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 wants to use the Pega's Healthcare Industry Foundation data model to build applications for employees to manage changes to their coverage. The new enrollment applications will be available from Front Stage's employee portal. Only Front Stage HR will have access to the desktop client that MyHealth provides to enroll new members. The use of the Pega Healthcare Industry Foundation 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 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.
1 Identify design options
Option 1: Mapping document
Create a mapping document that you can hand off to a member of your team to implement. For the purpose of this challenge, 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.
Map only the entries from the spreadsheet. You do not need to map all properties from the Member class.
Option 2: Web Service
You find that the web service does not meet the requirements of the business service-level agreement (SLA) during testing. If the web service does not perform according to the business service-level agreement, you can 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) can 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.
2 Recommend the best design option
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 8.5 loading sample data topic. 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 the class in which the new property resides. Use the Pega Foundation for Healthcare 8.5 Data Model spreadsheet, here:
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 manages the data model and integration rules.