BPM Takes on Industry Regulation

by Penny Lunt

When Blue Cross Blue Shield of Minnesota needed a new system for processing HIPAA-compliant healthcare transactions and interacting with the national Blue Cross Blue Shield (BCBS) Association, it chose the BusinessWare Platform from Vitria, Sunnyvale, CA.

The selection of this business process management (BPM) system was easy in part because BusinessWare had already been selected by the Chicago-based national association to meet HIPAA demands. The Health Insurance Portability and Accountability Act requires that healthcare claims and inquiries use certain transaction codes. To support the flow of transactions among the Blues, the national BCBS association standardized on the BusinessWare and dubbed the system BlueExchange, yet it allowed state BCBSs to make their own software choices.

While Minnesota looked at many BPM applications, the Vitria solution allowed both batch and real-time transactions, which the BlueExchange required, explains John Ounjian, CIO of BCBS of Minnesota. "Vitria not only routes and parses transaction data, it also translates codes as they hit the different Blue Plan systems. Our back-end applications are all COBOL programs that use different formats, and this software presents the claims to each in the right way."

Vitria's BusinessWare platform provides process management, analysis and monitoring, vocabulary management, enterprise application integration and B2B integration software. The solution started out as a telecom solution for DSL provisioning. However, the company also targeted healthcare and insurance customers, including Blue Cross Blue Shield organizations. BusinessWare has also been deployed by financial services companies, which use its global straight-through processing Application for handling securities trades in compliance with T+3 settlement guidelines.

BusinessWare's main strength is in letting companies build and integrate business processes that stretch across multiple applications while still providing an end-to-end view of even the most complex processes — for example, a manufacturing transaction from order placement to payment, a 360-degree view of a customer relationship or a start-to-finish view of a health insurance claim process.

"Customers typically tell us that their CEO or line-of-business managers want more visibility into their business processes," says Suresh Chandrasekaran, Vitria's senior director of product management. "Over the last five years, everybody has invested heavily in packaged applications to automate functional processes, such as human resources, customer relationship management and enterprise resource management. But they're not able to get an end-to-end view of their business from those strategic processes. A single view is what they need to reduce cost and improve customer service."

Such a holistic view would allow a company to prepare for a large influx of orders, for example, or reduce a bottleneck in one stage of the process.

Vitria also provides focused modules built on the BusinessWare platform called Vitria Collaborative Applications. These prepackaged integrations for specific processes cut across multiple functions and partners. One such application for HIPAA-compliant claims processing is in use at BCBS of Minnesota and will soon be available to others. The module facilitates the exchange of information among healthcare providers, hospitals, payers and insurance companies. Of interest to financial services organizations, another Vitria Collaborative Application is available for global straight-through processes, and it is designed to help broker/dealers and settlement houses speed up their trades to meet eventual T+1 settlement guidelines.

These process-specific applications have found favor with analysts. "Vitria has done a good job taking process expertise and starting to offer specific products to industries," says Kimberly Knickle, research director at Boston-based AMR Research. Of the basic platform, she notes, "all the EAI vendors have some business process management capabilities; Vitria has the most mature product. It provides BPM and modeling beyond intelligent routing."

[ BACK | NEXT ]