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Open Group Presentation Iterative Approach To Build An Ea For Hix Final

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Open Group Presentation Iterative Approach To Build An Ea For Hix Final

  1. 1. OracleEnterprise Architecture Oracle Enterprise Architecture <Insert Picture Here> Iterative approach to build an Enterprise Architecture for Health Insurance Exchange Speaker Name: Maharshi Desai, Director, IT Strategy and Enterprise Architecture
  2. 2. AgendaTopicsObjectiveEA Methodology and Framework• EA Guiding Principles• Discuss Oracle’s EA methodology and frameworkApplying Principles and Methodology to HIX• What is Health Insurance Exchange?• Discuss Plan and approach• Discuss artifactsSummaryOpen Discussion and Q/A Copyright ©2011 Oracle Corporation. All rights reserved. 2
  3. 3. Objectives• Understand how to apply iterative methodology to build Enterprise Architecture• Understand the Oracle Enterprise Architecture Framework and Oracle Architecture Development Process• Use case on how to apply iterative approach to build exchanges like Health Insurance (HIX) Copyright ©2011 Oracle Corporation. All rights reserved. 3
  4. 4. Methodology and Framework Copyright ©2011 Oracle Corporation. All rights reserved.
  5. 5. Oracle EA Guiding Principles Agility and SustainabilityBusiness Driven Forward Thinking Best Practices Time to Value Copyright ©2011 Oracle Corporation. All rights reserved. 5
  6. 6. Oracle Architecture Development Process Aligns with customer and industry standard EA frameworks Iterative Agile EA Approach Reuses best practice business models and reference architecturesPractical Approach, ProvidesProven Methodology Governance Copyright ©2011 Oracle Corporation. All rights reserved. 6
  7. 7. Oracle Enterprise Architecture Framework Best Practices, • Best Practice Reference ArchitecturesProven EA Artifacts • Reduces Architecture/Solution Development Time Copyright ©2011 Oracle Corporation. All rights reserved. 7
  8. 8. Applying Iterative approach to buildHealth Insurance Exchange Copyright ©2011 Oracle Corporation. All rights reserved.
  9. 9. Health Insurance Exchange Background• The Patient Protection and Affordable Care Act was passed on March 23, 2010. The law requires states to participate in 1 of 3 options: – Establish and operate a state-run exchange – Partake in a regional exchange (multi-state) – Federally-administered exchange• States must have infrastructure operational by January 1, 2014• A Health Insurance Exchange (HIX) A central marketplace for citizens to compare: – Rates – Benefits – Quality of Care Copyright ©2011 Oracle Corporation. All rights reserved. 9
  10. 10. Health Insurance Exchange Background…Exchanges will help: – Individuals/families with incomes between 133-400% of the federal poverty line (2010) • Up to $43k for an individual; $88k for a family of four • Cap on premiums and “out-of-pocket spending” – Small businesses (up to 100 employees) • Small Business Health Options Program (SHOP) • About four million small businesses could qualify • Total of $40 billion in relief for small firms over the next 10 years Copyright ©2011 Oracle Corporation. All rights reserved. 10
  11. 11. HIX Vision Architecture Individuals Workers Providers Employers Mobile / Phone, Email, Local Web Web Phone, IVR Email Text ChatText Chat Local Office Disconnected Fax, IVR Imaging Office Eligibility Automation Portal Layer (Customer, Worker, Provider) Health Insurance Exchange Portal Online Profile Eligibility Request Other Self-Service AHBE Access SHOP Access Calculators Content Applications Management Screening Service Tools Dashboards, OLPA/Data mining, Ad Hoc & Scheduled ReportsSecurity – Identity and Access Management, SSO Health Insurance Exchange Functions Eligibility & Plan Customer Financial Communications Oversight Enrollment Management Services Management Business Intelligence Policy Automation Mandatory E-Commerce/Catalog Contact Center Billing Marketing/Outreach Reporting Eligibility Determination Carrier Portal Self-Service Collection Notices Dashboards & Alerts Subsidy/Premium Carrier / Employer / Premium Calculation Plan Certification Escalations Metrics / KPI Broker Support Reconciliation Enrollment Renewal Account Management Payment SOA Enterprise Integration Services Authoritative MMIS Issuers Master Data Management Data Management Data Systems & Data Quality Services Matching Address Structured & IRS DMV Medicaid Plans / Pricing Services Cleansing Unstructured Data SSA HHS CHIP Enrollment De-duplication Fraud Detection Data Security & Availability DHS Equifax OSHASP Billing Standardization Client Index Copyright ©2011 Oracle Corporation. All rights reserved. 11
