Table of Contents
 table of contents
 

Report Outline

Workshop Summary 3

1. Common Industry Issues 3

2. Implementation of Rules within Object Systems 3

3. Acceptance of the Web 3

4. Industry Boundaries are becoming Blurred 3

5. Components and Frameworks 3

Insurance and Health Care Workshop Organizing Committee 5

List of Organizers and Participants: 5

"The Workshop Team" (Photos) 6

Major Topics 7

Business Rules, Patterns and Agents 7

Distributed Computing 8

Component-based development 10

This report is available as a MS Word document: HC_INS_OOPSLA98_MidYear_Workshop_Summary.doc

Workshop Summary

This workshop continued on a theme discussed in a workshop conducted in both the midyear conference and at the 1997 OOPSLA conference, on the application of Object Oriented technology in the Health Care and Commercial Insurance industries. This year, we had 14 participants as well as a couple drop-ins who had heard what a great time we were having and wanted to get in on some of the action. A summary of the workshop's key items of interest was presented in the closing plenary session:

1. Common Industry Issues

There are a number of common issues facing both Health Care and Insurance, and likely other industries as well:

· Myriad issues and opportunities presented through evolving complex relationships with providers, brokers, agents, institutions, electronic commerce

· Transformation of legacy systems must proceed in both a tactical and strategic fashion.
Tactical: Allow partitioning of legacy functions by using object wrappers around legacy functions
Strategic: Core systems need to be revamped and core business processes re-engineered. The use of Components, OO Design and Use cases is critical to the success of such ambitious undertakings

A very real challenge in accomplishing the strategic replacement or renewal of legacy systems is ROI, $$$

· Fraud detection and prevention, Security, Call Centers, Government regulations will impact IT systems development and enhancements

2. Implementation of Rules within Object Systems

The workshop included presentation and discussion of projects which are successfully implementing rules processing within OO systems

3. Acceptance of the Web

As the industries accept the web, we see more web-enabled interfaces and electronic interaction internally and externally conducted over internet technologies. Of key importance to the workshop participants was the need for improved security and messaging, and common and broadly accepted standards

4. Industry Boundaries are becoming Blurred

Health care organizations, financial institutions and insurance companies are offering cross-industry services and products that historically were offered only within the separate industries. As an example, an insurance company may now offer health care delivery, health care insurance and financial products to its members, agents, and external constituents.

5. Components and Frameworks

The key software engineering challenge for the next decade is the systematic creation of industrial-strength, reusable, application-area, architectural frameworks. These frameworks will provide the underlying architecture infrastructure and functions as components, and facilitate the development of individual applications using components. The workshop team shared the following on frameworks and components:

Framework:

· Consists of objects, components, or design notions implementing one or more patterns

· Assists in solving a problem, but is a partial implementation

· Cannot be used without modification or instantiation. It is required to be specialized

· Components can be created from the instantiation of the framework

Component:

· Is an encapsulation of object(s) or other component(s) with published interfaces

· Is able to be used as is

· Must be plugged into something else to be useful

· Is configurable

OOT in Health Care and Insurance Workshop Participants and Photos

Insurance and Health Care Workshop Organizing Committee

Mamdouh H. Ibrahim, Electronic Data Systems

Dory Velten-Lerescu, The EQUITABLE

Leroy Bliven, EDS/LTM/IOS

Tim Duval, EDS/BSC

Juggy Jagannathan, CERC, CareFlow/Net

List of Organizers and Participants:

"The Workshop Team" (Photos)

"These were taken Monday evening of the workshop. We were assembled in the lobby, then went to dinner at Trail Dust (or was it Trail Dirt, Cow Pies, whatever... ;-). Hmm boy, I can still taste those mountain oysters...'slice 'em thin,' that's what I always say... :-0", Jim Davis

Workshop Discussion Abstracts

Architecture, templates, patterns, frameworks, rules as objects, standards, Java, decision support with object-oriented systems, were some of the key topics from the Insurance and Health Care workshop. Beyond this, there was a lot of good conversation, networking, socializing, participation in the birds-of-a-feather sessions, and brainstorming sessions on hot topics and issues within the Insurance and Health Care industries. We even were able to reach some consensus around what a component or a framework really is-no small feat for this varied and experienced group.

