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From Legislation to ExecutionModernizing the citizen interaction with Oracle Policy Automation

Tamas Kramer

Sales Executive, Policy Automation, Central & Eastern Europe

Bucharest, November 3, 2010

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The following is intended to outline our general

product direction. It is intended for information

purposes only, and may not be incorporated into

any contract. It is not a commitment to deliver any

material, code, or functionality, and should not be

relied upon in making purchasing decisions.

The development, release, and timing of any

features or functionality described for Oracle‟s

products remains at the sole discretion of Oracle.

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ORACLE POLICY AUTOMATION

and

SIEBEL Public Sector Case Management

presents

The Citizen

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Dynamic legislation drives the need to automate policies

Freedom of information is increasing the pressure from customers and citizens to prove compliance with policies and standards

Budgetary pressures forceefficiencies

Costly IT projects and resource-intensive call centres are expected to innovate, and deliver more with less

Accountability requires transparency

Security, geopolitical and financial events drive frequent legislative changes and high expectations of enforcement

Making accurate and consistent decisions is difficult when finely targeted policies are needed to deliver the best outcomes

Policy complexity is growing

Legislative changes are accelerating

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What does Oracle Policy Automation do?

• An engine for making complex decisions and calculations based

on a set of rules

• Users create their rules in their natural language using

Microsoft Word

Microsoft Excel

Microsoft Visio

• The rules are kept separate from any application code

- Easier to test and maintain

- The rules look like the source documents

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What is policy?

Legislation

Policy

Interpretation

Policy can be interpreted as:

A company/public body’s interpretation of their legislative obligations

Rules created by the company/public body which are allowed under legislation and drive how the company/public body function

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Policy Automation: Mission & History

20 years as a proven EPA leader

Mission is to “Optimize Enterprise Policy Automation” (EPA)

Customers include the world‟s largest government agencies and global 1,000 financial services, insurance and commercial customers

Consistently recognized as a leader by industry analysts

Customers and revenue from across North America, EMEA, Asia-Pacific, and Australia

Patented technology automates legislation and policy using natural language rather than programming language, with multiple languages already supported

Designed for rapid creation of industry content that can be easily configured for an organization's unique requirements

Standard, pre-built integrations with leading enterprise application vendors

Government agencies use Haley to serve tens of millions of citizens

Tier 1 commercial banks use Haley to serve millions of customers

Global insurers use Haley to automate tens of thousands of daily claims transactions

Dynamic self-service applications and high-volume enterprise automation based on complex policy and legislation

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The Public ROI from Policy Automation

Key Operational Levers

• Faster Implementation of Government Policy

• Heavy Political cost of making errors

• Complexity is hard to explain to constituents

• Automated decision making• (self service )

• Lesser paid staff can do more

• Reduced errors and appeals

• Drastically reduced implementation costs

• Open and transparent decisions

• Understand the impact of policy change

• Reduce red tape for citizens and businesses

Value DriversObjective

Return On Public

Investment

Social ROI

Financial ROI

Political ROI

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Policy Automation Customers

Financial Services and Insurance

Government Other

American Fidelity (US)

Countrywide (US)

Credit Suisse (Switzerland)

UBS (Switzerland)

BUPA (UK, Ireland)

NASD (US)

United Healthcare (US)

HealthMarkets (US)

American International Assurance (US)

Farm Bureau Financial Services (US)

British American Tobacco (UK)

Motosport (US)

Cisco (US)

Intel (US)

AT&T (US)

Toyota Motor Corp (US)

Internal Revenue Service (US)

Govt of British Columbia (Canada)

Montana DMV (US)

HM Revenue & Customs (UK)

Home Office (UK)

Ministry of Defence (UK)

Dept Trade and Industry (UK)

Dept of Social Security (Sweden)

Westchester County (US)

ICF Road Home (US)

50+ Local Councils (UK)

Small Business Service (UK)

Dept of Statistics (Netherlands)

