Healthcare Services Platform

Summary

Healthcare master services platform is a high-performance software system that integrates the healthcare benefits from multiple providers in a unified system; provides clear and easy access to the benefits for consumers, while facilitating sponsorship of these benefits by employers.

Customer

The project was implemented for an emerging US healthcare benefits provider.
The customer's goal was to provide employers and employees with the tools, education, and support needed to implement a successful Consumer Directed Health Care program featuring Health Savings Accounts (HSAs).

Product Features

The Service Platform allows for proper integration of consumer focused services in an easy to use, singularly managed user account with all necessary events, data and funds exchange between the services to achieve highest value proposition for the member.
The platform comprises a number of governing functional items:

• Single point of enrollment into all services
• Single account to manage all funds and expenses related to all services
• Single point for service coordination
• One point of service in the form of a dedicated service executive
• One website to go to and one phone number to call

Thus, the system makes a complete healthcare management solution for consumers, employers, healthcare service providers and brokers. It effectively beats the competition like Health Equity, HSA Bank and others.

Implementation

The Service Platform is designed in the Services Oriented Architecture, with extended MQ Series messaging capabilities. Services are mapped out as a set of requests and responses that make up each service, with specific interfaces on top of that.
The system is connected to banking and financial networks, which enables consumers to manage their healthcare savings online, pay their bills, use an electronic card for their healthcare shopping etc. Also the system features an online account management console, call-center support with administrative console for consultants, management by fax and by surface mail.
The system's administrative console provides for effective low-cost system monitoring and administration, extensive reporting capabilities, and flexible integration tools for interaction with third-party entities.
The system is implemented in J2EE 3-tier architecture, with additional elements that handle security, scalability, and external interface features.
The architectural solutions provide for high-volume performance (first release supports 100,000 users with a 5% concurrency level; extensible to 1,000,000 users). Scalability, reliability and security are integral parts of the project.
Architecturally, the system consists of three high-level components:

Tools and Technologies

Platform: Novell SUSE Linux
Application Server: IBM WebSphere Application Server
Database: IBM DB2 Universal Database
Language: Java 2 Enterprise Edition, JDK 1.4
Technologies: SOAP, XML/XSLT
Messaging: IBM MQ Series
Performance: up to 1,000,000 users with 5% access concurrency
Effort: over 160 man-months