Problems in operations and enterprise workflows
Enterprises today face immense pressure to modernize their back-office operations to drive efficiency, ensure compliance, and accelerate time-to-market. However, they are frequently paralyzed by technical debt, resulting in manual bottlenecks and spiraling operational costs. As a Solution Designer, you must address structural root causes across the enterprise rather than surface symptoms such as slow processing times:
Legacy rigidity and technical debt
- Symptom: Inability to quickly launch new products, adapt to market changes, or update processes (for example, slow time-to-market for insurance products, rigid manufacturing, enterprise resource planning (ERP), or stagnant government systems).
- Root cause: Business rules and workflows are embedded directly in aging, monolithic core systems (ERP, mainframes, core banking), which makes changes slow, expensive, and risky.
Fragmented orchestration and limited end-to-end visibility
- Symptom: Work items are delayed or lost in processes such as claims processing, corporate onboarding, and supply chain sourcing, and stakeholders lack end-to-end visibility across the workflow lifecycle.
- Root cause: Teams rely on manual handoffs through email and spreadsheets and on disconnected point solutions, rather than a Center-out® orchestration layer that tracks work from initiation to completion.
Costly exception handling and compliance risk
- Symptom: Operational costs rise, large processing backlogs grow, and regulatory risk increases in complex processes such as KYC/AML, payment disputes, underwriting, and government grants.
- Root cause: Without intelligent automation and centralized business rules, human workers must manually parse data, check policies, and route exceptions.
Disconnected partner ecosystems
- Symptom: Collaboration with external parties (dealers, distributors, citizens, suppliers, and network providers) and work across internal shared services introduces friction and delays.
- Root cause: Workflows remain within isolated department silos, with no secure, extensible architecture to bring external stakeholders into the process.
Persona pain points and the diagnostic translation layer
In operations-heavy environments, stakeholders focus on throughput, risk, and the cost of processing work. As a Solution Designer, your role is to translate these frustrations into structural failures in orchestration, decisioning, and system design.
The operations leader (insurance, head of claims)
(Head of Claims or VP of Operations)
Focuses on claims processing speed, cost per claim, backlog, and service-level agreements:
| Symptom | Root cause |
|---|---|
| "Our claims backlog keeps growing, and we are hiring just to keep up." | High-volume, repetitive tasks (such as claims validation and document review) are being handled manually instead of through automation. |
| "It takes weeks to settle a claim." | Work moves through manual handoffs between intake, assessment, and payout, with no end-to-end orchestration. |
| "We lose visibility once a claim leaves intake." | There is no centralized case management layer acting as a single source of truth. |
The risk and compliance leader (banking, head of know your customer)
(Head of Know Your Customer (KYC) or Chief Risk Officer)
Focuses on regulatory compliance, auditability, fraud prevention, and financial risk:
| Symptom | Root cause |
|---|---|
| "I am worried about passing our next audit." | Compliance rules are not system-enforced; they exist in documents and manual processes. |
| "Manual reviews are slowing onboarding down." | There is no centralized decisioning to automate low-risk checks and isolate true exceptions. |
| "We miss regulatory deadlines or checks." | There is no automated SLA tracking or escalation built into the workflow. |
The business unit leader (government, program director)
(Program Director or Head of Public Services or Licensing)
Focuses on service delivery speed, citizen experience, and program outcomes:
| Symptom | Root cause |
|---|---|
| "It takes months to deliver a new service or policy change." | Business rules are embedded in rigid legacy systems that are difficult to update. |
| "Citizens and partners struggle to work with us." | Workflows are not digitized or extended to external stakeholders. |
| "We are falling behind more modern digital agencies." | The organization operates on a siloed architecture that cannot adapt quickly. |
The IT and transformation leader (cross-industry, enterprise architecture)
(Chief Information Officer (CIO) or Head of Enterprise Architecture)
Focuses on modernization strategy, technical debt, and system complexity:
| Symptom | Root cause |
|---|---|
| "We cannot touch our core systems: they are too risky to replace." | The team assumes modernization requires full replacement instead of layering orchestration on top. |
| "We have many automation tools, but nothing is actually faster." | The organization has isolated automation solutions without a unified orchestration layer. |
By using this translation layer, you can shift the conversation away from surface symptoms, such as adding headcount or changing core systems. The focus should be on the root cause: orchestrating work and centralizing business rules across the enterprise.
Operational root cause analysis
In operations and enterprise workflows, the most common trap a Solution Designer falls into is accepting the "rip and replace" premise or settling for task automation, such as building a bot to handle data entry. To uncover a Pega-shaped problem, you must drill down to find the absence of end-to-end orchestration and centralized business rules.
The diagnostic drill-down
When a stakeholder says, "We need to hire more people to handle the processing backlog," use the five whys to shift the focus from headcount to architecture:
- The request: "We need to hire 50 more analysts to manage the corporate onboarding or claims backlog."
- Why 1 (performance gap): Why is the backlog growing so fast?
