Enkata Optimizes Claims Processing

Enkata used to focus its products on improving agent performance in the contact center. It has gradually expanded that focus to include improving the performance of workers in the back office, an effort that has culminated in a suite of products that help companies improve processing of healthcare claims.

The process begins by tracking how employees who handle claims use their desktop systems. Enkata’s software is loaded on the desktop and captures key strokes, regardless of whether the user runs an application, starts a search or enters or retrieves data into or from a business application. Managers or analysts can group key strokes and the sequence in which they are used to represent a task; that may include, for example, opening a claim through to closing the claim or looking up customer information. The product can analyze the tasks users carry out, spotting variations in how they complete a task compared to how they are expected to do it, and noting when they do the tasks, any unproductive tasks they do and when they are idle. All of this information is displayed in graphical forms that, for example, show where each user spends time, a timeline that maps how each user spends the day, and timeline maps that show how different users spend their days. The analysis can go into greater depth and display the steps users take within a task to flag, for example, if a user misses a required step.

Armed with this information managers and analysts can pick out patterns and variations from the expected. This type of analytic inquiry is becoming important for many organizations. Our benchmark research shows that analytics is the most important business technology innovation for 39 percent of organizations. Enkata’s claims processing product includes a software scripting tool with which users can develop tracking applications that search for defined patterns or exceptions and display the names of users who exhibit the specified behaviors as they carry out their tasks. The final step in the process is to use this information to identify improvement opportunities and display them graphically on forms that include “click to action” buttons showing how the user needs to improve; for example, they can instruct the user to take a training session, receive coaching or adhere to a best practice. Reviewers can use these charts to set out action plans. Broader analysis across multiple users helps managers and analysts identify process improvements and action plans to ensure that more employees follow best practices.

Enkata has always positioned itself in the performance management space, and this product fits there. The end-to-end process of capturing data, analyzing it and creating action plans closes the claims processing loop and enables manages to enforce best practices. Over time the analysis can help companies improve the overall process by informally following Six Sigma procedures: set targets, measure performance against target, identify reasons for not meeting targets and put in place improvement programs to get future performance on target.

The product runs in the cloud and can be run in isolation or integrated with business process management applications; in that case it can input information on activities (processes) completed (including by who and when) and provide granular analysis of tasks within a process or steps within a task. Although Enkata’s first release is focused on claims processing, the concepts behind it apply equally to other processes so I expect to see other packages from the company.

In a tough economy, companies not only have to operate as efficiently as possible but also need to identify the consequences of processes or employee actions, such as the long-term cost of an employee settling a claim incorrectly. Companies also need to know what remote employees are doing and the outcomes of their actions. The analysis produced by Enkata’s software enables companies to do both. I recommend that those involved in processing claims evaluate it as they look to optimize processes and employee performance.

Regards,

Richard J. Snow

VP & Research Director

Salesforce.com Is Full of Surprises

Anyone who follows salesforce.com is used to surprises, but over the last couple of months the company has come up with some that go beyond the usual. It rebranded the recent user conference in London as a customer company event. This follows from changing its messaging to urge every company to become a customer company not a social company. The event itself was everything we have come to expect, using an array of customer case studies to show how salesforce.com’s products help companies innovate and be successful, and a large partner and product showcase to prove how many products and partners salesforce now has. The real surprises were tucked away in meetings arranged for the many analysts present.

Two messages struck major chords with me. The first was the repeated claim that “salesforce.com is not a product company with a development platform; it is a company with a development platform that has products.” Its history is of course the complete opposite: The products started with CRM in the cloud and evolved to marketing and sales services in the cloud, with an array of other services never called software. It achieved this status by a combination of product development and acquisitions, all of which developed on top of  Force.com, which has been renamed and expanded into the salesforce.com development platform. This shift places salesforce.com in a position where it can “own” customers, persuading them to standardize on products built on the development platform, whether they are salesforce products, in-house developed products or third-party products available through the AppExchange. The message includes the extensive integration capabilities that help companies integrate these with other internal systems and other third-party products on-premises or in the cloud. The goal is to tie companies to salesforce for the long term.

The other surprise was how extensively salesforce is getting into mobile apps. A little while back I wrote that the use of mobile devices is growing and that consumers are gradually adopting mobile apps as a form of self-service. That change is continuing, but salesforce.com seems to want to take it further. As part of the developer platform, it now has tools dedicated to helping companies build mobile apps, and so it joins the growing number of companies with such tools. However the message is about taking a different approach, which it proposes is needed to match users’ changing life and work styles. Salesforce presents this as enabling work on the move and doing “things” as apparent one-off tasks; for example, you look up someone’s details, make an appointment, open an opportunity, write up a meeting and place an order. The idea is to have an app for each of these and build systems that join them in end-to-end processes. I am not sure the market is ready for this yet, but then again no one predicted the impact social media would have on customer engagement.

Throughout the sessions there were mentions of the Marketing Cloud and how it supports companies as they move into social marketing, which is very different from traditional approaches. Against that background it was a major surprise when salesforce announced the acquisition of ExactTarget, a cloud-based digital marketing company, which takes a more conventional approach founded on email marketing. “Where does this fit in the grand strategy for Marketing Cloud?,” someone asked. “Where does this leave salesforce customers that have worked with other marketing products?,” asked another. I deduced from an analyst briefing from John Tascheck, Senior Vice President Strategy that ExactTarget has a large customer base that salesforce.com will sell into and that over time there will be rationalization of the products; so for now it is about market share and business as usual but clearly Salesforce is getting serious about meeting marketing needs by making acquisitions.

To cap all the surprises came the news that salesforce.com has signed a definitive partnering agreement with Oracle, which comes along with Oracle’s new partnering agreement with Microsoft. This one is hard to read given the contentious history between Marc Benioff and Larry Ellison, although it should be remembered that a lot of the salesforce,com products already use Oracle technology. The terms of the deal seem straightforward: salesforce standardizes on some Oracle development tools, and the Oracle HCM and financial cloud are integrated into salesforce’s; both leaders said it is important for customers to have better integration between their cloud applications. These deals could be about Oracle getting its cloud act together. It was late in moving to the cloud, so maybe these partnerships give it access to the expertise it needs to develop its cloud strategy. But if that is the case, why would salesforce and Microsoft give away their advantage? Is it plain and simply about gaining market share? If so, from whom – IBM? SAP? Only time will tell, but as many other commentators have remarked, it is a strange world we live in.

Regards,

Richard J. Snow

VP & Research Director