Data Quality
                 From Theory to Practice

         MARCUS EVANS CONFERENCES
Paul Ormonde-James
Group Intelligence
MBF Australia
Agenda


         •   Why is data quality important?
The problem to be solved…..

                              Target




     You
     are
     here
The problem to be solved…..

                              Target




     You
     are
     here
Paul Ormonde-James – Presenter, Speaker, Author

       • Paul, has spent many years in the field of
         Change Management. He has
         qualifications in Cybernetics (Robotics &
         Artificial Intelligence), Computer Sciences,
         a Master of Business Administration (MBA)
         and post grad in Company Law. He has
         driven many change programs and used
         Business Intelligence, Competitive
         Intelligence and Knowledge Management
         to drive such cultural change to increase
         company value.
Business Intelligence, simply…..

            Corporate Survival & Growth
                       “Growing through Knowing”




            More effective decision making




At the



To the
Data quality practical guide
Business BI
Why do we need data quality?

   •   There is a growing cross-industry recognition of the value of
       high-quality data.

   •   2001 PricewaterhouseCoopers Global Data Management
       Survey, 75 percent of the senior executives reported significant
       problems as a result of defective data.

   •   In 2002, The Data Warehousing Institute published its Report
       on Data Quality in which they estimated that the cost of poor
       data quality to U.S. businesses exceeds $600 billion each year.

   •   Two critical pieces of legislation passed within the past few
       years impose strict information quality requirements on both
       public corporations in the U.S. (the Sarbanes-Oxley Act of
       2002)

   •   As well as U.S. federal agencies (The Data Quality Act of
       2001).

   •   Both of these laws require organizations to provide auditable
       details as to the levels of their information quality.
Do Managers really understand data quality?????

        • How many times does a manager or executive ask
          where the data comes from?

        • How many executives understand the numerous
          data sources in and across an organisation

        • How many Executives understand the errors
          generated as incorrect data is summarised.

        • Are executives more focussed on quality data the
          more important the decision?
The Journey…..




                 Self Service Model
                                   Place Logo Here
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Enterprise Business Reporting & Analytics
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           (DW Strategy)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Current Applications Model
                                 Customers
                                                                       Customer Reports, Investment Performance Reports (Quarterly, Monthly)




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Business Unit Classification
                                                                             Clearview Exit Reports (Weekly / Ad hoc) (via MS PowerPoint)

                                                                                   Clearview Leads Reports (Weekly / Ad hoc) (via MS PowerPoint)

                                                                                       Funds Sales Reports (Weekly / Ad hoc) (via MS PowerPoint)

                                                                                             Misc. Clearview & MBF Life Reports                           Financial Services                           Group Marketing                                                         Risk Management &                                                                 MBF Health                                    Corporate Culture &                                          Group Strategy & New                                                         PHI                                         Group Finance &
                                               Board                                                                                                                                                                                                                                Treasury                                                                       (PHI)                                        Communication                                               Business Development                                                                                                    Corporate Services
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               KPI / Balanced Score Card (via spreadsheet or flat file on J Drive)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Membership &
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Sales Reports
                                                                                                                                                                                                                                                                                                                                                   Claims, Provider,                                                                                                                                                                                                                                                                                                MBF Health KPI (via MS Excel)
                                   General, KPI &                                                                                                                   Clearview Product Reports (Ad hoc)                                                           Investment &                 Budget & Rate Rise Reports                    Health Program Reports
                                                                                                                                                                                                                  MBF & MBFH                                                                                                                                                       Actuarial Reports
                             Performance Reports                                                                                                                                                                                                             Actuarial Reports                                                                                                                                                                                                                                  P&L & OPEX
                                                                                                                                                                                                                  Sales &                                                                                                                                                                                                                                         Ad-hoc Reports                                                                                           Executive Pack Reports
                                                                                                                                                                                                                  Membership                                                                                                                                                                                                                                                                                          Reports
                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Claims Reports                         Ad-hoc
                                                                                                                                                                                                                  Reports                                                                                                                                                                                                                                                                                                                                             - National Claims Reports (via Excel & Word) (Daily & Monthly)
                                                                                                                                                                                                                                                                                                                                                                                                                                                         In2Life Campaign Reports (Monthly)                   Membership
                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Customer Matrix (Monthly)                                                                     - Member Services Reports (via Excel & Word) (Daily, Weekly & Monthly)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Reports                                                 - Customer Enquiry, Complaints & Compliments Reports (via Excel & Powerpoint)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Sales Reports (Monthly)                               - Membership, Members’ Exits & Exit Interviews Reports
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Ad-hoc Reports                            - Teams’ Performance Reports (via Powerpoint)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Dashboard Suite of Reports (Monthly)                   Membership & Sales Reports
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Membership Reports                 Customer Retention & Sales Reports
External Organisations and          Customer Contact Channels                                                                                                                                                                                                                                                                                                                                           Ad-hoc Reports         FTE Reports
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Reporting on Investment, Regulatory, Budgeting, Pricing, Variances, EOM Provisioning, Claims Analysis
Components
                                       Staff Assisted                                                                                                                                                                                                                                                                                                                                                                                         MBF & MBFH
                                                                                                                                                                                                                                                                                                                                                                                                                            Misc. Membership & Competitors
                                                                                                                                                                                                                                                                                                                                                                                                                                  ad-hoc Analysis & Reports
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Exceptional
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Request /
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Reports



                                                                                                                 Financial Services                                                          Business Intelligence                                                                 Group IT & Program                      Business & Clinical Analysis                                 Risk Management &                                                          Group Marketing                                       Group Finance &                                                                  MBF Health                                                                            PHI
                                                                                                                                                                                               (Group Finance)                                                                        Management                                      (PHI)                                                  Treasury                                                                                                                   Corporate Services                                                                  (PHI)
                                                                                                                                                                                                                                                                                                                                                                                                                                   Membership Report                       Analysis Reports                                                                                                                                                                            KPI (via MS Excel)
                                                                                                                                                                                                                EOM & Ad-hoc                                                                                                                                                                                                                                               (eg. Customer,
                                                                                                                                                                                                                Reports (via Excel)                                                                                   Investment & Actuarial / Membership, Benefits & Sales Reports & Analytics                      Customer Profiling & Demographic Data                                                                                                                                        Membership &        Sales Reports (Weekly,Monthly)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Competitor)                                                                                                            Sales Reports                                                                                Dashboard Data from all MBF Business Units
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Satisfaction Surveys (via Excel)
                                                                                                                                Call Center Management Reports (Weekly)

                                    Front End Processing Components                                                                                                                        Complete Claims History Data (Monthly) (via Flat File)                                                                                                                                                                                                                                                                                                                                                                                                                                           Back End Processing                           Back Office Departments
                                                                                                                                                                                                     Summurisation of Revenue & Membership Data (Monthly)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Components
                                                                                                                                                                                                                                                                                                                                                                                Customer Enquiry, Complaints & Compliments Reports (via Excel & Powerpoint) / Membership, Members’ Exits & Exit Interviews Reports

