Q3 Technologies helped the client in developing a formulary management system to assist pharmacists and clinicians in managing and developing the formularies. A formulary is a list of prescription drugs, both generic and branded that are managed by a committee of physicians, nurse practitioners and pharmacists.

Client Background

The client is state-of-the-art, full-service pharmacy benefit management provider with the most advanced and innovative technological platform. It ensures to deliver the highest quality pharmaceutical care to its members.

Industry Landscape

In healthcare industry, the end goal is to serve the patient effectively and efficiently. Patient is usually covered under a specific health plan with government or an insurance company. Health plan consists of a set of covered prescription drugs. Hence, a system is required to manage and develop the list of prescribed drugs.

Opportunity

The client required an online application to develop and manage formularies i.e, the list of prescribed drugs. The client also required a system to manage coverage exceptions, drug limitations, step therapies, prior authorization justification groups and MAC prices. Expectation was to instill the innovative methods in the application to perform the search to look up the drugs from central repository in order to create limitations, exceptions, etc. Representation of million drugs should be easy enough to apply the advanced search, the attributes and attaching prior authorizations. In addition, requirement was to attach the formulary to the price list of drugs.

Solution

Our team of Business Analysts addressed the business opportunities by analyzing the already existing formulary creation processes and the processes to apply exceptions, drug disease limitations, step therapies, prior authorization groups, etc. on the formularies.

Business Analyst designed a rich, intuitive and a user friendly graphical interface called Formulary Wizard by keeping the existing processes in mind. The wizard navigates the user to different modules in order to create formulary’s drug list, applying exceptions, limitations, drug disease limitations etc. in an easy and effective manner. The application also allowed user to store and edit the formularies previously created.

Business Analysts worked upon:

  • Application development services by conceptualizing and creating wireframes and mock-ups
  • Analyzing the new screens and the data flow of fields within the module or with other modules.
  • Eliciting the business requirements from multiple stakeholders using interviews, workshops, etc.
  • Preparing Business Requirement Definition (BRD) document
  • Determining application scope
  • Preparing AS- IS functional document of the existing functionalities and To-Be functional document of proposed functionalities
  • Preparing business use cases

Our team of technical experts addressed the functional requirements by developing an ASP.Net MVC based application in a wizard form. The application had intellisense search to look up for the drugs. In addition, application consisted of drug tree that showed millions of drugs in GPI based hierarchy. Information pertaining to all the drugs was visible on UI in an easily understandable format.

The REST web services were used in combination of JSON method to fetch and display all the data from the SQL Server database into the application.

Business Impact

Enabled the users to get the desired list of drugs by using filter and search options.
Allowed the user to view the detailed information of the drug, such as, drug name, drug Id, GPI, exceptions, limitations, etc.
Delivered a rich, intuitive, user friendly interface in a wizard form for displaying the significant information to attach drugs to formulary, attach the price list of drugs that were added in formulary, etc.