Health Insurance Industry Struggles to Update Legacy IT Infrastructure

Health insurance legacy IT infrastructure was designed for transactions centered around claims, not for a consumer-engaged environment, observed Beth O’Rorke, chief information officer and senior vice president at Blue Cross Blue Shield of Massachusetts. Moving to a consumer-engaged environment requires different IT systems to unlock data and make a difference to the healthcare consumer, O’Rorke told a session at the MIT Sloan CIO Symposium held in Cambridge May 22. Understanding the patient in the middle is very different in healthcare compared to retail. Data is distributed, and there are a lot of legacy systems that are unsupported, she explained. When O’Rorke joined BCBS in 2015, “we created a roadmap because we were on fire from security breaches in healthcare,” she said. “We had to figure out how to boost our security, which means our applications patching, critical things like that.” “Then we had to figure out how to streamline our business. The legacy systems were all hard-wired around transactions. We had to rethink our business model. When I started, it was all about data and analytics and digitization. That is the journey we are on now to unlock what we need to do as a business from a healthcare perspective and our broader ecosystem,” O’Rorke said.