                                                                                                                                                                                                                                                                                   MISC                                                                                        Internal Reporting (Membership, Claims, Sales Activity) (Weekly)
                                                                                                                                                                                       BASE SAS                                                MONTH END                                                                                                                                                                                                                                                                                                                                                                                                 CONSOLIDATED                                         CDATA
                                                                                                                                                                                                                                               DATABASE                        SPREADSHEETS                                                                                 Membership & Sales Reports (Weekly, Monthly)                                                                                                                                                                                                                                   FINANCIAL
                                                                                                                                          Standard Detailed Claims Data         Data Formatting &          Revenue, Membership
                                                                                                                                                                                                                                                                                                                                                                                                                                      P&L, Cost Centre OPEX (Monthly) (via OPEX Excel Spreadsheet)                                                                                                                                                        REPORTING                                        Census Data
                                                                                                                                                                                                              & Claims Data             (MS Access Database)              Various spreadsheets
                                                                                                                                                                                  Consolidation
                                                                                                                                                                                                                                                                          used by Investments &                                                                                                                                                                                                                                                                                                                                                             (MS Word)
                                                                                                                                                                                                                                                                               Actuarial for                                                                    PMP Compliance, Risk & Contract Reports (via Excel for Formatting)
                                                                                                                                                                                                                                                                           Analysis & Reporting                                                              Services Utilization Reports
                                                                                                                                                                                                                                                                            Eg GL Variances                                                              Misc Reports
                                                                                                                                                                                                                                                                               Calculations                                                           Services Utilization Reports
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Retail, Corporate & Travel                                                                                                                                                          Business Intelligence
                                                                                                                                                                                                                                               Misc. Data (via Dynamic Link)                                                                   Claims Leakage & Exception Reports (via Excel)
                                                                                                    Misc. Clearview &                                           Misc. Reports
                                                                                                                                                                                                               Month End Claims Data                                                                                                    PHI Health Program Reports
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Self-Service Reports    Sales eBusiness Reports                                                                                                                                                               (Group Finance)
                                                                                                    MBF Life Reports                                                                                                                                                                                                              Clinical & Business                                                                                                                                                                                                        from Web Channel
                                                                                                                                                                (excl. Financial Services & IT)                                                                                                             Claims Reports                                                                                                                                                                                                                                                                                                                                                                                      Executives Commentary                          Balanced Score Card
                                                                                                                                                                                                                                                                                                                                  Analysis Reports                                                                                                                                                                                                           (Weekly, Monthly, Ad-Hoc)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Census Data                                                         Data (Via J drive)
                                                                                                                                                                                                                                                                                                                                                                                                                                                 2   4   5                                4   5




                                                 MISC. PRODUCT                                                                                                                               BUSINESS OBJECTS                                   CRYSTAL REPORTS/                                               MISC AD-HOC                    HEALTH                                                                                         SAS PRODUCTS                                                                                           MISC WEBSITE                                                       MISC REPORTING                      CUSTOMER                                   CUSTOMER FACING
                                                                                                           CRYSTAL REPORTS                                         META CUBES                                                                                                                                                                                                  XRAY                                 SPSS                                                                  FUTRIX                              TM1                                                     CENTREVU
                                                    ANALYSIS                                                                                                                                        5.9                                         CRYST. ENTERPRISE                                              DATABASES                    MANAGEMENT                                                                                           SUITE                                                                                             ANALYSIS TOOLS                                                        DATABASES                       EXPERIENCE DB                                  SYSTEM (CFS)
                                                   REPORTING                                                 Reports Formatting                              Analysis Cubes. IBM.                                                                                                                                                            PROGRAMS                   Based On SAS AF.                  - Customer Profiling                                                    Aka Online Cubes for           - Contract Modelling &                                                Avaya IVR
                                                                                                                                                                                                     Reporting                                     Data in Crystal                                        Around 50 MS Access                                                                                                               - Base SAS (H&B Stats)                                                                                   MS Excel/Access                                                  (MS Access Database)              Customer Experience                           GTX-PROD Database
                             Research. Data                                                                                                                                                                                                                                                                                                                               Benchmarking                        - Data Mining                    - Enterprise Miner
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Self-Service Usage.                  Reporting.                                               Call Tracking System
                                                 - Customer Analysis                                                                                           Decommissioned                      Analysis Cubes                                    Enterprise.                                               Databases                Preventive, Asthma &             Providers Against                - Statistical Analysis                                                                                      - Self-service                                                                                                                   & Satisfaction Surveys.                        (Graham Technology)
                                                                                                                                                                                                                                                                                                                                                                                                                                           (Data Mining & Modelling)
                                                - Competitor Analysis                                                                                             in favour of                    & Data Extraction.                                 Use of DW                                                                           Diabetes Programs.             Industry Profiles &                                                                                       Analysis & Reporting             - Based On Excel.                                                                                   Used by Customer                (MS Access Database)
                                                                                                                                                                                                                                                                                                                                                                                                                                               - Enterprise Guide
                                                     - Investment                                                                                             Business Objects XI                                                                is Recommended                                                                           Updated Monthly                     Trends                                                                - SAS Stat                                                                                                                                                         Service & Retention                                                                Call Center Data
                                                Performance Tracking                                                                                                                                                                                excluding for                                                                      (MS Access Database)                                                                                       - SAS Graph                         Written In SAS                                                                                                                                                    Used By Customer
                                                                                                                                                                                                                                                Operational Reporting                                                                                                                                                                                                                                                                                                                                                                                   Service & Retention
                                                                                                                                                                                                                                                                                                                                                                                                                                                          Clinical & Business                                    Activity &
                                                                                                                                                                                                                                                                           Clinical & Business Analysis Data                                                                                                                                                                                                 Analysis Data
                                                                                                                                                                                                                                                                                                                                                                                                                                                          Analysis Data           Manipulated Clinical &                                                                                      Call Centre Data                                     Customer Retention (Cancellations) & Sales Data (via MS Access)
                                                                                                                                                                                                                                                                                                                                                                                    Manipulated Clinical & Business Analysis Data
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Business Analysis Data
                             Customer, Brand & Product Data
                             Service Call Survey Data                                                                                                                                                                                                                                                                 Claims Data                                                                                                                                                                                                                                                                                                                                                                                                                              PHI
   Research Agencies                                                                                                                                                           1                                                                                                                                                                                                                                                                                                                                                      Sales Reporting By Channel

                                                          Client & Product Data                                                                                                                                                   Tasmania Sales &                                                                        EOM Provisioning (via MS Excel & Access)                                                                                                                                                                                                                                                                                                                  Prosthesis Pricing Data (Monthly)
                                                                                         Client & Product Data                                                                                                                    Membership Data                                                                                               Levies, Revenue & Reinsurance Data (Monthly)                                                                                                                                                                                                                                                                                  Medical Pricing Data (Monthly)
                                                                                                                                                   Misc. Reports                                                                                                                                                                                                                                                                                                    MS Access Databases
                                                                                                                 Funds Data                                                                                                         (from Diamond)


