German former international young rider Theresa Friesdorf has welcomed the KWPN bred and former Danish warmblood licensed stallion My Toto VDT into her barn My Toto VDT is a 7-year old Dutch warmblood gelding by Toto Jr out of Velvet VDT (by Ferro x Calypso) He was originally named Morricone VDT and is out of Velvet VDT a proven KWPN broodmare with no less than 31 (!!) offspring as she has been bred through embryotransfer since 2018 Morricone VDT was first presented and accepted at the 2020 KWPN Stallion Licensing in 's Hertogenbosch and got renamed My Toto VDT He is Velvet's fourth approved son; the others are Goldfinger VDT My Toto sold through the KWPN Select Sale for 175,000 euro to Andreas Helgstrand The horse  never did his performance test in the Netherlands He was named premium stallion by the Danish warmblood society in March 2020 He finished fifth in the 2020 Danish Warmblood Autumn Performance testing with 829.5 points He was ridden by Mette Sejbjerg Jensen during his time in Denmark Morricone VDTThe stallion began his sport career in France Helgstrand had sent him to Jessica Michel-Botton for training and she won silver in the 4-year old division at the 2021 French Young Horse Championships When Michel got pregnant the horse was sent to Helgstrand Germany but did not compete there In 2022 his FEI passport was put to Leonie Richter's name but no show results are recorded in the German Equestrian Federation database Helgstrand sold the rising 7-year old to Bernhard Friesdorf for Theresa to ride. Dressprod first broke the news "My Toto VDT has been part of our family since August," Friesdorf told Eurodressage as we both want to concentrate on the sport together as a team." Theresa Friesdorf competed internationally as a Young Rider from 2020 to 2022 aboard Quotenkonig before selling him to Celestine Kindler Friesdorf and Quotenkonig in 2020Friesdorf who is based at the Luttgen family's yard Gut Mödrath in Kerpen aged out of Young Riders and is now a senior In 2023 she focused on competing nationally horses but also ponies due to her petite size Her main ride at the moment is Ferdinand (by Furstenball x Don Romantic) whom she shows at small tour level "After I get my bachelor’s degree at the end of 2023 I’m currently concentrating more on working with the horses there," said Theresa I am incredibly grateful for this opportunity and wouldn’t want to miss these training opportunities." Photos © Les Garennes - Dirk Caremans - Astrid Appels Stalls for Rent at Durondeau Dressage in Peer, Belgium Exceptionally Well Located Equestrian Facility in Wellington, Florida Well-built Equestrian Estate With Multiple Business Opportunities in Sweden Stable Units for Rent at Lotje Schoots' Equestrian Center in Houten (NED) For Rent: Several Apartments and Stable Wing at High-End Equestrian Facility Stable Wing Available at Reiterhof Wensing on Dutch/German border Real Estate: Well-Appointed Country House with Extensive Equestrian Facility in the U.K. Rémi Blot Deporting illegal immigrants is lawful. Imprisoning them in El Salvador makes a mockery of the Eighth Amendment. Jeff Kowalsky / AFP / GettyA Perfect Case for Congressional ActionNo one man should control the economy. Illustration by The Atlantic. Source: Win McNamee / Getty.The Trump Team Has a Double Standard on State SecretsOfficials have been careless with sensitive information while claiming that innocuous facts can’t be public. Illustration by The Atlantic. Source: Getty.Trump Is Deporting ‘Them’ in Ways That Threaten UsThe president’s strategy for targeting foreigners endangers the rights of Americans too. Pedro Mattey / AFP / GettyMake Public-Health Officials Stay in Their Lane AgainFighting anti-Semitism isn’t RFK Jr.’s job. Ian Maule / GettyDEI Has Lost All MeaningWe can’t debate its merits when we don’t agree on what it is. Illustration by The AtlanticThe Obvious Inefficiency of Elon Musk’s New OrderDOGE is wasting time and money on what makes sense only as a troll or a publicity stunt. Francis Chung / POLITICO / APHow to Rebuild From the AshesSanta Rosa’s Coffey Park was destroyed by a fire in 2017—but mostly recovered. It could be a model for Altadena and Pacific Palisades. Illustration by The Atlantic. Source: Matt Dutcher / Getty.Don’t Politicize Aviation SafetyThe tragic airliner crash in Washington underscores the risks of cavalier changes to regulatory agencies. Andrew Caballero-Reynolds / GettyL.A. Isn’t Ready for What’s NextSooner or later, a winter storm will hit, and deadly mudslides and debris flows will likely follow. Li Ying / Xinhua / Eyevine / ReduxThe Atlantic DailyGet our guide to the day’s biggest news and ideas, delivered to your inbox every weekday and Sunday mornings. See more newsletters Your newsletter subscriptions are subject to The Atlantic's Privacy Policy and Terms and Conditions Subscribe and support more than 160 years of independent journalism Payers face a distinct set of challenges that will need to be tackled head-on to create an environment that supports digital and AI transformation Functions within payer organizations are frequently siloed and some may have their own motivations to maintain the status quo rather than facilitate change adopting AI to help review prior-authorization requests might increase call-center volumes holistic planning is needed to avoid conflicts There are also tailwinds such as regulations encouraging data sharing and reimbursement models—for instance value-based care—that rely on frequent data sharing payers can build enough momentum to overcome undeniable hurdles and achieve sufficient business results for the transformation to become self-sustaining The transformation journey starts with creating a digital road map Many companies have hundreds of projects running in parallel with none delivering business results at scale We instead recommend dividing business processes into ten to 15 domains—such as marketing and sales—each representing thematically connected processes By starting with a clear focus on one or two business domains and a goal of improving performance by more than 25 percent (Exhibit 2) the organization can focus its attention and build momentum for the broader transformation Decisions about where to start can be informed by a review of performance against targets in areas such as customer and caregiver satisfaction Starting a pilot with domains in which the feasibility of transformation success is comparatively high—such as marketing and sales or enrollment and billing—can help payers build initial momentum and deliver quick wins To explain the rationale for starting with these domains payers are missing two critical components of user engagement: payers could launch their first full wave in the domains with the highest value at stake—in particular care management and network and contracting Although these domains are more complex than those in the pilot wave they have higher potential value from increased efficiency and more-targeted medical spend Rewiring for digital and AI transformation requires a talent bench with critical business and IT skills Because the healthcare industry overall tends to lag behind others in digitalization payers may lack the skills needed to reenvision and rebuild business processes using digital and analytics tools including AI Talent planning could emphasize acquiring or developing talent in the IT organization (for example and data engineers) and filling important roles on the business side The latter includes experienced product owners whose role is to help leaders identify promising analytics use cases and then “translate” the business requirements to IT professionals Taking a domain-driven approach facilitates talent transformation because it enables payers to invest in upskilling the workforce in stepwise fashion rather than all at once Payers that have had to attract outside talent have been successful in emphasizing the benefits of working in an industry with a high degree of job security and whose mission is to improve human health filling critical roles such as product owners may require payers to pair healthcare experts with technical experts to get the requisite level of knowledge as true end-to-end owners of business process and technology to make “fit for purpose” decisions about technology one pod may need gen AI expertise to optimize data quality so that it can collect all required information to process a claim while another may need neural network expertise to write rules-optimization algorithms that enable traceability and explainability in the adjudication process resource-constrained payer IT organizations can turn to vendors for mature modern off-the-shelf platforms and use gen AI to reengineer the business logic encoded in them to facilitate the transition In cases where full replacement is impractical or too expensive in the near term payers can still capture platform benefits by building interface layers that streamline and simplify interactions with legacy core systems a large global health insurer established a modern integration layer on top of its region-specific core solutions enabling workflows to be managed in a uniform way across geographies without the need to replace the core systems themselves Modernizing core platforms can free up IT capacity to focus on step change advances that can give payers a distinctive edge such as fine-tuning adjudication and prior-authorization processes and building tailored member offerings This work can be enabled by embedding AI models and ensuring rapid innovation through microservices owned by agile pods ready-to-use data sets can be reused across the organization to help break down organizational silos and facilitate scaling of the digital transformation payers that aspire to become orchestrators of healthcare ecosystems and guide patients through the system along care pathways will need to build out interoperable data ecosystems across healthcare stakeholders Once payers and care delivery organizations have aligned targets to optimize patient care using data-driven approaches digital twins can be jointly built up and used to optimize processes at points of care including traditional settings Ensuring successful adoption and scaling is a prerequisite for value generation this comes down to the following principles: You find a time machine and travel to 1920 A young Austrian artist and war veteran named Adolf Hitler is staying in the hotel room next to yours so you could easily stroll next door and smother him Is it acceptable to kill him to prevent World War II This is one moral dilemma that researchers often use to analyze how people make difficult decisions one group re-analyzed answers from more than 6,000 subjects to compare men's and women's responses They found that men and women both calculate consequences such as lives lost But women are more likely to feel conflicted over what to do Having to commit murder is more likely to push them toward letting Hitler live "Women seem to be more likely to have this negative gut-level reaction to causing harm to people in the dilemmas whereas men were less likely to express this strong emotional reaction to harm." Every question in the study had two scenarios each with slightly different consequences in order to tease out different ways of thinking about the dilemma weighing costs and benefits to make a decision Philosophers would label the first group as utilitarians The latter are more likely to let Hitler live One hypothetical dilemma replaces Hitler with a man who abducts a child and holds her ransom for a week because both philosophies would support letting the kidnapper live so a person motivated by social norms will let him live so a person motivated by consequences would argue that the costs outweigh the benefits which is why the researchers used 10 scenarios The Hitler example relies heavily on time travel but Friesdorf worries that people won't respond properly unless they fully accept time travel If they assume that time travel is impossible There's a similar problem with self-interest – whether the person asked is in immediate danger A person might be more willing to torture a prisoner if he or she is in immediate danger Friesdorf says that she finds the "Hard Times" dilemma to be one of the most interesting "You are the head of a poor household in a developing country Your crops have failed for the second year in a row and it appears that you have no way to feed your family are too young to go off to the city where there are jobs "You know a man from your village who lives in the city and who makes sexually explicit films featuring girls such as your daughter he tells you that in one year of working in his studio your daughter could earn enough money to keep your family fed for several growing seasons "Is it appropriate for you to employ your daughter in the pornography industry in order to feed your family?" even though it will save the rest of the family," says Friesdorf She also analyzed a small subset of the data in which each subject reported how difficult it was to choose a course of action Women tended to find it more difficult to decide and Friesdorf hypothesizes that this is because they feel more conflict between weighing benefits and harms versus following society's moral rules "Women seem to be feeling more equal levels of both emotion and cognition They seem to be experiencing similar levels of both so it's more difficult for them to make their choice," she says Friesdorf says we encounter less dramatic variations of them all the time a manager might need to make an employment decision that would weigh the future of one person against the fate of a group "If these [gender] differences also hold in that context then that could have some implications for how women and men are making those decisions," she says Become an NPR sponsor Theresa Friesdorf has handed over the ride on her number one Quotenkönig is a 14-year old Westfalian gelding by Quaterback out of Fleet Street (by Furst Piccolo x Sandro Hit x Contender) The liver chestnut became the third ranked premium stallion at the 2011 Westfalian Stallion Licensing He was owned by Karin Dust at the time and she bought back her own colt in the auction for 170,000 euro He did his 30-day suitability test in 2012 in Munster and scored 8.38 for dressage and 7.18 for show jumping He achieved his full licensed status through the Bundeschampionate qualifiers At the 2016 World ChampionshipsQuotenkönig was first competed by Lisa Lindner (née Neukäter) in 2012 They won bronze at the Westfalian Young Horse Championships and silver at the Bundeschampionate that year In 2013 there was gold at the Westfalian Championships but did not start at the Bundeschampionate They repeated gold in 2014 at the Westfalian Championships and got fourth place at the Bundeschampionate Wolfgang Suttrop was listed as his owner at that time In 2015 the pair finished 9th in the finals at the World Championships for Young Dressage Horses in Verden At the 2015 Bundeschampionate they were fifth At the 2016 World Young Horse Championships in Ermelo they were 6th in the consolation finals for 7-year olds In 2018 Quotenkönig moved to Isabell Werth's yard to be developed to Grand Prix level and sold Niklaas Feilzer showed him in the Nurnberger Burgpokal qualifiers and in 2019 they moved to Grand Prix level Werth Werth competed the horse herself once In February 2020 he sold to the Friesdorf family for Theresa to ride Friesdorf and Quotenkonig at the 2020 CDI HagenThe pair made its international show debut at Young Riders' level at the 2020 CDI Sint-Truiden in Belgium and they competed internationally through July 2022 with starts in Hagen, Le Mans and Aachen. In 2020 and 2021 they were 9th at the German Young Riders Championships 2022 was Friesdorf's last year as a young rider and at the start of the year she ride him in the Piaff Forderpreis selection trial for German Under 25 riders in Warendorf At the end of the year they were 6th in the 2022 German Young Riders Championships Friesdorf rode her last show on Quotenkönig in October 2022 in Mönchengladbach at Intermediaire II level The 19-year old Celestine Kindler has now taken over the ride on Quotenkönig Kindler began competing in 2016 on pony Valencia (by Viscount x Top Gun II) In 2019 she moved onto horses with Deal or No Deal (by Don Juan de Hus x Florestan) and showed him at L level Celestine Kindler on RomeoShe premiered at junior M-level aboard Romeo a 13-year old Danish warmblood by Romanov x De Noir which she discovered when he was offered for sale on Eurodressage in the early spring of 2020 Kindler and Romeo first competed internationally at the CDI Hagen in September 2020 and then went to the CDI Ornago a year later They did one international in Achleiten in 2022 She rode her first young riders' level tests on Romeo in the autumn of 2022 Kindler will have a confirmed Prix St Georges horse to rely on for her time as a young rider Photo credit: Lemuel Cantos (Creative Commons) would it be right to kill Adolf Hitler when he was still a young Austrian artist to prevent World War II and save millions of lives Should a police officer torture an alleged bomber to find hidden explosives that could kill many people at a local cafe men are typically more willing to accept harmful actions for the sake of the greater good than women women would be less likely to support the killing of a young Hitler or torturing a bombing suspect even if doing so would ultimately save more lives According to new research published by the Society for Personality and Social Psychology this gender difference in moral decisions