The next VMworld innovator interview focuses on how a fast-growing healthcare claims company is gaining better control and optimization across its IT infrastructure. Learn how IT leaders at Navicure have been deploying a comprehensive monitoring and operational management approach.
To understand how they’re taming IT complexity as they set the stage to adopt the latest in cloud-computing and virtualization infrastructure developments, join Donald Wilkins, Director of Information Technology at Navicure Inc. in Duluth, Georgia.
The discussion, which took place at the recent 2013 VMworld Conference in San Francisco, is moderated by Dana Gardner, Principal Analyst at Interarbor Solutions. [Disclosure: VMware is a sponsor of BriefingsDirect podcasts.]
Here are some excerpts:
Gardner: Why is your organization so focused on taming complexity?
Wilkins: At Navicure, we’ve been focused on scaling a fast-growing business. And if you incorporate very complex infrastructure, it becomes more difficult to scale it. So we’re focused on technologies that are simple to implement, yet have a lot of upward availability of growth from the storage, the infrastructure, and the software we use. We do that in order to be able to scale that growth we needed to satisfy our business objectives.
Gardner: Tell us a little bit about Navicure, what you do, how is that you’re growing, and why that’s putting a burden on your IT systems.
Wilkins: Navicure has been around for about 12 years. We started the company in about 2001 and delivered the product to our customers in the late 2001-2002 time-frame. We’ve been growing very fast. We’re adding 20 to 30 employees every year, and we’re up to about 230 employees today.
We have approximately 50,000 physicians on our system. We’re growing at a rate of 8,000 to 10,000 physicians a year, and it’s a healthy growth. We don’t want to grow too fast, so as not to water down our products and services, but at the same time, we want to grow at a pace that better enables us to deliver better products for our customers.
Revenue cycle management
Claim clearinghouses have been around for a couple of decades now. We’ve evolved from that claim-clearinghouse model to what we refer to as revenue cycle management. We pioneered that term early as we started the company.
We take the transactions from physicians and send them to the insurance companies. That’s what the clearinghouse model is. But on that product, we added a lot of value-added services, a lot analytics around those transactions to help the provider generate more revenue for their transactions. They get paid faster, and that they get paid the first time through the system.
It was very costly for transactions to be delayed weeks because of poorly submitted transactions to the insurance company or denials because they coded something wrong.
We try to catch all that, so that they get paid the first time through. That’s the return on investment (ROI) that our customers are looking for when they look at our products, to lower the AR days and to increase their revenue at the bottom line.
Customer service is one of the foundation cornerstones of our business. We feel that our customers are number one, and retaining those customers is one of our primary goals.
Gardner: Tell us a little bit about your IT environment.
Wilkins: The first thing we did at Navicure, when we started the company, is we looked at and decided that we didn’t want to be in the data-center business. We wanted to use a colo that does that work at a much higher level than we could ever do. We wanted to focus on our product and let the colo focus on what they do.
They serve us from our infrastructure standpoint, and then we can focus on our products and build a good product. With that, we adopted very early on, the grid approach or the rack approach. This means that we wanted to build a foundational structure that we can just build on as we get go into business and grow the transactions volume.
That terminology has changed over the years, and that can be referred to a software-defined infrastructure today, but back then it was that we wanted to build infrastructure that would have a grid approach to it, so we could plug in more modules and components to add to scale out as we scale up.
With that, we continued to evolve what we do, but that inherent structure is still there. We need to be able to scale our business as our transactional volume doubles approximately every two years.
Gardner: And how did you begin your path to virtualization, and how did that progress into this more of a software-defined environment?
Ramping up fast
Wilkins: In the first few years of the operation of the company, we really had enough headroom in our infrastructure that it wasn’t a big issue, but as we got four years into the company, we started realizing that we were going to hit a point where we would have to start ramping-up really fast.
Consolidation was not something that we had to worry about, because we didn’t have a lot to consolidate. It was a very early product, and we had to build the customer base. We had to build our reputation in the industry, and we did that. But then we started adding physicians by the thousands to our system every year.
With that, we started to have to add infrastructure. Virtualization came along at such a time that we could add it virtually faster and more efficiently than we could ever have if we added physical infrastructure.
So it became a product that we put in a test, dev, and production all at the same time, but it was something that just allowed us to meet the demands of the business.
Gardner: Of course, as many organizations have used virtualization to their benefit, they’ve also recognized that there is some complexity involved. And getting better management means further optimization, which further reduces costs. That also, of course, maintains their performance requirements. How did you then focus in on managing and optimizing this over time?
Wilkins: Well, one of the things we tried to look at, when we look at products and services, was to keep it simple. I have a very limited staff, and the staff needs to be able to drive to the point of whatever issue they’re researching and/or inspecting.
