Creating an active process with SOA and Business Rules – TheMoneyOffice

The Vision Service Program, VSP, demonstrates the use of business policies to create agile health business processes. VSP has about 55M customers in its plans and has been an IBM / ILOG customer since 2002. Every health process is governed by policies and regulations – each policy contains decisions that must be made according to the rules outlined by these policies and regulations. Everything from medical results to billing. Healthcare companies deal with activities such as managing recurring risks and extending time to make a difference. Lack of transparency and inability to analyze “what-ifs” make it worse because business users want more visibility and more control.

The VSP has a tonne legacy system built since 1955. Most of them run on mainframes in Gobol. Many systems have been created for a particular area (claims, qualifications), which has become a growing burden. Many processes have manual steps, which are also unacceptable. Whenever they want to add a new product offer, it takes 9–12 months. It reduces agility, despite having too many tests at the moment, the rules are at risk.

The Vision Service Program, VSP, demonstrates the use of business policies to create agile health business processes. VSP has about 55M customers in its plans and has been an IBM / ILOG customer since 2002. Every health process is governed by policies and regulations – each policy contains decisions that must be made according to the rules outlined by these policies and regulations. Everything from medical results to billing. Healthcare companies deal with activities such as managing recurring risks and extending time to make a difference. Lack of transparency and inability to analyze “what-ifs” make it worse because business users want more visibility and more control.

The VSP has a tonne legacy system built since 1955. Most of them run on mainframes in Gobol. Many systems have been created for a particular area (claims, qualifications), which has become a growing burden. Many processes have manual steps, which are also unacceptable. Whenever they want to add a new product offer, it takes 9–12 months. This reduces agility, and at this time too many tests run the risk of missing rules because they are hidden in the system. Finally there is knowledge of many tribes in the field of IT. In 2002, SOA began to adjust business policies and business processes.

Improving agility is important to bring new products to market. This will reduce costs, but agility is important. They seek to improve the reuse of services, rules and process practices while engaging business and information technology individuals in the policy management process. The goal is to find and manage central policies and make final-first processes easier. VSP finds that this is not a system and plan to be created, but a way to continuously improve.

The first step is to define the architectural context. It consisted of a presentation/request layer, a business process service layer, a business services layer, and an infrastructure services layer. Each layer Most IBM-Centric-Websphere products are used with one core-frame infrastructure center in each layer. They still have support for a service registry and have their own service bus, but moreover, IBM is on the line.

Creating a reference framework, they move to some sources of concept projects and prototype services. A POC is a calculator of patient options available in a physician’s office. Most key components (web layer, pairing services, mainframe connection) are required, but this is somewhat limited. I learned some interesting things about the development process in particular. For example, they started with a downstream, Java-centric approach, but found that it was more fragile and that the Model / XSD-enabled top-up approach would be more effective. In particular, it provided policy information.

The next stage is a large release and wide application of the rules. Better external and customer service websites and value claims. 53 services have been developed with 42 and 6,500 development times in production. Some of these services get 80–100,000 hits a day.

Processing claims include submission, verification, pricing and payment. Each of these results – is this a correct claim? How much should I pay for this claim? – Automated using business policies. Initially they were written as “codes” in the rule machine, but also with this enhanced business communication compared to traditional code. The rate also increases directly through processing. Built-in lab routing service built using the rules of the claim process. Policies were highlighted using the easiest-to-use tool for the business user, and this increased efficiency and accuracy – not just for business user participation. Better accuracy and agility than the old system is dramatic. Java writing has ILOG v 30% faster creation rules, business analysts’ rules, and about 4,000 rules. Now switch to the rating machine and upgrade the pricing machine.

Another program revolves around business processes – an example is customer service letter processing. This process collects information from several mainframes and related sources and then draws to form letters. The use of the WebSphere Process Server was able to reduce the number of screens required to collect data and automate information gathering. It now continues to manipulate members on boards – a process that involves multiple hand-offs and manual steps in multiple groups. It now uses WebSphere to monitor processes to improve visibility and integrate various phases.

SOA enables VSP to achieve business performance and momentum in the market. SOA is not easy, but being persistent and hardworking can have real benefits. As the strategy continues to be used, they use a better phrase, “commitment and adaptation”, to reflect the current need to change it. SOA is an approach that does not apply to all approaches, so modify it to work for you.