Major Topics

· Business Rules, Patterns and Agents

- "Rules and Objects," Dory Velton-Lerescu, The Equitable

- "Template-based Code Generation from Business patterns," Kevin Rasmus,
Country Companies Insurance

- "Using Objects and Patterns for Building Compliance Agents," James Davis, HealthMagic

- "Architecture to Respond to Unanticipated Change," Parker Whittle, Health Systems Technologies

· Distributed Computing

- "TeleMed: Wide-area, Secure, Collaborative Object Computing," David Forslund,
Los Alamos National Laboratory

- "Medical Terminology System Coupled with Terminology Service,"
Thomas C. Culpepper, 3M Health Information Systems

- "Java for the Insurance Industry," Gary Anderson, IBM

- "New Generation of Decision Support Systems," Geraldo Costa, Delphos Corporation

· Component-based development

- "Component Based Solution for Payor Administration," Roger Carpenter,
EDS Health Care

- "Secure Software Components and CorbaMed," V. Juggy Jagannathan,
CareFlow/Net; West Virginia University

Business Rules, Patterns and Agents

Rules as Objects

Dory Velten-Lerescu and Leroy Bliven shared the power of rules in the context of a project, named EQ2, to replace legacy systems and expand use of BPR. Rules in this system are stored as objects on an OODBMS, and accessed by a generic engine. The rules can be run from either a server or a client, and can be packaged to be placed onto the client for performance improvement. The solution includes a rules editor and a rules engine, and is designed to scale to the needs of The Equitable.

A key rationale for using rules, is to be able to implement changes quickly to domain rules without changing the application, and to separate the domain rules from the main application logic. Combining the data and methods of the rules also results in better reuse and the creation of dynamic reusable components.

The presentation materials and position paper provided by Dory and Leroy are included in the following links: Equitable_Bliven_OOPSLA98, Equitable_Bliven_Position_OOPSLA98

Template-based Code Generation

Kevin Rasmus, of Country Companies Insurance, discussed a CORBA-based distributed object system to support Life Insurance Underwriting, and the usefulness of patterns in the design and analysis aspects of the project. To improve quality and increase developer productivity, Kevin worked to provide a code generation capability via parameterized templates, that naturally supported the patterns that were the basic building blocks for the project. This project also implemented rules as objects. While the rules objects (approximately 20) an the C++ templates (about 215) were coded by hand, 98% of the business objects code was created by the framework and code generation capability. Kevin has implemented a highly productive, reuse environment to support his company's needs.

The position paper for the workshop is available in the following link: CCI_Rasmus_OOPSLA98

Objects and Patterns for building software agents

Jim Davis, our workshop's "meta" expert, walked us through a project that uses patterns and object technology to develop software agents to monitor compliance to specified health care protocols and treatment or plan regimens (patient disease management). Use case analysis and state transition and sequence diagrams (using UML) are important aspects of the methodology Jim Davis tailored for the creation of compliance agents. A rigorous OOA/D process is followed and documented using UML to depict objects, patterns, behaviors for the agents, knowledge sources, and interaction protocols. The agents were implemented in Java using the JATLite agent toolkit and the JESS (ie CLIPS) inference engine, and using JDBC interfaces to the underlying database.

The position paper for the workshop is available in the following link: HealthMagic_Davis_OOPSLA98.pdf

Architectural support for Responding to Unanticipated Change

Parker Whittle walked us through his project and philosophy around using patterns and frameworks and the underlying principles that constitute good design. He and his company have developed architecture design patterns and development principles that should allow for applications to be more adaptable to unanticipated change. This is to be done by not merely partitioning an application into client separated from business logic and sometimes a separate data layer but by providing three degrees of separation. These three separations are at the semantic level, the data level and the presentation level. At the semantic level, you have business objects, semantic integrity, referential integrity, and generalizations. This level supports the Global logical model. At the data level, the focus changes to maintaining object instance data and the data level enforces referential data integrity and transactional requirements. This level accommodates changes in the semantic layer. At the presentation level, the focus is on business processes and units of work. This level is responsible to enforce workflow or task-oriented constraints and satisfies semantic integrity. "If the semantic and data layers of a component are entirely opaque to the remainder of the system, then the only means of integration is at the presentation layer. This renders the system far less adaptable to changes which were not accounted for during the initial design. However, when properly limited to the boundaries of each layer of abstraction, information hiding tends to increase a system's adaptability.

The presentation materials and position paper provided by Parker are included in the following links: HST_Whittle_OOPSLA98 , HST_Whittle_Position_OOPSLA98.

Distributed Computing

Wide-area, Secure, Collaborative Object Computing

In his demo and discussion, and in sharing his projector with other workshop participants, David Forslund made quite an impression at the workshop. The project he supports, Los Alamos TeleMed, was designed to give healthcare providers easy access to electronic medical records, and is developed following the Corbamed standards. The project is designed to create and maintain electronic medical records and to share records over the Internet. Security is a big concern. The solution developed is hand-crafted because the preferred CORBASecurity solution was not yet available, and provides object-level authorization and confidentiality. It uses PKI technology to validate client and server, and uses an authentication server. Java was selected for this project in conjunction with CORBA, to provide for an n-tiered architecture, flexible interface, and to leverage Java Beans interoperable components. JIT compilers have been a major benefit, and performance is adequate, although scalability may still be a concern.

