Régie de l’assurance maladie du Québec (RAMQ)
An Integration Solution Offering Unlimited Future Growth
Faced with compatibility problems between the infrastructure of its billing agencies and its central system, the RAMQ required a flexible integration solution that would facilitate the flow of information. The organization selected Web Services to update its claims transmission system and Microsoft® BizTalk® Server 2004 as the integration platform to standardize its operations and transactions on. As a result, the organization now has increased scalability, real-time access to information and a platform that it can expand in the years to come.
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Company Overview
When submitting healthcare claims, the 4,700 organizations representing Quebec’s medical practitioners choose from nearly 100 customized applications offered by independent software providers. Previously, these organizations connected to the RAMQ by a private network dial-up link. The RAMQ received the claims with proprietary software installed on the central computer and on the PCs of the claims organizations. A major problem occurred when RAMQ’s vendor stopped supporting the proprietary software running on the RAMQ central system. The claims organizations were thus faced with a compatibility problem with the new software versions.
Business Challenge
“Our organization was faced with compatibility problems as our proprietary software could no longer scale to the meet the solutions used by healthcare claims organizations in the Province,” says Mario Blouin, IT designer, RAMQ.
With high numbers of submissions to be processed on a daily basis, integration and interoperability became key drivers for RAMQ to select a new system that could help to meet its organizational goals.
As a result, the RAMQ had to find a system that would allow the claims organizations to select the type of operating system and software adapted to their needs while remaining compatible with the RAMQ’s system. Faced with a limited budget, the RAMQ sought a flexible solution that would not necessitate reorganization of all its internal processes, and that would scale to meet future requirements. After reviewing different solutions, RAMQ chose BizTalk Server 2004 software as the integration platform in conjunction with Web Services to update its claims transmission system.
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Solution
Among the offerings reviewed, the most plausible was to use Web Services for communication with the billing agencies and use message queue software for integration with the organization’s central system. Although this solution completely meets the modernization needs of the claims transmission system, it required the RAMQ to maintain point-to-point integration with back-end systems.
To meet its needs, RAMQ turned to Fujitsu Consulting Services, a Microsoft® strategic software partner that the organization has worked with in the past. Fujitsu suggested a solution that could meet the needs to simplify the claims transmission while integrating with the RAMQ’s enterprise applications built upon BizTalk Server 2004. Part of the Windows Server System, BizTalk Server 2004 helps customers to efficiently and effectively integrate systems, employees and trading partners and help improve their time to value.
The RAMQ solution utilizes Web Services for communication with its clients. Previously, client claims were sent as flat files, but they are now sent as XML files, which helps simplify the independent software providers’ programming when creating applications. BizTalk Server receives the XML files from the Web server, converts the data to the existing format and sends the information to the central system in real-time.
The RAMQ’s IT environment is built on Microsoft Windows® 2000 Advanced Server operating system running on HP/Compaq Pentium 4 multiprocessor servers. In addition, two servers run BizTalk Server to address application integration and load balancing while minimizing down time and maximizing efficiencies.
In the forefront of the solution are two servers running Internet Information Services version 5.0, making it possible to host ASP.NET Web-based services. The RAMQ uses these servers for basic authentication. The access codes are verified in relation to the identity data managed by the Active Directory® service. Two cluster servers running Microsoft SQL ServerTM 2000, support BizTalk Server and store data to assure the persistence of data for the claims. The Websphere MQ product serves as a communication platform between BizTalk and the central computer.
“Using Biztalk 2004 allowed us to model and implement the RAMQ’s claims business processes quickly within the budgets and the very short deadlines we had to meet,” says André Lemieux, solution architect, Fujitsu Consulting Services.
Business Benefits
By using BizTalk Server with Web-based services, the RAMQ solved its compatibility problems between its clients’ PCs and its central computer. In the long term, the solution will allow integration of the various systems within the RAMQ infrastructure, such as UNIX, Tandem and NCR. In addition, the solution met one of the RAMQ’s key objectives – to create a technological base that can grow with this government agency’s needs.
“It’s strategically advantageous to use BizTalk,” says Blouin. “We wanted a solution that we could use for future updates and changes. We plan to use it in our future projects throughout our organization.”
In addition to solving incompatibility problems, the solution offers an integration infrastructure scalable to technological innovation, without generating additional costs. The RAMQ anticipates that the development time may be reduced by up to 40 percent.
Real-time synchronization
In the previous IT environment, the RAMQ used batch processing to synchronize the data between its internal systems. These batch processes were programmed procedures running at most once a day, creating a lag of over 24 hours in updating the systems. The development of these batch processes was specific to the exchanges between two systems. The organization needed solid links between these systems to effect this synchronization.
As a direct result of deploying BizTalk Server, the RAMQ is taking the first step to synchronize information in real time, thus making data accessible to the clients faster. In the long term, the RAMQ plans to use the solution to coordinate real-time exchanges between systems. Further, using BizTalk Server as an integration engine allows the RAMQ to reduce the development efforts for integration of this system by reusing the business logic and simplifying its infrastructure. Each system integrates only with BizTalk Server, creating a single synchronization point and the organization anticipates a 25 percent to 40 percent reduction in the systems integration efforts for these information technology resources.
Unlimited future growth
As a result of its increased functionality and scalability, internal software developers at RAMQ now have the freedom to create and modify their products, which accelerates and simplifies the development of solutions. Claims organizations also have the freedom to choose their operating systems.
The growth capacity offered by BizTalk Server combined with use of Web services, the RAMQ solution can now easily scale to address new services. The RAMQ is confident that BizTalk Server will make it possible to keep pace with technological progress by simplifying integration into its back-office systems and reducing the development efforts for integration.
Microsoft Windows Server System
Microsoft® Windows Server System is a comprehensive, integrated, and interoperable server infrastructure that helps reduce the complexity and costs of building, deploying, connecting, and operating agile business solutions. Windows Server System helps customers create new value for their business through the strategic use of their IT assets. With the Windows Server operating system as its foundation, Windows Server System delivers dependable infrastructure for data management and analysis; enterprise integration; customer, partner, and employee portals; business process automation; communications and collaboration; and core IT operations including security, deployment, and systems management.
For more information about Windows Server System, go to: http://www.microsoft.com/windowsserversystem
For More Information
For more information about Microsoft products and services, call the Microsoft Sales Information Center at (800) 426-9400. In Canada, call the Microsoft Canada Information Centre at (877) 568-2495. Customers who are deaf or hard-of-hearing can reach Microsoft text telephone (TTY/TDD) services at (800) 892-5234 in the United States or (905) 568-9641 in Canada. Outside the 50 United States and Canada, please contact your local Microsoft subsidiary. To access information using the World Wide Web, go to: www.microsoft.com
For more information about DMR Consulting products and services, call (418) 653-6881 or visit the Web site at: http://ca.fujitsu.com/en/services/consulting/
For more information about Régie de l’assurance maladie du Québec products and services, call 1-(800)-561-9749 or visit the Web site at: www.ramq.gouv.qc.ca