is caused by stronger emotional aversion to harmful action among women; the study found no evidence for gender differences in the rational evaluation of the outcomes of harmful actions A new study finds that both men and women are slightly more attracted to younger partners during blind dates, challenging the common belief that only men prioritize youth. These real-world findings reveal a mismatch between people’s stated preferences and actual desire. A recent study sheds new light on the complicated nature of narcissism. Rather than a single personality type, researchers identified four different narcissistic profiles. Feeling unexpectedly grossed out by a romantic partner? A new study sheds light on “the ick,” revealing that individual traits—like how easily disgusted someone is or how high their standards are—can shape these reactions. Women reported it more often, but both genders experience it for surprisingly minor reasons. A new study finds that older adults engage in less self-reflection about their personality traits than younger adults. People with lower emotional stability or extraversion tend to reflect more, especially through comparisons with others or their past selves. Researchers have uncovered a link between politicians' dark personality traits and affective polarization, suggesting that voters who support these leaders experience greater dislike for political opponents—especially when they feel ideologically aligned with the candidate. A new study finds that people with avoidant attachment styles toward their parents are more likely to be childfree, offering insight into how early emotional bonds may shape decisions about parenthood. A large-scale study has found that conservatives in the United States trust scientists less than liberals across nearly all scientific fields. Attempts to boost trust through brief, targeted messages failed, suggesting these attitudes may be deeply rooted. Please enter your username or email address to reset your password. Researchers came to this conclusion by poring over the answers 6,100 people gave to a range of moral questions that involve committing harm for the greater good "Women seem to be more likely to have this negative, emotional, gut-level reaction to causing harm to people ... whereas men were less likely to express this strong emotional reaction to harm," says lead author Rebecca Friesdorf. The study, published in Personality and Social Psychology Bulletin looked at reactions to questions about torture if you lived in a poor household in a developing country and crops were bad for the second straight year would you let your daughter work in pornography to feed the family even though it will save the rest of the family," Friesdorf tells NPR she found that women struggled more with decisions likely because they balanced the outcome against the importance of following societal rules men were more utilitarian (concerned with long-term consequences) while women tended to be deontologists (dwelling on the morality of acts that break societal norms "Women seem to be feeling more equal levels of both emotion and cognition," says Friesdorf "so it's more difficult for them to make their choice." Graphic Designer Is it moral to end one life in order to spare five as well as the process used to arrive at a decision according to “Gender Differences in Responses to Moral Dilemmas,” a study published in the April edition of the Personality and Social Psychology Bulletin Researchers used a meta-analysis to reevaluate 6,100 responses from 40 consulting studies to determine how one’s gender can influence difficult moral decision-making They reported that men and women evaluate and weigh the outcomes of ethical dilemmas in different ways The studies in the analysis presented decisions about these dilemmas which are generally informed by two philosophies: An ethical dilemma that is decided by separate social and cultural rules is deontological while a utilitarian decision considers relative benefits and number of beneficiaries of the prospective action “Women were found to have stronger deontological inclinations whereas men and women were found to engage in similar levels of utilitarian inclinations,” said lead author Rebecca Friesdorf a master’s student in social psychology at Wilfred Laurier University “Women were fully aware that killing one to save five really you’re getting a better outcome by saving the five but they had a strong aversion to doing the harm and that’s what seems to be driving the differences in the decision.” The studies that researchers analyzed presented two scenarios with different outcomes to evaluate if subjects were making deontological or utilitarian decisions These findings supported previous research that establishes gender differences in moral choices but it was neat to see how strongly it was coming out in response to the moral dilemma,” Friesdorf said which has found that men and women don’t differ very much in terms of the cognition [or] in terms [of] how well they reason with most things but we know with things like empathy or relating emotionally to other people women tend to do those things more than men.” Having more women in traditionally male-dominated decision-making positions would lead to more diverse outcomes co-author and a professor of psychology at the University of Cologne in Germany “If you have primarily men making decisions then they will mainly focus on the logical rational outcomes of the activity,” Conway said “They sometimes might look at women and say they’re not thinking as hard as the men are,’ and that’s not true Our data shows clearly that women are thinking in a similar way that men are thinking Creating a better gender balance in decision-making bodies like Congress would be helpful for that to introduce a wider variety of opinions.” Research supports that women will likely have more empathy in the case of either outcome regardless of the utility of the decision “Women tend to have a stronger emotional reaction to the harm that will be dealt,” Conway said “They can more vividly imagine the people on the ground and their perspective and how that is bad Men are less likely to appreciate that element and I think if you’re going to make good moral decisions you should think more carefully about multiple perspectives.” Both biological and social factors contribute to the distinction between male and female decision-making “There’s links between how much testosterone people have and how willing they are to cause harm to other people,” Conway said “There’s [also] really important social distinctions girls get more feedback from the important people in their life that they should pay more attention to other people’s feelings Decisions like this are classically represented by dilemmas such as the “trolley problem.” The trolley problem is a utilitarian moral dilemma in which five people are strapped to a trolley-car track with an out-of-control trolley approaching There is a lever within reach that would divert the trolley to a track that only has one person strapped to it “This is a way of trying to say: How do we value different people when making a moral decision?” said Rami Gabriel an associate professor of psychology at Columbia “When we’re trying to decide on what is morality Conway said decision-makers have a hard time considering that different perspectives can influence the choices others make when faced with dilemmas “What I want people to take away is that there’s different perspectives on moral dilemmas,” he said If you don’t agree with someone’s moral decision it could be because they’re thinking about it in a different way than you are and people are disagreeing over this point of view we should listen carefully to each other and try and understand each other and why people feel the way they do because there could be the peer educator program and the student government association are celebrating Pride in May Seats in Columbia’s Courtyard Theatre were packed for the opening night of the School of Theatre and Dance production of “Rent.” The anticipation.. 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Metrics details The experimental realization of large-scale many-body systems in atomic-optical architectures has seen immense progress in recent years rendering full tomography tools for state identification inefficient To work with these emerging physical platforms new technologies for state identification are required Here we present first steps towards efficient experimental quantum-field tomography Our procedure is based on the continuous analogues of matrix-product states These states naturally incorporate the locality present in realistic physical settings and are thus prime candidates for describing the physics of locally interacting quantum fields To experimentally demonstrate the power of our procedure we quench a one-dimensional Bose gas by a transversal split and use our method for a partial quantum-field reconstruction of the far-from-equilibrium states of this system We expect our technique to play an important role in future studies of continuous quantum many-body systems This approach will allow us to give evidence that the state encountered in the laboratory is well approximated by a representative of this class We apply our procedure to non-equilibrium experiments of a continuous quantum gas of one species of bosonic particles whose correlation behaviour can be captured by translation invariant states of the form L] are the canonical bosonic field operators R∈Cd × d are matrices acting on an auxiliary d-dimensional space and completely parametrize the state L is the length of the closed physical system denotes the path ordering operator and Traux traces out the auxiliary space The bond dimension d takes the same role as the bond dimension for matrix-product states: Low entanglement states are expected to be well approximated by cMPS of low bond dimension; in turn every quantum-field state can be approximated the system can be well approximated by two parallel quantum fields that are homogeneous and translationally invariant The phase correlation functions are defined as where are the measured phase differences and the angular brackets denote the ensemble average (Methods section) To capture these correlation function in terms of a cMPS we use a description in terms of effective field operators for the phase difference As no density information could be obtained from the experiment in its current form the expectation value of these operators remains unknown and our work is a partial reconstruction of the state the obtained cMPS contains its full phase correlation behaviour we can write an n-point phase correlation functions as Since it is sufficient for performing the tomography procedure we will use the correlation information of the normal ordered subset with x1≤x2≤⋯≤xn of the even-order correlation functions assuming translation invariance and the thermodynamic limit We show projections of the relevant sections of the (a) experimental and (b) predicted six-point function for a hold time after the quench of t=3 ms This image shows the volumetric elements of certain projections of the high-dimensional six-point correlation function array and demonstrates a great overall agreement between experimental data and the predicted correlation data the absolute difference between the experimental and the predicted data points for the projection C(4)(0 the statistical uncertainties of the data as a transparent mesh as a figure of merit for measuring the performance of the reconstruction we use the mean relative deviation over all indices belonging to the relevant simplex of the data with x1≤ x2 ≤···≤ x6 (Methods section) and find a mean error of 2.5% and a maximum relative deviation of 9.1% We show projections of the four-point correlators for a hold time of (a) 3 ms The quality of the cMPS ansatz decreases substantially with the hold time with a mean relative deviation of the full four-point correlator as indicated in the figures This increase of the deviation with hold time could be seen as an indicator for the non-equilibrium processes in the system (see main text) but is presumably also related to the increase in s.e as indicated by the error bars (Methods section) Such entanglement growth could conceptually be unveiled by investigating how the fit quality changes when the bond dimension is increased Given the structure of the data set (analysis contained in the Methods section) and the increase of experimental errors with hold time the exploration of this observation lies outside the scope of this work but is surely an interesting topic for the near future thus making the data less translational invariant (Methods section) The work presented here is surely a first step in the direction of a larger programme advocating a paradigm change in the evaluation of experimental data from atomic-optical architectures Instead of comparing predictions of an assumed theoretical model with data one puts the data into the focus of attention and attempts a reconstruction in the mindset of quantum tomography seem an important development in the context of quantum simulators which have the potential to address questions on interacting quantum systems that are inaccessible with classical means While partial information of the results of a quantum simulator can easily be accessed a full read-out necessarily corresponds to performing quantum tomography where feasible tools are still lacking The present work offers a step forward and presents a novel tool to obtain and build trust in the complete results of a quantum simulation without having to include any information of the underlying Hamiltonian of the system The corresponding correlation functions are constructed by averaging over ∼150 experimental realizations This global phase diffusion results from small shot-to-shot fluctuations in the electrical currents that create the trapping potential These cause small random imbalances of the double well leading to random and unknown values for ϕ For the even-order correlation functions only differences between the θ at different positions need to be evaluated for odd-order correlation functions contributions ∼eiϕ remain the measured result does not only contain the pure dynamics but is significantly perturbed by the unknown fluctuations of ϕ To make the correlation function in equation 2 directly accessible to our reconstruction procedure we use the fact that commutes for different positions and employ the polar decomposition to construct an effective field operator where is taken to be the density of one of the two condensates The construction ensures that these effective field operators indeed fulfil the correct commutation relations the translationally invariant correlation functions in equation 4 can be directly calculated in terms of the cMPS variational parameter matrices R and Q in the thermodynamic limit as By writing all the matrices in the basis where the transfer matrix T is diagonal and performing the limit L→∞ The λk are the eigenvalues of the transfer matrix T according to the calculus of cMPS correlation functions the field operator term for each position corresponds to the matrix Note that equating two consecutive indices kj kj+1 in the n-point function in equation 10 leads to a (n−2)-point function there are many equivalent projections of a four-point function that correspond to two-point functions the experimental realizations of these projections are not identical Averaging over the projections leads an expression of the same form of a two-point correlation function from a translationally invariant cMPS as follows The remaining independent entries of the M matrix are fixed by included four-point correlation data we use a Nelder–Mead simplex algorithm that varies the parameters of the M matrix and calculates the corresponding residues according to with bond dimension d=2 in terms of λk and M To quantify the error of our tomography procedure we use the relative mean deviation with respect to the fitted (reconstructed) data starting with the reconstructed four-point function from the experimental data we add Gaussian noise with zero mean and s.d given by the statistical uncertainties from the experiment we perform our cMPS tomography procedure and reconstruct the six-point function We repeated this procedure 100 times and computed the entry-wise relative standard deviation of the six-point functions we obtain a deviation of 1.1% (with a maximum relative s.d This confirms that our reconstruction procedure is robust to the errors we expect in the experiment Towards experimental quantum-field tomography with ultracold atoms Quantum information processing and metrology with trapped ions Experimental repetitive quantum error correction Quantum simulations with ultracold quantum gases Goals and opportunities in quantum simulation Local emergence of thermal correlations in an isolated quantum many-body system Non-equilibrium coherence dynamics in one-dimensional bose gases Probing the relaxation towards equilibrium in an isolated strongly correlated one-dimensional Bose gas Quantum state tomography via compressed sensing Scalable reconstruction of density matrices Efficient and feasible state tomography of quantum many-body systems and variational renormalization group methods for quantum spin systems Continuous matrix product states for quantum fields Sub-poissonian fluctuations in a 1d bose gas: From the quantum quasi-condensate to the strongly interacting regime Relaxation and prethermalization in an isolated quantum system Exact relaxation in a class