It is the small project of the subject Data Warehousing and Business Intelligence of the course Business Consultant Master in Hochschule Furtwange. The purpose of this project is helping students understand more about Data Warehouse and Data Analytics, able to use SAP BI-DW and Qlik View to create dashboard, reports

1. Business Intelligence Solution
in the Business Case
of Health Insurance Industry
Created by:TranThi BaoThuy
Submitted to: Prof. Dr. Monika Frey-Luxemburger
17th Jan. 2017
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2. Agenda
• Company Profile, Problem Statement and Project Scope
• KPIs
• Data Modelling
• Excel Prototype
• Implementation in SAP BI DW
• Implementation in Xtract QV and QlikView
• Project Plan
• Lesson Learned
• References
2

3. GRANDSON INSURANCE Ltd.*
Industry: Third Party Administrator for Health and Travel Insurance
Operation in: Philippines, Indonesia, Thailand, Vietnam, Cambodia and Myanmar
Company Size: 450 employees
Gross Premium Revenue: US$ 21,5 mil. in 2014
Profit: US$ 1,3 Mil. in 2014
* Company name is changed
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
TPA Services:
• Design of Health and Travel insurance products
• Pricing, policy wording, benefit schedule, rules
and procedures
• Underwriting, Claim adjudication, renewal
assessment, analysis of product performance
3

4. Problem Statement
• CLAIMS are unknown and in some case, unpredictable
• LACK OF INFORMATION sharing among insurance companies
• CLINICS AND HOSPITALS charge different prices for the same work
• Places / location where go for health care VARIES IN PRICE
• Claim Department spends much time at the end of month to create REPORT for Partners
- Insurance Companies
SOLUTION PROPOSED:
Implementing a Business Intelligence Tool to improve business performance, easily create
reports, share visual information among top managers, partners as well as Claim
Department.
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
4

5. Project Objectives
Based on the scope of project, three main KIPs will be analyzed and presented as a part
of monthly report from Claim department.
• Top three hospitals with the highest treatment cost in the specific month
• Top three diagnosis with highest treatment cost in the specific month
• Top three treatment cost of the top three diagnosis at hospitals in the specific month
Project Scope
• Limited Project Area: Ho Chi Minh city,Vietnam
• Limited Products: Health Insurance,Out-Patient Service
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
5

6. Key Performance Indicators
6

7. KPI 1
Part I: Description
Identification Tophosmont
Description
Top three hospitals with highest total
treatement cost in month
Addressee Claim Dept. and Board Manager
Formula 1
𝑛
𝐼𝑛𝑣𝑜𝑖𝑐𝑒, n – invoice/current month/hospital
Target Value Total treatment cost per hospital in month
Unit USD
Periodicity Monthly
Dimensions Month, Hospital name, Invoice
Aggregations behaviour Sum
Planned values Below $50,000
Tolerance values Over $50,000
Escalation norms Mark in Red
Validity/Periodicity From now till the next updated version
Dependency Invoices of doctor visiting, medicine and Lab
Person in charge Thuy
Example Total Treatment Cost of FV Hospital in Nov. 2016
Part II: Determining the data
Data sources Export from HBS System to Excel file
Measuring method Amount of Invoices
Measuring points monthly
Person in charge Thuy
Part III: Data processing
Calculation methods
Sum of the invoice of each hospital in the month;
Choose top three hospital with largest amount
Data flow
Total Invoive = sum invoice of doctor visiting,
medicine and Lab tests
Person in charge Thuy
Part IV: Presentation
Layout Bar chart
Dimension Month, Hospital name, Invoice
Aggregation steps Roll up
Access Rights Claim Staff and board of manager
Archiving Report in PDF
Person in charge Thuy
1. Top three hospitals with highest total treatment cost in month (Tophosmont)
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
7

8. KPI 2
Part I: Description
Identification Topdiagmont
Description Top Diagnosis with highest treatment in month
Addressee Claim Dept. and Board Manager
Formula 1
𝑛
𝐼𝑛𝑣𝑜𝑖𝑐𝑒, n – invoice/current month/diagnosis
Target Value Total treatment cost per diagnosis in month
Unit USD
Periodicity Monthly
Dimensions Month, Diagnosis name, Invoice
Aggregations behaviour Sum
Planned values Below $10,000
Tolerance values Over $10,000
Escalation norms Mark in Red
Validity/Periodicity From now till the next updated version
Dependency Invoices of doctor visiting, medicine and Lab
Person in charge Thuy
Example Treatment Cost of Osteoarthritis in Nov. 2016
Part II: Determining the data
Data sources Export from HBS System to Excel file
Measuring method Amount of Invoices
Measuring points monthly
Person in charge Thuy
Part III: Data processing
Calculation methods
Sum of the invoice of each diagnosis in the month;
Choose top three diagnosis with largest amount
Data flow
Total Invoive = sum invoice of doctor visiting,
medicine and Lab tests
Person in charge Thuy
Part IV: Presentation
Layout Bar chart
Dimension Month, Diagnosis name, Invoice
Aggregation steps Roll up
Access Rights Claim Staff and board of manager
Archiving Report in PDF
Person in charge Thuy
2. Top three diagnosis with highest treatment cost in month (Topdiagmont)
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
8