  12. 12. Architecture Blueprint Plan 90-120 Day Plan Business – Application Architecture Business Architecture Establish Roadmap Architecture Business – Information Architecture Planning Vision Apps/Data – Technology ArchitectureKey Development Principles• Rapid Iterative Design (3 Week cycles)• Map Business to Functional Technology Design• Collaborative Design with Stakeholders• Leverage Oracle Reference Architectures Copyright ©2011 Oracle Corporation. All rights reserved. 12
  13. 13. Copyright ©2011 Oracle Corporation. All rights reserved. 13
  14. 14. Approach: Level 0 and Level 1 BoundariesOracle Enterprise Level 0 (L0) Level 1 (L1) Architecture Business Capability ModelsFramework Layers Business Process Models Business Process Support Models Business Define the core Business Architecture Capabilities Application Diagrams Application Capability Models Application Identify high level Application Application tech. Support Services required to support Architecture Models the Business Capabilities Data Object Models Data Identify high level Information Models, Data organization, Data Integration Diagrams Architecture and Data governance Data Context Identify high level Technology Technology Platforms Architecture required to support the Business Capabilities Technology Capabilities Technology Support Models Copyright ©2011 Oracle Corporation. All rights reserved. 14
  15. 15. Approach: Level 1 and Level 2 BoundariesOracle Enterprise Level 1 (L1) Level 2 (L2) ArchitectureFramework Layers Business Capability Models Business Process Models 1 Model for each App. Service Presentation Components Business Process Support Models Business Logic Components Business Data Objects Business Integration Services Architecture Data Services Application Diagrams Security Services Application Capability Models Application Application tech. Support Architecture Models For each high level Entity Data Object Models Next level Entity Models Data Data Integration Diagrams For each interface Architecture Detail Integration Diagram – High Data Context level Canonical Models, Technology, and Systems At the entity level only Technology Data Formats Data Standards Architecture Data Governance and Security Technology Capabilities Technology Support Models Technology Detail Models Copyright ©2011 Oracle Corporation. All rights reserved. 15
  16. 16. Business Architecture Approach Business Strategy & Value Business Requirements1 Business Area Eligibility & Enrollment (E&E) 1.1 Business Process Group E&E - Individual 1.1.1Business Process Prepare / Update Individual Eligibility Application 1.1.1.1 Business Activity Accept and Verify Application for Completeness and Accuracy 1.1.1.1.1 Business Tasks Manual Verification Use Cases Copyright ©2011 Oracle Corporation. All rights reserved. 16
  17. 17. Business Process to Service Mapping • 1.1.1.1 Business Activity Services Objects Business Business Service Objects Application Application Service Objects Copyright ©2011 Oracle Corporation. All rights reserved. 17
  18. 18. Architecture Execution PlanJuly 2011 August 2011 Sep 2011 Oct 2011 Nov 2011 Dec 2011Project startup Design activities Review 3 Week Cycle 3 Week Cycle Plan Management Plan Management Plan Management L1 L1-L2 L3 EE – Individual EE – Individual EE – Individual L1 L1-L2 L3 EE - SHOP Employer EE - SHOP Employer EE - SHOP Employer L1 L1-L2 L3 EE – SHOP Employee EE – SHOP Employee EE – SHOP Employee L1 L1-L2 L3 Financial Management Financial Management Financial Management L1 L1-L2 L3 Detailed Design Document Copyright ©2011 Oracle Corporation. All rights reserved. 18
