© 2013 IBM CorporationDecision Management Cases:Agility & Adaptability in Insurance, Travel & HealthcareJames Taylor,CEODe...
©2013 Decision Management SolutionsYour Presenter – James TaylorCEO of Decision Management SolutionsI work with clients to...
©2013 Decision Management SolutionsTwo Things3Business RulesManagementSystemswork1They work bestwhen you focus onmanagingd...
1 2 34 5 6AGENDADecisionManagementBusiness RulesManagementSystemsCase 1:Collaboration inInsuranceCase 2:Adaptability inTra...
Decision Management
6©2013 Decision Management SolutionsDecision Management isthe proven approachused to managedecisions and applybusiness rul...
©2013 Decision Management SolutionsDecision Management SystemsAgileAdaptiveAnalytic7
©2013 Decision Management Solutions 8Delivering Decision Management3 stages to better operational decisionsIdentify thedec...
©2013 Decision Management Solutions 9
©2013 Decision Management Solutions 10Suitable DecisionsRepeatableNon trivialMeasurable businessimpactCandidate for automa...
Business RulesManagement Systems
public class Application {private Customer customers[];private Customer goldCustomers[];...public void checkOrder() {for (...
©2011 Decision Management Solutions 13You Need Clarity And Transparency
DecisionService©2013 Decision Management Solutions 14Elements Of A BRMSTesting andDebuggingTechnicalRuleManagementNon-tech...
©2013 Decision Management Solutions 15What Makes A BRMS CompellingDesignTransparencyExecutionTransparencyCollaborationImpa...
©2013 Decision Management SolutionsA BRMS In Decision ManagementAgile• Design transparency for rapid, accurate change• Bus...
Case 1: Collaboration InInsurance
Case: North American Life InsurerBusiness challenges Solution BenefitsRe-engineeringlegacy systems andmanual processesBusi...
©2013 Decision Management SolutionsProcess And Rules DisconnectedIf customer is GoldCustomerand Home_Equity_Loan_Value is ...
©2013 Decision Management SolutionsDecisions Were The Glue1• Found Decision Points2• Modeled Decisions3• Mapped to KPIs4• ...
©2013 Decision Management SolutionsDecisions Manage Business Rules21
22Example DecisionsGet Eligible Products For CustomerValidate New ProductValidate Product CustomizationDetermine Contract ...
©2013 Decision Management SolutionsBuild Collaboration With DecisionsExtract Decisions From Processes, UseCasesSimpler Pro...
Case 2: Adaptability in Travel
Case: Vacation TravelBusiness challenges Solution BenefitsLegacy businessmodel focused onTravel AgentsGrowth of discounttr...
Simplified ArchitectureWebsiteERPProductsPricingInventoryCostsBRMSCacheProductCatalogSearchEngine26©2013 Decision Manageme...
©2013 Decision Management SolutionsImplement Decisions Incrementally27
28Example DecisionsWhat package to recommend to thiscustomer?What are the savings over commercial?What booking advice to d...
©2013 Decision Management SolutionsDeliver Adaptability With DecisionsDecisions Drive New BusinessNew MetricsNew Decisions...
Case 3: Focus in Healthcare
Case: Health ManagementBusiness challenges Solution BenefitsRules embedded incodeLow throughputLimited outsideexpert engag...
©2013 Decision Management Solutions 32Rule Management Is CriticalMany ways to author business rules including:Technical ru...
©2013 Decision Management Solutions 33Help The Business To Manage DecisionsSo you business-typeswant to be able tochange y...
©2013 Decision Management Solutions 34Different Decisions, Different Owners
35Example DecisionsWhat programs should we recommend?What communication should we send today?How does this person work wit...
©2013 Decision Management Solutions 36Build Collaboration With DecisionsManagement is more important thanexecutionRule exe...
Questions?
Begin WithThe Decision In Mind
©2013 Decision Management Solutions 39Decisions MatterDecisions simplify business processesDecisions work for the business...
