The Xerox Government Solutions Health Enterprise Portal supports all of the Health Care Program and Decision Support needs for MMIS management for several states. The solution is based on different IBM products, leveraging IBM Digital Experience and WebSphere Portal Server, WebSphere Application Server, Smarter Process and IBM Security Solutions. To ensure the best possible performance for the users of this major enterprise solution Xerox and IBM worked on optimizing the performance of the solution. To monitor and troubleshoot the solution and optimize the performance AppDynamics Performance Management was used. The session will explain the business drivers, use cases, and architecture choices selected for deployment. We will also discuss in detail how the team leveraged AppDynamics and other tools to optimize and manage the performance of the enterprise health care solution. Join us for a real world showcase how performance was optimized for a state of the art enterprise Health Care solution. This deck was originally presented at AppSphere 2015.

1. Performance and Scalability Optimizations - Xerox
Government Healthcare - Health Enterprise Portal
Gorkey Vemulapalli, Senior Architect, Xerox; Thomas Hurek, Senior Digital Experience Architect, IBM

2. Agenda
• About Xerox
• Medicaid Management Information System (MMIS)
• Architecture
• Performance Optimization
• AppDynamics
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3. ABOUT XEROX

4. Xerox
• Founded 1906
• 140,000+ employees
• Active in 190+ countries
• 2014 Revenue: $19.5 billion
• For more than a half a century, Xerox has been a leader in document
technology and services
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5. Xerox Healthcare solutions
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6. Xerox Health Enterprise Framework
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7. MEDICAID MANAGEMENT
INFORMATION SYSTEM (MMIS)

8. Solution
• Preferred Medicaid Management Information Systems
provider
• End-to-end healthcare program administration services and
solutions
• Automated solution for complex data intensive deeply
regulated market
• Interfaces with existing systems
• Input from web, phone, batch jobs, programmatic
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9. Features
• Service Oriented Architecture platform fully aligns with MITA
interoperability guidelines and web-based technologies
• Reusable, adaptable core provides common starting point
– Reduces implementation time & costs
• Fully aligned with the MITA 3.0, MECT & the Seven Conditions
and Standards from the first day of service
• Flexible architecture enables edits and updates to be
implemented in days or hours – not weeks or months
• More than 40 years experience with Medicaid and other publicly
funded health programs
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10. Use Cases
• Providers enter claims and other information
• End users can check health care coverage and claims
• State employees can approve / deny / administer
• Third Party Integration
• Batch processing
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11. ARCHITECTURE

12. Modularity
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13. Presentation Layer
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• Processes the presentation
and information dissemination
for users
• Web Portal provides the
information via a web browser.
• AVRS allows providers and
members access to information
by using a touch-tone
telephone.
• EDI provides connectivity for
the flow of data between
providers, state agencies &
switch vendors

14. Business Process Layer
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• Encapsulates high-
level business
processes exposed as
service for consumers
• Uses well-defined
execution of
services and
components

15. Services Layer
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• Composite services
– Combines granular business
services to reduce some
complexities and to reduce
coding efforts.
• Business Service Layer
– Provides specific business
services which are highly
cohesive and atomic
functionality
• Infrastructure Service Layer
– Supports systems integration
services that are necessary to
build a web application

16. HE System Interaction – Claims Processing
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PRINTER
SOURCE HEALTH
ENTERPRISE
ECHO-­‐SYSTEM OUTPUT
Call
Center
CLAIMS
Flat
File
ELIGIBILITY
Paper
Claims
PROVIDER
INBOUND
FINANCE
PRA
Provider
270
271 Flat
Files
837
OUTBOUND
Facility
TPs
Member
OCR
CLAIMS
ELIGIBILITY
PROVIDER
FINANCE
B2B
ONLINE
NON-­‐EDI
BATCH
INTERFACES
CONTACT
GLOBAL
SERVICE
AUTHORIZATION
PROGRAM
Provider
Facility
TPs
Member
CMS
Bank
NON-­‐EDI
BATCH
INTERFACEAdjudication
ORR
B2B
ELIGIBILITY
CLAIMS
PROVIDERS
Payments
ELIGIBILITY
CLAIMS
PROVIDERS
EFT
EOB
ELIGIBILITY
CLAIMS
PROVIDERS
FINANCE...etc
835

17. PERFORMANCE OPTIMIZATION

18. Goals
• Throughput
• Response time for different use cases
• Batch processing throughput and response time
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19. Implementation
• Agile process
• Rational Performance Tester for recording & playback
• Analysis of performance issues and bottlenecks with AppDynamics software
• Tuning and code adjustment
• Repeat
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20. Major Improvement Items
• Heap size tuning
• Connection pool tuning
• CPU and RAM assignments
• Virtualization changes
• Portal 8.0 -> 8.5
• WSRP updates as part of Portal upgrade
• Theme optimization
• WCM caching
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21. Major Improvement Items
• WSRP logout (now part of Portal 8.5 CF6)
• Database indexing / adding of new indexes
• Thread Pool Tuning
– LDAP
– WebSeal
– ORB
– WSRP
• Increasing number of JVMs where needed for memory
reasons
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22. Custom Code Adjustments
• Reduction of redundant calls
• Optimizing SQL statements
• Co-locating BPM and Business Layer
• Making calls asynchronous
• Reduction of logging
• Fixes in WAS, WSRP, JSF, Hibernate, Log4j
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23. APPDYNAMICS

24. Application Performance Management
• Auto-discover and monitor end-to-end application performance
• Monitor any production app within minutes
• Monitor production apps at code-level depth with minimal overhead
• Resolve application issues quickly for exceptional end-user experience
• Eliminate false alarms with automated baselining
• Broadest coverage of languages and technologies
• Deploy On-premises, in the cloud, or in hybrid environments
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25. Why use at Xerox?
• Easy to setup
• Allows code level analysis without large overhead / complicated
instrumentation
• Follows transactions through a complicated set of transactions on various
layers – even using different technologies
• History based data can be analyzed later – very helpful in multi-shore
development
• Agile
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26. Why use at Xerox?
• Production Monitoring and Alerting with very low overhead
• Flexible views and dashboards
• Dynamic detection of different transactions – via URL patterns
• Browser based
• Delegated Administration
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27. Adjustments
• Learning of URL patterns
• Database extensions / detail levels for slow SQLs
• Need to monitor physical CPUs vs. virtual
• Did not catch vmotion performance issues
• PMI data is available
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28. Case Study

29. Isolating Bottlenecks
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30. Server Monitoring
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31. Drill Down to Code Level
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32. Resolving Issues Real Time
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33. Health Enterprise Scalability : Results
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34. Thank You