                                                                                                                                                                                                                    Sales &                                                                                                                         HCP Data
                                              CUSTOMER                   MBF LEAD                     OPERATIONS                                      OBSC PORTAL                                                             MISC SALES &                                                                                                                          MISC. AD HOC                                         TM1                                                 MISC HOSPITAL                  MISC ANCILLARY                      MISC PROSTHESIS                  MISC MEDICAL                    MISC. MBF HEALTH                      IMPROMPTU                                      MISC PRICING DATA
                                                                                                                                                                                                                Membership
                                              WATCHLIST              REFERRAL SYSTEM                   TRANSFER                                                                                                        Data MEMBERSHIP DB                                                                                                                            REPORTING                                                                                                DATABASES                       DATABASES                            DATABASES                      DATABASES                         REPORTING
                                                                                                    TRACKING SYSTEM                                       Oracle                                                 (from DW) Extract, Match, Format
                                                                                                                                                                                                                                                                                                                                                                                                                       3 Cubes:                                                                                                                                                                                                                  Data Summarization                                   - MBF Prothesis Price
                                       Retention Campaign               Tracks Leads                                                                Balance Score Card                                                                                                                                                                                             - MS Access                                      - Investment                                               - Claims 2003                 - 3 Claims - Dental                   - New Prices04              - Duplicate Services                  (MS Excel)                      & Reporting.                                            List 2004
                                               Data.                  Transferred From                                                                                                                                        (MS Access Database)           Membership Data (Monthly)              Ad-hoc Data Extract                                                                                                                                                        - Claims 2004                - 6 Monthly Reports                      - Schedule 5                     V2000
                                                                                                    Tracks External Funds                             Web Front-End.                                                                                                                                                                                                - MS Excel                                           - FTE                                                                                                                                                                                                                  Part Of Cognos Suite.                                      - CMBS 2000
                                       Tracks Reasons Why            Member Centers To               Managers’ Rollovers.                                                                                                        - 7 State Sales DB                                                                                                             Membership Reporting                                 - Oracle GL                                               - Claims Fy04                  (Ancillary, Dental                - File Upload, Master           - Fy04 Gap Survey                 Data Extraction &                                                                           - AMA
                                        Customer Redeem                  Clearview.                       Assirt V6                                                                                                           - 7 Weekly Member DB                                                                                                                                                                                                                          - Claims Fy04 V97               Optical, Pharmacy,                 - Human Tissue Items            - Contract Modelling                  Formatting                                                                       - Diagnostic Schedule
                                         Clearview Funds.           (MS Access Database)            (MS Access Database)                                                                                                       - 7 Month Member DB                                                                                                                                                               Based On Excel.                                                  - Hospital               Physio, Membercare)                  - Deleted / Replaced            - CHC931 Medical                                                                                                     (MS Access Database)
    Commonwealth                      (MS Access Database)                                            To Be Phased Out.                                                                                                       - Misc DB: Sales Rep...                                                                                                                                                                                                                                                        - Quarterly Report               Items - Price Summary                   Claims




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Streamlined
  Department of Health               Client & Product Data                                                                                                                                                                                                         Membership & Claims Data Extract (from Diamond)                                                                                                                                                                                                                                                                                                                                     Customer, Claims,
                                                                                                                                                                                                                                                       Membership Movements, Gains and Exits Data
       & Ageing                                                           Client & Product Data
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Membership &
                                                                                                                                                                                                                 HCP (Monthly), Ad-hoc Provider Contract / Modelling Data (from DW via Text file)                                                                                                                                                                                                                                                                                                                                                            Sales Data
                                                                                                                                                                                                        HCP (Monthly), Ad-hoc All Providers Claims, Financial, Membership Data (via Flat file from DW / Mainframe Domain)
                                                                                                                                                                                                    Ad-hoc Financial Data Extract (from DW / Mainframe Domain)
                                                                                                                                                               Financials & Balanced Score Card Data                                                                                                                                                                                                                                                                                                                                                                                                                           Customer, Claims,
                                 Hospital Price Modelling & Ad-hoc Data                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Membership & Sales Data
                               Medical & Prosthesis Pricing (Monthly)
                          Industry & Regulatory Data (Quarterly)
                                    Integrated Data Domains                                                      Sales & Membership
                                                                                                                                                                                                      Report Query Data
                                                                                                                   Data (via Flat File)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Hospital To Be Modelled
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           MAXIMISER                        Hospital Details
                                                                                                                                                                                                                                                                                                                                                                                                                                       4     5
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        - Hospital Details                  from Hospital &
                                                          FINTECHNIX                                                SALES                                                                                 WEB-BASED                                                                                      DIAMOND RPT                                                                                                                                                                                                                                                                                                                                                                                                                    Benefit Management
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      - Contract Modelling
Private Health Insurance Synchronised Data              REPORT SERVER                                            OPPORTUNITY                                                                              CORPORATE                                                                                                                                                                                                            SAS DATABASE EAP37
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Maintained By Account
                                                                                                                 MANAGEMENT                                                                               DOCUMENTS                                                                                   Replicated Diamond                                                                                                                                               Hospital Details
 Administration Council           (Weekly)             Replicated Fintechnix                                                                                                                                                                                  Misc Data
                                                                                                                                                                                                                                                                                                       Environment for                                                                                                            Summarisation &                                                                                                                                                                                                                                                          Managers.
                                                          Environment For                                        (SOM) SERVER
        (PHIAC)                                                                                                                                                                                       Predefined Corporate                                                                            Reporting & Testing                                                               Census Data                                 Reformatting.
                                                       Reporting (Lifeprod).                               CRM Siebel Database                                                                            Key Reports.                                                                                                                                                                                                               - Prosthesis                                                                                                                                                                                                                                                    To Be Fed by Diamond
                                                       Life, Superannuation,                                                                                                                                                                                                                                                                                                                                                           - Hospital                                                                                                                                                                          Ancillary & Commissions Extract (Monthly)
                                                       Managed Funds Data                                                                                                                            3 Claims are Updated.                                                                                                                                                                                                             - Medical
                                                                                                                                                                                                                                                                                                                                                                                                                                      - Ancillary
                                                                                                                                                                                                                                                                                                                   Synchronised Data                                                                                           - Customer/Membership                                                                                                                                                                                                                                                      3M GROUPER
                                                                                                                                                                                                                                           Sales & Membership Data By State excl. Tasmania (via Text File)                                                                                                                         HCP, Providers
                                                                                                                                                                          Misc. Data              Misc. Data                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           HCP & Claims Data
                                                                                                                                                                                                                                                                                                                                                     Propensity Modelling




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Efficient
                                                                                                                                                                                                                                                                                                                                                                      Investment Data (via Excel)                                                                                                                                        Regrouped DRG                                                                                                                                                Matching & Cleansing

                                        Data Warehouse                                                                                                                                                                                                                                 Standard Claims & Membership Data
       Outsourced                           Mainframe Domain (Subject Areas)                                                                                                                                                                                                                   Regrouped DRG
     Modelling Agency                                                                                                                                                                                                                                                                                                                                                                                                    FTE (via Excel),
                                                                                                                                                                                                                                            (HCP) HOSPITAL CASE MIX                                                                                                                                           GL
                                                                                                                                                                                                                                                                                                                                                                                                                         Revenue, Claims &
                                                    CORPORATE PROFITABILITY                             REINSURANCE                                   WEEKLY SALES                                        CLAIMS                                                                              Reinsurance Provision Details                                                                               Journal
                                                                                                                                                                                                                                                   PROTOCOLS                                                                                                                                                             Expenses, Account
                                                                                                                                                                                                                                                                                                                                                                                                                         Balances (Monthly)                                                                                                                                                                                                                                                                                Misc Data Entry
                                                                                                                                                                                                                                                                                                                                                                                        1                                                                                                                                                                                                                                                                                                                                                     Business Solutions - DW
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Balanced Score Card Data (via Exchange of Flat File)
                                                                                                                                                                                                                                                                                              Synchronised Data                                     Oracle Financial Suite                                                                                                                                                                                                                                                                                                                                                                          (Group IT)

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Claims & Revenue Data
                                                                                                                                                                                                                                                                                                                                                         ORACLE BALANCED                                  ORACLE                                                                                                                                                                                                                                                                                       ITEMS DATABASE
                                               Diamond Domain (Subject Areas)                                                                                                                                                                                                                                                                              SCORE CARD                                   FINANCIALS
                                                                                                                                                                                                                                                                                                                                                              (OBSC)                 Financial                                                                                                                                                                                                                                                                                                              New Items
                                                           MGM                                          REINSURANCE                                                                                                                                                                        Synchronised                                                                                               - General Ledger                                                                                                                                                                                                                                                                                                                       Item/Category Data
                                                                                                                                                  MEMBERSHIP ACTIVITY                                     CLAIMS                                                                                                                                                                        Data                                                                                                                                                                                                                                                                                                           (Provided by IT-DW)
    National Custodian                           (MEMBERSHIP GROSS MARGIN)                                                                                                                                                                                                                 Data                                                                                                           - AP / AR
                                                                                                                                                                                                                                                                                                                                                                                     (via ETL)                                                                                                                                                                                                                                                                                                          To Be Matched to
     Services (NCS)                                 Replacing Corporate Profitability                                                                                                                                                                                                                                                                                                               - Asset Management                                                                                                                                                                                                                                                                                     Category of
                                                                                                                                                                                                                                                                                                                                                                                                        - Purchasing                                                                                                                                                                                                                                                                                       Procedures.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Updated Monthly