©2013 Decision Management SolutionsKnow Which Decisions Matter40
©2013 Decision Management SolutionsModel Decisions To Understand Them41
©2013 Decision Management Solutions 42Decision Management SystemsWhat if you could make your systemsactive participants in...
Thank YouJames Taylor, CEOjames@decisionmanagementsolutions.comMore on Decision Management atdecisionmangementsolutions.com
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Decision Management Cases: Agility and Adaptability

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Business rules are a powerful technology with a proven track record building Decision Management Systems. Successful projects deliver business agility, empowering business users to manage the decision-making in their systems so they can respond to changing business needs. Beyond agility, rules-based Decision Management Systems deliver the adaptability needed for long term continuous improvement. In this session leading expert James Taylor will use three real-world case studies to introduce Decision Management Systems, show how business rules are a critical element, and describe the agility and adaptability that companies can deliver.

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  • Business rules are a powerful technology with a proven track record building Decision Management Systems. Successful projects deliver business agility, empowering business users to manage the decision-making in their systems so they can respond to changing business needs. Beyond agility, rules-based Decision Management Systems deliver the adaptability needed for long term continuous improvement. In this session leading expert James Taylor will use three real-world case studies to introduce Decision Management Systems, show how business rules are a critical element, and describe the agility and adaptability that companies can deliver.
  • AgileChanging CircumstancesComplianceProcess ImprovementAnalyticManaging RiskReducing FraudTargeting and RetainingFocusing ResourcesAdaptiveFinding New ApproachesTesting and LearningManaging Trade-offs
  • RepeatableDefine timesSame informationDefined set of actionsConsistent measures of successNon trivialPolicies and regulationsDomain knowledge and expertiseAnalysis is requiredLots of data,Lots of actionsTrade-offsContinued changesMeasurable business impactCandidate for automationDetermine if a customer is eligible for a benefitValidate the completeness of an invoiceCalculate the discount for an orderAssess the risk of a transactionSelect the terms for a loanChoose which claims to Fast Track
  • So making decisions correctly will be hard unless we can pull all these rules together.Given this is how rules often look to start with, this is clearly going to be hard.But rules also change…Because your business policies doBecause your competitors doBecause the law doesBecause stock levels doBecause your services and products doBecause your customers doBecause your customers’ needs doSo we need something that will let us collect, manage and update the business rules that drive our decisions
  • Process ModelsRulesBBOR and no connectionBusiness v ITMany drivers of changeLegislative ChangePricing ChangeMedical ChangesClient requestsPolicy changeProduct change
  • We did launch the product on time.  We did need to do some crazy rules development weekend work sessions to get them all built out.  We ended up building over 700 rules.  The team has really taken to rules and the power it brings to the application.  We haven’t had any issues with them at this point.
  • Business, IT and Analytics team can collaborate effectively
  • Succeeding with rules or analytics requires a clear target - decisions
  • [twitter]Buy the book to learn more about #decisionmgt systems http://bit.ly/n4p25H [/twitter]
  • Decision Management Cases: Agility and Adaptability

    1. 1. © 2013 IBM CorporationDecision Management Cases:Agility & Adaptability in Insurance, Travel & HealthcareJames Taylor,CEODecision Management Solutions3188
    2. 2. ©2013 Decision Management SolutionsYour Presenter – James TaylorCEO of Decision Management SolutionsI work with clients to improve theirbusiness by applying business rules andanalytic technology to automate andimprove decisionsI have spent the 10 years championingDecision Management and developingDecision Management Systems2
