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TIBCO Patterns

A series of use cases

Dave Chamberlain 8/30/2011

FSI - Freezing assets - watch lists ................................................................................................................. 2 Government - maximize voluntary tax compliance, detect non-compliance ................................................ 3 Government Identifying prisoners on parole to prevent further crimes ..................................................... 4 Healthcare - Master Patient Index ................................................................................................................. 5 Healthcare - Prescribing the right medication............................................................................................... 6 Healthcare - claims processing and fraud ..................................................................................................... 7 Horizontal - Complex Event Correlation ...................................................................................................... 8 Horizontal - Cyber-Security .......................................................................................................................... 9 Horizontal - Making systems smarter ......................................................................................................... 10 Hospitality 360 degree customer view ..................................................................................................... 11 Insurance customer onboarding ............................................................................................................... 12 Insurance - professional witness identification ........................................................................................... 13 Manufacturing - Production order tracking ................................................................................................ 14 Manufacturing - Accurate sales order to production................................................................................... 15 Retail - Comparative/competitive pricing ................................................................................................... 16


FSI - Freezing assets - watch lists

Business pain International banks, acting on government orders to freeze assets from Libya, Egypt and Tunisia and other countries and organizations, are scouring hundreds of millions of client files for individuals and organizations on the new and existing watch lists. But in doing so, bank compliance officers are grappling with a peculiar challenge: the myriad ways of transliterating Arabic names together with the natural and often deliberate attempts made to disguise identities. Cost to the business The pressure is high, with banks fearful of falling afoul of justice officials. "While [Arabic transliteration] has always been a concern, it's become more of a challenge given recent events," said Vasilios Chrisos, a top U.S.-based compliance officer at Australian bank Macquarie Group Ltd. The Wall Street Journal recently reported on the difficulties banks have - Banks having trouble with names and quoted Mr Chrisos. TIBCO Patterns value-add TIBCO Patterns will assist greatly in matching customers, even if there name has been spelt differently either in error or deliberately to disguise the identity. This would help reduce the amount of time humans spend looking for the right person and also be able to present investigators with a more accurate candidate list of suspect individuals or organizations. However on top of this, multiple fields could be searched across in a single search, for example names, address, DOB, etc. ROI If a bank or other deposit taker does not freeze an individual or an organizations account after being instructed by their government to do so, they face legal action for non-compliance and incur high costs. Making their current systems smarter about the way they deal with name variations of any sort is clearly a defensive investment. Who to talk to Compliance officers at international banks and deposit takers.


Government - Maximize voluntary tax compliance, detect non-compliance

Business pain Taxation offices have a responsibility to their government and community to ensure that everyone pays the correct amount of tax in accordance with relevant laws. Revenue collection suffers significantly from lack of compliance (both intentional and non-intentional), partially due to the burdens of information volumes, information quality, and the growing numbers of information sources. Maximization of voluntary compliance and detection and deterrence of non-compliance is crucial to the efficient functioning of tax collection. Cost to the business The US IRS admits freely that estimates of non- or under-payment are more than a decade old. US Goverment report Costs generated by inefficient tax systems include: Economic costs that arise from distortion of firms and consumers behavior, Costs of operating the tax system, and Costs to firms and individuals in achieving compliance (the paper burden). Australian estimates of compliance costs for companies represent 22.9% of income tax revenue (48% internal and 52% professional advice), and 96% of companies incur higher compliance costs than they remit in income tax Australian government report Other cost estimates show personal income tax compliance costs as a % of revenue to be: Australia: 9.2% Canada: 2.5% UK: 3.6% USA: 5% to 7% TIBCO Patterns value-add Netrics addresses specific initiatives that have been identified as beneficial to the reduction of noncompliance and the cost of compliance: Supporting the provision of accurate guidance on areas to be addressed for taxation compliance by matching firm and individual profiles to known good and bad taxation return information, allowing faster and simpler self-assessment of requirements for compliance. Identification of standard and non-standard deductions matched to tax payers profile. Identification of materially-justifiable limits for which subsequent manual investigation is required.