                                    Contract Administration and Support Applications




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Effective
                                                                                                                                                                                                                                                                                                                                                  Health Programs
                                                                                                                                                                                                                                                                                                                                                  Data (Monthly)
                                                                                                                                                                                                                                                                                                                                                                                                  Revenue Data

                                                                                                                                                                                                                                                                                                                                                                                                       Clinical & Business Analysis Data (Monthly)
                                                             FINTECHNIX                                                                                                                                                                                                                                                        HEALTH INSURANCE                                                                                                                                                                                                                                                                                                                          WHICS
                                                                                                                                                                                                                                                                                                       DIAMOND                                                                                                                        Hospital Provider Claims Data (Monthly)
                                                       Clearview & MBF Life                                                                                                                                                                                                                                                          SYSTEM                                                                                                                                                                                                                                                                                                                     MBF Health Policies
                                                       Client & Product Data                                                                                                                                                                                                                   Membership, Product,             (HIS MAINFRAME)                                                                                                                              Ancillary Provider Claims Data (Monthly)                                                                                                                                                 Data
                                                                                                                                                                                                                                                                                                 Account Payable,
                                                                                                                                                                                                                                                                                                                                Membership, Claims,                                                                                                                                                           Prosthesis Provider Claims Data (Monthly)
                                                                                                                                                                                                                                                                                                 Claims, Provider,
                                                                                                                                                                                                                                                                                                 Premium Billing,                 Travel, Revenue,
                                                                                                                                                                                                                                                                                                                                Sales – Other, Health                                                                                                                                                                               Claims & Medical Provider / Hospital Pricing Data (Monthly)
                                                                                                                                                                                                                                                                                               Bemis/DDS, Customer                                                                                                                                                                                                                                                                                     EOM Aggregate Customer Feedback
                                                                                                                                                                                                                                                                                                      Service                         Rewards
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Hospital Data




                                                                                     Notes                               Data Flow Mode                                                   Business Unit Ownership
                                                                                                                                 Uncategorised                 Internal File                                                                                                                                                    Legend
                                                                                        1 Not being used                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Enterprise Business Reporting & Analytics (DW Strategy)
                                                                                                                                 Point To Point                    Email                           GROUP IT &                   FINANCIAL                        BUSINESS                GROUP FINANCE &                        GROUP                GROUP STRATEGY                     BUSINESS &                    MBF HEALTH                     PRIVATE HEALTH                        RISK                    UNCATEGORISED                                                                                              Current Applications Model Business Unit Classification
                                                                                                                                                                                                   PROGRAM                      SERVICES                       INTELLIGENCE                CORPORATE                          MARKETING                 AND NEW                          CLINICAL                                                    INSURANCE (PHI)                   MANAGEMENT &                                                                                                                                                   Version 1
                                                                                                                                                                                                                                                                                                                                                                                                                      Belongs to PHI                                                                                     Description                        PHYSICAL DATABASE
                                                                                                                                   Middleware                       Fax                           MANAGEMENT                     - Clearview                      Belongs to                SERVICES                          Description               BUSINESS                         ANALYSIS                                                            Description                 TREASURY                                                                                                                                           Effective Date: 13 July, 2005
                                                                                           Sales Reporting                                                                                                                                                                                                                                            DEVELOPMENT                                                                                                                                                                                                 Description                                  File: Copy (1) of MBF Business Intelligence Current Applications Model - BU (1.2).vsd
                                                                                                                                  File Transfer                                                      - ITS                        - MBF Life                   Group Finance &                Description                                                                               Belongs to PHI                                                                                 Eg. Investment &
                                                                                              is around                                                             Web                                                                                                                                                                                                                                                                                                                                                                                                                                             Contact: Paul Ormonde-James, MBF - Business Intelligence - (02) 9323 9783
                                                                                                                                                                                            - Business Solutions/                                             Corporate Services                                                                          Description                                                                                                                      Actuarial                                                                                                  Author: Marie-France Gara & Tamer Galil, Chartres Business Solutions (Email chartres@chartres.com.au)
                                                                                             All Products                             Voice                     Hard Copy                     Data Warehouse
                                                                                            (see Business                                                                                          - HIT, ...                                                                                                                                                                                                                                                                                                                                                                                                     This model has been prepared with due care from the information made available,


  The Chartres Path®
                                                                                          Behavioral Model)                          Screen                  External Memory
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   and is a true representation of the subject area as it was presented to the Author.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Commercial in Confidence




Duplication, Confusion, Inefficient                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Federated Service Model
Questions Regarding Data Ownership


         • Unless there is a set of clearly defined data
           ownership and stewardship policies, there are
           bound to be some questions regarding
           responsibility, accountability and authority
           associated with auditing and reviewing the quality of
           data sets.

         • This needs to be a collaboration between business
           and technical IT

         • Needs to have the business understand the uses of
           the data
Application-Based Data Management


       • The systems and applications that comprise an
         enterprise environment may be structured in way
         that the business manager for each system has
         authority over the information used within that
         system.

       • Consequently, each application in isolation has its
         own requirements for data quality.

       • In the development of an enterprise architecture, it
         is possible that application data may be used in
         ways never intended by the original implementers.

       •    This, in turn, may introduce new data quality
           requirements that may be more stringent than the
           original, yet there may be hesitation by the
           application teams to invest resources in addressing
           issues not relevant within their specific applications.
Administrative Authority


        • In some instances, the information used in an
          application originates from a source that is outside
          of the application manager's administrative
          authority. For example, in an application that is used
          to aggregate information from many information
          partners, many of the data quality issues are
          associated with problems at the partner level, not
          within the aggregated system.

        • Because the problems occur outside of the
          centralized administrative authority, even if the data
          is modified/corrected at the centralized repository, it
          does not guarantee that the next submission would
          not still include instances of the same problems.
Data Quality in an Advisory Role


        • In application-oriented organizations, another
          impediment to data quality coordination relates to
          how one deals with improving the quality of specific
          data used within an application when that data is
          sourced from an external data supplier, and is
          consequently managed outside of the application
          manager's jurisdiction.

        • Although in some organizations the project
          structures may already have an associated data
          qualtiy function, the more important issue is whether
          in practice all participants will cooperate with the
          data quality improvement process.
Data Quality as a Business Problem


        • In many organizations, business clients assume that
          any non compliance with expectations results from
          data quality issues and needs to be addressed by
          the technical teams.

        • However, in reality, the business rules with which
          the data appears to be noncompliant are associated
          with the running of the business.

        • Consequently, those rules should be owned and
          managed by the business client as opposed to the
          technical team members, whose subject-matter
          expertise is less likely to be appropriate to address
          the problems.
Impact Analysis


        • Anecdotal evidence may frequently inspire attitudes
          about requirements for data quality.

        • However, in the absence of a true understanding of
          the kinds of problems that take place, the scope of
          the problem and the impacts associated with the
          problems, it is difficult to determine the proper
          approach to fixing the problem as well as eventually
          measuring improvement.

        • There must be cooperation between business and
          IT to determine the scope of the problem
Reactive versus Proactive Data Quality:


        • Most data quality programs are designed to react to
          data quality events instead of determining how to
          prevent problems from occurring in the first place.

