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Case Study

HCA Healthcare transforms patient care with Pega

  • Created a unified care navigation platform
  • 90% reduction in staff effort via reusable assets
  • 35% increase in productivity for nurse case navigators

“For oncology alone, we've been able to eliminate over 56% of our documentation. Since going live, we've navigated over 40,000 patients. We've scheduled over 3,000 appointments and sent over 16,000 digital messages all from the Pega application.”

The Business Issue

HCA Healthcare serves millions of patients annually with a commitment to the care and improvement of human life. With a workforce of over 300,000, the company operates more than 180 hospitals and 2,300 ambulatory services across the United States and the United Kingdom.

The organization realized that a lack of standardization across its vast network frustrated employees and patients alike. Complex service coordination, extensive training times, and the challenge of personalizing care were taking a toll on the patient experience. Its fragmented care management experience meant that patient outcomes varied.

To mitigate this, HCA Healthcare embarked on a journey to create a unified navigation platform that would remove barriers, streamline care, and accelerate diagnosis and treatment, ultimately improving quality of life for members.

The Solution

HCA Healthcare's transformation journey, powered by Pega, began with a focus on the high-risk perinatal navigation program. With no existing HCA system in place, this pilot project set the stage for a wider evolution. Building on its success, the evolving solution's reach was extended to pediatric navigation and later incorporated oncology and multi-specialty navigation programs.

Collaborating closely, HCA Healthcare and Pega constructed a comprehensive solution that tackled provider challenges head-on. This solution focused on patient-centric care, workflow standardization, reusability, flexibility, and digital-first engagement. Using Pega Care Management, HCA Healthcare created an accelerator that allowed for rapid implementation of care management applications across multiple service lines.

This meant that speed to market was significantly enhanced and administration could be automated with data capture and guided decision-making. Training times were reduced, and healthcare teams experienced improved communication, gaining visibility into multiple personnel interactions with patients.

The Results

In addition to improved patient experience, standardized workflows, and faster development times, HCA Healthcare saw:

  • 90% reduction in staff effort via reusable assets
  • 56% prior documentation eliminated
  • 35% increased productivity for nurse case navigators
  • 40,000+ patients navigated since go-live
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Industry: Healthcare Product Area: Customer Service Solution Area: Customer Service
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