The ZZZS optimizes performance of key applications

Zavod za zdravstveno zavarovanje Slovenije (ZZZS) or the Health Insurance Institute of Slovenia (HIIS) in English is a public sector company and the country’s sole provider of compulsory health insurance. Headquartered in the capital city, Ljubljana, ZZZS comprises 10 regional units and 45 branch offices distributed throughout Slovenia, and employs approximately 890 people.

The institute was established in 1992, following reforms to Slovenia’s health insurance service, which focused on modernizing the system and introducing greater efficiency and financial stability. A key element of these reforms was the reintroduction of compulsory health insurance, which ensures that all insured individuals receive essential health care services, with full coverage restricted to those patients deemed to be most in need. For all other nonessential procedures and services, the majority of insured persons must pay a certain share of the total cost of the services.

In line with the health insurance service’s drive for modernization, ZZZS has introduced several new electronic systems, aimed at establishing a more efficient virtual network among healthcare and health insurance providers. One such system is an online application which gives healthcare providers instant access to patients’ health insurance status, and allows health insurance claims to be processed electronically. Following the application’s introduction in 2009, ZZZS experienced a significant increase in resource requirements, prompting the institute to review its infrastructure.

ZZZS has a long history with IBM mainframes that dates back to the institute’s establishment in 1992. ZZZS considered the possibility of making upgrades to its existing IBM System z10 Enterprise Class (z10 EC), but ultimately chose to move to the IBM zEnterprise 196 (z196), a decision motivated by the new system’s higher performance and suitability for web-based and data analytics applications. Equally, the zEnterprise BladeCenter Extension (zBX) enhances the z196’s capabilities, housing and supporting select IBM blade servers and workload optimizers, while zEnterprise Unified Resource Manager provides hardware and platform management for the system as a whole.

Samo Fakin, CEO at ZZZS, comments: "In terms of financial value, IBM zEnterprise was the most rational decision for us: It gives us a platform for all the services we need in the future, providing more computing resources for less money."

Mirjana Kregar, CIO at ZZZS, adds: “The zEnterprise and the zEnterprise BladeCenter Extension open up new possibilities around unified system resource management, which will help us to maintain stable staffing levels even as demands increase.”

Exponential data growth

Slovenia’s compulsory health insurance scheme covers all permanent residents of the country, either as primary members or as dependents: Practically the entire population is insured. As the sole provider of compulsory health insurance in Slovenia, ZZZS manages enormous amounts of data. Not only does the institute process information from millions of insured residents, it is also responsible for data generated by healthcare service providers, pharmacies and private insurers.

ZZZS requires incredibly reliable, high-volume systems to manage these considerable amounts of data, and has trusted IBM hardware with the management of its databases for decades. However, the institute began to experience an exponential increase in resource requirements after it undertook a complex development project that saw its electronic health insurance cards replaced with an online system that enables direct access to health insurance information previously held on the cards. In addition, ZZZS, healthcare service providers and voluntary health insurance companies use the system to exchange information, making more than one million transactions through it every day.

"Our goal is paperless administration in healthcare," comments Samo Fakin. "We wanted to enable faster and yet also more secure access to health data, and we wanted the health insurance card to be the key to the online data rather than the carrier of that data."

ZZZS needed to upgrade its hardware in order to guarantee that it could effectively meet the increased demand being placed on its IT infrastructure by this new online system, while simultaneously maintaining continuity for its existing mission-critical applications

Optimized mainframe environment

ZZZS replaced its existing IBM z10 Enterprise Class with the zEnterprise 196, a decision which was ultimately motivated by the improved performance and capabilities of the new platform. The zEnterprise System is a workload-optimized, multiarchitecture system capable of hosting many workloads integrated together, and efficiently managed as a single ensemble.

Olga Dragan Frlež, Consultant to the CIO at ZZZS, remarks: “The processors in the z196 are more advanced and much faster than those in the z10 EC. We using all of the specialty processors—ICF, IFL, zIIP and zAAP—and we see considerable performance benefits across all of these. Furthermore, the z196 architecture is better suited to web-based applications and data analytics applications.”

ZZZS added a zEnterprise BladeCenter Extension (zBX), which extends the mainframe environment across a set of integrated IBM blade servers. A high speed internal network connects the two elements, reducing the need for separate networking hardware and providing inherently high security. ZZZS has moved its mission-critical 'On-Line' application to this environment, and is now adding IBM DataPower® XI50z appliances to the zBX. These will replace standalone DataPower appliances, and will be used to run the security and XML-parsing engines.

“We had to decide whether to preserve the standalone environment or switch to the new hybrid technology,” explains Olga Dragan Frlež. “By introducing the zBX component into our mainframe environment, we were able to bring our DataPower environment closer to the z196.”

Finally, IBM zEnterprise Unified Resource Manager provides a single point of control and management for the entire ensemble. By orchestrating the multiarchitecture resources of the zEnterprise and enabling them to work effectively together, Unified Resource Manager helps ZZZS provide consistent and reliable service delivery for multitier applications running on different parts of the zEnterprise System.

Citizen benefits

The new online health insurance system enables citizens, medical staff and insurers to check insurance details and medical information securely from any location. In the past, this was only possible at one of 300 or so self-service terminals—which could entail a long journey for citizens living in rural areas. It also meant that health insurance information was typically somewhat out of date, diminishing the quality of information held in the central system.

"Citizens and healthcare professionals like the new system very much," says Samo Fakin. "Citizens no longer have to go to a kiosk every three months, and healthcare professionals have instant access to the information they need, with much less administrative effort."

Providing high performance and continuity

As a longtime user of IBM mainframes, ZZZS has come to expect high performance, stability and scalability from IBM platforms, and zEnterprise is no exception. The z196 offers new levels of performance, capacity for growth and dramatic infrastructure simplification capabilities. By working seamlessly with other system components, the z196 provides an efficient and reliable data processing environment for the institute’s mission-critical applications, allowing ZZZS to continue providing high levels of service to policy holders and insurers.

Crucially, the zEnterprise also provides continuity for the institute’s existing mainframe systems, which enabled a smooth transition to the new solution with zero disruption to business processes.

“One of the major benefits of the z196 has been the continuity of operations for our applications,” notes Olga Dragan Frlež. “The upgrade to the new architecture required virtually no interventions or changes in the application environment. And with Parallel Sysplex® and DB2® for z/OS® Data Sharing, we continue to run 24×7 with no interruptions."

As ZZZS manages high volumes of important and sensitive patient information, reliability and security are key concerns. With the IBM zEnterprise 196, the institute benefits from a secure, reliable platform that ensures high levels of availability and efficient management of large quantities of data.

Mirjana Kregar says: "The new zEnterprise is the heart of our health insurance system, responsible for integrating all data and exchanging it securely with other institutions and healthcare partners. We have grown from 400,000 to 1.7 million transactions per day, and we continue to enjoy full availability of services and data around the clock."
Samo Fakin, General Manager of ZZZS, concludes: “We look to provide excellent healthcare security to all insured persons and to improve their satisfaction with the compulsory health insurance service. Our longstanding partnership with IBM has helped bring us closer to this goal, providing the cutting-edge technology needed to modernize and integrate our operations. The IBM zEnterprise System provides us with a reliable, scalable and powerful platform that offers new possibilities for enhancing data management and improving service levels.”