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Extending an industry foundation Data Model

2 Tasks

30 mins

Visible to: All users
Advanced Pega Platform '23 English

Scenario

The Human Resources department at MDC is collaborating with the organization's healthcare insurance provider, MyHealth. MyHealth provides a web service to enroll new employees in the health plan. MyHealth uses an industry-standard model to receive requests. 

MDC intends to use the Pega Healthcare Industry Foundation Data Model to develop applications for employees to manage changes to their healthcare coverage. The new enrollment applications will be accessible through the MDC employee portal. Only MDC HR has access to the desktop client provided by MyHealth to enroll new members. The use of the Pega Healthcare Industry Foundation represents a new area of application development for MDC. Although MDC does not have a center of excellence (COE), it plans to establish one within the year. 

Your task is to map the response elements of the MyHealth web service to MDC's Data Model. After completing the analysis, you will assign a team member to add new properties, create integration Rules, map the MyHealth web service properties to MDC, and test the round-trip web service. The web service must return a response within one second or less to meet the business service level agreement for enrolling 1000 employees in one day. 

The following table provides the credentials you need to log in the Delivery Service application. However, this challenge is mainly meant for evaluating the design options. There are no specific implementation tasks.

Role User name Password
Admin admin@deliveryservice rules

You must initiate your own Pega instance to complete this Challenge.

Initialization may take up to 5 minutes so please be patient.

Detailed Tasks

1 Identify design options

The two following design options are available:

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. 

Note: This mapping document is based on the PegaHC-Data-Party-Member class and the MyHealth Member Data Dictionary spreadsheet as the system of record Data Model. Review and validate the mapping before implementation. 

Map only the entries from the spreadsheet. You do not need to map all properties from the Member class.

Option 2: Web service

During testing, the organization discovered that the web service does not meet the business Service-Level Agreement (SLA) requirements. If the web service does not perform according to the business SLA, one possible solution is to investigate the usage of robotic desktop automation (RDA). However, RDA is not a viable solution because access to the MyHealth member enrollment application is restricted to HR.

Another option to consider is robotic process automation (RPA), which you can use with an enrollment Case Type to invoke process automation in the background. By automating the enrollment process using RPA, the system can complete the enrollment process faster and more accurately, which can help meet the business SLA.

2 Recommend the best design option

Your first step is to identify the fields contained in the sample data spreadsheet. Next, see Loading sample data. 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 Data Model spreadsheet in the following link: 

For more information, see Get Started with Pega Common Data Model

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, MDC COE will manage the Data Model and integration Rules.

Confirm your work

      



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