of non-equilibrium quantum lattice systems Quantum many-body systems out of equilibrium Prethermalization revealed by the relaxation dynamics of full distribution functions On entropy growth and the hardness of simulating time evolution The dynamics and prethermalization of one-dimensional quantum systems probed through the full distributions of quantum noise Experimental observation of a generalized Gibbs ensemble Light-cone-like spreading of correlations in a quantum many-body system Local relaxation and light-cone-like propagation of correlations in a trapped one-dimensional Bose gas Matter-wave interferometry in a double well on an atom chip Chiral pre-thermalization in supersonically split condensates Download references the FQXi and the BMBF (QuOReP) and the Austrian Science Fund (FWF) SFB-Foqus (P4010) for support acknowledge support by the FWF Doctoral Programme CoQuS (W1210) We thank the KITP in Santa Barbara for hospitality and acknowledge R Vienna Center for Quantum Science and Technology set up the experiment and carried out the measurements conceived the experiment and supervised the measurements wrote the manuscript with substantial contributions from all authors The authors declare no competing financial interests Reprints and permissions Download citation Anyone you share the following link with will be able to read this content: a shareable link is not currently available for this article Sign up for the Nature Briefing newsletter — what matters in science September 9, 2021By Ulrike Deetjen, Mathis Friesdorf, and Henning Soller Digitization is rapidly changing the competitive landscape for healthcare payers. Consumers increasingly expect seamless omnichannel offerings. Digital natives are driving innovation in integrated healthcare delivery, requiring payers to compete effectively in digital health ecosystems And continued economic pressure makes internal process efficiency the next necessary step change To stay ahead of the competition and take full advantage of digital opportunities payers globally need to build the required underlying foundations data is increasingly becoming the main limiting factor Payers usually excel in processing certain data they have only started to build the data foundations they need to execute their digital agenda including a 360-degree view of consumers for omnichannel service a data layer integrated across healthcare stakeholders to support ecosystems and process tracking and mining to enhance internal efficiency we have seen many payers build dedicated data marts for actuary optimization at impressive speed and establish analytics use cases with clear business cases behind them But few payers have succeeded at scaling this approach to areas where data management is often more complex Although healthcare payers have an abundance of data they often lack the ability to make it accessible and amenable to analysis that have become data driven in the past decades Health data is subject to a high level of regulation to protect patient information from cyberattacks, loss, or corruption, as well as to ensure privacy rights many healthcare payers have taken a conservative approach to data usage avoiding use cases that might raise privacy issues they have missed out on value-creation opportunities the major technology and e-commerce players have led the way and ready-to-use solutions are widely available What makes data management particularly challenging for healthcare payers is that data storage and evaluation need to be controlled in a way that both protects and handles each element according to its individual sensitivity storing and analyzing medical data of insured patients is not allowed in most European countries but might be critical to support disease-management programs each data point should be linked to a clear purpose An email address will always be used for billing but payers may not use it for sales unless individuals explicitly opt in well-established permission-management solutions must be tailored to specific healthcare situations This is the area where many payers still seem to struggle the most Europe’s General Data Protection Regulation (GDPR) has emphasized the importance of data deletion This requirement is particularly relevant for payers due to the wealth of sensitive data they collect Since this data is usually spread across multiple systems adhering to GDPR calls for elaborate deletion protocols that can be partially automated but will likely involve several manual steps payers must often improve their technology foundation Data-storage and data-management solutions need to be upgraded including optimized master-data management to improve data quality and consent and permission management to ensure compliance Modern streaming and data-lake solutions increasingly play a role in allowing organizations to process live data streams or unstructured data Many payers currently rely on simple manual routines Open-source tools as well as modern visualization and evaluation technologies can help fill this gap we see that the setup of full toolchains is no longer required but can be directly deployed from the cloud The biggest pain points for payers are often not data storage or evaluation but ensuring that functions across the organization have access to insights from data Addressing this issue requires payers to be more flexible in process design and to develop the capability to embed analytical models seamlessly This integration ensures that exceptions are flagged and the proper intervention is followed—for example if during the payment process certain medical conditions do not match with the procedures performed Modern process-integration tools can help manage these tasks in an automated fashion large-scale analyses; and the ability to leverage dedicated technology solutions as knowledge graphs for specific problems at hand the hesitancy of healthcare payers to move to the cloud has been a barrier to the adoption of such solutions that a clearly defined scope and the right technical and organizational measures can enable organizations to successfully deploy cloud solutions Data management becomes particularly relevant when assessing it from an ecosystem angle two types of ecosystems have emerged in healthcare First, traditional healthcare is integrated with e-health approaches, where providers and payers become more interconnected and medical data can travel seamlessly along care pathways—for example, by providing a medical history when a patient sees a specialist. Second, digital healthcare is becoming more prominent thanks to widespread use of telemedicine during COVID-19 patients are increasingly embracing medical apps and even healthy individuals monitor their well-being through tools such as fitness trackers These two trends have led to an ever-growing health ecosystem with potentially relevant data spread across a multitude of stakeholders An initial critical task for payers in participating in and orchestrating digital health ecosystems is transferring the data along care journeys: healthcare ecosystems still haven’t resolved the ownership of data and when and how it can be used imagine a patient enrolled in a payer disease-management program that is supported with a medical-support app built by a third party Should the payer now have access to all data from the app what kind of additional data can the payer provide to improve an app that is central to its disease-management program While such questions may appear to be legal issues they strike at the foundation of healthcare ecosystems addressing them will be a critical challenge for payers in the coming years and will ultimately define whether they are serving as effective stewards in guiding their population through the complexity of the healthcare ecosystem most healthcare payers can improve access to data-driven insights through targeted enhancements to tangible use cases and steps to integrate with broader ecosystems Cloud-based solutions and new technology databases can ease this journey significantly seamless integration with the processes through appropriate tooling typically remains the biggest lever to generate impact Ulrike Deetjen is a partner McKinsey’s Stuttgart office, Mathis Friesdorf is an associate partner in the Berlin office, and Henning Soller is a partner in the Frankfurt office The 11-year old formerly licensed Westfalian Quotenkönig has been sold to German Young Rider Theresa Friesdorf Quotenkönig is a 2009 born gelding by Quaterback out of Fleet-Street (by Fürst Piccolo x Sandro Hit x Contender) He is bred by Frank Dahlhoff and was owned by Wolfgang Suttrop The liver chestnut was approved at the 2011 Westfalian Stallion Licensing in Munster where he became the third ranked premium stallion At the licensing he was owned by Karin Dust but she bought back her own colt in the auction for 170,000 euro He did his 30-day suitability test in 2012 in Munster and scored 8.38 for dressage and 7.18 for show jumping Quotenkönig sired seven state premium daughters and one licensed son: Quo Vadis (by Quotenkonig x Londonderry x Warkant) At the 2012 BundeschampionateQuotenkönig was first competed by Lisa Lindner (née Neukäter) in 2012 In 2015 the pair represented Germany at the World Championships for Young Dressage Horses in Verden and finished 9th in the Finals after placing third in the consolation finals At the 2016 World Young Horse Championships in Ermelo they were 6th in the consolation finals for 7-year olds In 2018 Quotenkönig had moved to Isabell Werth's yard to be developed to Grand Prix level and to be potentially sold Niklaas Feilzer took on the ride and first showed him at small tour level starting in January 2018 and trying for the Nurnberger Burgpokal that season with the Developing PSG horse tests in Germany In 2019 Feilzer and Quotenkönig tackled the Grand Prix in the late spring Isabell Werth competed the horse herself only once at the national show at Gut Ising in the Inter II and short Grand Prix At the 2016 World ChampionshipsQuotenkönig has now been sold to German young rider Theresa Friesdorf who switched trainers from Antonius Holland to Jochen Bender is 18 years old and began on ponies with Chiwaja K (by FS Chiwago x Don't Worry) and junior horse Formelli (by Furst Grandios x Fidermark Most recently she competed Wolfgang Zant's Shadow 678 (by San Amour x Fidermark) at regional Grand Prix level and obtained her Golden Riders Badge  Friesdorf is yet to make her international show debut "With my new coach Jochen Bender I started looking for a new sports partner for next year's Under 21 tour and finally found Quotenkönig," Friesdorf told Eurodressage "I'm looking forward to a great season with my horses and the support of my trainer." and a seamless journey focused on their individual needs chatbots and other artificial intelligence (AI) assistants are now being systematically deployed to support consumers on their digital journey Although companies in these industries still offer consumers traditional channels and contact points with service employees most consumers enjoy the convenience that digital offers them and would not want to go back to the days when all transactions had to be dealt with in-person The overall substandard experience that most payers offer consumers is often justified by the complexity of the payer business model Since payers offer low-involvement products demand is not sufficient to justify a major investment in omnichannel capabilities Although many consumers still prefer to use traditional channels (e.g. call centers) to contact their health insurer a clear trend toward greater demand for digital channels is emerging (Exhibit 1) an omnichannel approach can bring impressive benefits to traditional channels The regulatory requirements for payers prevent omnichannel offerings existing restrictions are often cited as a major challenge that need to be addressed when a payer is building omnichannel capabilities many other industries that are also heavily regulated (e.g. banking) have managed to work around these obstacles regulators in many countries are increasingly supporting ways to legally enable digital channels This article provides guidelines payers can use to build omnichannel capabilities and design a solid foundation for a seamless best-in-class consumer experience Some payers have argued that the nature of the health insurance industry makes it impossible to achieve that level of consumer experience (see the sidebar for more details) We disagree—we have seen a few payers offer consumer experiences that rival those offered by leading digital-native companies In addition to improved consumer experience omnichannel can yield substantial business benefits through leaner and more efficient member onboarding and service processes Omnichannel can also reduce operational expenditures on member service in three ways: Exhibit 2 illustrates the impact achieved by one German payer the payer’s member service was heavily based on branch networks; the use of digital offerings was limited the payer was able to move about 50 percent of its member services to digital channels which reduced the cost of delivering a service by 30 to 50 percent the omnichannel transformation improved the member experience by making faster service possible The payer’s remaining branches now focus on value-added services Omnichannel relies on two main building blocks: best-in-class channels and seamless channel integration (Exhibit 3) Given the current quality of most payers’ digital channels As payers begin to integrate their channels they should bear in mind that at least in the short term digital offerings cannot fully replace traditional consumer service channels Traditional channels may still be needed as an escalation lever to provide targeted support and resolve complex issues a payer might want to steer some consumers to live-person channels (e.g. to use the live contact to increase sales or because a member’s illness requires intensive support) some consumers may simply prefer talking to a service employee although research shows this group is shrinking (Exhibit 1) as payers begin their omnichannel transformation they should make sure that their live-person channels are also best-in-class seamless integration is the ability to switch easily between channels at any time without having to provide information twice A common use-case example involves a member who starts filling out a form online or through an app The member should be able to reach a contact center employee who has access to the data already filled in and should not have go through any additional authentication processes (Exhibit 4) This type of seamless integration usually poses the greatest challenge in an omnichannel transformation because it has extensive implications for organizational setup and IT capabilities A mature omnichannel operating model requires strong performance in four areas (Exhibit 5) By optimizing offerings and using targeted approaches an organization can attract new members and reduce churn among existing members Optimizing internal processes can lead to a substantial increase in efficiency The underlying IT architecture needs to be extended significantly to ensure seamless integration across consumer journeys the organization itself needs to adapt to make omnichannel truly successful we address seven key questions in these areas and discuss how a successful omnichannel operating model can be established omnichannel helps increase their satisfaction and reduces churn and has the potential to decrease claims costs by optimizing the use of medical services member requests have been processed by mail rooms and contact centers many members believe they can reach out to companies through any of a number of channels and rapidly receive an appropriate response some members may air grievances on social media (e.g. payers are being forced to change with the times or be left behind Omnichannel member service relies on three main building blocks (Exhibit 6) a self-service portal ensures that all services are available on digital channels and all information is accurate and up to date member-centric design is crucial to ensure that the service portfolio is targeted to user needs Given that most health insurance members currently rely on offline channels steering them to self-service options may sometimes be a challenge offering intuitive user interfaces and providing digital access to the complete service portfolio can go a long way in attracting members to digital channels it is important to offer member journeys with a very low usage barrier and to have a flexible yet secure way for identity management (see section 4 below) To serve members on their preferred channel payers have a strong need to seamlessly integrate traditional channels with digital offerings the integration requires an “omnichannel desktop.” Its main functionalities should include: Creating these desktops is one of the major IT challenges for omnichannel (see section 5) Once the digital and live-person channels are in place service requests need to be routed logically to improve both member satisfaction and efficiency The logic should be based on traditional routing concepts in contact centers and rely on employee knowledge profiles and the suitability of different channels for certain requests Incorporating advanced analytics models can help a payer go beyond its usual up-selling model by enabling it to predict why a consumer is calling and provide recommendations on topics the consumer might raise during the call It is particularly important that payers shift to proactive