Success Story: Union Nationale de Mutualités Socialistes

Automation, visibility and integration for one of Belgium’s largest health insurers

  • Headquarters

    Brussels, Belgium
  • Industry

  • Challenge

    • ƒIS and external data flows too complex to manage
    • Excessive manual processes burdening data exchange
  • Solution

  • Results

    • Data flows are centralized for tighter control
    • Information is translated into partners’ required formats
    • ƒData exchanges are regulated, automated and monitored in real time
    • UNMS able to connect to MyCareNet (medical data paperless project)

“With Axway, a long-term relationship of trust was developed. We took a leap forward from a technology standpoint and became more confident in our information system, which has become more flexible and efficient. The technical aspect no longer blocks the projects we wish to develop — quite the opposite, it opens up prospects! UNMS is equipped for the standards of the future, which gives us a very clear competitive edge. SEPA, XML: we are now ready to pass major turning points."  

Growth Creates Challenges

UNMS prepares to go digital

Union Nationale des Mutualités Socialistes is fully automating its information system with the assistance of Axway and moving one step ahead in the implementation of the medical data paperless project (MyCareNet project).

Union Nationale des Mutualités Socialistes (UNMS) is a private establishment responsible for the management of a public service for the Belgian national health agency. UNMS has seen a steady rise in its activity for close to 10 years, due mainly to high-quality service and attractive tariffs. UNMS, which handles medical reimbursements for 3 million people, is a confirmed major player in the national health sector and is the second largest supplementary health insurance agency in Belgium.

The UNMS information system (IS) consisted of several different platforms: mainframes, AS400s, and numerous Windows workstations. Over the past few years, the latter had grown significantly and the number of applications running under Windows was constantly on the rise. The wide variety of formats and interconnections in such a diverse system made back office maintenance more and more complex. For example, manual processing of transfers in FTP and the impossibility of generating XML flows from a mainframe placed a considerable burden on data exchange processes. “Due to its diverse nature, our IS had become too complex to manage. It was therefore urgent to obtain more active responsiveness.”

UNMS gave the matter considerable thought and determined two major objectives: ensure automatic integration of internal exchanges to reduce manual processing and simplify external flows with the authorities and healthcare professionals. “We naturally sought one response to these two issues,” said Pierre Cools, IT Manager, Union Nationale des Mutualités Socialistes.

The Right Solutions

Connectivity and formatting to meet industry requirements

UNMS needs to satisfy various legal obligations in terms of connectivity with institutional partners. Banque Carrefour, a public organization, the vocation of which is to centralize exchanges between national health institutions, requires data exchanges to be in XML format. Moreover, the Institut National d’Assurance Maladie Invalidité (INAMI), the responsibilities of which include consolidation of accounting information received from supplementary health insurance companies, requires specific, secure data exchange formats. To meet these requirements, UNMS chose to acquire the Axway integration platform: Axway Gateway, for centralized flow routing; Axway Integrator, for control and conversion of data; and Axway Sentinel, to supervise exchanges and alert technical teams using all types of media (e-mail, mobile, etc.).

“We had envisaged two options: specific development work to reorganize our flows or directly adopt a central platform that would enable us to achieve savings of scale by pooling resources and which would ensure simpler maintenance and updating. We finally chose to abandon our (silo-type) exchange infrastructure and adopt a process-oriented approach. Axway proposed a platform able to support all current and future market formats as well as an efficient solution for end-to-end monitoring and supervision — a global response that finally convinced us,” said Mr. Cools.

New Platform Brings Immediate Results

Regulation, automation and monitoring of exchanges

UNMS set up the integration platform published by Axway shortly after the presentation of a particularly conclusive Proof of Concept (POC) in July 2007. Platform parameterization started at the same time as the training of UNMS teams. The benefits became quickly evident: flows now transit via a unique point, information is translated into the formats required by partners, and all exchanges are monitored in real time. All these elements foster the integrity of data and the processing chain. “Our IT teams had a positive reaction to the POC — they were soon pleased with the modular aspect of the solution as well as its parameterization capability. Their involvement was considerable — they immediately took the tool on board and feedback was very favorable. Don’t forget — a project of this size cannot be conducted without consolidated effort from in-house teams! The presence of Axway throughout consultation and implementation was a decisive factor in the success of this ambitious project. In barely three months, a large portion of our internal and external flows were regulated, automated, and monitored. What a performance!” said Mr. Cools.

Thanks to Axway, UNMS is the first supplementary health insurance company in Belgium able to connect to MyCareNet. The aim of the MyCareNet project is to dematerialize information flows between the various healthcare professionals such as hospitals, individual service providers, the national health agency, and supplementary health insurance companies.

As a result, healthcare forms, invoices for medical treatment, and certain administrative documents will very soon be fully paperless and exchanged via the MyCareNet platform. In a project of this scope, the identification of insured individuals and healthcare professionals is vital. This role is handled by the government BeHealth platform. Backed onto MyCareNet, it is entirely dedicated to verification of the coverage of insured individuals and the accreditation of healthcare professionals. Belgian supplementary health insurance companies must be able to bring these controls into play in the form of Web services. UNMS is the first supplementary health insurance company in Belgium to satisfy this regulation.

“The MyCareNet project is a far-reaching plan that will switch Belgian health insurance over to digital. There are many stakeholders in the project: insured individuals, healthcare professionals, supplementary health insurance companies, and the authorities. With the Synchrony platform, we are now calmly ready to accept the requirements of accessibility to MyCareNet and BeHealth, as well as future requirements,” said Mr. Cools.

The UNMS IS is now the most automated and best-monitored system: the Synchrony platform offers a modern, efficient exchange infrastructure, end-to-end monitoring in real time, and an alert system in the event of malfunctions. Other projects are underway at UNMS such as the implementation of exchanges in SEPA format for medical expense reimbursements.

“With Axway, a long-term relationship of trust was developed. We took a leap forward from a technology standpoint and became more confident in our information system, which has become more flexible and efficient. We have saved considerable time and no longer apprehend future integration and changes in regulations relating to our activity. The technical aspect no longer blocks the projects we wish to develop — quite the opposite, it opens up prospects! UNMS is equipped for the standards of the future, which gives us a very clear competitive edge. SEPA, XML: we are now ready to pass major turning points,” said Mr. Cools.

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