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Margaret: Hello. Welcome to today's fireside chat. Today, we're going to be digging into a very interesting topic that we are all dealing with on a day-to-day basis, which is integrations. Specifically, we are going to dive into how low-code platforms are a potential solution to some very complex problems. Before we do that, a couple of introductions. My name is Margaret. I am the Vice President of HealthConsult here at Simplify Healthcare. I'm joined by my colleague, Namrata. She's our Senior Vice President of Strategic Solutions. Namrata, why don't you introduce yourself?

Namrata: Thank you, Margaret. Hello, everyone. I’m very happy to be here. I’ve spent about 15-plus years doing transformations for various Payers. The most important point there is integrations and how that basically is responsible for creating a connected experience for all the work that is being done under transformations and modernization. So, I’m excited to talk about integrations because that’s so deep into what I’ve been doing for the past many years.

Margaret: Right. I mean, between the two of us, we've got many, many decades of experience here helping the health Payers. So, let's dive in. So What are some of the typical challenges, integration challenges specifically, that are facing the health Payers today?

Namrata: Well Healthcare Payers, you know, they have a breadth of problems and they basically start with, you know, a business having their own set of problems, IT having their own. The businesses are having to deal with using Excel sheets and applications that can capture information subjectively. The rules are embedded in somebody’s head, and it’s very difficult to get that out from years of experience that they have had. The IT has its own set of challenges. They are trying to solve for automation in terms of the work that is being done from a traditional development standpoint. Trying to address every change that comes in as a software development life cycle, thus lengthening the time that it takes to get something up and running. And then they both are really trying to also collectively solve for the competition that’s out there that they have to deal with and also the regulations that come in, you know, at peak times for them to react to.

Margaret: Right, nonstop. You know, legacy systems, right? I mean, both the business and IT are left dealing with the technical debt and just the know-how of using systems that have potentially been around for decades. So, let's talk about low-code platforms. First, a very easy question. What is a low-code platform?

Namrata: Well, low-code application platforms are really something that citizen developers or normal users who doesn’t have technology skills or background can use to create their own set of applications not by coding but using visual modeling tools. And that makes it easy for them to get something up and running versus having to look at the skill set that is required for them. And they are really flexible. They have the agility; they have flexibility, and scalability to really get to where an organization wants to be from an innovation standpoint. And, of course, they are a very low maintenance overhead around it because of the type of skill set that is required.

Margaret: Okay, so it sounds like, you know, there's some benefits. But what are some of the drawbacks of the typical low-code solutions that are out there today?

Namrata: Well, the ones that are out there today, skill set availability is a problem. They have to be, you know, trained on a particular LCAP for a long period of time. There are certifications involved. And then there is also that most of them really take you to maybe 80 percent of code free application creation and customizations. And the remaining 20 is where you are kind of left with a bag in your hand.

Margaret: So, if I'm a health Payer today, where would you suggest I start if I am considering using a low-code platform?

Namrata: I think what has worked well is doing POCs. You know, that allows them to check whether a certain capability or transformation or configuration or customization is something that can be solved. Now, those POCs need to be boxed. But, you know, there has to be an intelligent way of articulating what the outcome needs to be and what we are looking for — Total Cost of Ownership — and also, you know, from a performance and scalability point of view. 

Margaret: Yeah, I personally love being part of any POC where the business can see a tangible value being produced, where it's not just done in a silo with the IT departments. I think that would be great. So, kind of switching gears, I know here at Simplify, we've been using our own low-code platform for years to develop our product because we also realize it would help us accelerate our development. So, very happy that this year we released the Simplify App Fabric™ to the market. So tell me, what distinguishes our platform from some of those other solutions that are out there?

Namrata: Well, for one, we are purpose-built for Payers. We started our journey building this low-code application platform to solve problems with benefits and providers for Payers. But very soon, we also built layers on there, which were very specific to healthcare Payer needs: effective dating, versioning, document generation, integrations, auditing, activity logging, error logging, all of that is so basic in terms of the needs of a Payer ecosystem, so we kind of pay special attention to that. We did quick integration capabilities that would allow us to connect the information that has been captured within any solution, within our solutions, to become extensible to other ecosystems or other applications within the ecosystem as well. So, that allows them to write their own set of models or data models, and then this information actually becomes immediately available with automated APIs and relational databases with the click of a button. So, that basically accelerates all of the work that is required to be done. Whether it’s our solutions or whether it’s other whitespace problems that we are trying to solve. 

Margaret: With integrations. Well, you know, most of the integrations I work on, you know, people are scared. It takes them quite a bit of time. What other capabilities do we have that make integrations faster?

Namrata: Well, we have a secret sauce. Right so, we kind of pay special attention to anything that might require ingestion of information, transformation of information, and dissemination of information. So, what that means is we pay special attention to anything that would require APIs. So, ensuring that we make that configurable, whether it’s event-based or RESTful APIs, make that quickly configurable, ENT and ETL processes that are required for all of these transitions make them a code-free process versus having them to write code. There are RPA bots that are required to be created for so many robotic process automations that are required to be done over and over again, so to convert them, to create your own configuration of an RPA and get going. And, to top all of this, there is the effective dating, version control, and audit of not only what operations would look like but also when you’re configuring within these tools; what does that look like? So, it’s very exciting that all of this is under one hood and can be deployed in one go with the channeling studio. 

Margaret: So, let's get tactical. Can you think of a couple of recent examples that you've been using the Simplify App Fabric™ for?

Namrata: Sure. There are lots. The top of my mind is one that basically requires, you know, some of the Blues to convert information or claims information to submission, reconciliation, and disposition formats. Typically, for any one format, it has seemed to be taken about 800–1000 hours for a given healthcare Payer. And we were able to take that on as a use case and, you know, solve for one of those within two to three hours. And that’s a huge savings in cost, effort, timeline, going to market, and that has been simply very validating of what we were, what we have built so far. And the other one is, you know, there is one where there are regulations that are, you know, kind of laid out by CMS and other regulatories, cand they have to be monitored on an ongoing basis. So, it’s a robotic automatic process. And that is something that we were able to, you know, use our RPA bots to make that configuration quickly. There were 70-plus websites, if I remember correctly. And all of them we were able to achieve within 100 to 200 hours. So, simply validating what we are building is going to really bring down the whole cost of ownership in terms of building something on their own. 

Margaret: Right. I love that. Right. So, basically, to just kind of wrap up, you know, the themes here of the low code platforms is a lower barrier to entry than people might think. A lower tech skills required than people might think. And then the advice, I love your advice about doing a proof of concept, right? Do a POC, a quick POC to help see it in action. Bring a use case to life so that the business and IT fix can validate that. That'll work for them. Just curious, like, kind of wrapping up here. I know it's probably not typical that health Payers are using low-code platforms or LCAPs in their development practice day to day. They tend to want to either use the package solution or build their own homegrown solutions. So, if you had your crystal ball in the future, where do you see the adoption of a low code platform going with the health Payers, or where would you like to see it going?

Namrata: Oh well, Low-code application platforms are exciting. They’re scary. And I think picking the right one is important because it will, it will go a long way. Once you do one POC and one use case, there’s confidence that you will gain automatically. You just have to take that leap. And with something that’s easy to configure, easy to navigate I think that’s the way to move forward. That is where the industries are moving just to be able to take matters into their own hands. And do the things that are required from a business vantage point for their businesses and business use cases.

Margaret: Terrific. Thanks, Namrata. I appreciate it. Lovely to talk to you today. Thanks. Bye Bye.