Dept of Defence (Australia)

Dept of Veterans‟ Affairs (Australia)

Dept of Immigration (Australia)

NSW Government (Australia)

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Business users create the content

Unique tools check rules

& show implications

Quick, high performance deployment

• Business people write rules in Natural Language and therefore no cost or risk associated with translation by IT

• Manage rules with business tools like Microsoft Word, Excel, Visio reduces training requirement and allows for agility with updates

• Policy Isomorphism providing confidence in and visibility of rules

• In-built simulation and scenario modelling gives capacity to analyse and test policy and rule outcomes

• Detailed determination reporting documents how conclusions were reached for audit purposes

• Automated and interactive rule testing to ensure that deployments give correct results

• Fully SOA-enabled out-of-the-box providing low cost flexibility

• Integrated with Siebel

• High performance inference engine with Temporal Reasoning architecture

Policy Automation Value Proposition

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• Dramatically improves time-to-market

for changes to policies and rules

• Simplifies development and

maintenance

• Ensures accuracy and consistency in

complex decisions and

determinations

• Reduces the burden on IT resources

• Assesses the impact of changes in

policy on customers and citizens

through “what if” scenarios

• Provides full audit-trail capability

The Resulting Key Benefits

Policy Documents

Modelling

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7 Unique Product Differentiators

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Key Enabler: Policy Isomorphism (Patented)

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The Source Legislation or

Policy

Executable Document in Natural Language that Business users can

understand and modifyCopy, Paste, Markup

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Key Enabler: Dynamic interactive interviews

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Asks least number of questions in

most logical order to finalize a

determination

Questions automatically created from

source document without need

for any programming

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Key Enabler: Determination Reporting

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Positive and Negative

statementsautomatically

created to explain determination

Can be used to build the content

for a letter of advice or audit

Natural language engine provides personalization

and pronoun substitution

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Key enabler: Temporal Reasoning (Patent Pending)

• Efficiently handle changes in:

– Eligibility, e.g. a change in minimum age, which takes affect on a certain date

– Rates, e.g. quarterly increase of a benefit rate

– Customer circumstances, e.g. number of children, marital status

• Benefits of the Oracle Policy Modeling approach to temporal reasoning:

– Accurate calculation of payments even when notification is retrospective

– Expressing time-based logic is simple and concise

– Optimal performance, without forgoing transparency or decision audits

Annual rate

increase

Annual rate

increase

Annual rate

increase

Claimant is married

New childPay riseNew child

Neweligibility

rules come into effect

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Key Enabler: Business User Regression Testing

Clearly define and communicate expected behavior for complex

scenarios

Ensure that between policy versions only expected

differences occur

Instantly run 100s or 1000s of test cases, and drill into

report results

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Key Enabler: Policy Visualization

Quickly find dependencies

across sections, and claimant data

Clearly identify base data needed

for decision making purposes

Find orphaned sections of

legislation, and identify unused

data items

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Key Enabler: Outstanding Performance

• Patented high-speed Linear Inferencing algorithm

– Faster than Rete which is widely used within BRE industry

– Better exploits modern CPU architectures

– More space efficient (stateless)

– Well suited to batch/transactional processing scenarios

• Results of benchmarking:

– Over 1 million premise evaluations/sec

– Using dual CPU Sun Fire 280R

0

0.5

1

1.5

2

2.5

3

0 2000 4000 6000 8000 10000 12000

# concurrent users

Avera

ge r

esp

on

se t

ime

(secs)

Oracle Web Determinations on 8 CPU Sun server

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Key Enabler: Multi Lingual capability

Model rules in your native language in Word or Excel

Easily add new verbs as needed

Integrate natural language questions into any application

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Automatic Language Parsing

Available for English, French, German, Spanish, Dutch, Swedish, Danish, Italian, Turkish*

* beta version

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Case Studies

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Delivering rapid benefits to Dentists in Sweden