        • A mature data quality program determines where
          the risks are, the objective metrics for determining
          levels and impact of data quality compliance, and
          approaches to ensure high levels of quality.

        • Once again the business and IT must work together
          to deliver this approach
Personal Objections
 •   While it is unlikely that any individual would specifically disagree
     with any of the data quality concepts that constitute an effective
     improvement program, that does not necessarily guarantee any
     specific individual's participation. Providing a clear business case
     that demonstrates how specific data quality issues impede the
     stated business objectives, as well as a discussion of the steps
     that need to be taken to address the problem, will make the
     decision to introduce the improvement very clear.

 •   Must be some guiding principles for development and approval of
     data quality guidelines,

 •   as well as approaches to integration of the best practices into the
     enterprise. Our approach has been to adapt data quality best
     practices within a documented guideline structure that conforms to
     internal policies and standards and can be approved through
     internal procedures. When a particular activity has been approved
     through the standard internal channels, it transitions from
     "guidance" into organizational policy, with all the compliance
     requirements that implies.
What is metadata…..

    • As the term implies, metadata is data about data.

    • Metadata is, of course, data as well, and has its own
      metadata (meta-metadata), implying that metadata
      exists at many levels of granularity.

    • Metadata is generally defined in terms of usage as
      technical or business metadata.
       – Technical metadata describes the technical aspects
         of the data such as field type, length, allowable
         values, and so on.
       – Business metadata describes the business context of
         the data, such as: “This forecast data was submitted
         in march 2005 and includes revenue....”
Metadata – View by pattern:

        • Syntactic metadata:
           – Data describing the syntax of the data; for
              example, language syntax, format

        • Structural metadata:
           – Data describing the structure of the data; for
              example, document structures, DTDs, XML
              schemas, relational schemas

        • Semantic metadata:
           – Data describing the meaning of the data in a
             specific domain, such as definitions of
             “product,” “accounting period,” “total revenues”
Metadata – Another key concept is ontologies
 •   Data that formally specifies how to represent objects, concepts, and
     other entities in a domain of interest, as well as the relationships
     that bind them; for example, a taxonomy of typical data domains
     such as “product” and “market” and their relationships.

 •   Whereas taxonomy is simply the hierarchical structure or
     classification of the data (e.g., “product” attributes and their
     structure), ontology is an overarching term that includes not just the
     taxonomy, but also the relationships and mapping between the
     attributes.
 •
 •   Therefore, ontologies will include not just entity structures and
     relationships, but acceptable values of the entity attributes, their
     synonyms, word variants, abbreviations, etc.

 •   Industry standard ontologies exist for common data domains (such
     as “product,” “country,” etc.) and provide a pre-built base of
     metadata for an enterprise.

 •   These ontologies can be adapted for specific enterprise needs, and
     mappings created for data structures across enterprise entities or
     divisions
Why Should Enterprises Care about Metadata Integration


         • Data in a typical organization is scattered across
           multiple databases, files, and networks. To link data
           from disparate sources, enterprises have developed
           many levels of integration: business process
           integration, UI integration, application integration,
           etc.

         • However, what is most critical to effective decision
           making and innovation is that the integrated data be
           accurate, complete, consistent, and timely, and be
           insulated from changes in underlying data
           structures.

         • Metadata is what decouples integrated data from
           changes in granular data sources. Further, this
           metadata is most effective when shared across the
           enterprise, requiring enterprise metadata
           integration.
A Prerequisite for Defining an Enterprise Metadata
Strategy
   •   Before you can think of implementing metadata, you need to
       build an awareness of data integration needs.

   •   Typically, an organization uses data either for operational needs
       or for business intelligence. For operational systems, source
       data may be relatively homogeneous (syntactically, semantically,
       and structurally) and data integration may not require extensive
       metadata validation.

   •   However, in complex data flows between operational systems,
       or systems providing business intelligence, metadata assumes
       much greater significance. Data typically flows through distinct
       steps in the organization’s information supply chain:
        –   ·   Acquisition: acquiring data from multiple sources
        –   ·   Consolidation: normalizing data within a given source
        –   ·   Aggregation: integrating data across multiple sources
        –   ·   Dissemination: delivering data to end users

   •   If these steps are not supported by an underlying metadata
       infrastructure, disseminated data will be degraded, inconsistent,
       inaccurate, and lack integrity. Therefore, it is imperative to
       identify sources of record for given data domains and optimize
       data platforms to serve one or more of the above functions.
A Prerequisite for Defining an Enterprise Metadata Strategy

•   Key Requirements for successful metadata – Checklist.

Effectiveness         Provide users more useful information than they currently get

                      Allow metadata to be extended easily to reflect the addition of
Extensibility
                      business such as a new product or market

Reusability           Provide reusable metadata across different business functions in an
                      organization
                      Connect to disparate systems to glean metadata. The solution
Interoperability      should also provide APIs or services to access metadata by different
                      systems
Efficiency and
                      Process a user’s metadata request in a timely and efficient manner
Performance

                      Allow metadata built around one business unit or function at a time
Evolution
                      to be promoted to the enterprise

Entitlement           Allow delegated administration, data entry, and access
A Prerequisite for Defining an Enterprise Metadata Strategy

                    Allow for changes to the underlying data structures without affecting
Flexibility
                    existing business processes

                    Distribute and segregate metadata into several sub-systems,
Segregation
                    maintained at a business-unit level


User interface      Provide a friendly user interface


Versioning          Control metadata versions


                    Deal with different types of metadata such as syntactic, structural,
Versatility
                    semantic, and ontological

Low
maintenance         Provide ease of administration and a self-maintenance model
cost

                    Store metadata for semi-structured or unstructured data; transform
Others              metadata into different formats: human readable, machine readable,
                    etc.; and analyze patterns and detect inconsistencies in stored
                    metadata
Usability - What and Why

   •   Usability is the "make it or break it" of any BI initiative. Just
       because a BI tool is in place does not mean people will use it. If
       people do not use it, it does not matter how well the solution is
       designed or developed.


   •   The solution should have an intuitive user interface, enabling
       users to get the information they need with just a click - without
       calls to tech support. The BI tool should make operations
       easier, not more complicated. Ease-of-use drives early user
       acceptance and early adoption. An intuitive interface minimizes
       training and reduces costs in the long run. Most importantly, the
       simple interface maximizes use, so decision-makers will be
       more likely to use the system on day one.

   •   A usable BI solution will provide the ROI it should. The initiative
       must result in delivering something that can be used
       immediately to resolve today's problems and assist in
       accomplishing the business goals that have been set.
Data quality practical guide
Questions




        pormonde@cybertreking.com
Data quality practical guide

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Data quality practical guide