ROI Reduced cost of compliance for individuals and companies in completing tax returns (this ROI will be a portion of the 22.9% of income tax revenue). Reduction of cost of operation of the tax system, spanning revenue collection, tax assessment, manual investigation, reduction of negative investigation costs, and others. Who to talk to Taxation commissioners, Taxation compliance officer, Taxation accounting practice lead, Chief Financial Officer


Government Identifying prisoners on parole to prevent further crimes

Business pain Convicted criminals who have been released on parole and then go on to commit a further crime are not always identified correctly as a parolee. Cost to the business As an extreme example - seven criminals who had breached their parole orders in Victoria Australia had committed murder while out of jail and were not identified as parole violators because the Victoria Police computer systems did not always allow a Police officer to find them! prisoners on parole commit murder Obviously, murder is the extreme case. However this situation would surely be echoed many times louder if the same research was undertaken on lesser crimes. TIBCO Patterns value-add By allowing TIBCO Patterns access to all the names and demographic information that are currently stored in multiple Victoria Police systems, police officers will be able to locate with a MUCH higher accuracy criminals who are currently on parole or who have been in the past. This will include times when a criminal may have changed their address, name, date of birth or other minor detail in order to avoid being processed correctly and escape detection. ROI For any police force it goes beyond "hard dollars". When in this example, seven different individuals who were allowed to be in the public have gone on to commit murder. Imagine what other acts have been committed and haven't been uncovered yet. Surely a reasonably priced system which could prevent unnecessary loss of life is relevant today and not tomorrow. Who to talk to Police Commissioner, Politician responsible for crime portfolio in geographic area, Head of Parole board


Healthcare - Master Patient Index

Business pain MPIs tend to have high duplicate rates, as high as 90% in some cases - so that for every single patient there could be an average of 10 records. This makes it difficult for people and systems to find the right patient with potential life threatening consequences. In the ER a new record is created because they cant find the right record about that patient - losing all history and therefore exposing the patient (and facility) to great risk. Records about patient encounters; procedures, therapies and prescriptions are linked to the wrong patient or the wrong record about that patient, leading to: expensive and dangerous nuclear tests being re-done; therapy being administered to the wrong patient; drug allergies being lost; physicians time wasted -- the list of consequences is almost limitless. Cost to the business Physicians and administrators time is wasted trying to find the right patient record. In addition, patients are exposed to potentially life-threatening risk - and in turn providers are exposed to the risk of litigation and non-compliance. Expenses and patient exposure are increased because expensive tests need to be re-done. Industry studies show the direct cost to be around $100 per duplicate record. TIBCO Patterns value-add Duplicates beget duplicates TIBCO Patterns provides a highly accurate way of identifying duplicate patient records in an existing Master Patient Index, and then preventing the creation of new duplicate records. Eliminating duplicate records enables people and systems to find the right patient, first time. ROI The productivity of clinicians and administrators is increased because they can more readily find the data they need to do their job more effectively. Patient safety is increased - the healthcare provider now has an accurate record of each patient together with a comprehensive treatment history. Provider risk is reduced because they are far less likely to administer costly and dangerous treatment to the wrong patient. Who to talk to CIO, Director of IT, Informatics Team