    3. 3. ©2013 Decision Management SolutionsTwo Things3Business RulesManagementSystemswork1They work bestwhen you focus onmanagingdecisions2
    4. 4. 1 2 34 5 6AGENDADecisionManagementBusiness RulesManagementSystemsCase 1:Collaboration inInsuranceCase 2:Adaptability inTravelCase 3: Focus inHealthcareBegin with theDecision in Mind
    5. 5. Decision Management
    6. 6. 6©2013 Decision Management SolutionsDecision Management isthe proven approachused to managedecisions and applybusiness rules andpredictive analyticseffectively
    7. 7. ©2013 Decision Management SolutionsDecision Management SystemsAgileAdaptiveAnalytic7
    8. 8. ©2013 Decision Management Solutions 8Delivering Decision Management3 stages to better operational decisionsIdentify thedecisions that aremost important toyour operationalsuccessDesign and buildindependentdecision servicesto automate thesedecisionsCreate a “closedloop” betweenoperations andanalytics tomeasure resultsand driveimprovement
    9. 9. ©2013 Decision Management Solutions 9
    10. 10. ©2013 Decision Management Solutions 10Suitable DecisionsRepeatableNon trivialMeasurable businessimpactCandidate for automation
    11. 11. Business RulesManagement Systems
    12. 12. public class Application {private Customer customers[];private Customer goldCustomers[];...public void checkOrder() {for (int i = 0; i < numCustomers; i++) {Customer aCustomer = customers[i];if (aCustomer.checkIfGold()) {numGoldCustomers++;goldCustomers[numGoldCustomers] = aCustomer;if (aCustomer.getCurrentOrder().getAmount() > 100000)aCustomer.setSpecialDiscount (0.05);}}}©2013 Decision Management Solutions 12Most Business Rules Are Unmanageable
    13. 13. ©2011 Decision Management Solutions 13You Need Clarity And Transparency
    14. 14. DecisionService©2013 Decision Management Solutions 14Elements Of A BRMSTesting andDebuggingTechnicalRuleManagementNon-technicalRuleManagementImpactAnalysisDataManagementVerificationand ValidationDeploymentRuleRepository
    15. 15. ©2013 Decision Management Solutions 15What Makes A BRMS CompellingDesignTransparencyExecutionTransparencyCollaborationImpactAnalysis
    16. 16. ©2013 Decision Management SolutionsA BRMS In Decision ManagementAgile• Design transparency for rapid, accurate change• Business and IT collaborationAnalytic• Turn analytic insight into executable rules• Collect specific dataAdaptive• Support test and learn, experimentation• Log what happened and why16
    17. 17. Case 1: Collaboration InInsurance
    18. 18. Case: North American Life InsurerBusiness challenges Solution BenefitsRe-engineeringlegacy systems andmanual processesBusiness userscollecting &managing businessrulesIT disconnect overapplication of rulesManageprocesses, decisions and rulesDecomposedecision points tounderstanddecisionsMap decisions tovocabulary andbusiness rulesMap decisions toKPIsClear where in theprocesses eachbusiness ruleappliesBusiness and ITcollaborate betterFocused vocabularyand rule harvestingImprovedtraceability
    19. 19. ©2013 Decision Management SolutionsProcess And Rules DisconnectedIf customer is GoldCustomerand Home_Equity_Loan_Value is more than $100,000then college_loan_discount = 0.5%If member has greater than 3 prescriptionsand prescription’s renewal_date is less than 30 days in the futurethen set reminder=“email”If patient’s age is less than 18and member’s coverage is “standard”and member’s number_of_claims does not exceed 4then set patient’s coverage to “standard”19
    20. 20. ©2013 Decision Management SolutionsDecisions Were The Glue1• Found Decision Points2• Modeled Decisions3• Mapped to KPIs4• Mapped Rules, Vocabulary to Decisions5• Decisions in Implementation Use Cases20
    21. 21. ©2013 Decision Management SolutionsDecisions Manage Business Rules21
    22. 22. 22Example DecisionsGet Eligible Products For CustomerValidate New ProductValidate Product CustomizationDetermine Contract Approval RequiredValidate ClaimVerify EligibilityAdjudicate ClaimRoute ClaimAudit Claim©2013 Decision Management Solutions
    23. 23. ©2013 Decision Management SolutionsBuild Collaboration With DecisionsExtract Decisions From Processes, UseCasesSimpler ProcessesReuseDecoupled UpdatesDecisions First, Rules SecondDecisions Fit into a Business ArchitectureDecisions Fit into a Technical ArchitectureDecisions Scope and Manage Rules23
