1667 making z rules work session

© 2014 IBM Corporation

Making zRules Work with Healthcare at

Humana

Session # ASZ-1667

Helen Havener Rob Hilgert

Technical Architect Technical Architect

Humana Humana

Agenda

1

• Humana at a Glance

• Addressing Application Transformation

• Why Operational Decision Manager, why “z”

• Humana Operational Decision Manager (ODM) Background

• Rule Adoption within Humana

• Reflections/Summary

• Special Thanks

• Reference Material

Leading health care company that offers a wide range of insurance products

and health and wellness services; founded in 1961; headquartered in

Louisville, KY

2014 revenues of $48.5 billion

Total assets of approximately $23.5 billion

Over 30 years of experience in the Medicare program

One of the nation’s top providers of Medicare Advantage benefits with

approximately 2.9 million members

Approximately 13.8 million medical members nationwide

Approximately 7.7 million members in specialty products

Operates more than 500 medical centers and approximately 200 worksite

medical facilities

About Humana

2

Humana has two zEC12 CEC(s) supporting workloads

•ODM environmentWebSphere Application Server on z/OS (webservice calls)

Test, QA and Production (Decision Server)zRES – standalone execution server (COBOL and CICS calls)

Test, QAProduction - 3 LPARS

Decision Center – DB2 Repository on z/OSRule Execution Server – DB2 Repository on z/OSOne Administration for multiple LPARS

• CICS environment

Running CICS v5.1 (since March 2014)

168 CICS Regions

18,000 CICS COBOL programs

90+ Million transactions / day

200+ CICS Web Services

CICS related project growth = 5%

Reuse is low

• Initiatives

Transparency

Ease of Use

Agile

Performance

Modernization of Applications

Reduction of general CP MIPS

Increase Re-Use of Resources

Humana’s IT Environment

Agenda

4







• Special Thanks


Transform Humana’s IT Assets to Preserve Investments

Legacy Applications – Monolithic, Siloed, Module-Based Approach that mixes program Code for Flow, Data Access, Integration, Presentation and Business Logic

VERSUS

Modernized Applications - Layered Service-Based Approach with Separation of Process Flow, Data Access, Integration, Presentation, Business Rules, Events, Monitoring and Business Services

Creating Business Components/Services from harvested/salvaged legacy modules…

Benefits of Application Renovation are:

– Simplify - Separate business functions from legacy applications and re-use of existing application services in new business processes

– Flexible - Process Assembly approach verses Complex Custom Code approach

– Respond - Increase IT responsiveness to business needs

– Align - IT Process Models with Business Process Models

– Agility - Increase revenue by enabling business to more quickly and dynamically adapt and capture new market opportunities

– Reuse – Extend the useful life of valuable, proven IT Assets

Monolithic Siloed

Applications Consist of

Intertwined:

• User Interface Logic

• Process or Flow Logic

• Security Logic

• Integration Logic

• Data Access Logic

• Error / Recovery Logic

• Plumbing Logic – threads, memory,

sockets, transactional semantics,

etc…

• Application Rule Logic and finally…..

• Business Logic

Modern Layered Applications

Consist of:

• UI Layer – Channels: Mobile, Web, Portal,

ESB, Client, Cloud API, etc…

• Process Layer – Process Engine

• Security Layer – Application / Security

Server and Directories

• Integration Layer – ESB

• Data Access Layer – Database Manager

and Related Capabilities

• Error / Recovery – Application Server

• Plumbing Logic – Application Server

• Business Rule Layer – Rules Engine

• Business Logic Layer

VS

Monolithic Versus Layered Approach

Agenda

7







• Special Thanks


“ I look at technology as a way for us to engage with and help our customers. If we don’t do it, someone else is going to.” Humana CEO Bruce Broussard

• Aligning ODM with Humana’s Core Values• Pioneer Simplicity, one resource for Business Rules• Thrive Together, initiates collaboration in rule creation• Rethink Routine, Reuse of corporate assets across LOB’s

• Enforce Consistency to ensure Compliance

• Leverage Information to Manage Risk

• Cost Savings

• Reduce Time to Market

• Better Visibility and Control

Why ODM on z?

