in most cases MS Office. Those licenses are being paid for by our customers, and we are also buying a license for the same person.
We should gather a user advisory group, hire a facilitator to keep it focused, and have them come up with the best and worst parts of the OHM system, and then we can develop sub-committees from that group to design improvements for each module that needs to be built.
By building our own application, we would take away the ability for any other company to use the same application that we are using, which would give us a competitive advantage. Currently, there is no advantage, because any competitor can purchase OHM and sell it to their customers as well.
We should then charge the client for licensing of this web based product, with a larger setup fee, followed by some licensing feel on an ongoing basis. This will support the human capital necessary to maintain and upgrade the solution.
Making this truly web based would allow easier access to the data from more places. We would also need to build a portal for limited access for interested parties such as supervisors.
With this model, the cost of licensing could become a source of improved operating income since the cost would not be spent paying a third party company. In addition the licensing would only be valid for as long as the contract was active. This would be an asset to customer retention.
This concept will allow Concentra to build a product that was truly customized for our needs, and effective. There is nobody who knows the end user needs for a system better than our colleagues working in our locations. It would decrease the cost of licensing, and may decrease the cost of maintaining the Citrix Metaframe Presentation Server, although that would need to be phased out over time.
I believe this project should have an expected life span of 2-3 years for design, beta testing and implementation. It would be a long term investment with significant impact on end user satisfaction, decreased IT systems and hardware maintenance as well as operating income.

STAFF DEVELOPMENT
This section of the report will establish the value of the following three association memberships, in regards to the furtherance of the company's growth and mission.
The Information Society for the Information Age is an association that provides a forum for bringing people together to bridge the gap between the unique needs of researchers, developers and end users, and furthering the opportunities between new technologies and applications. (Membership, 2006)
This organization has been in existence since 1937, in an attempt to bring about new theories, technologies and approaches to accessing information. As this company's needs for information warehousing continues to grow, I believe that membership in this organization would be very beneficial. It will open our network of knowledge to the entire membership, and we will then have the opportunity to attend the annual conference and learn about the latest technological advances in handling information. The purpose of this group is to enlighten professionals working in one specific field, about techniques that are being used in other possibly unrelated areas, that then can potentially be used in our own area of development.
The cost of this membership is low ...