communication with members to enhance transparency—the ideal would be to avoid service requests altogether digital channels offer a whole new way to ensure that members fully understand the current status of their requests and receive timely updates Omnichannel delivers an integrated sales and service experience throughout an entire consumer journey—the payer is always reachable and perfectly informed about the consumer’s needs and its offerings are consistent at all touch points Exhibit 7 illustrates what is needed to succeed in one consumer journey (selecting an insurance plan) attracting and capturing a consumer’s attention requires the ability to leverage knowledge about the consumer so that messages can be tailored to preferred channels and communication behavior all forms of modern advertising should deliver a coherent message that aligns with consumer needs systematic leads management must collect promising leads and form an integrated view of each one A leads engine should then identify the most promising leads and determine each consumer’s preferences existing internal and third-party data can be used to make smart recommendations about plan choice without the need for the consumer to provide information cross-channel campaign management ensures that potential members are approached in an optimal way Once potential members begin to actively reach out for information all channels should deliver consistent information about the insurance product A systematic approach to knowledge and digital asset management can help ensure that all channels Once the potential member has filled out an application calculating the offer often requires an exceedingly complex underwriting process the focus should be on adaptive underwriting and seamless channel integration to ensure that the potential member can enter the required data points in the most efficient way many payers require bureaucratic processes to finalize sales and (depending on the country and product) sometimes still rely on paper-based processes omnichannel should allow the consumer to sign the policy and finalize the sale through any channel the payer must have the necessary technical capabilities (e.g. a new sales-attribution model to determine how sales should be attributed to sales staff and departments) sales incentives must be adjusted to ensure that everyone involved in facilitating a sale is appropriately compensated Omnichannel is not only a powerful instrument to attract new members and better serve existing ones—it can also be a significant driver of increased internal efficiency (Exhibit 8) omnichannel is inextricably intertwined with digitization as a whole (including increased automation and optimized digital document processing) All aspects of digitization should be driven in parallel to maximize efficiency Reducing the number of member interactions can be achieved in two ways member questions and concerns can be automatically addressed without them ever surfacing explicitly a digital interface can provide transparent status tracking avoiding the need for members to have to call repeatedly to find out when their claim will be processed The interface should provide the same level of detail accessible to customer service representatives not summarized views (which is often the case in current apps) the shift to digital channels—an integral part of omnichannel—usually simplifies processes and speeds them up thereby reducing the number of member touch points required to resolve a request Omnichannel also reduces the time required to handle individual requests A shift to digital communication minimizes the need to devote human resources to handling member requests offering members digital self-service tools makes it possible to automate many back-office processes and can provide assistance when human evaluation is required For requests that need to be handled by service employees an omnichannel desktop (as described in the previous section) makes optimizing the overall workflow of every employee possible; the direct member interactions in all channels can markedly increase employee productivity (by about 20 to 50 percent the interface ensures that all forms and requests are submitted digitally again supporting digitization and automation which raises significant challenges for automation and analytical evaluation We have found that the main culprit is the use of physical letters is still the most common way to reach members The quality of data gathered through digital forms is much higher than that obtained when physical documents are later scanned omnichannel ensures that even employees with limited experience and know-how can confidently navigate member interactions Because the front ends of IT systems for service employees are integrated across all business areas and channels the barriers for employees to help members effectively are lowered customer service representative training becomes easier effectively also reducing recruiting requirements for the job When combined with increased automation of simple requests and a clear focus on value-adding work omnichannel can be a major driving force for increased employee satisfaction and efficiency Payer data contains some of members’ most personal information and a range of incidents have already demonstrated that current processes are not sufficient to protect the information adequately the European Union’s General Data Protection Regulation or GDPR) are imposing concrete security standards and minimum requirements for protecting personal data securing member information on all channels will be a pivotal part of omnichannel in coming years a payer could consider building a comprehensive identity platform (Exhibit 9) This platform establishes a bridge between two processes at the core of secure communication: the generation of omnichannel identities and their later use as authentication tools Omnichannel identities should provide a comprehensive identity package with a focus on the requirements of digital and phone communication This package should include an initial username and password for digital channels (including member portals and online forms) as well as a separate password to secure telephone communication To ensure that particularly sensitive information and processes are secured two-factor authentication with mobile transaction authentication numbers should be put in place including traditional postal identification procedures personal touch points with agents and physicians such as voice identification or fingerprint sensors on mobile devices these identity packages can easily be created and exchanged; however retroactively equipping existing members with identity packages is challenging Every relevant member touch point should be used to offer—and to promote the creation and use of—the identity package A comprehensive view of member interactions and their context is crucial again stressing the importance of an omnichannel desktop Once a member’s secure identity is established which poses additional complexity because security standards differ between channels ordering a new insurance card to be sent to an existing address) can usually be authorized by asking a few personal questions since the critical data is sent to a secure data point—in this case since they could make subsequent data breaches possible all payer processes can be mapped and assigned differing security levels for each use case and channel a comprehensive IT architecture needs to be put in place This effort requires fundamentally new member and employee tools as well as the integration of formerly isolated solutions for different channels and/or use cases The architecture can typically be separated into four key building blocks (Exhibit 10) The digital platform provides personalized digital touch points the same digital platform should support a variety of use cases—for example providing general information to unauthenticated users on the public website allowing authenticated users to get access to a member portal and enabling employees to perform transactions Seamless integration of digital and live-person channels is particularly important when members decide to interrupt their digital journeys and switch channels (Employees must often take over in the middle of a request and directly edit the digital form a member had filled in previously.) Additionally the digital platform should offer device-independent service portfolios and give members the ability to switch devices while on a single journey The personal interaction platform integrates the technology solutions required to handle individual interactions between members and employees in all channels (e.g. and service operations for the contact center) Just offering best-in-class solutions for each channel is usually a significant challenge—integrating them adds even greater complexity the personal interaction platform must provide seamless integration and a consistent member context for handling requests thereby building the technological basis for an omnichannel desktop workforce management and workflow/routing solutions must ensure that all requests reach the correct specialist while also balancing the service load to minimize overcapacity While these tools have been part of contact center operations for many years omnichannel increases their importance and complexity significantly requires that request types be classified automatically through text recognition or interactive voice response employee abilities be appropriately segmented and available member data be automatically matched to an incoming request The integration and data layer provides an aggregated high-availability 360° view for all member data; it also makes possible real-time channel switches and validation through both the digital and personal interaction platforms it helps orchestrate integration of services and the sales experience and supports overarching channel management Truly personalized lead management is enabled by big data technologies that facilitate storage and analysis of member information at an extraordinary level of detail (including click-stream data from digital platforms) from a variety of ecosystems (e.g. data security and privacy concerns need to be considered Member requests are processed by the back end enabled by consistent application programming interfaces (APIs) This element of the architecture connects member interactions to automated business processes and IT systems that manage core insurance services When the overall IT architecture is initially being built it is important to check that the APIs for the integration and data layer are designed to support the level of service (e.g. in terms of speed) that should be offered by the digital and personal interaction platforms Establishing comprehensive omnichannel IT architecture requires a wide range of technological solutions Getting all these solutions in place is a challenging and potentially costly task combined with an agile way of development and a fail-fast mentality and adequate frameworks should be deliberate; all potential stakeholders (including external providers of key back-end components) should agree on them early on to avoid high switching or adaption costs privacy and data protection regulations (e.g. GDPR) should be incorporated into all key design decisions Since the journeys of current and potential members typically involve multiple organizational units and touch points managing a journey end to end is often subject to a lot of friction which can negatively affect the consumer experience Typical issues include a lack of collaboration between different channels and data pools functional silos that prevent effective collaboration and a rigid service logic that does not increase the potential to steer consumers into appropriate service hubs/self-service platforms implementing omnichannel has fundamental implications for service organizations (Exhibit 11) if consumer experience is truly to become the focus of an organization the key performance indicators (KPIs) that business units are measured against should reflect consumer experience This type of measurement is best achieved by establishing feedback mechanisms for consumers as a standard across all channels and then linking the feedback to management incentives we recommend introducing KPIs that are directly related to omnichannel targets that enable an ideal consumer experience (e.g. ensuring 100 percent of consumer contacts are properly documented rewarding agents for member portal registrations or introducing an ambitious first contact resolution rate) Omnichannel requires the optimization of the working practices within specific business units some payers have permitted consumers to call specific customer service representatives at any time to raise requests this consumer service approach entails regular interruptions for many employees the approach is not tailored to an omnichannel world that allows consumers to engage on multiple channels Centralization of consumer service across channels could help address some of these concerns having the contact center handle the requests is often ideal; only rarely should the requests be sent to a business unit we recommend that payers establish service pools that have dedicated business unit employees handling consumer service omnichannel also has significant implications for collaboration across business units—most importantly employees in all units need to start working on one shared IT platform to ensure a common and comprehensive database To optimize consumer experience during journeys payers can set up cross-functional teams that are responsible for end-to-end journey design This approach breaks down existing silos and promotes effective collaboration incentives must be homogenized between business units and IT the goals of IT shift from simply delivering solutions on time to driving business impact the business units become responsible for effective IT delivery and support IT whenever necessary Transforming an organization to omnichannel is a challenging task—one that multiyear program involving large groups of IT and business stakeholders including positive impact on a wide range of KPIs (from net promoter scores to measures of internal efficiency) can be substantial it is crucial to establish a clear structure and to remain focused on generating short- and long-term value for the organization an agile project setup usually works well; teams can be organized along journeys while central digital factories drive IT improvements by establishing experience labs) can be helpful to keep driving the transformation in the right direction An important element of an omnichannel transformation is to define intermediary goals and ensure short-term value We find it useful to think of the transformation as having three phases (Exhibit 12) best-in-class communication channels are established The focus is typically on digital channels and newer forms of communication most typically have room to improve their self-service offerings by increasing their functional scope and enhancing user experience it is particularly important to ensure that members do not receive inchoate—or even contradictory—information on different channels as soon as a coherent channel landscape is in place true omnichannel offerings should be established from both a technology and process point of view information needs to be carried consistently between channels it also becomes feasible to steer consumers across channels to drive efficiency and consumer satisfaction To ensure that the transformation retains a consumer-centric point of view it is critical to think about cohesive end-to-end consumer journeys rather than one-off consumer touch points and gimmicks a two-pronged approach typically makes sense For a set of prioritized consumer journeys the three steps in Exhibit 12—from establishing digital channels to seamlessly integrating all channels—should be executed critical underlying capabilities must be identified and built Since these platforms can in themselves be rather complex a clear minimal viable product logic is needed the remaining consumer journeys can be implemented iteratively about far more than merely establishing a new technology—it also requires a comprehensive change-management effort This effort goes far beyond encouraging internal employees to use new tools; siloed functions must be integrated Employees as well as consumers have to be introduced to a new way of interacting with the payer steering consumers effectively and educating them about new offerings is a major driver of a successful omnichannel transformation we have highlighted the crucial success factors for an omnichannel transformation in four areas: consumers the transformation needs to be tailored to each payer and its business model but we believe that the general outline of the transformation is similar for most payers Omnichannel transformations require significant investment and building and refining the required IT platforms may take years we believe it is crucial to establish a clear prioritization early on and focus on the clearly articulated value of the transformation with quick wins on the horizon significant value can be realized in the early phases of the transformation We therefore typically recommend that an omnichannel transformation be a multiyear effort one that strikes the right balance between an initial focus on high-value use cases that drive short-term value and building the right foundations for medium- and long-term success By bringing smaller offerings into the market quickly a payer