• Components of WebSphere Operational Decision Manager

• Rules and Events Designer

• Decision Center

– Decision Enterprise Center Console

• Decision Server

• Humana’s Deployment of Decision Center

• Rule Execution Server Deployment Options on z/OS

1. WebSphere Application Sever Rules Deployment Option

2. Standalone Rules Deployment Option

3. CICS Rules Deployment Option

4. Batch Integration

• Integration Patterns and Benefits of Rule Execution Server Deployment Options on z/OS

Rule and Event Designer

• Design

• Rules and events business objects

• Vocabularies

• Projects structure and organization

• Rule Templates

• Test

– Step by step debugging

– Value inspectors

– Test and simulation suites

– Completeness reports

• Configure

• Business environment (Decision Center)

• Deploy

• Rules and events projects to their respective execution environments

Comprehensive technical environment

Event DesignerRule Designer

Decision Center Enterprise Console

• Access rule artifacts concurrently without conflict or

delay

• Represent complex policies using rule overrides and

hierarchies

• Take control of very large rule bases

with Smart Views, easy search

and reporting

• Get automatic notification of potential

rule conflicts, redundancies

• See where rules are used across

projects using queries

• Hot-deploy rule and event changes in minutes

• Secure, integrated with enterprise security facility

including single sign-on

• Multiple release management supporting diff and merge

Web-based Event and Rule

Maintenance

Decision Center Console

Decision Center

Decision Server

Synchronize

Deploy

Deploy

Decision Center Enterprise Console

Decision Center Repository

Rules and Events Execution Server

Rules and Events Designer

Ruledocs

Rule Solutions for Office

RuntimeDesign

time

Decision Center Business Console

z/OS

Rule

Execution

Server

z/Linux

Decision

Center

DB2 DS Repository

Deploy Rules

Decision Center – Humana’s Deployment on z/Linux

• Advantages:

Takes advantage of IFL so no additional costs

“z” hardware qualities of service

Use of hipersockets to communicate with z/OS

Improved Security Configuration

The platform of choice for server consolidation including simplification of support model

DB2 DC Repository

z/OS

WebSphere Application Server

for z/OS*

Events ExecutionServer

Rule Execution Server

CICS TS v5.1

*Limited Use

zRule Execution Server

zRule Execution Server

• Deployment runtime options on z/OS:

Deployed on WebSphere Application Server for z/OS

Deployed standalone to z/OS for COBOL

Deployed in CICS TS 5.1 in JVMServer environment

ODM Deployment Options on z/OS

3

2

1

1

2

3

Deployment Option

Rule Execution Server for WAS

on z/OS

Web Services, Plain Old Java Object (POJO), Message Driven

Beans (MDB), Enterprise Java Beans (EJB).

Decisions can also be invoked from COBOL applications

using the WebSphere Optimized Local Adapter (WOLA).

WOLA is a functional component that provides an efficient

cross-memory mechanism for calls both inbound and

outbound calls to WAS z/OS

Options for Rules Invocation, Integration Patterns and Benefits

1

Integration Patterns

Unique Cross memory communication, z/OS WLM and a secure infrastructure.

Ease sharing of Rules: Decision services can be invoked from distributed platforms using the patterns shown above

Unique Automated Workload Balancing, High Availability and Scalability with WAS on z/OS topology

Rule execution is offloaded to zAAP reducing mainframe software costs and freeing up CPU cycles.

Rules shared across Logical Partitions in z/OS for unparallel high availability requirements (SYSPLEX)

Unique in industry Events Execution Server is integrated within the deployment option.

Ability to grow Rules and Events usage based on system capacity and application requirements versus a “per”

project basis.

Benefits:

Deployment Option

zRule Execution Server (Standalone) Simple COBOL API


2

Integration Pattern

COBOL applications use copybooks as the interface to invoke decisions making development simple.

z/OS permits the copying of message buffers from one virtual address space to another which makes ODM efficient,

fast and secure as it is within LPAR.

zRES can be added in an Automatic Restart Manager (ARM) sequence. This will allow zRES to be started

automatically in case of a failure.

Rule execution is offloaded to zAAP reducing mainframe software costs, freeing up CPU cycles.

Rules shared across LPARS: With DB2 data sharing, rules can be stored in DB2 and accessed from multiple LPARs

in a SYSPLEX environment

Batch/CICS and Rules Engine running on the same LPAR adds to better performance as there are no network hop.

Decision services are deployed and instantly available across z/OS without making any application changes

Ability to grow Rules and Events usage based on system capacity and application requirements versus a “per”

project basis.

