Shock to the system

The IT manager of one of the leading medical insurance outsourcing companies in the UAE warns that the introduction of a law making health insurance compulsory for workers could result in a meltdown of systems. Daniel Stanton investigates.

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By  Daniel Stanton Published  June 1, 2006

|~|burgess200.gif|~|Burgess: The huge amounts of extra data could be too much for Neuron's systems to handle.|~|By the end of 2006, all workers in the UAE must have health insurance, but Alisdair Burgess, IT and operations manager for Neuron, the UAE's second-biggest medical insurance outsourcer, believes that the huge amount of additional data his system and other systems will have to cope with could be too much to handle.

Neuron processes the data for health insurance claims for several large insurance companies in the UAE and the Middle East. Around 500 healthcare providers make use of the system and Neuron's helpline operates every day of the week.
The company started five years ago with around 1,400 lives on its books, and has grown at a rate that surprised even its management.

“Last year we had approximately 8,000 lives under management here on the medical side, and to date we have near enough 70,000, so the growth here has been phenomenal,” says Burgess. “The volume of claims that is coming through the door now is increasing, and it's going to keep on increasing.”

It is hard to predict how many more people will take up health insurance by the end of the year, but it is likely to place huge demands on Neuron's systems, which run a software system called Medvantage to process claims. “How's the system going to cope with it?" Burgess asks. “I don't know.”

There have already been warning signs. “At the end of last year we had only the one server, and we run two databases, a dollar database for overseas clients and a dirham database for our GCC clients,” Burgess says.

“The server wasn't big enough and the machine just constantly crashed. That was just down to the fact there was too much information, the server wasn't big enough. So we got a new server, running on Windows 2003, and we've split the databases.”

Following the installation of the new server, there were further problems, though these have now been resolved.
Faisal Mohammed, head of corporate sales, Cad Gulf, which carried out the implementation, says that the problems were not down to the server. “There were some teething problems basically with the compatibility issues between the Medvantage application and the new database.

“The connection would be lost and they would have to restart the server. So, every four hours or so they would have downtime of a minute and then once you restart the services on the server they would be back. This was solved by the patch that Medvantage gave us,” he says.

Burgess is finding ways to cope with the situation. He says: “The only thing we can do now is make sure on a daily basis we have got our backups and in the event of something happening we can basically start again the next day.”

But backing up the servers has also caused difficulties. “As of two weeks ago, unbeknown to us because it's all automated, we found that it was having to go onto a second disk,” says Burgess.

“Obviously doing a backup on two disks can be a bit dodgy so we've now put the order in for a larger capacity tape drive and we'll use that.” The company has ordered a 100GB tape drive, but in the meantime the organisation is having to perform manual backups onto another server.

Neuron's main concerns centre around not being able to address problems in the Medvantage solution itself and the time it takes to get responses from the application’s developers.||**|||~|einstein200.gif|~|Johnson: MedNet has put systems in place to prepare for high growth.|~|“One unfortunate thing is that we don't have the source code for this application, so we can't mess with it,” says Burgess. “So then we have to send it off to the UK. Then we've got to wait three or four months for them to decide what's wrong with it. We waited for a patch once for 18 months.”

He is now investigating the development of a new application, but Neuron is also considering buying the source code for Medvantage, or upgrading to a new health insurance product by the same developers. Burgess believes that they need to do something urgently to cope with the huge amount of new business.

“It will blow up,” he says. “I'm sure it will. One day we're going to come into the office, we're going to turn on Medvantage and that's it, it's just not going to be there. So that's a bit scary.”

The company also needs to decide on its approach to security as it prepares to move to a new office and adopt wireless technology. “I don't think it was something that was addressed when the company first started up,” says Burgess. “We're using something like Trend Microsystems now, we've got a firewall and that's it.

“So security really does have to be addressed in a big, big way now otherwise we're going to have huge problems with the whole thing.”

The company has made steps towards security with new policies. Now, only two or three people within the company are allowed to send out sensitive emails, and they are checked by other people first. “As the company's getting bigger, reports are going out that are more sensitive,” Burgess says. “We are having to address more and more of these issues on a daily basis.”

Einstein Johnson, systems administrator at MedNet, the number one medical outsourcing provider in the UAE, also expects to see a surge in demand, but says that his company has planned ahead. MedNet upgraded many of its systems two years ago in anticipation of high volumes of data in the future.

“We changed our database from Oracle 7 to 9 and our OS was changed from HPUX to [RedHat] Linux 3.0 ES,” he says.
MedNet now operates with nine servers and uses in-house software, called Mednext, which can be updated quickly to meet changing business demands.

“We upgraded our mail server, our firewall, everything,” says Johnson. “We'll be able to handle the large amount of data which will come through this year, next year, or even the year after.”

While Cad Gulf insists that Neuron's hardware is not running at full stretch - its new Sybase databases are at barely 30% of capacity - the company faces an anxious six months as it trys to strengthen its systems.

Burgess has made his own diagnosis. “I don't think we're working smart, I think we're working hard,” he says.||**||

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