The presentation materials provided by David is included in the following link:

Telemed_Forslund_OOPSLA98

Medical Terminology / Lexicon Query Service

3M has developed a prototype for a medical terminology system to be used in a distributed object computing environment. Terminology refers to the terms, codes or language used to describe elements. It is a specialized subset of language used to provide unambiguous information exchange. In the medical domain, there is a large number of disparate terminologies in use, and countless ad hoc terminology systems. While it is unlikely a single vocabulary will ever be agreed upon, it is desirable for a common means of accessing information across different terminology systems to be in place to help resolve the problems inherent in using disparate systems. An OOA/D process was used to develop the prototype, and modeling was done in UML. C++, Orbix, and ObjectStore were used to build the prototype. The demonstration provided the team was very impressive.

3M has a vision to utilize OOT as an engineering practice to design and develop reusable components, which in turn allows them to produce high quality and more timely solutions. OOD was used to combat complexity and to reduce risk due to availability of knowledge and tools. Standards being developed by various standards organizations is also helping to move towards the vision. In the end, OOT will advance 3M towards greater software reliability, greater development effectiveness and greater functionality.

The presentation materials and position paper provided by Thomas Culpepper are included in the following links: 3M_Culpepper_OOPSLA98, 3M_Culpepper_Position_OOPSLA98.

Java for Real Applications

Gary Anderson of IBM walked us through his experiences gained developing two separate Java projects in a presentation he entitled "Novel (non-fictional usage) Approaches to Insurance IS Development." One project focused on data mining, and used a slim client applet client and JDBC access to an RDBMS, with all data encrypted across the public Internet. The other project was for disability insurance and was designed to link policyholder and caseworkers and center of expertise in real-time. The result is the ability to develop a consensus "return to work" plan in a single, real-time session. Some of the issues in common across both projects discussed were the immaturity and evolution of Java as it relates to the availability of adequate interface components, and browser issues relating to different security models or code file formats (JAR or CAB). Also discussed was unavailability of skilled Java developers, security issues relating to firewalls, and the difficulties encountered when trying to develop and use emerging technology.

The position paper provided by Gary is included in the following link: IBM_Anderson_Position_OOPSLA98.

DSS with OO Systems

Geraldo Costa presented a very real issue he is facing in how to best provide decision support capabilities for object-oriented systems. He and his company is developing a Risk Analysis system to analyze data and generate a risk score for a data classification. The system has interfaces for data collection, rules, and a calculation model editor, and decision support functions. If an object system is used in the risk analysis, it becomes a question as to whether drill-down operations are the same as going down through subclasses, or if the n-cube, for multi-dimensional data analysis is generated from the class relationships. The team discussed further implications of using ODBC interfaces to object data bases to allow access to standard report writers or existing DSS tools. It was generally agreed, that it would be best to not do the DSS against on-line OO systems, and that perhaps using data warehouses or other non OLTP databases for analysis would be preferred over using DSS against the on-line OO systems.

The presentation materials provided by Geraldo is included in the following link: Delphos_Costa_OOPSLA98.

Component-based development

Component Based Solution

Roger Carpenter led a discussion around transformation of legacy systems and the many issues that have prevented this from happening in the past-not the least of which is a lack of ROI. An EDS managed care solution, called MetaVance, was presented as a legacy system which is being developed using components. The MetaVance Payor Portfolio will be delivered as components. The portfolio will be a combination of purchased and developed components that will provide flexibility and customization, and high-volume processing for EDS' customers. Customization, and account-specific components will be provided using the underlying architectural framework, facilitating reuse and reducing time to market. This system is provided on a 3-tier or n-tier architecture, and is Web-enabled where needed. It leverages COOL:Gen by Sterling Software and uses relational data structures. The mechanism(s) to interface or integrate purchased and developed components is not yet finalized, but will likely consist of standard interfaces through CORBA, DCOM, MOM (messaging), Master Patient Index, file transfers and interface engine technologies.

The presentation materials provided by Roger is included in the following link: EDS_Carpenter_OOPSLA98

Components and CorbaMed

V. Juggy Jagannathan, one of the workshop co-organizers, shared and demonstrated information on CareFlow/Net, which consists of components built on web technology, distributed object standards (CORBA and DCOM), or health care standards such as HL/7. The system developed provides open, plug-and-play software components. Juggy also walked the workshop team through the many object-oriented standards in healthcare. While there are many, they are largely non-competing and complementary, and include CorbaMed from the OMG, The Clinical Context Object Working Group (CCOW), HL/7 which is an ANSI-accredited standards body, ActiveX for HealthCare (AHC), Andover Working Group (AWG), DICOM (formally known as the ACR/NEMA standard), ASTM, X12, IEE MIB, and more.

More detail can be found in the position paper Juggy submitted which is included in the following link: CERC_Juggy_OOPSLA98_Standards

Workshop Credits

Thanks to the conference chair, Bob Marcus, for the opportunity to get together and associate one with another and to share experiences. Thanks also to Mamdouh Ibrahim for chairing the Insurance and HealthCare workshop. We really did have a great time!