Challenges

• Implement new Dental Reform legislation in tight timescales

• Deliver new Dental benefits calculations and improve Fraud detection

• Complete in parallel with modernisation of Legacy back office systems

Results

• New legislation delivered in four months

• Highly scalable and performant solution

• Success achieved by „externalising‟ rules from core applications

• Business users built and now own the rules

• Benchmark for future modernisation projects

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Veterans’ Entitlements

Overview

• Department of Veterans‟ Affairs is responsible for providing funding to former Australian soldiers and service personnel

• It approves and provides funding for a number of purposes, including

– Healthcare

– Pensions

– Home renovations

Challenges

• Highly critical Auditor General report on veteran compensation payments

• Lengthy claim process: 6 months with only 2 days or so work on each claim (veterans dying before processing)

• Up to 12 staff members involved in processing each claim

• Senior staff needed to approve claims

• Legislation allowed subjectivity and discretion by assessors

• Assessments were inconsistent and open to appeal

Results

• 60% more claims in 60% less time

• 80% productivity improvements

• Appeals reduced by 30% (cost of appeals previously half the total cost)

• Reduction in the processing staff by 1 / 3

• Reduced reliance on senior staff / doctors

• Administrative savings alone of more than $2m per annum

Solution

• Haley‟s technology enabled a comprehensive re-engineering of the compensation claims policy and process

• Solution delivered a system that guides assessors through the rules governing more than 250 medical conditions

• System enabled single assessor processing, end to end

• Personalised evidence-gathering questionnaires tailored to the client‟s medical circumstances and service history

• Determination of rates of payments, if any

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Social Security Bank

Sociale Verzekeringsbank (SVB) is the organization that implements national insurance schemes in the Netherlands. SVB makes sure that you, your children or your parents receive child benefit, AOW pension or Anw survivor benefit correctly and on time. They have been doing this for more than a century, by order of the government. Some 4.9 million clients count on SVB.

SVB initiated a huge Customer Program called "Ten for Service“ with 3 key business drivers:

1) Enhance Customer Service with one integral customer view

2) Improve efficiency (reduction of 700 FTE out of 3.000 FTE) by less administrative paperwork

3) Become more adaptive and agile by centralising social service policies into one business rule engine

Products:

Siebel Public Sector Case Management, Oracle Policy Automation (Haley), Siebel Universal Customer Master (MDM), Oracle Contact Center Anywhere, Siebel Public Sector E-Support, SOA suite for Oracle Middleware, Weblogic Suite, OBI EE+.

Why Oracle:

Total Social Security solution footprint, proven track record in Social Security worldwide, vendor stability and viability but also Haley as proven Policy Automation solution was clearly a key differentiator!

The Competition:

IBM bidding Websphere and BeInformed Business Rule Engine,

Logica bidding Tibco, Microsoft Sharepoint Portal and BeInformed Business Rule Engine

Accenture & Ordina were bidding Oracle (Siebel) and Beinformed Business Rule Engine

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Family and Normative Benefits Management

Hungarian State Treasury / Ministry of Finance

• Hungarian State Treasury is a centralbudgetary agency whose major area ofoperation comprise the execution andcontrol of the central budget,management and allocation of funds

• Managing benefits for over a millionfamilies, more than 1.7 million children,530,000 cases per annum

• Managing normative benefits for10,000+ schools and social institutions,3,120 municipal authorities

The Background The Issue

Separate legacy systems operating with:

• No consistency across the departments –no accurate visibility on payments and benefits paid to families and institutions

• Financial and operational inefficiencies while working under a very strong budgetary pressure

• Too complex benefit eligibility rules

• Difficult to follow changes in legislation

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The Solution The Benefit

• Interactive systems designed toreflect complex legislative and associated policies

• Path of life approach in the wholeapplication process (includingelectronic archive)

• Automated judgment of claims

• Standardized and 360˚ view of cases

• Electronic data exchange with other functions and organizations (including harmonization of processes with EU member states)