    24. 24. Case 2: Adaptability in Travel
    25. 25. Case: Vacation TravelBusiness challenges Solution BenefitsLegacy businessmodel focused onTravel AgentsGrowth of discounttravel sitesChallenges in self-service forvacationsIdentify criticalDecisions in newbusiness modelMap Decisions tonew KPIsRedesign systemsaround businessDecisionsRedesignedbusinessScalable knowledgeDirect to consumerDecision supportTechnologyselection driven bynew businessneeds
    26. 26. Simplified ArchitectureWebsiteERPProductsPricingInventoryCostsBRMSCacheProductCatalogSearchEngine26©2013 Decision Management Solutions
    27. 27. ©2013 Decision Management SolutionsImplement Decisions Incrementally27
    28. 28. 28Example DecisionsWhat package to recommend to thiscustomer?What are the savings over commercial?What booking advice to display with this deal?What supplements to cross-sell thiscustomer?What changes to this booking would re-priceit?What pre-travel information to send?Should we acquire more inventory?Should we re-price this deal? ©2013 Decision Management Solutions
    29. 29. ©2013 Decision Management SolutionsDeliver Adaptability With DecisionsDecisions Drive New BusinessNew MetricsNew DecisionsDeliver Decisions IncrementallyStart with piecesMix manual and automated decisionsEvolve and improve29
    30. 30. Case 3: Focus in Healthcare
    31. 31. Case: Health ManagementBusiness challenges Solution BenefitsRules embedded incodeLow throughputLimited outsideexpert engagementHard to customizefor clientsNo BRMSexperienceUse Decisions todrive developmentApply BRMS bestpractices from thebeginningFocus on businessownership inspecific DecisionsSuccessful firstBRMS projectLaunched on timeBusiness usersmanaging hundredsof rules withoutdifficulty
    32. 32. ©2013 Decision Management Solutions 32Rule Management Is CriticalMany ways to author business rules including:Technical rule languageGuided editorsDecision TablesDecision Trees…One size does NOT fit allProgrammersMedical ResearchersBusiness ProfessionalsDoctors…
    33. 33. ©2013 Decision Management Solutions 33Help The Business To Manage DecisionsSo you business-typeswant to be able tochange your businessrules?I want to change ouradvice to reflect newbest practicesI want to be able to includethe new medical researchI need to add the newregulationsNo…
    34. 34. ©2013 Decision Management Solutions 34Different Decisions, Different Owners
    35. 35. 35Example DecisionsWhat programs should we recommend?What communication should we send today?How does this person work with theirhealthcare providers?How does this person exercise?What issues does this person workenvironment have?What health issues might this person have?©2013 Decision Management Solutions
    36. 36. ©2013 Decision Management Solutions 36Build Collaboration With DecisionsManagement is more important thanexecutionRule execution rarely the barrier to successImpact analysis is criticalShow the business impact of decisionsOne size does not fit allDevelop rule management one Decision at a timeLink Decisions to business prioritiesLink Decisions to Organizations
    37. 37. Questions?
    38. 38. Begin WithThe Decision In Mind
    39. 39. ©2013 Decision Management Solutions 39Decisions MatterDecisions simplify business processesDecisions work for the business and ITDecisions scope and manage business rulesDecisions drive business architectureDecisions drive incremental developmentDecisions improve rule management
    40. 40. ©2013 Decision Management SolutionsKnow Which Decisions Matter40
    41. 41. ©2013 Decision Management SolutionsModel Decisions To Understand Them41
    42. 42. ©2013 Decision Management Solutions 42Decision Management SystemsWhat if you could make your systemsactive participants in optimizing yourbusiness?What if your systems could actintelligently on their own?Decision Management Systems cando all that and more. This bookshows how to integrate operationaland analytic technologies to createmore agile, analytic, and adaptivesystems.Bookstore signing rightFor more information about this new release, visitwww.decisionmanagementsolutions.com/book
    43. 43. Thank YouJames Taylor, CEOjames@decisionmanagementsolutions.comMore on Decision Management atdecisionmangementsolutions.com

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