Extending an industry foundation Data Model
Archived
1 Task
10 mins
Scenario
The Human Resource department at Front Stage is working with the organization's healthcare insurance provider, MyHealth. MyHealth offers a web service to enroll new employees into the health plan. MyHealth uses an industry standard model for receiving requests.
Front Stage uses Pega's Healthcare Industry Foundation data model to build applications for employees to manage changes to their coverage. The new enrollment application will be available from Front Stage's employee portal. Only Front Stage HR has access to the desktop client that MyHealth provides to enroll new members. This is a new area of application development for Front Stage. Front Stage does not have a center of excellence (COE) in place yet, but plans to establish a COE within the year.
Your assignment is to map the MyHealth web service response elements to the Front Stage's data model. Once you complete the analysis, you will assign a member of your team to add new properties, create the integration rules, map the MyHealth web service properties to Front Stage, and test the round trip web service. The web service must return a response within 1 second or less to meet the business service level agreement to enroll 1000 employees in one day.
Approach
Create a mapping document that you can hand off to a member of your team to implement. For the purpose of this exercise, focus on mapping elements of the PegaHC-Data-Party-Member class. Download the MyHealth member data dictionary spreadsheet to use as the system of record data model.
Only map the entries from the spreadsheet. You do not need to map all properties from the Member class.
Consider an alternative approach if during testing you find that the web service is not meeting the requirements of the business service level agreement.
Detailed Tasks
1 Solution Detail
Your first step is to identify the fields contained in the sample data spreadsheet . Next, go to Pega Community and open the Pega Foundation for Healthcare 8.3 Data Model ERD and the Pega Foundation for Healthcare 8.3 Data Model. For each field in the sample data spreadsheet, look up the corresponding property in the data model and record the property's name and class. If there is a new property name, highlight that property and identify in which class the new property should reside.
The result of your analysis is a map of the system of record data elements to the industry data model properties and any new fields that need to be added to the PegaHC-Data-Party-Member class in the organization ruleset of your application. In the future, the Front Stage COE will manage the data model and integration rules.
Solution Alternatives
If the web service does not perform according to the business SLA, you could investigate the usage of robotic desktop automation (RDA). Access to the MyHealth member enrollment application is restricted to HR, therefore, RDA is not a viable solution. Robotic process automation (RPA) could also be used in conjunction with an enrollment case type to invoke the process automation in the background, making RPA a viable option to consider.