Rounding Up Business Rules

Computerworld - Do you know where all of your company's business rules are?
Most enterprise users are surprised to discover how many important -- and not-so-important -- rules, regulations, policies and procedures are scattered all around the organization. For example, last year's marketing manual has guidelines for creating advertising campaigns; equations for calculating employees' health and retirement benefits are embedded in Cobol code; and best practices for writing software code reside only in the minds of senior developers, since no one has been asked to write them down.
In older, slower eras, this diffusion of policies and rules wasn't such a big problem. But business and IT executives find themselves under greater pressure than ever to adapt to rapid changes in the market and in government regulations -- as well as to operate at maximum efficiency. As a result, they are looking to round up these renegade rules and put them someplace they can be easily accessed, updated and applied to business processes. To do that, they're turning to business rules engines -- execution environments and repositories for business rules -- and management systems.
Catching Errant Claims
A case in point: The District of Columbia provides financial assistance to needy residents, some of whom also qualify for Medicaid or other federal programs. Recently, managers working for the district discovered that the local aid program was often getting the bill for services that should have been covered by federal programs. If an employee failed to catch such errors, it would be a costly misapplication of the rules.
To catch more of the bad claims and more quickly process legitimate ones, the district began developing its Automated Client Eligibility Determination System. The new system relies on ILOG Inc.'s ILOG Rules business rules engine to determine eligibility for D.C. and federal programs. It asks applicants a series of questions -- much like a TurboTax automated tax program does -- and then prints out completed applications for the programs for which they are qualified.
The ILOG engine, which is accessible to anyone with a Web browser, has a very high accuracy rating -- 99%, according to Donna Ramos-Johnson, associate director at Washington's Office of the Chief Technology Officer. That delivers better performance than the legacy system, which is an IBM mainframe running an Adabas/Natural database that was used internally for claims processing and financial transactions.
Ramos-Johnson says more federal programs will be added to the rules repository, which will eventually be used by the legacy system as well. "We expect to have the major federal programs