Resources can be tight with any startup, but one area of technology investment that HealthBridge Financial decided it could not do without was an enterprise integration platform.
The Michigan-based startup makes available financial resources to enable its business customers to offer their employees a benefit option to pay out-of-pocket medical expenses, such as deductibles and co-insurance, over time so they won't delay or forgo healthcare.
To do so, HealthBridge CTO and CISO Tim Heger knew the company would need to establish a secure and scalable mechanism to exchange data between the disparate systems of its insurance, healthcare and payment providers and its business applications.
"We're a data company. We receive and send data. That's how we live and breathe," Heger said. "How we get, receive and transform data is paramount to our business success."
Heger was familiar with the painful process of integration from his prior consulting work on large-scale e-commerce platform transitions with Asics, Harley-Davidson, Kohl's and Payless. So, he knew he would need to make an enterprise integration platform one of his top priorities when he became HealthBridge's first hire in August 2017.
"You can set up an amazing website and do all kinds of great customer-facing things, but if you didn't have great connections back into your inventory and your payment processing and accounting, it was for naught," Heger recalled.
Heger's e-commerce consulting experience also had an impact on other important decisions he made to help the startup get up and running. He knew he did not want to devote precious time, money and IT resources to set up a data center and buy, rack, configure, manage, monitor, patch and update servers. So, he chose AWS to run all of the company's applications, save the ones its SaaS providers such as Sage, Slack and Jira host themselves.
"It's really the smart way to handle a very scalable business," Heger said. "We could hit a peak, and Amazon will scale up with us. When the peak goes away, it automatically scales back down. The only thing that changes is our bill. We pay only for what we use instead of buying servers that sit latent for months and months."
The next foundational piece was security, because HealthBridge handles HIPAA-protected health information. Heger said he follows a defense-in-layers/defense-in-depth approach that is common among CISOs and uses a collection of Amazon and third-party security tools coupled with AWS best practices.
"For me, Amazon was the clear choice. They have amazing tools and processes and as much skin in the game as we do as far as security. They can't afford issues any more than we could," Heger reasoned. "I've got tools in place on 16 different levels that are monitoring traffic, behavior, patch levels and known security issues. We're alerted and address them quickly."
Next on the priority list were the development tools for integration. Heger again drew on prior experience, this time with integration platform as-a-service (iPaaS) products. A year prior to joining HealthBridge, Heger had overseen a "bake-off" to compare the iPaaS options of Boomi, which Dell Technologies sold last month, and MuleSoft, which Salesforce acquired in 2018.
"I became enamored with that whole integration service option," Heger said, "because it really took away a lot of the complexity and risk on delivering projects on time."
Boomi vs. MuleSoft iPaaS
MuleSoft proved to be the better fit for Asics. But Heger said he selected Boomi's AtomSphere iPaaS within weeks of his HealthBridge start date because the tool required less technical skill to create and deploy integrations. Boomi's no- and low-code tools have since enabled Heger to become the lead Boomi developer and integrator, even though he is the least skilled member of HealthBridge's development team.
"Imagine how many more developers I would have had to hire to write plumbing code that is very important, but at the end of the day, moves data from point A to point B," said Heger. "Now I'm able to provide huge value to my very skilled people who need this data, and I don't have to distract my Michelangelos to help me paint the living room."
Heger knew the average developer might view pre-built code with "jaundiced eye," but he said the HealthBridge team now uses Boomi to handle more and more data transformation because they've seen it can speed up the process, perform well and ease deployment. Plus, Boomi updates and maintains the connector code.
"The shortest time to business value is my goal," Heger said. "If it's custom development, then we write it ourselves. If we need to use a tool like iPaaS, that's what we do. We constantly evaluate the new development we do at HealthBridge to choose the right tool. If your answer is always custom code, then you're not giving the business and your investors any help."
Building a scalable platform
HealthBridge spent about 18 months building a platform through a combination of Boomi and custom code before entering the market in early 2019. Heger said the startup expects to hit the six-figure mark for the number of claimants using the platform next year.
"One of my mantras for my team was you have to think at scale. You have to assume that we have a million members, and we have to be able to support them, process their claims and give them the level of service they need," Heger said. "For that year and a half, we were building a fully automated platform. So, with a light staffing model, we're able to support and scale up to a very large number of members and employers."
So far, HealthBridge has not run into any providers that use a data format that the Boomi tool does not support. The two dozen insurance companies and healthcare providers with which HealthBridge exchanges data have mature technology stacks, and many use the healthcare electronic data interchange (EDI) format.
"My goal was to never show up at one of these partners and say, 'We're going to have a test match on which format we're going to use,'" Heger said. "I wanted to make sure we were the easiest people to work with. We show up and we say, 'Your favorite format is our favorite format.'"
Heger said HealthBridge most commonly deals with flat files, JSON and EDI formats. The Boomi software converts the incoming data into the "HealthBridge standard format" for processing in the company's back-end systems and converts it back to the partner's format when sending data in the reverse direction.
"If tomorrow we get a new payer partner, we don't have to disturb our integration with Blue Cross," Heger said. "We just create a brand net new one for the new partner. Then the first step is transitioning into the HealthBridge standard format."
Speeding up customer onboarding
Heger said he generally can build a near production-level integration prototype within a few days using the Boomi tools, so HealthBridge engineers can get to work establishing and testing secure communications to exchange the sensitive data. Heger said HealthBridge can onboard a customer in less than a week, depending on the formats and fields they use.
HealthBridge elected to run Boomi in AWS, not Boomi's cloud, to have greater control over HIPAA-protected information and layer in security controls for identity and access management, Heger said. The company uses Okta to control user access to applications.
With the company's four-year anniversary approaching in August, HealthBridge's technology team now consists of 18 staffers and 15 contractors. Heger said just six are non-developers. If not for the decision to go with AWS, Heger said he would now be in the throes of buying new hardware with a team of network engineers tasked only with load balancing and managing servers.
Heger said he might have been able to save "a couple of bucks" with a do-it-yourself, on-premises infrastructure approach, but the risk of not being able to scale on demand, the unknown costs for needed resources, and the dearth of good network engineers were too high.
"For me, it just wasn't worth the time and effort," he said.
Instead, Heger now keeps his focus on new ways to try to help HealthBridge gain benefit from its investments.
"That's what I do all the time with all of our tools, not just Boomi," Heger said. "Take your applied knowledge and try to figure out other places that you can get business value quickly."