  • 1. Data Quality From Theory to Practice MARCUS EVANS CONFERENCES Paul Ormonde-James Group Intelligence MBF Australia
  • 2. Agenda • Why is data quality important?
  • 3. The problem to be solved….. Target You are here
  • 4. The problem to be solved….. Target You are here
  • 5. Paul Ormonde-James – Presenter, Speaker, Author • Paul, has spent many years in the field of Change Management. He has qualifications in Cybernetics (Robotics & Artificial Intelligence), Computer Sciences, a Master of Business Administration (MBA) and post grad in Company Law. He has driven many change programs and used Business Intelligence, Competitive Intelligence and Knowledge Management to drive such cultural change to increase company value.
  • 6. Business Intelligence, simply….. Corporate Survival & Growth “Growing through Knowing” More effective decision making At the To the
  • 9. Why do we need data quality? • There is a growing cross-industry recognition of the value of high-quality data. • 2001 PricewaterhouseCoopers Global Data Management Survey, 75 percent of the senior executives reported significant problems as a result of defective data. • In 2002, The Data Warehousing Institute published its Report on Data Quality in which they estimated that the cost of poor data quality to U.S. businesses exceeds $600 billion each year. • Two critical pieces of legislation passed within the past few years impose strict information quality requirements on both public corporations in the U.S. (the Sarbanes-Oxley Act of 2002) • As well as U.S. federal agencies (The Data Quality Act of 2001). • Both of these laws require organizations to provide auditable details as to the levels of their information quality.
  • 10. Do Managers really understand data quality????? • How many times does a manager or executive ask where the data comes from? • How many executives understand the numerous data sources in and across an organisation • How many Executives understand the errors generated as incorrect data is summarised. • Are executives more focussed on quality data the more important the decision?
  • 11. The Journey….. Self Service Model Place Logo Here Enterprise Business Reporting & Analytics (DW Strategy) Current Applications Model Customers Customer Reports, Investment Performance Reports (Quarterly, Monthly) Business Unit Classification Clearview Exit Reports (Weekly / Ad hoc) (via MS PowerPoint) Clearview Leads Reports (Weekly / Ad hoc) (via MS PowerPoint) Funds Sales Reports (Weekly / Ad hoc) (via MS PowerPoint) Misc. Clearview & MBF Life Reports Financial Services Group Marketing Risk Management & MBF Health Corporate Culture & Group Strategy & New PHI Group Finance & Board Treasury (PHI) Communication Business Development Corporate Services KPI / Balanced Score Card (via spreadsheet or flat file on J Drive) Membership & Sales Reports Claims, Provider, MBF Health KPI (via MS Excel) General, KPI & Clearview Product Reports (Ad hoc) Investment & Budget & Rate Rise Reports Health Program Reports MBF & MBFH Actuarial Reports Performance Reports Actuarial Reports P&L & OPEX Sales & Ad-hoc Reports Executive Pack Reports Membership Reports Claims Reports Ad-hoc Reports - National Claims Reports (via Excel & Word) (Daily & Monthly) In2Life Campaign Reports (Monthly) Membership Customer Matrix (Monthly) - Member Services Reports (via Excel & Word) (Daily, Weekly & Monthly) Reports - Customer Enquiry, Complaints & Compliments Reports (via Excel & Powerpoint) Sales Reports (Monthly) - Membership, Members’ Exits & Exit Interviews Reports Ad-hoc Reports - Teams’ Performance Reports (via Powerpoint) Dashboard Suite of Reports (Monthly) Membership & Sales Reports Membership Reports Customer Retention & Sales Reports External Organisations and Customer Contact Channels Ad-hoc Reports FTE Reports Reporting on Investment, Regulatory, Budgeting, Pricing, Variances, EOM Provisioning, Claims Analysis Components Staff Assisted MBF & MBFH Misc. Membership & Competitors ad-hoc Analysis & Reports Exceptional Request / Reports Financial Services Business Intelligence Group IT & Program Business & Clinical Analysis Risk Management & Group Marketing Group Finance & MBF Health PHI (Group Finance) Management (PHI) Treasury Corporate Services (PHI) Membership Report Analysis Reports KPI (via MS Excel) EOM & Ad-hoc (eg. Customer, Reports (via Excel) Investment & Actuarial / Membership, Benefits & Sales Reports & Analytics Customer Profiling & Demographic Data Membership & Sales Reports (Weekly,Monthly) Competitor) Sales Reports Dashboard Data from all MBF Business Units Satisfaction Surveys (via Excel) Call Center Management Reports (Weekly) Front End Processing Components Complete Claims History Data (Monthly) (via Flat File) Back End Processing Back Office Departments Summurisation of Revenue & Membership Data (Monthly) Components Customer Enquiry, Complaints & Compliments Reports (via Excel & Powerpoint) / Membership, Members’ Exits & Exit Interviews Reports MISC Internal Reporting (Membership, Claims, Sales Activity) (Weekly) BASE SAS MONTH END CONSOLIDATED CDATA DATABASE SPREADSHEETS Membership & Sales Reports (Weekly, Monthly) FINANCIAL Standard Detailed Claims Data Data Formatting & Revenue, Membership P&L, Cost Centre OPEX (Monthly) (via OPEX Excel Spreadsheet) REPORTING Census Data & Claims Data (MS Access Database) Various spreadsheets Consolidation used by Investments & (MS Word) Actuarial for PMP Compliance, Risk & Contract Reports (via Excel for Formatting) Analysis & Reporting Services Utilization Reports Eg GL Variances Misc Reports Calculations Services Utilization Reports Retail, Corporate & Travel Business Intelligence Misc. Data (via Dynamic Link) Claims Leakage & Exception Reports (via Excel) Misc. Clearview & Misc. Reports Month End Claims Data PHI Health Program Reports Self-Service Reports Sales eBusiness Reports (Group Finance) MBF Life Reports Clinical & Business from Web Channel (excl. Financial Services & IT) Claims Reports Executives Commentary Balanced Score Card Analysis Reports (Weekly, Monthly, Ad-Hoc) Census Data Data (Via J drive) 2 4 5 4 5 MISC. PRODUCT BUSINESS OBJECTS CRYSTAL REPORTS/ MISC AD-HOC HEALTH SAS PRODUCTS MISC WEBSITE MISC REPORTING CUSTOMER CUSTOMER FACING CRYSTAL REPORTS META CUBES XRAY SPSS FUTRIX TM1 CENTREVU ANALYSIS 5.9 CRYST. ENTERPRISE DATABASES MANAGEMENT SUITE ANALYSIS TOOLS DATABASES EXPERIENCE DB SYSTEM (CFS) REPORTING Reports Formatting Analysis Cubes. IBM. PROGRAMS Based On SAS AF. - Customer Profiling Aka Online Cubes for - Contract Modelling & Avaya IVR Reporting Data in Crystal Around 50 MS Access - Base SAS (H&B Stats) MS Excel/Access (MS Access Database) Customer Experience GTX-PROD Database Research. Data Benchmarking - Data Mining - Enterprise Miner Self-Service Usage. Reporting. Call Tracking System - Customer Analysis Decommissioned Analysis Cubes Enterprise. Databases Preventive, Asthma & Providers Against - Statistical Analysis - Self-service & Satisfaction Surveys. (Graham Technology) (Data Mining & Modelling) - Competitor Analysis in favour of & Data Extraction. Use of DW Diabetes Programs. Industry Profiles & Analysis & Reporting - Based On Excel. Used by Customer (MS Access Database) - Enterprise Guide - Investment Business Objects XI is Recommended Updated Monthly Trends - SAS Stat Service & Retention Call Center Data Performance Tracking excluding for (MS Access Database) - SAS Graph Written In SAS Used By Customer Operational Reporting Service & Retention Clinical & Business Activity & Clinical & Business Analysis Data Analysis Data Analysis Data Manipulated Clinical & Call Centre Data Customer Retention (Cancellations) & Sales Data (via MS Access) Manipulated Clinical & Business Analysis Data Business Analysis Data Customer, Brand & Product Data Service Call Survey Data Claims Data PHI Research Agencies 1 Sales Reporting By Channel Client & Product Data Tasmania Sales & EOM Provisioning (via MS Excel & Access) Prosthesis Pricing Data (Monthly) Client & Product Data Membership Data Levies, Revenue & Reinsurance Data (Monthly) Medical Pricing Data (Monthly) Misc. Reports MS Access Databases Funds Data (from Diamond) Sales & HCP Data CUSTOMER MBF LEAD OPERATIONS OBSC PORTAL MISC SALES & MISC. AD HOC TM1 MISC HOSPITAL MISC ANCILLARY MISC PROSTHESIS MISC MEDICAL MISC. MBF HEALTH IMPROMPTU MISC PRICING DATA Membership WATCHLIST REFERRAL SYSTEM TRANSFER Data MEMBERSHIP DB REPORTING DATABASES DATABASES DATABASES DATABASES REPORTING TRACKING SYSTEM Oracle (from DW) Extract, Match, Format 3 Cubes: Data Summarization - MBF Prothesis Price Retention Campaign Tracks Leads Balance Score Card - MS Access - Investment - Claims 2003 - 3 Claims - Dental - New Prices04 - Duplicate