can collect consumer feedback and test the suitability of partners Given the complexity of an omnichannel transformation early success can be crucial for aligning the organization and driving commitment to making bold changes Markus Hedwig is an associate partner in McKinsey’s Cologne office Mathis Friesdorf is an engagement manager in the Berlin office Yuri Goryunov is a partner in the Chicago office Florian Niedermann is a partner in the Stuttgart office and Marcel Meuer for their support in researching and writing this article tech leaders were looking forward to a future where a global IT architecture on scalable cloud infrastructures would provide their companies with a full array of technology services efficiently with a set of fragmentation forces rendering the prospect of a single Local regulations (China alone has passed 21 data and tech laws) disruptions to supply chains driven by geopolitical and trade issues as well as the COVID-19 pandemic and marked regional differences in customer behaviors such as the contrasting preferences for WeChat in Asia and texting in Africa have combined to undermine the prospect of a globally harmonized IT architecture Most tech leaders are all too aware of issues like these yet the solutions they turn to can sometimes end up making things worse developed—and supported—three different full-scale financial systems to meet local needs an electronics manufacturer operates two parallel production processes with dedicated factories equipped with different 5G technologies to comply with the security laws of the products’ final markets Compromise solutions may not work either; some businesses have found that using a single centralized system while making local adjustments leads to undue complexity and maintenance costs can help companies balance the level of local solution tailoring with the need to harness scale efficiencies these solutions are more widely accepted and can be more easily realized in modern cloud platforms These developments are enabling leading companies to evolve their operating models by building standardized and configurable solutions that maximize business flexibility and efficiency while making data management more transparent (Exhibit 1) Ensuring that these new architectures and solutions work effectively requires companies to embrace new forms of IT governance that include stakeholders from the business side and delegate decision authority to teams that are closer to the customer The most successful governance model balancing global efficiency with local needs is often a federated model with a central core of standard IT components and local layers that allow for selective deployment of capabilities in individual markets or business units (Exhibit 2) businesses work through an iterative process that involves identifying strategic trade-offs between global standardization and local differentiation reorganizing IT architecture around capabilities and building a global IT architecture and operating model around modules that can be flexibly adapted to local requirements What makes such a model distinctive is that it isn’t a force-fit compromise between standardization and differentiation it makes choices conscious and transparent and puts in place a repeatable process to continuously adjust the balance as external conditions or business needs change Before sketching out the new model, IT and business need to develop a shared understanding of their company’s strategic business priorities and constraints and identify likely trade-offs between standardization and differentiation The drivers for global standardization include: the drivers for local differentiation include: Weighing the pros and cons of standardization and differentiation is challenging not least because people’s views are often shaped by their function Risk managers often favor centralized controls while country leaders push for local autonomy Managing these conflicts requires hard facts such as the cost implications of a specific decision and sometimes the willingness of a senior leader When a manufacturing company assessed the case for standardization versus differentiation in key business domains (exhibit) it decided to centralize some functions because of the clear benefits: procurement to increase its bargaining power and drive efficiency across regions; and talent management with a focus on making remote working the norm for most key staff This made it an attractive employer for digital nomads and gave it access to new hires anywhere in the world innovation management was managed separately by each of the company’s two subdivisions reflecting their very different product portfolios and customers which would not have been well served by a single unified system customer management was harmonized at the regional level to allow the sales force to approach customers consistently across business units warehouse management was organized regionally within each subdivision Minimum requirements were set to allow integration with global supply chain systems and processes but local operating models ensured the efficient management of a heterogeneous network of small suppliers and transport companies and processes to be shared across countries The advantages claimed for market-specific products and processes must always be carefully weighed against the disadvantages of increased complexity and limitations on scaling (see sidebar “Balancing customization and efficiency at a manufacturing company”) Discussions on how far to standardize and how far to differentiate can easily get lost in the weeds or become oversimplified companies can draw up a capability map such as the one illustrated in Exhibit 3 for a European P&C insurer Its purpose is to provide an abstract overview of individual business domains that use similar business capabilities such a map helps leaders visualize the business dimensions and related IT services of a given capability and determine what level of customization or harmonization is needed for their target system architecture and operating model The capability map shown in Exhibit 3 includes all the top-level capabilities required for the company to operate “output management” comprises all the processes needed to create and deliver outbound communications and the IT services needed to support them each capability is broken down into sub-capabilities typically functionalities developed and maintained centrally by a cross-functional team with members from IT and the business be broken down into “sales performance” and “call center” reporting Wanting its business to be “as global as possible and as local as necessary,” the insurer used the capability map to help it make trade-offs as it shaped its system design and operating model the online “web and mobile” sales customer journey was developed as a single global set of microservices by a central agile team so that it could be harmonized across countries with parameters customized only when necessary underwriting and pricing are managed via a shared global system but local experts can reconfigure elements using a low-code/no-code rule engine and a standard software component Some of the insurer’s top-level capabilities required a more differentiated approach Managing multiple local insurance aggregators each with its own integration requirements capabilities that have a regulatory dimension such as vehicle registration for car insurance A flexible global platform architecture consists of three components: IT can allow local teams to tailor their technology needs either through configuration where IT develops all the components for a given capability that local teams can configure where locally developed components are linked to the global platform through centrally developed standard interfaces Configuration may be appropriate for capabilities that require only limited local differentiation or those where differentiation is required by business logic and local configuration can be readily achieved an open-source process-automation solution enables business leaders to configure underwriting rules locally without having to rewrite any code Localization through extension is an approach often adopted by consumer companies to handle payments and last-mile logistics with all their country-specific challenges Country-specific capabilities are typically developed and maintained by local cross-functional BizDevOps teams and integrated with the global platform via APIs However useful these localization capabilities are they will not work as needed unless local teams have sufficient autonomy (at some companies clear decisions through central headquarters which is a major roadblock for pace and innovation) The best companies provide local teams with specific decision rights within guidelines and support them by providing necessary capabilities such as IT talent embedded with local market teams to get customer feedback early Balancing these localization capabilities is a central organization which safeguards standards and provides clearly defined services and APIs for local use This balance helps reduce complicating adjustments and overlapping or conflicting implementations and enables the management of an effective global services architecture We have mapped how this approach might work for automotive OEMs operating in China to find the optimal local/global balance across key functional areas (Exhibit 4) As a company builds out a new global architecture and operating model it will need to avoid common issues that doom these kinds of programs Following are some critical items to bear in mind: One European bank found this balance after one unit struggled to integrate the solutions that the main IT team was developing because of an array of issues including poor documentation and IT solutions that were worse than those the local team could create The bank launched an initiative to address this issue and developed a series of best practices including people rotations between the local and main teams and adopting better sharing mechanisms the drawbacks of central globalized IT systems have become ever more apparent while the advantages gained by running multiple national systems are often outweighed by complexity and costs federated models like those described in this article are providing a better solution Other multinationals may want to take note and follow suit Oliver Bossert is a partner in McKinsey’s Frankfurt office, Mathis Friesdorf and Wolf Richter are partners in the Berlin office and Andreas Kopper is an associate partner in the Vienna office Leaders throughout industries have ambitious visions of how digitization will transform their core businesses the vision typically includes completely new consumer journeys enabled by comprehensive self-service and full utilization of all available data data flows digitally in a highly automated manner it is highly unlikely that payers will be able to adopt fully paperless processes despite the myriad problems manual document processing entails Although many payers have taken steps to move away from paper they have found that eliminating it is more difficult than they anticipated Both internal and external factors have made the transition to fully paperless processes nearly impossible as of yet We expect that a large share of all paper-based interactions at most payers today could remain paper-based for at least the next several years finding ways to process paper-based documents in the most efficient way possible—and to smoothly merge data from paper and digital sources—is becoming an imperative for all businesses that must process a high volume of documents from consumers we describe an approach that payers can use to achieve these goals In every industry in which paper plays a significant role manual document processing causes problems It requires employees to perform repetitive monotonous tasks while adding little value Manual processing is also error-prone and not transparent and thus often causes operational inefficiencies and confusion among teams As payers expand their use of omnichannel strategies the lack of process transparency also impairs consumer satisfaction since it makes it more difficult for companies to gain insights from advanced analytics Why have these and other payers found it so hard to stop using paper The progress toward fully digital document processing has been hindered by a variety of factors Internal roadblocks include general organizational rigidity then integrating them into existing organizational technology is inherently complex and usually requires changes in both behavior and processes Given the economic benefits of fully digital document processing many companies are starting to find ways to overcome these obstacles they have found it much harder to get around external obstacles Payers operate within ecosystems that include partners Getting all these stakeholders to agree to adopt fully digital communications requires a comprehensive transformation which for many of them entails significant switching costs providers in countries with multipayer health systems may need to adapt their claims submissions processes to account for the requirements of different payers Many consumers may be reluctant to switch to digital self-service because health insurance is often a low-involvement product—touch points are infrequent which gives consumers little incentive to memorize login credentials and keep their contact information up to date regulations may hinder the move away from paper in many countries Payers and other companies that deal with health data are usually subject to strict data protection laws Security and privacy standards are not only stringent but also often tailored to the use of paper-based communication regulations may require a member’s signature on a form Even if the regulations do permit two-factor digital authorization as an alternative it is often difficult for payers to establish sufficiently secure transactions paper-based processes endure because they are well-established in payer organizations avoid high switching costs for outside parties and do not require members to interact with digital platforms they may use infrequently Because this situation is unlikely to change rapidly payers that want to gain a competitive advantage must find better ways to handle paper while moving toward the longer-term vision of fully digital processes Payers can generate significant value during the transition to a fully digital future by optimizing the way in which they process paper documents and other data The consequences of suboptimal document processing are significant Effective handling of paper is crucial because data is at the core of the payer service offer and paper continues to be a main source of data from day-to-day operations data analytics is increasingly important to support strategic decision making Leading businesses use analytics to discover valuable consumer and operational insights; the lack of access to data in digital form makes it much harder for a payer to do this new technologies have emerged that enable more efficient processing than has been possible before including quicker and more accurate information retrieval from paper documents (This retrieval process is called document ingestion.) Ranging from intelligent character and pattern recognition to machine learning the technologies have made impressive progress in recent years The benefits offered by these new technologies go far beyond efficiency improvements (as important as those improvements may be) structured data is a prerequisite for many other digitization efforts from omnichannel to analytics transformations Automation efforts rest on good data and cannot be successful when information is buried in large piles of paper Digital document processing has three main phases document ingestion—our main focus in this paper—is the route through which incoming information on paper documents is “consumed” and then made available in a structured digital data is processed internally using automated workflows which often avoids the need for redundant stakeholder communications (for e.g. asking consumers for the same data multiple times) By combining the data derived from paper documents with the wealth of digital data already available a comprehensive data landscape can be established significantly enhancing data evaluation and analytics possibilities documents are delivered to stakeholders more efficiently Many types of outgoing communications are shifted to digital channels and the processes required for paper-based communications are streamlined Keeping coherent records is a crucial efficiency lever because it ensures that information is sent to the appropriate point of contact (for e.g. when billing confirmations are sent to providers) To get digital document processing (including document ingestion) right payers must understand and master all three phases they need to consider the full range of documents that will have to be processed Incoming mail and other physical documents are an important source of data but not the only one—many documents that arrive digitally can pose significant challenges if not handled correctly may require significant effort to become structured digital data that can be processed automatically To incorporate the full range of documents that need to be processed a digital document ingestion workflow typically has six steps (Exhibit 3): Effective document ingestion cannot be established without a proper foundation payers need to put these critical components in place: technology Document ingestion requires effective new