Healthcare - Prescribing the right medication

Business pain When an overseas patient presents a pharmacist/hospital/doctor with the name of their current medication it is not always obvious what the correct local equivalent will be due to inconsistencies in naming around the world, and even having multiple drugs with the same name for different purposes. A good article describing the problem drug name problems this is not just an issue with overseas patients, in every country there are an increasingly large number of drugs with similar complex names, it is easy for any rushed healthcare provider to prescribe the wrong medication or a pharmacist to wrongly fill a hand written prescription. Cost to the business If a pharmacist/hospital or even doctor gets this decision wrong, they may put the patient at serious risk. In this example where a local prescription was incorrectly dispenses due to a similar sounding name. drug prescriptions gone wrong TIBCO Patterns value-add With a TIBCO Patterns powered search a pharmacist or doctor could see where and when multiple therapies have similar sounding names or spellings and then review the ingredients or description more closely before dispensing the medication. This is one example of where getting right really can be a life or death decision. ROI Preventing the incorrect dispensing of drugs can range from not treating a patient correctly to putting their life at risk. Making patients safer is key, and reducing the liability of healthcare providers, pharmacists and others involved is a major consideration. Who to talk to Hospital directors, head pharmacists, risk and compliance officers.


Healthcare - Claims processing and fraud

Business pain A major California based healthcare payer/provider uses the Medical Record Number (MRN) as the ID to identify a patient. But since the ID is only 8 digits, only 100M members can be uniquely identified. Given that members die, move out of network and so on, and that the MRNs are not efficiently reused, this ID alone is not enough to identify a member. They use the ID together with first name, last name and date of birth (but only MM/YY). This information is displayed on the member card. But since not all provider locations have a magnetic card reader, and out-of-network hospitals do not know how to swipe the card, they rely on humans reading and entering the card information, resulting in errors and the chaos that follows. This causes individual members considerable frustration; for instance as claims bounce back and forth because the emergency room (out-of-network because by-law ambulance has to send you to the closest emergency room, so by law you cannot avoid going to out-of-network) cannot find the members insurance details even though the member provided their card with all the relevant details. Cost to the business Claims processing is a major expense for any healthcare provider or payer. A substantial number of out-of-network claims take far more manual effort than they need to; this increases the time taken to resolve claims and results in considerable member frustration. TIBCO Patterns value-add Provider and payer organizations need to make their systems smarter about the way they deal with this type of imperfect data. TIBCO Patterns enables two major capabilities for the healthcare providers and payers. First the ability to identify duplicate records in their member EMPI and provider databases, making it easier for people and systems to find the data they need. Second the ability for their systems to work in a very human-like way, recognizing the similarity despite what might be numerous errors and inconsistencies, speeding up the claims process, reducing claims processing costs and eliminating member frustration. ROI Unpaid claims represent a massive burden on both the healthcare industry as a whole and of course the individual member. In addition, because healthcare systems are not as smart of they should be, fraud costs the industry over $100 billion a year - CNN - the cost of US healthcare fraud. This substantially increases the cost of healthcare, and reduces the level of service everyone. Who to talk to Head of claims services, CIO, head of compliance, head of fraud


Horizontal - Complex Event Correlation

Business pain CEP implementations can be unnecessarily complex due to errors, variations and inconsistencies in the data. This results in related events going undetected, and/or having to spend significant human time and resources chasing and fixing these data variations. Cost to the business This depends on the particular application of CEP; however, these are typically "crown jewel" processes and the cost can be substantial, essentially because sub-optimal conclusions are reached. Added to this is the unnecessary risk introduced into every CEP implementation that depend on understanding that multiple records represent the same entity, such as a customer, transaction, or physical asset. TIBCO Patterns value-add CEP with BusinessEvents is emerging as one of the highest value end goals TIBCO offers. The types of events span all industries and the CEP is the cornerstone of the 2-second advantage. However, in order for BE to work its magic it has to determine that individual events are related to one another. In BE currently, this is done via very cumbersome rule creation. This makes it a never-ending chase to make sure that events aren't missed. TIBCO Patterns is the perfect complement to this problem and substantially bolsters the event correlation capabilities that TIBCO offers. The bottom line is that if BE cannot tell that two or more events are related because of data errors, then it misses the correlation and the 2-second advantage goes unrealized. TIBCO Patterns solves this problem elegantly and with NO RULES! Technological Chocolate+Peanut Butter at its finest. ROI Greater accuracy of event correlation and substantially reduced implementation time because the need to write rules to accommodate data variations is obviated through the use of Netrics. BE is able to reach better conclusions, providing the business with improved results and faster time to value. Who to talk to CIO, Director of IT, Informatics Team