"Because it takes an analyst 14 days to process a single complex application." - Why 2 (manual gap): Why does it take 14 days?
"Because the analyst has to manually check the data against compliance rules, then email the risk department for approval." - Why 3 (logic gap): Why are those compliance rules not automated and routed automatically?
"Because the rules are stored in a 200-page PDF manual, and our legacy system is too old to handle dynamic rule changes." - Why 4 (structural root cause): Why does the workflow rely on the legacy system?
Root cause: The organization lacks an orchestration layer. Human workers manually connect static legacy systems to complex business rules.
Core diagnostic questions for Solution Designers
Use these diagnostic questions during discovery to identify the need for Case Management, Intelligent Automation, and a Wrap-and-Renew approach:
| Structural gap | Diagnostic question |
|---|---|
| Legacy rigidity | "Why does it take IT six months and significant investment to update a simple underwriting or compliance rule in the core ERP or mainframe?" |
| Process visibility | "Why are we using email and spreadsheets to pass high-value claims, disputes, or onboarding requests between departments?" |
| Automation islands | "If we already have Robotic Process Automation bots to perform data entry, why does a human still decide where the file goes next?" |
| Disconnected partners | "Why do our external suppliers, dealers, or citizens have to call us for a status update instead of participating directly in the digital workflow?" |
Determining the right solution scope
After you identify a root cause, apply the following tests to confirm the solution scope:
Is this a task problem or a process problem?
- If the goal is to complete a single step faster (for example, copying data or validating a field), it is likely a task-level problem suited to point solutions or simple automation.
- If the goal is to move work from initiation to completion across multiple steps, teams, and systems, it is a process-level problem that requires orchestration, visibility, and coordination. This combination is the hallmark of a Pega-shaped problem.
Are you addressing a single step or the end-to-end flow of work?
- Fixing individual steps may improve efficiency locally, but it does not resolve delays, bottlenecks, or breakdowns across the lifecycle.
- True improvement comes from designing and orchestrating the entire process. Work then moves predictably, transparently, and efficiently from start to finish.
Pega Platform solutions for operational root causes
In operations-heavy domains such as claims processing, customer onboarding and due diligence, or underwriting, organizations often struggle with fragmented workflows and rigid systems. The role of the Solution Designer is not to replace these systems, but to identify where coordination, visibility, and decisioning are breaking down.
A Solution Designer maps each operational root cause to a structural solution:
1. The legacy rigidity problem versus centralized business logic
- Root cause: Legacy systems contain critical business rules (for example, pricing an insurance policy or validating a government grant) in ways that make them difficult to change, test, or apply consistently.
- Solution: Centralizing business logic. Pega Platform defines business rules once and applies them consistently across processes and channels.
- Outcome: Greater agility. Organizations can update rules, adapt processes, and respond to change more quickly without disrupting the systems that support them.
2. Limited process visibility versus end-to-end Case Management
- Root cause: Organizations manage work across departments through disconnected tools, which results in limited visibility, missed handoffs, and missed service-level agreements.
- Solution: End-to-end Case Management. Pega Platform tracks each unit of work as a single, continuous lifecycle from initiation through completion.
- Outcome: Full visibility and control. Stakeholders can see where the work is, who is responsible for it, and what the next action is.
3. Manual exception handling versus intelligent automation
- Root cause: Skilled workers spend significant time on repetitive validation, document handling, and routing tasks rather than higher-value decisions.
- Solution capability: Intelligent Automation. Pega Platform automates routine tasks and low-risk decisions, and identifies and escalates exceptions appropriately.
- Outcome: oved efficiency and focus. Work moves faster through the process, and human workers focus on complex or high-value activities.
4. Disconnected partner ecosystems versus extensible workflows
- Root cause: External stakeholders (such as partners, suppliers, or citizens) have no path into the workflow, which results in delays, rework, and reliance on manual communication channels.
- Solution: Extensible workflows. Processes can securely include external participants as part of the same end-to-end flow of work.
- Outcome: A more connected ecosystem. Work moves across internal and external participants without duplication or loss of context.
The goal is to design the flow of work across the enterprise. Organizations must coordinate work, maintain visibility, and govern it through consistent logic from start to finish.
Google improves service efficiency with Intelligent Workflow Automation
Google reduced service ticket processing times by 10x by replacing a manual, error-prone dispatch process with a Rules-based orchestration solution built on Pega Platform:
- Business issue: Google's Global Networking team manually navigated hundreds of websites, apps, and systems to route service tickets and schedule field engineers across all Google product areas. The volume of tickets made the process unsustainable and error-prone.
- Solution: Google adopted Center-Out® architecture to build an intelligent orchestration platform. By centralizing business rules and wrapping its existing internal systems with Case Management, it automated exception handling and streamlined complex routing.
- Results: Google achieved a 10x improvement in service ticket processing times, which reduced manual work, accelerated onboarding, and created a scalable, automated operational framework.
For more information, see Google improves service ticket processing times by 10x.
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