tools it also has significant implications for the supporting IT architecture Introducing new technology is a pivotal element in establishing document ingestion Although basic OCR solutions to digitize information are typically easy to implement subsequent steps in the workflow are much more challenging information into meaningful data often requires highly advanced OCR solutions such as intelligent character recognition (ICR) software which has much higher recognition accuracy than traditional OCR software Once the information is made available in a structured digital format the data usually requires further refinement before it can be processed automatically; it is because of this requirement that document ingestion goes far beyond the mere reading of information the data must be embedded into comprehensive records stored in a consistent format and find its place in comprehensive data models describing consumers and providers from a payer point of view An event bus (a software mechanism that allows different components in an IT system to communicate with each other) must pass the information on and ensure that all relevant IT systems are made aware of the new data Automating this part of the process often requires a wide range of application programming interfaces or robotics solutions Improving document-handling processes takes significant cross-functional effort Document ingestion has important implications for a payer’s organization the organization needs to establish corresponding roles and responsibilities to ensure that all steps in the ingestion process run properly altering the way paper is handled requires a significant change effort Many organizations could benefit from establishing a dedicated team to act as a “digital factory” that uses a process-by-process approach to achieve organizational change in all business units and departments Such a team is usually staffed with full-time members who operate in an agile environment with substantial management support The digital factory builds new IT tools and processes but also reshapes the ways different organizational units work on a day-to-day basis The addition of cross-functional project teams with rotating personnel inside of the digital factory enables the spread of new knowledge throughout the organization Implementing the correct technologies and processes and ensuring that the necessary changes are embraced typically require the use of both internal and external expertise To successfully implement document ingestion companies need the right capabilities—they need to be able to redesign existing processes These capabilities can be built in-house or acquired by partnering with vendors or other organizations both internal and external resources are necessary the document ingestion industry is shaped predominantly by OCR vendors Their solutions are a central pillar of the overall technology blueprint but some organizations have found their products difficult to install and run know-how is usually lacking outside of these specialized firms companies often find themselves locked in with individual vendors Strong vendor management capabilities are therefore especially important A large German payer enabled a large-scale digital transformation by optimizing digital document ingestion Several factors had led this payer to believe that paper would remain a major channel for several years or more many of the providers and government agencies it dealt with were behind the curve in digital adoption and regulatory issues (including data privacy concerns) were making it difficult for the payer to move consumers to digital channels The payer therefore decided to incorporate paper-based communication into its overall omnichannel strategy but also created a road map to help it move toward omitting paper from its internal processes The payer started by optimizing its methods for scanning and OCR of all paper documents and then entering the digital files into a document management system the payer was able to avoid storing additional documents in physical archives and reduced the time that many work items were in transit These changes made it easier for employees to work from home by providing digital access to all documents and improved the company’s performance management capabilities The payer’s second step was to create a shared-services center that would be responsible for data transfer from paper documents into the company’s core IT systems; the business units would take over once the data was in the core systems the business units increased their efficiency through labor arbitrage and more straight-through processing Because of the momentum generated on the business side the payer then established a central output management system for printing and letter finalization which allowed the business units to achieve higher quality and even greater efficiency No letters had to be handled manually by an employee automated data extraction was introduced to manage the transfer of data from documents into the core systems the shared-services center gained efficiency which freed up valuable time so that employees could focus on more consumer-centric processes Companies that successfully implement digital document processing—including document ingestion—often use a similar approach which is frequently embedded in a larger digital transformation these companies identify the right technology vendors to build and run the necessary components along the full document processing value chain they typically assess the potential of process redesign and identify the behavioral changes that will be needed throughout the organization the companies often use a dedicated project team to put the essential IT infrastructure in place relatively quickly they undertake an initial technical proof of concept and then start building the IT infrastructure while transforming the first end-to-end processes (for e.g. invoice processing for a group of chosen pilot providers) they scale up the effort by setting up a digital factory (as described above) and start to rotate people in and out of the effort they begin transforming payer processes one by one (perhaps by starting with claims the new technology and organizational structure of all paper-based processes at the companies are transformed the companies not only use a digital factory but also undertake a dedicated change management effort to implement the digital document processing system Employees who are used to paper-based processes and often have considerable control over process decisions typically need help in adapting to the new digital processes The change management effort is crucial to ensure the transformation is carried out to the end because the last 20 percent of paper-based processes are usually the hardest to eliminate Attention to change management helps give employees at all levels of the organization the ambition to fully eliminate paper are finding it difficult to realize their vision of fully digital processes they can gain immediate benefits by improving their approach to digital document processing—especially digital document ingestion This approach acknowledges that paper documents will remain a reality for some years to come but enables payers to move along the path to a fully digital future digital document processes must consider the full range of inputs (both paper and digital) and cover the end-to-end workflow a payer typically needs to build or acquire the required technologies and establish the necessary organizational foundation Payers that cannot get digital document processing right will put their other digitization efforts—and their ambitious digital goals—at risk and digital document ingestion in particular are important for core back-office functions their relevance for corporate functions varies across industries (Exhibit 4) the typical level of digital document processing maturity also varies across (and within) industries and regions Payers and most of the stakeholders they work with lag behind most other industries in their level of maturity and thus face high switching costs if they want to move to fully digital processes Mathis Friesdorf is an engagement manager in McKinsey’s Berlin office. Markus Hedwig is an associate partner in the the Cologne office. Florian Niedermann is a partner in the the Stuttgart office. Florian Schaudel is a partner in the the Frankfurt office The authors would like to thank Siamak Sarvari for his support in researching and writing this article and Ajit Sawant for insightful discussions on the future of digital document processing Automation at scale could solve the following problems health insurers currently face: Increasing cost pressures are pushing many payers to significantly improve operations Many claims adjudication and call center activities such as claims reprocessing and post-call documentation are highly repeatable and costly when handled manually which makes them good candidates for automation the workforces of many payers are shrinking as employees reach retirement age—and finding replacements is increasingly difficult Automation can help payers effectively manage natural attrition and ensure that the remaining workforce is focused on high-value work which makes it difficult to implement necessary operational changes Frequently seen problems include the absence of standardization and integration workflows that span multiple disconnected systems and often require duplicative manual data entry and less-than-optimal IT service provider relationships Automation at scale is one lever that can address these problems It is most effective if deployed as a key element of a payer’s holistic digital process transformation Successful approaches are usually owned by strong business leaders who are looking beyond cost reduction By taking a holistic P&L perspective when undertaking automation efforts the leaders ensure that freed-up employees are dedicated to new tasks with the highest business value which often enables new consumer-facing business models we discuss six topics payers should consider if they are contemplating adopting automation at scale: Five core technologies are currently propelling automation:3Federico Berruti et al., Intelligent process automation: The engine at the core of the next-generation operating model, McKinsey white paper, March 2017. Robotic process automation (RPA) is the application of technology to allow organizations to automate routine tasks (e.g. extracting and cleaning data) through existing user interfaces (Bots are algorithms that execute automated usually repetitive tasks.) Because bots utilize existing user interfaces RPA does not require changes to the core IT systems Smart workflow is a process-management software tool that can be configured to merge tasks performed by groups of humans and machines so that bots can be integrated into regular workflows Machine learning and advanced analytics software use algorithms to identify patterns in structured and unstructured data When algorithmic outputs exceed a certain level of confidence (often 95 percent) these technologies can be used in place of employee judgment and decision making Natural-language processing enables the creation of seamless interactions between humans and technology It translates observations from data into prose and vice versa Cognitive agents are created by combining machine learning and natural-language processing to build completely virtual entities (so-called agents) that are capable of executing tasks the agents can make decisions based on logic the detection and prediction of client behavior and emotions Many payers begin the journey to automation at scale by implementing RPA as a short-term solution This technology allows payers to automate some processes (or parts of processes) within existing IT systems and does not require significant changes to those systems which markedly lessens the potential for business disruptions Maximum benefits are typically achieved by using it concurrently with other automation technologies Automation at scale can bring numerous benefits to companies lower demand for manual activities (through improved auto-adjudication and self-service capabilities) increased revenue (by refocusing employees on new activities) The benefits are particularly strong in data collection and processing an advantage especially relevant to payers and other insurers given automation’s potential to improve back-office and service activities in five major ways: Technology and machines can replace much of the work that is currently done by hand the change can lead to average cost savings of up to 30 percent within five years for many payers Streamlined processes and automated routine tasks make it possible to complete in minutes activities that previously took days The accelerated service and delivery can improve the user experience for members as long as automation does not restrict service offerings (e.g. by limiting access to some service channels) Technology and machines can operate 24/7 and scale up or down with demand creating previously unavailable capacity and further increasing operational efficiency and flexibility As the pace of change in healthcare continues to rise it is extremely important for payers to be agile and able to adapt rapidly if they want to remain competitive and win in the marketplace Automation can transform testing and quality control because the increased capacity it provides allows a company to move from spot checks to 100 percent quality control which reduces the error rate to nearly zero When machines take on formerly manual tasks Automation—in particular machine learning and advanced analytics—can generate and analyze much larger data sets and hundreds of new factors making it possible to predict drivers of business performance and generate important new insights a growing number of payer IT departments are likely to adopt RPA and other automation technologies as a service for the business A few leading payers have begun the journey to automation at scale and are beginning to achieve real success as this case study and the following one illustrate The company is a statutory health insurer (SHI) It recently consolidated with a few other SHIs and wanted to increase its efficiency and lower costs It also needed to find a way to compensate for its shrinking workforce the SHI decided to pursue digital innovations the SHI determined that its consumer onboarding function was particularly ripe for a digital process transformation More than 90 percent of its new-member forms were paper based and processed manually parts of the robotic solution required to eliminate manual processing would make it easier to automate several other back-office processes without the need for large IT efforts or expenditures later on the SHI decided to develop a new web-based front end and to deploy RPA because this light-touch noninvasive technology would not require it to immediately make major changes to its existing IT systems and processes The SHI is now in the process of implementing three steps (Exhibit): The SHI has made significant progress in these three areas and is planning to tackle new-member form supplementation next It also has plans to make the digital member onboarding journey available through all channels both members and employees will have views with individualized functionalities and live consumer support will be available to assist prospective members in real time thus improving consumer satisfaction while maximizing conversion rates the same bot will automatically “feed” the data into the SHI’s core IT systems the SHI is extending its use of RPA and machine learning to a wide variety of processes in many areas of the company Results to date suggest that the SHI is reaching its goals By delivering consistent outcomes and higher responsiveness automation is enabling it to increase its efficiency and effectiveness repetitive tasks is making it easier for the SHI to cope with the shrinking size of its workforce A large national US payer had adopted digital in a few areas based on specific use cases It then decided that it wanted digital to be a central part of its strategy and thus embarked on a more holistic end-to-end digital transformation of its core business processes The payer started this effort by identifying end-to-end user journeys that were particularly important to its stakeholders It quickly realized that its inability to have clean provider demographic data was causing significant dissatisfaction within the provider community as well as several downstream issues If it could improve its “help me update my data” journey for providers it would markedly strengthen the experience it offered providers—and enable it to achieve significant administrative cost savings The redesigned journey now gives providers intuitive interfaces they can use to update their demographic data as well as visibility into data update requests which is minimizing the need for both follow-up calls to service desks and error corrections after claim denials The payer is now near its goal of achieving about USD 30 million in annual administrative cost savings because it increased its digital work intake by approximately 60 percent enabling it to decrease its manual downstream activities considerably it has reduced adjudication problems related to provider-data-related issues by about one third the payer has developed critical internal capabilities It is continuing its transformation by digitizing roughly 15 additional journeys Tool and bot proliferation has made it difficult to navigate the thousands of