Rules Engines are Good for your Health

What is a Rules Engine? There are many products, big and small, in the marketplace that are defined as a rules engine. For the sake of this blog, a rules engine is simply an automated system that executes an organization’s policies and procedures – often called business rules – against an identified set of organization data. Rule engines exist to better automate processes and increase efficiency.

Rules engines generally operate in real time and impact/inform an organization’s operations. Rules engines also serve organizations by breaking rules down into smaller pieces that can be combined to create a bigger rule. This allows for two things: 1) rule “building blocks” can be reused to construct multiple rules, and 2) multiple systems can benefit from the same rules.

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One non-technical way of looking at this would be to imagine that a rules engine is like a traffic cop. Traffic cops have, through training, acquired the knowledge necessary to enforce the “rules of the road.” He or she monitors traffic for compliance to these rules. When a traffic cop monitors traffic they are comparing the data points (cars), and quickly assessing them and their actions. When necessary, traffic cops intervene to apply the rules, and their prescribed outcomes, to data points with the appropriate action. A rules engine does the same thing, but instead of organizing cars, a rules engine watches your data’s traffic to apply the rules set up by your organization.

What types of information would a rules engine be used for?

There are an almost infinite amount of possibilities, but some examples are:

  • A patient record created in an Electronic Health Record System (EHRS),
  • A database query returns results,
  • An invoice submitted from a client,
  • An Internet of Things enabled sensor (for example, a sensor for current air quality provides a new reading), or
  • A rule in a rules engine triggers a subsequent rule.

For a rules engines to act on an organization’s information, the business must be connected to the data sources that the rules are being applied to. Most modern rules engines have “out of the box” support for web services, data base calls, xml, and more. This simplifies connectivity between data sources. In the world of health care, this connectivity is often achieved by connecting to an enterprise service bus (ESB). This way, all health data exchanged between systems can be monitored by a rules engine and acted upon when necessary.

Health care organizations are implementing rules engines across more and more aspects of their care models, in everything from patient health records and provider claim adjudication, to validating whether a patient has opted in or out of a service.

A common use case for this is what we are seeing in Health Information Exchanges (HIEs). Rules engines ensure that patient health records contain the correct information, are sent to the proper provider, and even checks to be sure that the patient wants to have this data shared. A robust and efficient rules engine allows large volumes of data to be exchanged, examined and acted upon so that it can be transported to the right destination quickly.

When you want your data to travel safely and swiftly, secure a rules engine. Rules engines are traffic cops for data. By enforcing the rules of the road, a rules engine ensures that the right data makes it to the right place. It also saves time and money by efficiently sharing and implementing the rules across your organization.

By | 2017-04-21T10:25:17+00:00 February 17th, 2017|

About the Author:

Jeremy Dean is Chief of Business Development at Trinity Technology Group. He specializes in Health Interoperability and tackles obstacles at work like he tackles them as a Spartan. Visit him on Linkedin here.

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