Benefits:

Deployment Option

zRule Execution Server (CICS JVM) Simple COBOL API


3

Integration Pattern

Same benefits as option 2 plus additional

Running ODM inside CICS allows access to the CPSM* Qualities Of Service like workload management, reliability,

availability and security within a CICS infrastructure.

Uniquely Integrates with Business Event Emitting from CICS, which results in meeting high volume capacity

requirements.

Local execution within CICS region.

* CICSPlex System Manager(CPSM ) is a system management tool to manage multiple CICS Instances from a single

point.

Benefits:

Localize Execution of Decisions within a Batch Application

Address Space

JVM

Native

Control

Code

Rule

Server

User COBOL

Application

Decision

Service Stub Decision

Engine

• When calling zRES API call stays within same address space

• No cross address space communication or memory copies

• Reduced ‘native code’ path -> higher percentage zIIP eligible

• Configured and managed the same way as a standard zRES

CONN

RULE

DISC

Initialise

Invoke

Destroy

zRES API commands with Batch local deployments

• HBRCONN

• Starts the JVM locally and RES ready for rule execution

• Initially starts one processing thread

– Make threads configurable as part of this work

• Does not return successfully until the environment is started and waiting to execute rules

• HBRRULE

• Sends a rule request to the zRES code and points to the local data structures

• Waits for the local rule engine to return control

• HBRDISC

• Issues the call to the native code to terminate and clean up the JVM

• Frees all local storage and unloads all product code

What does ODM bring to z/OS?

Challenges forHumana

1. Consolidation, Isolation, Extension of COBOL application portfolio

2. Ability to react to increasing variety and volume of change requests regardless of platform

3. Sharing business rules across platforms & channels

4. Ensuring seamless business experience in migration/ application evolution

Benefits of the ODM Approach

Cost savings

– Shorter change cycle, without increased business risk

– Rule engine processing is zIIP eligible (approximately

90+% offload experienced)

Improved agility

– Improved Time to Market

– Manage business decisions in natural language

– Decouple development and business decision change

lifecycles

Single version of the Truth

– Consolidated and shared expression of business policy

– Maintainable with a Center of Competency model

Incremental Adoption

– Deploy decision methodology one decision at a time

– Focus on decisions that need to change often & quickly

– Expand adoption of “market validated” decisions

Agenda

21







• Special Thanks


Humana had two initiatives with IBM Investigating ODM feasibility

• PBP (distributed based application) Humana CMS Software used to create Medicaid /Medicare Bids

Governing Body for Medicaid/Medicare Bids

CMS Publishes a questionnaire and we’re required to align our

700+ plans with those questions

.net Application

1500 rules ranging from simple to complex

Primarily executed January through July

Every plan, will execute business rules

SLA of 2 seconds

Critical Application within Humana

Planned Benefit Package (PBP)/Solar Application

• Solar (z/OS based application) Agent and Commission Application

COBOL Application

CICS/Batch

DB2

IDMS

WebSphere MQ Initiated (migrating to CICS Web Services)

Humana ODM Environment

Agenda

24







• Special Thanks


•MPPR (Multiple Procedure Policy Reduction) Primarily used for determining reduction in payment of claims

COBOL CICS Application and scheduled batch daily processing

Frequent changes anticipated based upon government regulation with limited time to

implement

Approximately 422 Rules

Currently over 1 million ruleset executions daily

Sub-second response time requirement for CICS transactions

Majority of rules are not complex

Business vocabulary a plus for Line of Business

Ongoing ODM Adoption

• LL (Language Library) Enable Humana Plan Rules to be created based upon the language required.

Currently supporting English and Spanish

1500+ Rules

Supports the PBP application mentioned previously

Enabled the business users to build their own LL complex rules based on Humana

plans

.net application

• CCVT (CAS Constraint Verification Tool) Used to compare benefits and benefit types to ensure they meet requirements to pay

claims correctly.

Updated yearly to ensure logic is accurate

.net application

Agenda

26







• Special Thanks


Understanding the extent and the visibility to which Operational Decision Manager, or a BRMS will impact the

Enterprise is Vital to SuccessCulture Impact

• Lines of Business are the initial point of development for business rule change• Timing for LOB changes are not aligned with application release schedules

• ODM promotes collaboration at all levels• Blurring of roles and responsibilities • New Roles will be required• Rapid technology adoption• Understanding Infrastructure Requirements to meet LOB Requirements

• Physical (sizing)• Licensing

Business Impact• LOB’s are more aware of BRMS, in theory, than generally the larger audience in IT• Business requirements for change are frequent resulting in concurrent change

activities outpacing typical application release change implementations• There is varying skill level within the business and different levels of engagement• Consulting engagements expedite adoption• Change activities involve integration and testing the backend

Reflections

Reflections Continued

28

Role Considerations (Source Redbook Governing Operational Decisions in a Enterprise

Scalable Way)

• Business Owner – Request business decision changes, provides business approval for release

• Change Control Board – Triages and selects change requests to be included in a specific release.