• Integrated Siebel CRM Public Sector Case Management and OPA front-end solution, with DB, WL, SOA, BI and UPK

• Meet the objectives of the New Hungarian Development Plan and the IT Strategy of the Ministry ofFinance

• Integrated central registry of individual and institutionalclaimants

• Introduce on-line and proactive customer services for the entire lifecycle of all kinds of benefits

• Government channels to standardize eligibility processesand improve visibility of allocation of funds

• Get prepared for the EU2012 directives for electronic communications across governments and services

Family and Normative Benefits Management

Hungarian State Treasury / Ministry of Finance (ctd)

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Tax and Revenues

Overview

• Department is responsible for Tax revenues from 58M UK residents

• It also processes Tax credit claims and is responsible for all UK ports plus associated Customs procedures.

Challenges

• Inaccurate and inconsistent advice being provided by staff

• Drive to reduce costs and increase use of technology

• Complexity of legislation and frequency of changes required.

• Reduce time to market for new applications

• Improve the Citizen interaction experience

• Closing the tax gap through efficient tax collection

Results

• Up to Ten times quicker deployment

• First project saved £3M+

• Significant Call Centre headcount savings

• Increased Self Service usage

• Policy Automation part of five year strategic plan.

Solution

• Improved accuracy consistency and transparency of determinations by staff

• Quicker deployment of legislative changes and new applications

• Business now owns policies and has greater flexibility and control.

• Solutions deployed across multiple channels including Self service

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Policy Automation goes mobile!

•Light rules on a mobile device, extends Siebel capabilities

•Java or .net version

•Rollout to 50 BAT Countries globally

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Example Outcomes with Oracle Policy AutomationImproved Agility and Customer Service with Reduced IT Project Costs

Area Without

OPA

With

OPA

Net

Benefit

%

Benefit

Business Rule Capture 200 days 20 days 180 days 90%

Logic Updates 90 days 3 days 87 days 97%

Call Center Training 60 days 5 days 55 days 95%

Business Logic Implem. $1M* $200K* 800K* 80%

Processing days / case 30 3 27 95%

Call Center calls / case 4 1 3 75%

Error Rate / 1000 cases 50 24 26 52%

Appeal Rate / 100 cases 5 3 2 45%

Source: OPA customer interviews. 2000-2009. *Relative expenditure figures based on customer side-by-side study vs. other implementation techniques

Imp

roved

A

gility

Imp

roved

C

usto

mer S

erv

ice

Lo

wer

ITP

roje

ct

Co

sts

Hig

her

Qu

ali

ty

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Summary: The Policy Automation Difference

• Handling business logic that requires:

• Modelling complex legislation, policy, regulation in a portable

Microsoft Office Document

• Temporal logic or data changes

• Frequent rule changes or updates

• Business rules managed in English or other languages

• While delivering:

• Explanations for how decisions were reached

• Interactive decision guidance

• Compatibility, integration and high performance

• Incomparable rule authoring lifecycle productivity

• Strong testing and maintainability

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Questions

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Questions

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Thank you.

(and automate your policies!)

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Oracle Policy Automation

OPA Product Components and Architecture

Oracle Policy Modelling

Oracle Web Determinations

Oracle Determinations Engine

Oracle Determinations Server

CRM, Portal

HR, ERP

Middleware / Native Web Services / Java / .NET

Other Database

Oracle Policy Automation Connector for Siebel

Oracle Policy Automation Connector for SAP JCo

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Is one of the 5 leaders in Business Rules...

Haley has leading

solutions for

business analysts

across all verticals

Source: Forrester, “The Forrester Wave™: Business Rules Platforms, Q2 2008,” April 8, 2008.

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...but unique in Determinations

Haley’s eligibility

determinations

technology is

recognized as

unique as well as

being a leader

Source: Forrester, “The Forrester Wave™: Business Rules Platforms, Q2 2008,” April 8, 2008.

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