Horizontal - Cyber-Security
Business pain
Security intrusions lead to loss of sensitive customer/corporate data, brand damage and ultimately irrecoverable loss of business. Cost to the business This is the core business problem - when customers lose trust, they will not continue to provide sensitive data. This will cause millions if not billions of dollars in lost revenue. The recent Sony PlayStation Network intrusion is a classic example - Sony Playstation Network hacked Businesses need to prove to their customers that they have world-class security in place to protect their customers data. TIBCO Patterns value-add Many businesses have spaghetti marketing campaign software that interacts with their customers through the DMZ using file transfers, SOAP, HTTP calls and Email gateways. Security intrusions can lead to information about millions of customers being at risk. Point security solutions that target DMZ, databases etc, are not the answer. Every organization is looking for increasingly flexible ways for customers to interact with them, but at the same time they need to detect and prevent any bad behavior that m ight indicate possible malicious intrusion. They want to identify good ways of interaction and stop bad ways of interaction. They know what the good ways of customer interaction are, but they cannot predict all the permutations and combinations of bad behavior - these interfaces are open on the internet. TIBCO has proposed a TIBCO Cyber security solution that will use a mix of CEP (with statically defined rules), S+ (statistical pattern analysis) and Netrics (distinguish good behavior from bad behavior). Netrics is a key part of the solution, as they need real time detection of bad behavior and the ability to stop the bad behavior in real time by using TIBCO SOA layer to their underlying infrastructure. ROI Hundreds of millions or billions of dollars saved. Customers need to over-invest in this solution and keep their brand reputation and revenue from online operations safe and secure. Who to talk to CEO, CIO, CTO


Horizontal - Making systems smarter

Business pain For humans and systems alike, finding the right records can be daunting. Enterprise and government databases are often full of errors, near duplicates and inconsistencies. This can be the root cause of ineffective business processes - leading to time wasted by people looking for the right data and a large human working matching the data the systems could not match automatically. Cost to the business Longer and less effective than needed business processes lead to, for example: missed business opportunities; ineffective cross-sell up-sell strategies; poor competitive pricing; customer dissatisfaction; customers not being able to find the products they are trying to buy; increased patient risk. In addition valuable human resources are needed to get it right. TIBCO Patterns value-add Using a very human-like way of gauging similarity enables systems to be made smarter -- without any need to rip-and-replace. Any business process, application or system can benefit from increased matching accuracy, without the costs usually associated with major system upgrades. TIBCO Netrics is able to deal effectively and efficiently with just about any type of structured data in a language and cultural independent way. The engine runs anywhere and is easily integrated into any system that needs to deal with imperfect data. ROI Increasing the level of automation leads to more effective business processes and reduces the human intervention required to get it right. This in turn leads to beneficial results, such as; safer patients, happier customers, better cross-sell and up-sell opportunities - the list is virtually endless Who to talk to CIO, Director of IT, Informatics Team

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Hospitality 360 degree customer view