  19. 19. Running Workshop Level 1 60 Minute session (3 Level 2 Business Days/Week):Process Flow Architecture Level 1 • Business Analysts & • Process SME Business • Enterprise ArchitectureRequirements • IT Team (Optional) Application 90 Minute session to Data review Application Component, UI Review Technology Component, Data Level 2 Component and Business Objects: • Business Analysts (Optional) Refine • Enterprise Architecture • IT Team (Data & Apps) 90 Minute JAD session: Level 3 & 4 • Business Analysts • IT/Development Team Copyright ©2011 Oracle Corporation. All rights reserved. 19
  20. 20. Connecting Blueprint Phase toDevelopment Phase Federal State Requirements Requirements Requirement Architecture Models Baseline Level 1 and Level 2 Finalize JAD Session Product Vision Architecture Models Use Cases Level 3 and Level 4 Iterative Product Demo and Acceptance Development Copyright ©2011 Oracle Corporation. All rights reserved. 20
  21. 21. Business Architecture Artifacts Copyright ©2011 Oracle Corporation. All rights reserved. 21
  22. 22. Highlights the key architecture capabilities and their alignment Copyright ©2011 Oracle Corporation. All rights reserved. 22
  23. 23. Highlights alignment in greater detail for each business process Copyright ©2011 Oracle Corporation. All rights reserved. 23
  24. 24. Highlights alignment of Business Services to Application Services Copyright ©2011 Oracle Corporation. All rights reserved. 24
  25. 25. Application Architecture Artifacts Copyright ©2011 Oracle Corporation. All rights reserved.
  26. 26. Highlights how each business services are map to apps services Copyright ©2011 Oracle Corporation. All rights reserved. 26
  27. 27. Highlights how each apps services are map to UI component and BO’s Copyright ©2011 Oracle Corporation. All rights reserved. 27
  28. 28. Data Architecture Artifacts Copyright ©2011 Oracle Corporation. All rights reserved.
  29. 29. Highlights application data object mapping of business data objects Copyright ©2011 Oracle Corporation. All rights reserved. 29
  30. 30. Define overall ERD diagramCopyright ©2011 Oracle Corporation. All rights reserved. 30
  31. 31. Highlights in-a-glance identified HIX data integration touch points Copyright ©2011 Oracle Corporation. All rights reserved. 31
  32. 32. Highlights overall view of how data is supported in its associated context Copyright ©2011 Oracle Corporation. All rights reserved.
  33. 33. Technology Architecture Copyright ©2011 Oracle Corporation. All rights reserved.
  34. 34. Highlights the required HIX Technology Capabilities Copyright ©2011 Oracle Corporation. All rights reserved. 34
  35. 35. Highlights the focused technology capabilities of a specific component Copyright ©2011 Oracle Corporation. All rights reserved. 35
  36. 36. Map to products required to support the specific capabilities Copyright ©2011 Oracle Corporation. All rights reserved. 36
  37. 37. HIX Logical ArchitectureLogical Architecture provides component view of HIX Solution Copyright ©2011 Oracle Corporation. All rights reserved. 37
  38. 38. HIX Technical ArchitectureSolution Architecture provides overall physical view of the architecture Copyright ©2011 Oracle Corporation. All rights reserved. 38
  39. 39. Summary• Agile/Iterative EA approach works for effective solution• Provides agility and sustainability• Oracle uses Oracle Enterprise Architecture Framework (OEAF) and Oracle Architecture Development Process (OADP)to build Agile/Iterative Architecture• OEAF creates top down business driven architecture solution• Its based on just-enough, just-in-time method• Oracle also provides Complete Solution with Complete Enterprise Architecture services Copyright ©2011 Oracle Corporation. All rights reserved. 39
  40. 40. Q&A Be Prepared For The Challenge for EA can make it Possible Business Driven Approach If You Believe in themOrganization need to Focused Enjoy your success on Business Goal Copyright ©2011 Oracle Corporation. All rights reserved.

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