tools and vendors Because the number of tools and vendors has expanded rapidly the complexity and time required to assess the best-fitting means for automation has increased Even a “standard process” may involve many combinations and interrelationships and developing the corresponding bots to cover them all can be confounding these bots need constant maintenance that requires tight management of the change and release processes bots present a number of technical challenges: CIOs have been known to put proposed automation programs on hold or have refused to allow the installation of new bots—even ones that vendors have worked on for months—until solutions have been created to scale the programs effectively The fallacy that sustainable automation can be delivered by the IT department alone Sustainable automation requires the collaboration and commitment of the entire organization It is therefore crucial that a payer maps out who and what will be affected by automation before the bots and RPA agents are installed and updating all the different linkages RPA tools will develop and rely on is a whole new set of responsibilities—one that may not be appropriate for the IT department to take on Clarity about how automation will be managed at scale—and who will accept this responsibility—is critical before If the organization believes that automation is one of several levers to be used in a process optimization effort then responsibility for automation must reside with the business process owners Only in this way can the organization embed critical analytical and digital skills in the lines of business Pursuit of quick “small potato” wins while overlooking larger opportunities Payers are usually under pressure to showcase the captured benefits of automation which can cause them to focus on opportunities that are relatively unimportant but quick and easy to implement While achieving quick wins can be worthwhile as a proof of concept it is essential to develop an overall strategy and invest in important longer-term opportunities to capture the value that can be generated by automating large processes and automation tools may address only some of them automation tools often treat localized pain points Fixing one bottleneck may just move the problem elsewhere in the process—or elsewhere in the organization the financial outcome of automation rarely matches the original expectations sustainable savings usually require a fundamental transformation of the organization A cost-myopic view that ignores the value derived from improvements in quality Cost reduction is a key benefit of automation at scale such as better consumer experience and improved quality are important to a payer’s long-term success Developing metrics to measure and track these benefits can make it easier to recognize and demonstrate them establishing strong business leaders with P&L responsibility can help scale automation towards highest business value Although automation can eliminate some jobs it also has the potential to provide new opportunities and free capacity to focus on value-added work call center employees could shift their focus to proactive service or sales instead of manually documenting interactions at length companywide communication and clear articulation of the value of automation are crucial Treating employees as problem solvers and enabling them to use automation tools to help solve problems can improve their work experience Rather than running the tools from a central authority delegating authority to employees—teaching them how the tools work and perhaps how to configure or code them—can lead to greater employee engagement and continuous improvements in the organization Such results are in line with other initiatives such as agile development and continuous delivery that many companies are currently launching to empower employees high performers whose jobs will be eliminated can be considered for other roles within the organization System integrators and other vendors often bring in personnel with expertise and experience to help implement automation programs and increase staffing flexibility a payer that uses only external suppliers for implementation misses the opportunity to build the internal capabilities critical for scaling and sustaining automation over the long run Significant advantages can be gained from having employees work side by side with vendors on implementation so they can develop the capabilities needed to bring future automation work in-house One payer’s CIO emphasized this point by arguing that without these internal capabilities business process owners would not be able to grasp the design options available to them Many opportunities for automation exist throughout the payer value chain the following areas have the biggest potential for automation in the next five years: successful payers start with an understanding of the total opportunity and value at stake They then develop an ambitious organizationwide vision for the end state which typically includes significant cost savings and a fundamental restructuring of their cost base to create and sustain their competitive advantage The payers then develop a high-level implementation road map that shows the way to achieving those aspirations they may transfer routine or basic processes (the ones likely to become commodities in the future) to vendors so they can focus on automating the processes essential to their long-term competitiveness It is critical for business leaders with P&L responsibility to own the vision and outcome is crucial for achieving sustainable impact and expanding the effort’s scope beyond mere cost reduction Freeing up employee time and allowing them to refocus on higher-value tasks can deliver significant value but requires clear prioritization on where the extra time should be focused automation can help build additional consumer-facing services and generate new business opportunities Significant personnel changes may result when a company implements automation at scale and realizes its full value—even if few employees lose their jobs it is crucial for human resources (HR) to be part of the transformation from the beginning HR can help coordinate retraining and learning new ways of working It can also play an essential role in creating new workforce management practices and using analytics to help redeploy and retrain employees which can be high in such areas as call centers and recent or planned retirements to control and minimize forced exits making automation a way to fill holes in the workforce that are emerging naturally responsibility for process automation must lie with the business process owners a close partnership with the IT department is essential because that department is responsible for designing the overall system’s lifecycle managing the rollout against other priorities the IT department should be an integral part of the process—from the start and throughout implementation The program’s steering committee and governance structures can help ensure this happens Lasting in-house capabilities to achieve sustainability One way successful companies sustain the value created by automation at scale is by establishing a centrally located center of excellence (COE) Its role is to govern the transformation and support the rapid deployment of automation-at-scale solutions Among the approaches the COE can use to accomplish these goals are internal capability building An automation COE can be fairly small because it can call on other COEs in the organization (e.g. those focused on lean operations or process optimization) for assistance when necessary Although the automation COE is responsible for putting systematic controls in place business ownership and execution of the transformation should sit in the lines of business any implementation of automation at scale should combine a few quick wins with the pursuit of larger The road map for the transformation should take this into account Successful companies examine every line of business to assess its degree of potential for standardization and automation as well as the value that could theoretically be derived they then determine what changes would be necessary to capture the value The opportunities identified are then sequenced and built into the road map Payers that are designing and deploying automation transformations should keep three risks in mind so they can actively develop plans to mitigate them: A diagnostic is the best way to identify the repeatable processes employees currently undertake manually and the value that could be created if the processes were automated it can size the full value at stake from automation at scale Create a vision and make automation a strategic priority It should also set an aggressive cost-savings target and include a fundamental restructuring of the cost base Develop a strategy to deploy automation technologies systematically Deciding on which processes will be automated is not sufficient It is equally (perhaps more) important to decide on the right implementation strategy the switch to automation at scale should be part of a broader digital process transformation Formulate a road map to implement the strategy a focus on robotic process automation can help ensure fast progress and results such as cognitive agents and machine learning The need for a few quick wins should not overshadow the importance of capturing larger Having strong business leaders be involved from the beginning of the effort increases overall business ownership and helps steer the transformation toward maximum business value Driving automation efforts from a business P&L perspective typically expands the scope beyond efficiency increases and often uncovers the potential for developing additional services or business models Do not depend on vendors for everything—ensure the IT function’s involvement companies rely primarily on external organizations especially system integrators and other vendors This approach creates strong dependence on the vendors and inhibits internal capability building One promising way to ensure capability building is to create an automation COE staffed with internal resources ensure that the right groups are involved early on and provide on-the-job training for employees (from external experts Extend capabilities across business units and decentralize governance Responsibility for automating business processes must cascade across business stakeholders Employees from different business units may need education and training so they can improve their thinking about automation Go beyond building and testing single solutions; internalize both costs and benefits The change effort must not focus on testing automation solutions for individual processes the effort must also consider end-to-end processes and the target operating model Change mindsets and prioritize workforce management The other factor necessary for the change effort to reach its full potential is a fundamental mindset shift throughout the entire organization Achieving this shift requires a change-management approach tailored to the organization and its people Recent technological advances are enabling payers to more effectively respond to a wide range of market challenges next-generation technologies—not only automation at scale but also digitization and process redesign—will likely be pivotal for payers that want to improve efficiency and data quality and deliver a better experience for members Payers that do not get these technologies right will put many of their other digitization efforts at risk Yuri Goryunov is a partner in McKinsey’s Chicago office. Ralf Plattfaut is an associate partner in the Düsseldorf office. Mathis Friesdorf is an engagement manager in the Berlin office. Greg Gilbert is a partner in the Washington The authors also thank Adi Kumar and Nina Jacobi for their expert input The air dome turns the Friesdorf outdoor pool into an indoor pool in winter A corridor with a revolving door leads to what is currently Bonn's most unusual indoor pool It looks like a cross between the Friesdorf outdoor pool and the Radom in Wachtberg Under the white honeycombs of the air dome construction Only the airlock-like access ensures that the slight overpressure that keeps the air dome in shape does not escape The indoor pool guests use the same showers and changing rooms lockers and lockers as the outdoor pool guests in summer "I personally am always surprised at how good the climate is in the air dome," says Rafael Röger Chairman of Freibad Freunde Friesdorf (FFF) The winter solution for the Friesi is intended to at least partially replace the water areas of the closed Kurfürstenbad The year-round use of the outdoor pool also has advantages for the FFF association "We now have times on Saturday mornings for seahorse training with children," reports Röger is the conversion time required for year-round operation "The outdoor pool season is very limited as a result and an extension is not possible," says the chairman with well over 2000 visitors to the Friesi in three months so far According to the press office of the city of Bonn a total of 2240 bathers came in October 2023 2398 in November and only significantly fewer in December with 1531 visitors the good intentions apparently took effect again and the Friesi recorded its strongest month of the season so far with 2733 guests One person who regularly comes to the air dome on Tuesdays and Fridays is early swimmer Franziska Gutsche "I would always compare the Friesi to the outdoor pool and of course that's much better," she says the air dome is of course a luxury and is particularly popular with professional swimmers and people who want to do something for their health as the diving platforms are not in operation and there are no other play options in and around the pool "A water slide would be nice," says Franziska Gutsche The pool is open to the public on Saturdays from 9 am to 6 pm and Sundays from 9 am to 4 pm there are no loungers or other options for relaxing around the pool as the air dome remains a temporary solution the air dome has proved its worth in Bad Godesberg: "If only because it will ensure school and club swimming for the district until the new Kurfürstenbad opens The air dome was and is therefore indispensable." According to the press office twelve schools have used the Friesi since October The city does not have more precise figures on the number of classes You can find out how many lanes are available to the public and when by checking the opening times on the city's website it can happen that - as was the case last week on Wednesday morning - only the non-swimmers' pool is needed for school swimming all other lanes are released for individual guests at short notice There is an exact occupancy plan according to which lanes are reserved but we react by releasing the lanes that are actually intended for this school for the corresponding period for the public," says a member of staff from the press office Rafael Röger knows of a primary school that was left empty-handed when the times were allocated "If you find out that a school is not using its times you should release them for others," he says The Freibad Freunde Friesdorf are already in the planning stages for the new season It is certain that the film nights will take place on the last weekend in July and the first weekend in August and the Friesathlon but that's not quite ready for finalisation yet," says Röger The trio Wellenbad has been asked to organise an event with spherical music under water Such events are very important for attracting new visitors says the chairman: "The film nights in particular have attracted people who were previously unfamiliar with the outdoor pool." During the air dome season You can look up at the honeycombs from a supine position and imagine you are swimming in a radome (Original text: Bettina Köhl; Translation: Mareike Graepel) The Friesdorf outdoor pool was opened in 1961 the pool liner was renewed and a new three-metre stainless steel diving tower was built In addition to the multi-purpose pool and non-swimmers' pool a paddling pool is available to bathers in summer The sunbathing lawn has been upgraded in recent years with the support of the Friends' Association It offers additional sports facilities such as beach volleyball A playground offers climbing facilities in a large sandy area the Friesi is therefore popular with families with children A technical defect triggered a power failure in Friesdorf and parts of Bad Godesberg on Saturday morning Around 7000 households were affected - including shops and surgeries Not much was going on in the Radiological Institute at Michaelshof on Monday morning: the staff could not start up the X-ray machine The reason for this was the power failure on Saturday morning which plagued parts of Friesdorf and Bad Godesberg for hours "We have power-up problems and are still in the process of repairing the equipment," said Dr Bernhard Knopp on Monday morning The team had to put his patients off until another appointment Knopp was able to understand the connection between power failure and equipment faults when he reviewed the logs "We had a power failure of about four hours," said the specialist Knopp regularly experiences short power cuts in Bad Godesberg there has not yet been a comparable equipment failure as at the weekend We are a high-tech location," Knopp wonders The technical problems at the Radiological Institute should be solved by Tuesday morning at the latest The power failure was triggered by a technical defect on Saturday morning about 7000 households in