Background A major Las Vegas casino plans to add additional properties in the future through acquisition and needs to better manage data associated with its customers. Customer data can come from a number of sources: their online reservation system, hotel systems, food and beverage systems, gaming systems (player card), and other systems including various shows at any given time hosted at the property, such as the Mob. Because there is no single process for managing data on their customers, the data is in separate systems with varying degrees of accuracy. This greatly impacts their ability to effectively deal with and get an accurate 360 degree view of their customers. Business pain Marketing is the key business unit affected by this lack of data accuracy on their customers. There really is no effective way to know their customers, what they are spending and where. Most importantly, since they do not have a single, integrated view of their customers, they cannot do effective marketing programs to entice people to stay at the property or to come back and stay again; to effectively cross sell promotions on venue events, food and beverage and casino play, thereby increasing the average spend per customer. Just yesterday, the CEO asked a question in an executive meeting as follows: "Over th e past 2 months, what percentage of our hotel guests were first time guests versus return guests?" A response from the executive team was "7%." When the CEO asked how they arrived at that number, they realized they did not have the data to back up the response. They have to understand where the data is, clean it and most importantly, make their systems smarter about the way they deal with customer data. Cost to the business Although metrics are always somewhat difficult to measure, their VP of Marketing estimates they waste at least $50,000 to $75,000 a year on marketing programs that do not get to the right people. They also estimate that without this program in place there is another $750,000 to $1,000,000 in lost sales opportunities at this single property. They actually feel the number may be a lot larger, but these numbers were relayed back to me to justify an initial spend of $600,000 with TIBCO by late summer, 2011. TIBCO Patterns value-add Two major areas: first, helping to clean the data for customer records, likely in the range of at least 750,000 to 1,000,000 records, is very important. They have to know that the records in the repository that they establish initially are clean, and each represents a unique customer, and there are not duplicate records, so that the downstream marketing programs can be efficient and effective. Second and just as important, keeping the data clean is also critical. So when customer records are added at a number of customer touch points such as on kiosks, online, at the front desk, food and beverage locations, venue locations and others, TIBCO Patterns will be used to check if that customer already exists and report a level of certainly. If high enough, the data will be added to the existing record; if low, then the record will be added as new and if somewhere in-between, a simple workflow will be initiated for a human to check the record and make a decision. This important system can only be effective with TIBCO Patterns at the heart of everything they do to check the accuracy of data and enable them to achieve their business goals for additional revenue generation, customer retention, customer loyalty, and other key aspects for the program, without it, there really is no program. ROI At a minimum, they calculate yearly ROI in the area of at least $1,000,000 in terms of additional revenue for the property and savings in wasted marketing spend. With an initial investment of around $600,000, the breakeven period is around 7-8 months. Who to talk to VP of Marketing, CIO

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Insurance Customer onboarding

Business pain The problem spans across several verticals, where there are several channels that feed in Customer data. Typical example includes customer entering information when requesting an insurance quote. Day 1 they visit the website and keys in first and last name, the system assigns a customer id based on the information entered during the process. The policy was not bought and hours later he stops at the agents office and provides first, last names and middle initial and some extra information. The customer onboarding system thinks this is a different customer and assigns a different id. This causes inconsistency and is currently being identified by a batch process, which is highly inconsistent. Currently the system takes a long time and requires a lot of human effort to identify and rectify the issue. Meanwhile downstream systems have two versions of the identifier, which causes the system to produce inconsistent results or even system failure due to invalid customer identifiers. Adding TIBCO Patterns into the customer onboarding system makes the system smarter and able to recognize and deal effectively with the similarity. Cost to the business Inconsistent data causes unpleasant customer interactions and results. Mishaps can happen if a CSR uses the old identifier information for validating the customer details, instead of processing claim on the new address, notifications could be sent to the old address. Another effect is that customers can shop for the lowest price across the carriers own channels and agents reducing profitability. TIBCO Patterns value-add Rather than allowing systems to accept inconsistent data and then react to it later, the ability to identify and prevent such data errors and inconsistencies at the start of the process allows the enterprise systems to be smarter and proactive. This reduces the overall costs of customer onboarding and makes for a more effective and efficient business process. ROI As with many situations, the cost of identifying and dealing with errors increases as you move further along the business process. Dealing with these types of situations as they happen reduces the manual work needed later, makes the onboarding process more effective and prevents possible fraud. Who to talk to CIO, Director of IT, Informatics Team

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Insurance - Professional witness identification

