Core System Integration

In order to keep up with the rapidly changing healthcare and health insurance landscape, our client – an east coast not-for-profit health insurer, had three identified goals that pushed them to invest further in their technologies:

• Rank within top 10% of all US companies based on Net Promoter Score
• Have a 5-star rating for all products
• Hold premium increases to less than 2% based on total cost of care

Our client needed to replace their consolidated core membership, claims and billing system with a new core system that was able to keep the areas consolidated into one system. X by 2 sought to review and document the high-level current state integration architecture to provide clarity and an appropriate level of abstraction for the relationships and dependencies between existing enterprise systems, which were a mix of purchased third-party products and custom developed applications.As part of the overall enterprise integration strategy and implementation of the new core system, X by 2 helped the client to more effectively and extensively use their Enterprise Service Bus (ESB). X by 2 identified 3-styles of data exchange (batch, synchronous and asynchronous) of which the ESB was to serve as a single location for all synchronous data exchanges. The insurer needed the ESB to eliminate point-to-point integrations and instead move to a hub-and-spoke model in order to improve consistency in the data and maintainability for the applications. These enterprise applications needed to receive data from an Operational Data Store (ODS) through the ESB.

X by 2 provided technical leadership as part of the execution of the enterprise integration strategy, inclusive of a directional vision for the future state. The envisioned future state included an approach for a federated architecture group with architects from multiple domains creating and implementing architectural standards. X by 2 also made recommendations for better utilizing existing integration tools and utilities along with guidance to improve the client’s integration development capabilities. As part of the core system replacement effort, X by 2 developed a high-level strategy for the near-future and provided integration architecture leadership.

As part of the overall core system integration strategy, X by 2 led the design and development of enterprise services built on top of the ESB utilizing REST API services. The ESB consolidated all synchronous integrations required for the core system replacement and defined the integrations (file to database, messaging, etc.). New service level agreements were created as part of the modernization effort, and X by 2’s ESB design met all standards regarding data quality, accuracy, and retrieval speed when communicating with the ESB.

X by 2’s expertise and leadership in our client’s enterprise integration strategy, and development of an Enterprise Service Bus, enabled them to successfully replace their core legacy system while also positioning them for future growth. As a result of centralizing the location of all enterprise applications data via the ESB, the data quality and consistency was greatly improved. Further, the design and implementation of the ESB enabled an increase in development speed as developers no longer had to worry about creating individual ODS retrieval mechanisms. The ESB implementation also improved the maintainability of data overall (including problem solving) as a single entity handled all ODS to application interactions.