parts of Friesdorf and the Bad Godesberg city centre were without electricity A short circuit initially occurred at a transformer station in Friesdorf The circuit breaker used as protection then tripped and disconnected two cable lines in Bad Godesberg and Friesdorf from the grid Seventeen local network stations and six consumer stations were affected The technical defect also affected the drinking water system on Annaberger Straße Two crews were deployed to repair the lines the streets could be supplied with electricity again Friesdorf was fully connected to the power grid again the fault in Bad Godesberg's city centre was also completely repaired and the StVO signage that is always present at every signalised intersection or junction applies," says Lea Hoffmann from the city's press office "We have not received any special reports about the power failure," says Telekom spokesman Peter Kespohl on request routers and telephones should start up again without any problems and log into the network customers can contact our service hotline," says Kespohl The Stadtwerke state: "We posted information online at an early stage and informed the media about the power outage Also affected by the power cut was the fish shop Stuch at Theaterplatz "Our cash register systems don't work without electricity We were unable to act during this period and could not serve the customers," says branch manager Timo Scholz This resulted in a considerable drop in sales before the holiday "We then sent the customers to the sales trolley at the weekly market This allowed us to cushion the losses somewhat," says Scholz Because the electricity apparently continued to flow at the weekly market "The outages were probably sporadic." The rows of shops up to the Fronhof Galeria and also the Rewe market at Michaelshof were affected The Fisch Stuch employees were able to save their goods with lots of ice And yet: "I have never experienced such a power failure here," says Scholz The Frohnhof Galeria was not affected by the power failure "It didn't affect business at all," says the owner's representative This is because in the event of a power failure the emergency power supply in the shopping centre kicks in Escalators continue to run and shops have light "The building services have noticed the failure but we have not received any reports from the shops," says Otting The Waldkrankenhaus in Bad Godesberg has triple protection The hospital is connected to two power networks Frank Eichner: "to Bad Godesberg and via Annerberger Hof" which allow us to keep all vital things running," Eichner says He adds that the emergency supply is regularly tested by the technical staff "We can't find any verifiable interruptions there," Eichner says explains master electrician Thomas Schulte you don't normally need to do anything." This is because refrigerators and freezers can maintain their temperature for over twelve hours "People don't need to worry," says the owner of Elektro Schulte you only have to reset the clock on electronic appliances such as the oven Nothing usually happens to the fuse box in the event of a power failure either Tenants and owners can prevent a power failure by installing a balcony power plant - if the sun is shining at the same time as the power failure several stations are connected in series via medium-voltage cables The power is supplied from one side from a transformer station If a section is defective in the event of a fault it is switched off and the supply is then switched on from the other side we can restore the supply in 90 per cent of cases by switching over even if the fault still exists," SWB explain There is no doubt that the summer in Bonn was very nice even if it was marked by the Corona pandemic the Corona pandemic did not stop at the open-air swimming pools in Bonn whose season initially threatened to end completely before they were opened step by step in May some of which are now being continued in the indoor pools the Sports and Pool Authority has drawn up its own hygiene concept which now applies to all public indoor pools in the city - i.e the Beueler Bütt and the Friesdorfer Bad with its air hall Probably the most important message for bathers: they do not need to book via the Internet to visit a pool within a certain time frame This rule had been in place at the open-air baths until the end of August in order to be able to better control the flow of visitors there are still a number of things that bathers need to bear in mind the number of bathers who are allowed to be in the pool at the same time is strictly regulated school classes and clubs get their money's worth only one indoor swimming pool in Bonn is open to the public from Tuesday to Friday is possible Monday to Friday at the Frankenbad Tuesday to Friday at the Hardtbergbad and the Beueler Bütt and Monday school swimming is initially suspended until the autumn holidays because of the current ban on school sports in halls and will then be spread over the period from Monday to Friday the times for club swimming have been agreed with the clubs and the occupancy plans have been changed accordingly "The pools are cleaned during the breaks at the weekend and after the club swim," explains the Sports and Pool Office Forms are available on the Internet and at the pool cash desks for tracking customer contact data which must be completed and handed in when leaving the pool could also be a strain on the patience of many citizens In order to comply with the required distance rules the city has limited the number of visitors present at the same time The basis for the maximum number is the water surface of the individual baths This means that a maximum of 108 people are allowed to stay in the Frankenbad 68 in the Traglufthalle Friesdorf and 60 in the Hardtbergbad you have to wait until someone leaves the bath no problems have been reported for bathers waiting in vain by the weekends and autumn holidays at the latest Inside the baths - but not in showers and swimming halls - guests must wear a mouth-nose cover Swimming aids such as swimming noodles or diving rings are not lent out either The changing room area has been redesigned to ensure that the distance rule is observed The collective changing rooms will be closed for bathers The use of showers and toilets is only possible if the minimum distance is observed Every second shower will be closed for this purpose A maximum of two persons may enter the toilets simultaneously None of this has any influence on the admission prices: the regular rates apply (Original text: Rüdiger Franz / Translation: Mareike Graepel) 400 kilograms of ice cream per day: Lolita Imperiale behind the counter at the Bianchi ice cream parlor Bonn's Eiscafé Pusterla is located right on the border between the old town and the northern part of the city Regulars appreciate the family atmosphere and the relaxation on the terrace - you hardly notice the traffic on Kaiser-Karl-Ring The Italian gelateria has been in that spot for almost 35 years and Giuseppe Pusterla and his wife Habiba have been running the ice cream parlor for ten years "I make my ice cream with my heart," says the 56-year-old who hails from the small Apulian town of Nardò in the province of Lecce and looks confusingly like the famous Italian film comedian Totò and that's been my recipe for many years.“ Demand for vegan ice cream has increased in recent years one of his regulars stops by daily to enjoy five scoops of lemon ice cream The lemons for the vegan fruit ice cream come from Sicily the friendly couple bring a vegan Italian tricolore of woodruff (green) lemon (white) and raspberry (red) in three wafers A visit to Giovanni Imperiale in Friesdorf where the 49-year-old restaurateur has been running the Bianchi ice cream parlor on Klufterplatz since 2000 actively supported by his partner Lolita and daughter Isabella Imperiale also comes from the Apulian province of Lecce Now the 49-year-old is standing in his Friesdorf ice cream kitchen between bulky freezers and stainless steel buckets creating a new vegan ice cream composition he tells of the origins of ice cream in China how Marco Polo brought the knowledge with him to Europe - and how people in Sicily hoarded snow in caves on the Etna volcano and later enriched it with citrus fruits and sold it That's why Imperiale calls his just-emerging creation "yesterday's snow" The light yellow mass comes out of the ice cream machine at minus nine degrees Celsius you almost only taste the cold," Imperiale says "It's not until the second spoonful that the flavors come." And he's right The second tasting spoon tastes even better Now the bowl of "yesterday's snow" is stowed away in the freezer at minus 35 degrees The second vegan ice cream created by the 49-year-old ice cream maker is called "Pistacchio di Mare Giovanni." The pistachios for it come from Iran and were processed in Piedmont into a wonderfully fragrant paste Now this paste is mixed with sea water from the Costa Brava Imperiale uses a refractometer to check the sugar content in the resulting ice cream "We often washed fruit in the sea when we were kids in Puglia." The result is stunning: a very intense with the seawater echoing in the background "An ice cream is never the same," says Giovanni Imperiale "You can try to make it the same next time but it will always be a little something different it's his life partner and daughter who try a new creation next the 49-year-old makes up to 400 kilograms of ice cream a day His range includes at least six vegan varieties His chocolate sorbet made with organic cocoa from the Dominican Republic and Belgian chocolate is also very popular it would destroy the flavor." For the past decade or so demand for vegan ice cream has been growing And at Eiscafé Bianchi on Friesdorf's Klufterplatz [Foto: Michael Kleinjung --- Enzo Wirtz erreichte in der Torjägerliste den dritten Platz am letzten Spieltag hatte der Meister aus Hohkeppel spielfrei.] Chris-Leon Kayser (SV Bergisch Gladbach 09) Marios-Paraskevos Akrivos (Germania Teveren) Alexander Hürtgen (Borussia Freialdenhoven) Aboudoul Tchadjej (Borussia Freialdenhoven) Leonardo Dos Santos Figueira (FV Bonn-Endenich) Jose Pierre Vunguidica (Eintracht Hohkeppel) Stefano Fragapane (SV Bergisch Gladbach 09) Nikolaos Mavroudakis (SV Bergisch Gladbach 09) Alexander Mironescu (SV Bergisch Gladbach 09) Maximilian Wickum (Borussia Freialdenhoven) Anmerkung: Die Tore aus den Partien mit Beteiligung des zurückgezogenen BCV Glesch-Paffendorf wurden aus der Übersicht genommen Zu dieser Meldung werden keine Leserkommentare freigeschaltet Вы используете блокировщик рекламы в вашем браузере В этом случае Вы не сможете пользоваться всеми функциональными возможностями нашего сайта и его отдельными страницами который мы используем для отображения видеоконтента активированный блокировщик рекламы может вызывать проблемы с загрузкой сайта и корректным его отображением чтобы получить возможность использовать наш сайт в полной мере внесите Dynamo.kiev.ua в «белый список» вашего блокировщика что любые попытки обсуждения этого и других решений редакции сайта немедленно влекут за собой ограничение по п.2.9 правил сайта Mykyta Kamenyuka, a 39-year-old former team captain and later coach of Luhansk's Zorya, told UA-Football about his time in Germany and a new turn in his football career a German sixth league team from Bonn that plays in the German Landesliga while also doing an internship at the Bayer Leverkusen Academy One of the most important factors for me was the opportunity to practice while learning German and adapting to German football I also tried myself as a coach who is responsible for the result and for the team as a whole This year was definitely a huge plus for me I gained a tremendous amount of experience I think it will definitely come in handy in the future - This became possible thanks to my Zorya teammate Joel Abou-Hanna who found out about this prospect for me at the Leverkusen club after which I was given the opportunity to work I signed a two-year contract with the Bayer Academy and started to fulfill my duties - I am an assistant head coach in the U-14 and U-15 teams in the process of communication it is very important to convey to the ward what and how you see - And what are your successes in mastering the German language I'm satisfied with how things are going with my German language learning - Has your family already settled in Germany - My eldest son continues to play football Last year he became the champion of one of the German youth leagues his knowledge of English helped him to adapt well in Germany My younger son started first grade this year and also plays football So I advise everyone to learn foreign languages - it will come in handy it is very difficult to adapt at the moment I think that everything will be normalized soon she is also adapting to the new environment The most important thing is that we are together - as always - Have you been able to attend matches of the Ukrainian national team and Ukrainian clubs in Germany I attended both our national team's matches and the matches of our teams in the European Cups Thanks to my friends and old acquaintances who always had tickets for me It's always interesting to watch and worry about your own - How do you assess the chances of the Ukrainian national team in the League of Nations after two initial failures What do you think about the European Cup prospects of Dynamo and Shakhtar I have never done it and I don't want to do it I only know that it is always easy to speak after everything has happened I would like to support the players and coaching staffs of our national teams and clubs But I would like our players to cope with this pressure I want everyone to remember how much positive emotions it can bring football is the most famous game in the world Make yourself heard while you still have the opportunity - Do you follow the Ukrainian championship I follow both the results and the standings I talk a lot with the guys I've known since I was a football player But there are already guys in the UPL whom I know as a coach I also follow the teams of my friends who play in the first league - I always intend to say only positive things about Zorya The results of their performances are different: sometimes better The main thing is that the team is there and does not disappear from the football map of Ukraine But what saddens me is that at this stage the team does not have its own players - those who understand and know what Zorya is I will always be a fan and a part of this club Стать участником фан-зоны Нажимая на кнопку, вы соглашаетесь с условиями членства в фан-зоне конвертировать карму в шурики Устанавливайте наше приложение и всегда оставайтесь в курсе футбольных новостей Men are from Mars and women are from Venus but could these planetary metaphors also translate to differences in our human moral compass An international team of researchers from Wilfrid Laurier University in Canada studied how men and women weigh moral dilemmas "Women seem to be more likely to have this negative, emotional, gut-level reaction to causing harm to people in the dilemmas, to the one person, whereas men were less likely to express this strong emotional reaction to harm," the study’s lead author Rebecca Friesdorf, a social psychology graduate student at Wilfried Laurier University, told NPR so it's more difficult for them to make their choice." The research team analyzed 40 data sets from various studies, which was published in the journal Personality and Social Psychology Bulletin and found when participants were presented with 10 different hypothetical dilemmas their answers depended on their gender Every dilemma presented two different scenarios for the person to weigh out with a cost-benefit analysis after studying 6,000 participants’ responses men and women both calculated consequences such as how many lives would be lost by their decision But women were confronted with their own emotional responses to how it would feel to — as one of the dilemmas presents — kill Hitler to save millions of persecuted lives Friesdorf found the “Hard Times” dilemma the most interesting one to measure an individual’s moral compass Give it a try and see how a scientist would evaluate your moral compass: You are the head of a poor household in a developing country You know a man from your village who lives in the city and who makes sexually explicit films featuring girls such as your daughter Is it appropriate for you to employ your daughter in the pornography industry in order to feed your family There were very few people who said they would sacrifice their daughter’s virtue for the sake of the rest of their family Women had a much more difficult time grappling between the two circumstances They weighed out their interpretation on what will create benefit or cause harm and compared it to the rest of society’s moral definitions Philosophers would consider people who sacrifice their daughters as utilitarian, which means they operate for the common good, according to the Stanford Encyclopedia of Philosophy those who would protect their daughter in lieu of financial stability would be considered deontologists who focus on the rightness or wrongness of actions based on morality and adherence to rules Now that you’ve read the scenario yourself Gender Differences in Responses to Moral Dilemmas: A Process Dissociation Analysis Personality and Social Psychology Bulletin Medical Daily is for informational purposes and should not be considered medical advice, diagnosis or treatment recommendation. 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