Services (MS Excel) & Reporting. List 2004 Data. Transferred From (MS Access Database) Membership Data (Monthly) Ad-hoc Data Extract - Claims 2004 - 6 Monthly Reports - Schedule 5 V2000 Tracks External Funds Web Front-End. - MS Excel - FTE Part Of Cognos Suite. - CMBS 2000 Tracks Reasons Why Member Centers To Managers’ Rollovers. - 7 State Sales DB Membership Reporting - Oracle GL - Claims Fy04 (Ancillary, Dental - File Upload, Master - Fy04 Gap Survey Data Extraction & - AMA Customer Redeem Clearview. Assirt V6 - 7 Weekly Member DB - Claims Fy04 V97 Optical, Pharmacy, - Human Tissue Items - Contract Modelling Formatting - Diagnostic Schedule Clearview Funds. (MS Access Database) (MS Access Database) - 7 Month Member DB Based On Excel. - Hospital Physio, Membercare) - Deleted / Replaced - CHC931 Medical (MS Access Database) Commonwealth (MS Access Database) To Be Phased Out. - Misc DB: Sales Rep... - Quarterly Report Items - Price Summary Claims Streamlined Department of Health Client & Product Data Membership & Claims Data Extract (from Diamond) Customer, Claims, Membership Movements, Gains and Exits Data & Ageing Client & Product Data Membership & HCP (Monthly), Ad-hoc Provider Contract / Modelling Data (from DW via Text file) Sales Data HCP (Monthly), Ad-hoc All Providers Claims, Financial, Membership Data (via Flat file from DW / Mainframe Domain) Ad-hoc Financial Data Extract (from DW / Mainframe Domain) Financials & Balanced Score Card Data Customer, Claims, Hospital Price Modelling & Ad-hoc Data Membership & Sales Data Medical & Prosthesis Pricing (Monthly) Industry & Regulatory Data (Quarterly) Integrated Data Domains Sales & Membership Report Query Data Data (via Flat File) Hospital To Be Modelled MAXIMISER Hospital Details 4 5 - Hospital Details from Hospital & FINTECHNIX SALES WEB-BASED DIAMOND RPT Benefit Management - Contract Modelling Private Health Insurance Synchronised Data REPORT SERVER OPPORTUNITY CORPORATE SAS DATABASE EAP37 Maintained By Account MANAGEMENT DOCUMENTS Replicated Diamond Hospital Details Administration Council (Weekly) Replicated Fintechnix Misc Data Environment for Summarisation & Managers. Environment For (SOM) SERVER (PHIAC) Predefined Corporate Reporting & Testing Census Data Reformatting. Reporting (Lifeprod). CRM Siebel Database Key Reports. - Prosthesis To Be Fed by Diamond Life, Superannuation, - Hospital Ancillary & Commissions Extract (Monthly) Managed Funds Data 3 Claims are Updated. - Medical - Ancillary Synchronised Data - Customer/Membership 3M GROUPER Sales & Membership Data By State excl. Tasmania (via Text File) HCP, Providers Misc. Data Misc. Data HCP & Claims Data Propensity Modelling Efficient Investment Data (via Excel) Regrouped DRG Matching & Cleansing Data Warehouse Standard Claims & Membership Data Outsourced Mainframe Domain (Subject Areas) Regrouped DRG Modelling Agency FTE (via Excel), (HCP) HOSPITAL CASE MIX GL Revenue, Claims & CORPORATE PROFITABILITY REINSURANCE WEEKLY SALES CLAIMS Reinsurance Provision Details Journal PROTOCOLS Expenses, Account Balances (Monthly) Misc Data Entry 1 Business Solutions - DW Balanced Score Card Data (via Exchange of Flat File) Synchronised Data Oracle Financial Suite (Group IT) Claims & Revenue Data ORACLE BALANCED ORACLE ITEMS DATABASE Diamond Domain (Subject Areas) SCORE CARD FINANCIALS (OBSC) Financial New Items MGM REINSURANCE Synchronised - General Ledger Item/Category Data MEMBERSHIP ACTIVITY CLAIMS Data (Provided by IT-DW) National Custodian (MEMBERSHIP GROSS MARGIN) Data - AP / AR (via ETL) To Be Matched to Services (NCS) Replacing Corporate Profitability - Asset Management Category of - Purchasing Procedures. Updated Monthly Contract Administration and Support Applications Effective Health Programs Data (Monthly) Revenue Data Clinical & Business Analysis Data (Monthly) FINTECHNIX HEALTH INSURANCE WHICS DIAMOND Hospital Provider Claims Data (Monthly) Clearview & MBF Life SYSTEM MBF Health Policies Client & Product Data Membership, Product, (HIS MAINFRAME) Ancillary Provider Claims Data (Monthly) Data Account Payable, Membership, Claims, Prosthesis Provider Claims Data (Monthly) Claims, Provider, Premium Billing, Travel, Revenue, Sales – Other, Health Claims & Medical Provider / Hospital Pricing Data (Monthly) Bemis/DDS, Customer EOM Aggregate Customer Feedback Service Rewards Hospital Data Notes Data Flow Mode Business Unit Ownership Uncategorised Internal File Legend 1 Not being used Enterprise Business Reporting & Analytics (DW Strategy) Point To Point Email GROUP IT & FINANCIAL BUSINESS GROUP FINANCE & GROUP GROUP STRATEGY BUSINESS & MBF HEALTH PRIVATE HEALTH RISK UNCATEGORISED Current Applications Model Business Unit Classification PROGRAM SERVICES INTELLIGENCE CORPORATE MARKETING AND NEW CLINICAL INSURANCE (PHI) MANAGEMENT & Version 1 Belongs to PHI Description PHYSICAL DATABASE Middleware Fax MANAGEMENT - Clearview Belongs to SERVICES Description BUSINESS ANALYSIS Description TREASURY Effective Date: 13 July, 2005 Sales Reporting DEVELOPMENT Description File: Copy (1) of MBF Business Intelligence Current Applications Model - BU (1.2).vsd File Transfer - ITS - MBF Life Group Finance & Description Belongs to PHI Eg. Investment & is around Web Contact: Paul Ormonde-James, MBF - Business Intelligence - (02) 9323 9783 - Business Solutions/ Corporate Services Description Actuarial Author: Marie-France Gara & Tamer Galil, Chartres Business Solutions (Email [email protected]) All Products Voice Hard Copy Data Warehouse (see Business - HIT, ... This model has been prepared with due care from the information made available, The Chartres Path® Behavioral Model) Screen External Memory and is a true representation of the subject area as it was presented to the Author. Commercial in Confidence Duplication, Confusion, Inefficient Federated Service Model
  • 12. Questions Regarding Data Ownership • Unless there is a set of clearly defined data ownership and stewardship policies, there are bound to be some questions regarding responsibility, accountability and authority associated with auditing and reviewing the quality of data sets. • This needs to be a collaboration between business and technical IT • Needs to have the business understand the uses of the data
  • 13. Application-Based Data Management • The systems and applications that comprise an enterprise environment may be structured in way that the business manager for each system has authority over the information used within that system. • Consequently, each application in isolation has its own requirements for data quality. • In the development of an enterprise architecture, it is possible that application data may be used in ways never intended by the original implementers. • This, in turn, may introduce new data quality requirements that may be more stringent than the original, yet there may be hesitation by the application teams to invest resources in addressing issues not relevant within their specific applications.
  • 14. Administrative Authority • In some instances, the information used in an application originates from a source that is outside of the application manager's administrative authority. For example, in an application that is used to aggregate information from many information partners, many of the data quality issues are associated with problems at the partner level, not within the aggregated system. • Because the problems occur outside of the centralized administrative authority, even if the data is modified/corrected at the centralized repository, it does not guarantee that the next submission would not still include instances of the same problems.
  • 15. Data Quality in an Advisory Role • In application-oriented organizations, another impediment to data quality coordination relates to how one deals with improving the quality of specific data used within an application when that data is sourced from an external data supplier, and is consequently managed outside of the application manager's jurisdiction. • Although in some organizations the project structures may already have an associated data qualtiy function, the more important issue is whether in practice all participants will cooperate with the data quality improvement process.
  • 16. Data Quality as a Business Problem • In many organizations, business clients assume that any non compliance with expectations results from data quality issues and needs to be addressed by the technical teams. • However, in reality, the business rules with which the data appears to be noncompliant are associated with the running of the business. • Consequently, those rules should be owned and managed by the business client as opposed to the technical team members, whose subject-matter expertise is less likely to be appropriate to address the problems.
