Is there any business rules embedded in the data / work that is described, and think about whether that may be detrimental.

What role did business rules play in the case as described?

When the system described is in place, who will then develop the rules that may end up "being the way since I got there."?

Excerpt from: SIDEBAR: WELLPOINT STRATEGY DRIVES CULTURE CHANGE Under pressure to rein in costs without compromising quality of care, insurers are turning increasingly to analytics for a solution. Many insurers are using population health care analytics, which aggregates and analyzes insurance data to help providers better understand and serve their patient populations, to help improve patient outcomes and reducing costs. WellPoint the largest for-profit managed care organization within the Blue Cross Blue Shield umbrella is a case in point. An important component of WellPoint's strategy is to use analytics to change how it pays providers. WellPoint is shifting from a model where it pays physicians based on volume (procedures, visits, admissions) to one where doctors are paid based on "value" (ability to manage costs, improve patient outcomes and quality of care). To make that model work, WellPoint intends to share insurance data with physicians to create a 360-degree medical view of every patient, enabling providers to spot patients likely to go to the emergency room or be readmitted to a hospital, expenses that contribute to the high cost of health care delivery. Sharing insurance data with physicians became a significant organizational challenge, requiring data integration across numerous regional health plans that did not share a common language for defining key data points and assuring physicians that WellPoint was a trustworthy partner willing to share cost savings. A short term goal was to create a few Excel-based reports covering five key data points: 1. list of the physician's total patient population 2. list of patients with gaps in care 3. list of patients visiting the emergency room 4. list of patients admitted to the hospital highlighting those at high risk for readmission 5. list of high-risk patients to focus on with actionable information around their risk drivers Within WellPoint, creating these reports became a classic showdown between IT and interests from the business side. When the IT team delivered its first report several months late, Ariel Bayewitz, the manager in charge of the analytics program, was stunned it didn't actually work in Excel. True, the report could be downloaded, but it couldn't be sorted. "It might as well be a PDF," he had thought to himself. The point was to give physicians content they could do something with. If they couldn't sort it, they couldn't figure out which patients would benefit most from their help. The first three reports all had problems. For instance, different units within the company reported an emergency room visit in different ways. The IT team's explanation: no one told it the definitions had to be the same. That much was true the business side didn't think it should have to specify that emergency room visits be consistent across reports. The high-profile project was subsequently placed in Red status, and senior management got involved. Problems were escalated to executives who ensured resources were allocated. Outside consultants were hired. Experts were hired. More resources were diverted to the project. And, after many challenging discussions, IT and the business began to work together using an iterative development approach, called "Agile