Rules Engine Simplifies Code Changes

Vitria Technology Inc. has embedded ILog Inc.'s JRules rules engine into its middleware system for health-care companies. The addition means that business executives can make changes in complex business processes without IT writing new rules in Cobol code.

Vitria has built a vertical-market middleware system around its core BusinessWare business-process integration platform. Among its customers are Blue Cross and Blue Shield of Arizona, Blue Cross and Blue Shield of Michigan, Cardinal Health, and PacifiCare Health Systems.

Rules engines can detect violations of the claims process, such as when a doctor uses the wrong diagnosis code on a form. The ILog rules engine is being integrated with future versions of BusinessWare Health middleware. It codifies business rules applicable to a situation and uses those rules to resolve questions that arise in claims processing and other business processes. If a claim is being processed and three paths are possible, according to company policy, a claims processor would have to ask IT programmers to add those rules into what is typically a Cobol legacy system. The wait for the rules to be implemented can take six to nine months. Meanwhile, claims processors must manually handle all claims that fit the case, delaying and adding expense to the process.