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A model-driven business process integration solution that offers better tracking, measurement and control capabilities
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Business impact This engagement helped the client create IT solutions that can:
ˇ Address business problems faster and more cost-effectively than previous measures
ˇ Align directly with business objectives, helping to close the business-IT gap
ˇ Adapt easily to changing business requirements
Issue Provider data load is the process of adding or terminating a healthcare provider in an insurer’s networks, as well as simply updating information about a provider. At a major healthcare insurance company, the process had become slow and error prone, resulting in costly mistakes and physician dissatisfaction. Performance monitoring was hindered by inconsistent processes and metrics; the process was undocumented and practiced differently in each region. Accountability was poor due to lack of reliable performance measurements and disparate improvised workflow tracking tools.
Executive summary With the company’s business needs in mind, IBM researchers developed an approach that included:
ˇ Faster, semi-automated creation of integration solutions from business operation models
ˇ Centralized, Web-based user workplace tracking for real-time performance measurement
ˇ Executive dashboard and standardized reporting of business performance measures across regions
What IBM did Using model-driven methodology, IBM researchers developed a business process integration solution that was deployed on an IBM WebSphereŽ Business Integration Server Foundation. A new unified provider data load process model now facilitates controlled variation in each region, and a role-based user workplace allows for automatic workflow tracking.
The solution applied the tools and methods of IBM’s Model-Driven Business Transformation capability to the insurance domain. After analysis of the as-is provider data load process, the process was captured in formal business operation models and transformed semi-automatically into execution models. Key business performance indicators were linked to the operations model and configured for capture and display on an executive dashboard. These new models and linkages are designed to enhance the ability of the enterprise to monitor its business processes and to modify them in response to changes in the external environment.
Capabilities applied Creating high-level models useful to business users and creating meaningful mappings to execution models required significant technical innovation. The mappings, or transformations, automated a major part of the work of composing a solution from components.
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