Were you to have been asked that question some years ago, the answer most likely would have bee “I’m not sure”....
HPE Shadowbase software presents new case study!
Prescription Drug Fraud Prevention - an HPE Shadowbase data integration case study
Prescription Drug Fraud Prevention – an HPE Shadowbase data integration case study
From the time of the earliest system implementations to oversee the dispensing of prescription drugs, there have been opportunities to exploit gaps. These gaps or loopholes opened doors for corrupt groups seeking new ways to defraud financial institutions. The amount of money flowing through these systems was enormous as the corrupt groups looked to funnel restricted drugs to people with chemical addictions – particularly opioids. In other words, opportunities for fraud ran rampart at both ends of these transactions, those prescribing the drugs and those dependent on the medications.
For most countries, government agencies are actively involved, and the enforcement often involves multiple agencies, each with their own set of priorities and jurisdictions. The demands on recent implementations of systems has produced levels of complexity which often only exacerbate the situation, whether it is a case of drug enforcement, money laundering detection, crime prevention, or simply drug waste identification. The data may be absent from the information provided or mechanisms for running analytics may be left to offline processes. The need to be more proactive and to intercede in real time has taken on a sense of urgency due to a history of delays (in awareness) as well as a lack of insight (into schemes). But unfortunately, as is often the case when dealing with government agencies, any updates of this scope have to be done utilizing existing equipment without any significant increases to the budget.
A centralized claims fraud adjudication and prevention decision support system was implemented to help a country’s government healthcare agency monitor the process and stem the losses. An already existing claims processing system, running on HPE NonStop systems, was supplemented by this new application running on Oracle Solaris with Oracle RAC. In today’s deployments across government agencies (or even across enterprise IT datacenters), it is common to integrate transaction processing systems running on HPE NonStop with solutions for analytics, decision support systems, workflow engines, and other processor-intensive activities. To many industry watchers, it foreshadows the future as hybrid IT takes hold.
Integrating the systems proved challenging for all involved. The separate agencies needed to continue without interruption (even as new systems could not be added into the environment). Compounding the situation was that both the NonStop systems, as well as the Solaris servers, were separated geographically and each had a second backup site. The customer introduced Shadowbase software into this environment and addressed the two most critical requirements. Considering that the fraud decision support system was new, the initial requirement to address was the loading of all the data from NonStop onto Oracle, while ensuring zero data loss of any occurring changes.
Shadowbase Online Loading (SOLV) software supported this requirement, which successfully addressed the need to load Oracle while not disrupting NonStop operations. Once operational, all subsequent changes were captured and sent to Oracle for updating. The need to keep the two disparate systems synchronized was most important – an operation that is a standard feature of Shadowbase replication. “It takes little imagination to see these types of mixed NonStop and open platform deployments pointing to what is now common to all datacenters,” said Gravic EVP, Paul Holenstein. “Today we see separate systems, but we are expecting to see even greater dependence on applications running in server farms, and even clouds as hybrid IT becomes more popular. With what we have demonstrated already for this customer, it puts Shadowbase software in a very strong position to help all NonStop customers facing a similar future inside their datacenters.”
Gravic recently published an HPE Shadowbase data integration case study describing this process and all the steps it took to ensure that the agency’s financial and technology needs were met. This case study is now available from the Shadowbase website using the link above. Prescription drug claims fraud is big business, costing billions of dollars. The agency chose HPE Shadowbase data replication software to provide real-time replication from an HPE NonStop claims processing system to feed the new decision support environment. Shadowbase SOLV enabled the new system to load with no application downtime.
This case study provides an excellent example of how new services can be rapidly implemented by using HPE Shadowbase data and application integration facilities. However, after reading the case study, if you have additional questions about how a similar configuration may prove helpful in your own situation, please contact your local HPE Shadowbase representative or SBsales@gravic.com for more information.