  • 17. Impact Analysis • Anecdotal evidence may frequently inspire attitudes about requirements for data quality. • However, in the absence of a true understanding of the kinds of problems that take place, the scope of the problem and the impacts associated with the problems, it is difficult to determine the proper approach to fixing the problem as well as eventually measuring improvement. • There must be cooperation between business and IT to determine the scope of the problem
  • 18. Reactive versus Proactive Data Quality: • Most data quality programs are designed to react to data quality events instead of determining how to prevent problems from occurring in the first place. • A mature data quality program determines where the risks are, the objective metrics for determining levels and impact of data quality compliance, and approaches to ensure high levels of quality. • Once again the business and IT must work together to deliver this approach
  • 19. Personal Objections • While it is unlikely that any individual would specifically disagree with any of the data quality concepts that constitute an effective improvement program, that does not necessarily guarantee any specific individual's participation. Providing a clear business case that demonstrates how specific data quality issues impede the stated business objectives, as well as a discussion of the steps that need to be taken to address the problem, will make the decision to introduce the improvement very clear. • Must be some guiding principles for development and approval of data quality guidelines, • as well as approaches to integration of the best practices into the enterprise. Our approach has been to adapt data quality best practices within a documented guideline structure that conforms to internal policies and standards and can be approved through internal procedures. When a particular activity has been approved through the standard internal channels, it transitions from "guidance" into organizational policy, with all the compliance requirements that implies.
  • 20. What is metadata….. • As the term implies, metadata is data about data. • Metadata is, of course, data as well, and has its own metadata (meta-metadata), implying that metadata exists at many levels of granularity. • Metadata is generally defined in terms of usage as technical or business metadata. – Technical metadata describes the technical aspects of the data such as field type, length, allowable values, and so on. – Business metadata describes the business context of the data, such as: “This forecast data was submitted in march 2005 and includes revenue....”
  • 21. Metadata – View by pattern: • Syntactic metadata: – Data describing the syntax of the data; for example, language syntax, format • Structural metadata: – Data describing the structure of the data; for example, document structures, DTDs, XML schemas, relational schemas • Semantic metadata: – Data describing the meaning of the data in a specific domain, such as definitions of “product,” “accounting period,” “total revenues”
  • 22. Metadata – Another key concept is ontologies • Data that formally specifies how to represent objects, concepts, and other entities in a domain of interest, as well as the relationships that bind them; for example, a taxonomy of typical data domains such as “product” and “market” and their relationships. • Whereas taxonomy is simply the hierarchical structure or classification of the data (e.g., “product” attributes and their structure), ontology is an overarching term that includes not just the taxonomy, but also the relationships and mapping between the attributes. • • Therefore, ontologies will include not just entity structures and relationships, but acceptable values of the entity attributes, their synonyms, word variants, abbreviations, etc. • Industry standard ontologies exist for common data domains (such as “product,” “country,” etc.) and provide a pre-built base of metadata for an enterprise. • These ontologies can be adapted for specific enterprise needs, and mappings created for data structures across enterprise entities or divisions
  • 23. Why Should Enterprises Care about Metadata Integration • Data in a typical organization is scattered across multiple databases, files, and networks. To link data from disparate sources, enterprises have developed many levels of integration: business process integration, UI integration, application integration, etc. • However, what is most critical to effective decision making and innovation is that the integrated data be accurate, complete, consistent, and timely, and be insulated from changes in underlying data structures. • Metadata is what decouples integrated data from changes in granular data sources. Further, this metadata is most effective when shared across the enterprise, requiring enterprise metadata integration.
  • 24. A Prerequisite for Defining an Enterprise Metadata Strategy • Before you can think of implementing metadata, you need to build an awareness of data integration needs. • Typically, an organization uses data either for operational needs or for business intelligence. For operational systems, source data may be relatively homogeneous (syntactically, semantically, and structurally) and data integration may not require extensive metadata validation. • However, in complex data flows between operational systems, or systems providing business intelligence, metadata assumes much greater significance. Data typically flows through distinct steps in the organization’s information supply chain: – · Acquisition: acquiring data from multiple sources – · Consolidation: normalizing data within a given source – · Aggregation: integrating data across multiple sources – · Dissemination: delivering data to end users • If these steps are not supported by an underlying metadata infrastructure, disseminated data will be degraded, inconsistent, inaccurate, and lack integrity. Therefore, it is imperative to identify sources of record for given data domains and optimize data platforms to serve one or more of the above functions.
  • 25. A Prerequisite for Defining an Enterprise Metadata Strategy • Key Requirements for successful metadata – Checklist. Effectiveness Provide users more useful information than they currently get Allow metadata to be extended easily to reflect the addition of Extensibility business such as a new product or market Reusability Provide reusable metadata across different business functions in an organization Connect to disparate systems to glean metadata. The solution Interoperability should also provide APIs or services to access metadata by different systems Efficiency and Process a user’s metadata request in a timely and efficient manner Performance Allow metadata built around one business unit or function at a time Evolution to be promoted to the enterprise Entitlement Allow delegated administration, data entry, and access
  • 26. A Prerequisite for Defining an Enterprise Metadata Strategy Allow for changes to the underlying data structures without affecting Flexibility existing business processes Distribute and segregate metadata into several sub-systems, Segregation maintained at a business-unit level User interface Provide a friendly user interface Versioning Control metadata versions Deal with different types of metadata such as syntactic, structural, Versatility semantic, and ontological Low maintenance Provide ease of administration and a self-maintenance model cost Store metadata for semi-structured or unstructured data; transform Others metadata into different formats: human readable, machine readable, etc.; and analyze patterns and detect inconsistencies in stored metadata
  • 27. Usability - What and Why • Usability is the "make it or break it" of any BI initiative. Just because a BI tool is in place does not mean people will use it. If people do not use it, it does not matter how well the solution is designed or developed. • The solution should have an intuitive user interface, enabling users to get the information they need with just a click - without calls to tech support. The BI tool should make operations easier, not more complicated. Ease-of-use drives early user acceptance and early adoption. An intuitive interface minimizes training and reduces costs in the long run. Most importantly, the simple interface maximizes use, so decision-makers will be more likely to use the system on day one. • A usable BI solution will provide the ROI it should. The initiative must result in delivering something that can be used immediately to resolve today's problems and assist in accomplishing the business goals that have been set.