• Release Manager - Coordinates the contributors work toward a release, gathers appropriate approvals.

• Business Analyst – Provides business domain knowledge. Oversees change and validation activities. Is

accountable for the quality of decisions.

• Business Policy Analyst – Determines and manages the implementation of a business policy. Formalizes the

business terminology used ODM. Acts as a liaison between the business and IT at the time of the design

and implementation of decisions.

• Rule Author – Authors rules to support decisions. Manages and runs test cases to test decisions. Runs

simulations

• Operational Decision Manager (DC Admin) – Creates and configures Projects, manages permissions and

access rights on projects and artifacts

• Configuration Management - Performs configuration management tasks that are related to the release.

Acts as a liaison between business and IT at the time of deployment

• IT Integration Developer – Develops components around integration to other systems, web services, and

data services

• IT Quality Assurance (QA) – Performs integration testing

Security

• Decision Center (running on Linux on System z with DB2 repository on z/OS)

• Need to define security in relationship to responsibility and roles

• Requirement to isolate projects such that one LOB, won’t have access

to another LOB’s project

• Ability to share and enforce rule reuse when appropriate

• Decision Server (running on z/OS)

• LDAP aligning with ACF2 security

• Decision Server is used in Test for monitoring traces

• A number of rule developers aren’t familiar with z/OS

• Decision Warehouse resides on z/OS

• Marshaller XOM and Java XOM are deployed separately and both

are deployed directly on decision server

• Decision Server developers have RES monitor and RES deployer

access rights

• RES Admin is only granted to infrastructure

• Development access to JES, zRES and WebSphere Log for

problem determination

Reflections Continued

Summary

IBM’s Operational Decision Manager delivers on the promise to automate, govern and

improve operational decision making across business processes and applications for

improved business outcomes.

Communication and Collaboration across the Enterprise is key to success.

It enables the implementations of business changes in a easy, reliable and secure way to

meet market demands and policy requirements

Line of business can implement rule changes in a expedited manner reducing the time

implementing business decisions, regardless of application release cycles.

ODM on z/OS is effective as an enterprise solution for enabling a BRMS across multiple

platforms relying on the strengths of the enterprise server

• Reliability, stability, and availability

• Redundant processing architecture

• Advanced Technology

• Cost of ownership

Alignment with IBM Technical Resources is critical.

Agenda




• Humana Operational Decision Manager (ODM)

Background



• Special Thanks/Reference Material

Special Thanks

• Craig Whitaker, Humana Technical Manager

• Craig Gardner, Humana Technical Architect

• Kripa Singh, Humana Technical Consultant

• John Cowel, IBM Certified IT Specialist, [email protected]

• Subhajit Maitra, zChampion Senior IT Specialist, [email protected]

• Dave Krouse, zClient Architect, [email protected]

• Bill Yager, Software Client Architect, [email protected]

• James Taylor, Master Inventor FVT Lead, Operational Decision Manager for

z/OS [email protected]

• Chris Backhouse, IBM Operational Decision Manager for z/OS

[email protected]

mailto:[email protected]






Reference Material

1. Flexible Decision Automation for Your zEnterprise

with Business Rules and Events, SG24-8014-01

Redbooks, published 7 November 2013, last updated 18

November 2013

2. Governing Operational Decisions in an Enterprise

Scalable Way, SG24-8127-00

Redbooks, published 26 April 2013, last updated 26 April

2013

3. WP102291 Why IBM Operational Decision Manager for

z/OS, last updated 05/29/2013

4. IBM ODM Information Center,

http://pic.dhe.ibm.com/infocenter/dmanager/v8r5/index.js

p?topic=/com.ibm.help.doc/zos_infocenter_homepage.ht

ml

http://www.redbooks.ibm.com/abstracts/sg248014.html?Open

http://www.redbooks.ibm.com/abstracts/sg248127.html?Open

https://www-03.ibm.com/support/techdocs/atsmastr.nsf/WebIndex/WP102291

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