Business pain Deliberately staged accidents are an increasing source of loss to insurance carriers. Professional witnesses substantiate the claims of negligence and injury, defrauding the industry of billions of dollars a year. Guide to fraudulent car accidents Cost to the business Conservatively estimated at $50K per claim in direct costs and much human effort needed to process and resolve each case. TIBCO Patterns value-add The capability to detect fraudulent claims before they are paid is enhanced. Being able to detect patterns of professional witnesses who use slight variations of their names to disguise themselves, for instance, is another example of how the process can be made more effective, and also greatly reduces costs by not paying the claims and not having to recover claims paid fraudulently. ROI Every fraudulent claim that can be prevented is good news for the carrier and every motorist. 10 of these claims in a year would result in direct costs to the carrier of say $500K or more, and of course involve considerable human effort to resolve. Carriers can become more competitive in their markets by keeping the costs of insurance coverage to a minimum. Who to talk to Head of the Special Investigation Unit

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Manufacturing - Production order tracking

Business pain Once a sales order gets converted to a production order by the ERP system it is sent to the plant floor for production. One sales order might be completed by 1 production in 1 plant or by 10 production orders in 5 plants in 3 different countries. Each production order gets a different name, tracking code, and description based on the vendor system that is processing it, which makes it impossible to keep track of it while it is being produced. Cost to the business Supply Chain Management cannot optimize delivery to customer since there is not a complete view of what state an order is in. Customer Relationship Managers cant give the customer updates on their orders and manual time and effort is spent in hunting orders down across systems and production plants. TIBCO Patterns value-add Using a very human like way of gauging similarity enables the rapid generation of a way to correlate production orders to sales orders across different plants and countries allowing frequent updates to SCM and CRM systems. ROI Customer deliveries can be better optimized according to production schedules, reducing costs and streamlining production. Better and more frequent updates can be provided on the order status to customers and to internal personnel. Who to talk to Account Execs, Customer Managers, Billing, Supply Chain Management

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Manufacturing - Accurate sales order to production

Business pain Manufacturing companies sell products according to a variety of technical and regional specifications, which a lot of times need to be matched up manually against technical databases across a variety of regions to make sure everything is correct. Then everything needs to be priced correctly according to regional and technical specification which again is a very manual and time consuming process. Then existing inventory levels need to be checked together with any customizations ordered by the customer. Cost to the business Sales orders take a long time to confirm before going into production, wasting time and using too much human resource to get it right. Orders get priced incorrectly, losing revenue. Existing Inventory might be missed - so unnecessarily requiring un-planned quantities of a component or product to be produced to fulfill orders. TIBCO Patterns value-add Using a very human like way of gauging similarity enables a greater degree of automation, providing product managers, inventory managers, and pricing specialists to speed up the processes they are involved with, leading to less human effort and faster, more efficient sales order to production cycles. ROI Decreasing the time and amount of manual effort needed before a sales order goes into production, accelerating revenue and reducing errors. Correct pricing of orders leads the elimination of unprofitable orders, reducing time to cash and profitability. In addition, existing inventory is used more efficiently and ad-hoc extra production is not required. Who to talk to Sales managers, product managers and inventory managers.

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Retail - Comparative/competitive pricing

Business pain Different retailers sell the same product with different names and descriptions and at different prices, making it very difficult and labor intensive to both understand and react in real time to competitors local and global pricing changes and strategies. Cost to the business Understanding and reacting in real-time to pricing changes the competition is a critical part of any retail strategy. Todays approaches rely heavily on the human (often a product manager) ability to quickly determine what same or very similar products are being sold by the competition - even though they may be described different. This is time consuming and leads to less optimal pricing strategies - reducing revenue and profitability. TIBCO Patterns value-add Using a very human-like way of gauging similarity enables the rapid generation of a more accurate set of comparables for product managers and pricing specialists to work with to determine what their pricing tactics should be and whether changes are needed. ROI Being able to more easily and quickly find an accurate set of comparables reduces the amount of manual effort needed, and shrinks the amount of time a retailer needs to react to competitive pricing changes. Who to talk to Head of competitive or strategic pricing, head of product/brand management.

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