9. KPI 3
Part I: Description
Identification Toptreatmentcost
Description
Top treatment cost per visiting for the top three
diagnosis at hospitals in month
Addressee Claim Dept. and Board Manager
Formula 1
𝑛
𝐼𝑛𝑣𝑜𝑖𝑐𝑒, n – invoice/current month/diagnosis/ visiting
Target Value Total cost per visiting for a diagnosis in month
Unit USD
Periodicity Monthly
Dimensions Month, Diagnosis name, Hospital name, Invoice
Aggregations behaviour Sum
Planned values Below $1,000
Tolerance values Over $1,000
Escalation norms Mark in Red
Validity/Periodicity From now till the next updated version
Dependency Invoices of doctor visiting, medicine and Lab
Person in charge Thuy
Example Cost of visiting for Osteoarthritis in Nov. 2016
Part II: Determining the data
Data sources Export from HBS System to Excel file
Measuring method Amount of Invoices
Measuring points monthly
Person in charge Thuy
Part III: Data processing
Calculation methods
Sum of the invoice per visiting of each diagnosis in the
month; Choose top three diagnosis with largest amount
Data flow
Total Invoive = sum invoice of doctor visiting,
medicine and Lab tests
Person in charge Thuy
Part IV: Presentation
Layout Bar chart
Dimension Month, Diagnosis name, Invoice
Aggregation steps Dice
Access Rights Claim Staff and board of manager
Archiving Report in PDF
Person in charge Thuy
3. Top treatment cost for the top three diagnosis at hospitals in month (Toptreatmentcost)
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
9

10. Data Modeling-Star Schema
Member List
Member No. (PK)
First Name
Last Name
Date of Birth
Product Type
Effective Date
Hospital List
Hospital ID (PK)
Hospital Name
Diagnosis List
Diagnosis ID (PK)
Diagnosis Description
Claim Type
Claim Type ID (PK)
Claim Name
Invoice
Invoice No. (PK)
Treatment Date
Date ID (PK)
Date
Year
Month
Day
Fact Table
Treatment Date (FK)
Claim No. (FK)
Hospital ID (FK)
Member No. (FK)
Diagnosis ID (FK)
Invoice (FK)
Claim Type (FK)
Amount
KPIs
•Top Hospital with highest
treatment cost
•Top Diagnosis with
highest treatment Cost
•Top Treatment Cost of
Top Diagnosis at hospitals
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
10
Claim Document
Claim No. (PK)
Claim Date

11. MS Excel Prototype
11

12. Fact Table in MS Excel
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
12

13. Dimensions in MS Excel
Member List Dimension
Hospital Dimension Diagnosis Dimension
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
13

14. Dimensions in MS Excel
Claim DocumentClaimType
Treatment Date
Invoice
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
14

15. Report in MS Excel for KPI Tophosmont
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
15

16. Report in MS Excel for KPI Topdiagmont
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
16

17. Report in MS Excel for KPI Toptreatmentcost
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
17

18. Implementation with SAP BI-DW
18

19. Metadata
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
19

20. Creating InfoArea
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
20

21. Creating Dimensions Using InfoObjects
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
21

22. Register Characteristics as InfoProviders
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
22

23. InfoCube Creation
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
23

24. DataSource Creation & Loading Master
data into InfoObject
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
24

25. Loading Transaction Data
Create Application Component, InfoSource,Transformation for InfoSource
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
25

26. Loading Transaction Data
CreateTransformation for InfoCube
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
26

27. Loading Transaction Data
Create DataTransfer Process and Loading Data to Infocube
Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
27

28. Implementation in Xtract QV
and QlikView
28

29. Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
29
Creating Queries

30. Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
30
Creating Queries

31. Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
31
Creating formular for Table and Charts

32. Company
Profile…
KPIs Data modelling Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
32
Table and Charts

33. Company
Profile…
KPIs Data model Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
33
Project Phase Task Start Date End Date Progress
1. Preparation
Formulating of Business Case 08/11/16 15/11/16 100%
Defining KPIs 15/11/16 29/11/16 100%
2. Modelling and Prototyping
Defining Data Model 29/11/16 13/12/16 100%
Designing Star schema 29/11/16 13/12/16 100%
Creating Excel prototype 29/11/16 13/12/16 100%
3. Implementation on SAP BI
DW
Creating Master Data, Transaction Data 29/11/16 06/12/16 100%
Creating InfoObjects and InfoCube 06/12/16 10/01/17 100%
Upload Master Data &Transaction Data 20/12/16 10/01/17 100%
4. Implementation on Xtract
QV and QlikView
Implementing on Xtract QV and Qlik
View
10/01/16 13/01/17 100%
5. Presentation Presenting 17/01/16 17/01/17 100%
Project Plan

34. Lessons Learned
• Indentifined and Defined right KPIs for business case
• Designed Data Model: Star Schema
• Able to use Microsoft Excel to create PivotTables
• Able to use SAP BI-DW
• Understood Metadata, InfoObjects, InfoCube, Characteristics,
Key Figures, Data Sources,Transformation in SAP BI-DW
• Able to use QlikView to create reports and charts
Company
Profile…
KPIs Data model Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
34

35. References
• David Haertzen, “The Analytical Puzzle: Profitable DataWarehousing, Business
Intelligence and Analytics”,Technics Publications, 2012
• OlegTroyansky,Tam Gibson, Charlie Leichtweis, “QlikViewYour Business: An
expert guide to Business Discovery with QlikView and Qlik Sence”, Wiley, 2015
• Miguel Garcia, Barry armsen, QlikView 11 for Developers, Packt Publishing, 2012
• Cindi Howson, Successful Business Intelligence, 2014
Company
Profile…
KPIs Data model Excel Prototype
Implementation
in SAP BI DW
Implementation
in Xtract QV and
Qlik View
Project Plan Lesson Learned References
35

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