As we’ve added technologies and services, we tried to add those that are very simple to scale, very, very simple to operate. We look at all these different tools to make that happen. This has led us to new products like VMware as they have also tried to drive to the same level, trying to simplify their product offering with their new products.
For years, we’ve been doing monitoring with other tools that were network-based monitoring tools. Those drive only so much value. They give us things like up-time alerting and responsiveness that are just about when issues happen. We want to evolve that to be more proactive in our approach to monitoring.
It’s not so much about how we can fix a problem when there is one. It’s more of, let’s keep the problem from happening to start with. That’s where we’ve looked at some products for that. Recently we’ve actually implemented vCenter Operations Manager.
That product gives us a different twist that other SMNP monitoring tools do. It’s a history of what’s going on, but also a future analysis of that history and how it will change, based on our historical trends.
Gardner: Of course, here at VMworld, we’re hearing vSphere improvements and upgrades, but also the arrival of VMware vCloud Suite 5.5 and VMware vSphere with Operations Management 5.5. Is there anything in the new line-up that is particularly of interest to you, and have you had a chance to look at over?
Wilkins: I haven’t had a chance to look over the most recent offering, but we’re running the current version. Again, for us, it’s the efficiency mechanism inside the product that drives the most value for us to make sure that we can budget a year in advance of the expanding infrastructure that we need to have to meet the demands.
vCenter Operations Manager is key to understanding your infrastructure. If you don’t have it today, you’re going to be very reactive to some of your pains and the troubles you’re dealing with.
That product, while it does allow you to do a lot of research for various problems and services to drill down from the cluster level, down into the virtual machine levels and find out where your problems and pain points or, actually allows you to more quickly isolate the issue. At the same time, it allows you to project where you’re growing and where you need to put your money into resources, whether that’s more storage, compute resources, or network resources.
That’s where we’re seeing value out of the product, because it allows me to go during budget cycles to say that looking at infrastructure and our current growth, we will be out of resources by this time. We need to add this much, based on our current growth. Barring additional new products and services we may be coming up with, we may be adding to our service, if we don’t do anything today. We’re growing at this pace and here’s the numbers to prove it.
When you have that information in front of you, you can actually build a business case around that that further educates the CFOs and the finance people to understanding what your troubles are and what you have to deal with on a day-to-day basis to operate the business.
Gardner: What sort of paybacks are there when you do this right?
Wilkins: Just being able to drive more density in our colo by being virtualized is a big value for us. Our footprint is relatively small. As for an actual dollar amount, it’s hard to pin something on there. We’re growing so fast, we’re trying to keep up with the demand, and we’ve been meeting that and exceeding that.
Really, the ROI is that our customers aren’t experiencing major troubles with our infrastructure not expanding fast enough. That’s our goal, to drive high availability for infrastructure and low downtime, and we can do that with VMware and with their products and service.
We’re a current customer of Site Recovery Manager. That’s a staple in our virtual infrastructure and has been since 2008. We’ve been using that product for many years. It drives all of the planning and the testing of our virtual disaster recovery (DR) plan. I’ve been a very big proponent of that product and services for years, and we couldn’t do without it.
There are other products we will be looking at. Desktop virtualization is something that will be incorporated into the infrastructure in the next year or two.
As a small business, the value of that becomes a little harder to prove from a dollar standpoint. Some of those features like remote working come into play as office space continues to be expensive. It’s something we will be looking at to expand our operations, especially as we have more remote employees working. Desktop virtualization is going to be a critical component for that.
Gardner: How about some 20/20 hindsight. If there were other folks that were ramping up on virtualization, or getting to the point where complexity was becoming an issue for them, do you have any thoughts on getting started or lessons learned that you could share?
Wilkins: The best thing with virtualization is to get a trusted partner to help you get over the hurdle of the technical issues that may bring themselves to light.
I had a very trusted partner when I started this in 2005-2006. They actually just sat with me and worked with me, with no compensation whatsoever, to help work through virtualization. They made it such an easy value that it just became, “I’ve got to do this, because there’s no way I can sustain this level of operational expense and of monitoring and managing this infrastructure, if it’s all physical.”
So, seeing that value proposition from a partner is key, but it has to be a trusted partner. It has to be a partner that has your best interest in mind, and not so much a new product to sell. It’s going to be somebody that brings a lot to the table, but, at the same time, helps you help yourself and lets you learn these products, so that you can actually implement it and research it on your own to see what value you can bring into the company.
It’s easy for somebody to tell you how you can make your life better, but you have to actually see it, because then, you become a passionate person for the technology, and then you become a person that realizes you have to do this and will do whatever it takes to get this in here, because it will make your life easier.
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