PAS tech | My Site 3

Prior Authorization System (PAS) - Tech

Design evolution of PAS from legacy to new automated screen.

What is PAS for Tech?

The Prior Authorization Technician will assist callers by providing quality service through efficient and accurate Prior Authorisation (PA) service support. They will be taking calls from pharmacies, physicians, and other medical professions in support of member’s Prior Authorisation for medication approvals.

Hello! How can I help you today?.....Hello! I am calling from Dr. Antony Lucas’s office and wanted to check about a cancelled PA request....Alright! may I have your contact information?.....Yes it is +12.......and this begins the story of a PA case. Looking for medical information while being on the call is what makes this work challenging.

Technicians have to look around in the sea of information to understand if the case can be created and sent to Pharmacist for approval or should it be cancelled as there are key information missing.

General workflow

Problem areas - Technician

Problem 1 - Physically gathering information

Tech try to get all the information to build the case for RPH on call. The person on call might or might not provide all right information. Autofill works when the call is IVR otherwise it is too manual.

Problem 2 - Information overload

While on the call, The amount of information Techs see to make a case is not customised or aligned according to different situations for the case. Overall all information is provided just in case they might need it, causing more confusion and time taken

Problem 3 - Payed for time

When we pay anyone for their time and most work they did in that given time. The race becomes of finishing the most, this might bring the quality of work.

Legacy Screens

Overall legacy screen design concept

Actions take part at the first top of the screen
bottom screen has bunch of information provided, user can pick and chose what they need at any given stage.
Left panel is multiple actions user can take, most of them are useless once they are in a case.
More information provided at the top, which are again used rarely in special cases otherwise while working on the case, users should not be moving outside of the case for other cases.

Legacy Screens

After speaking to users and understanding the underlying problems the first draft is created as a basic mockup for overall understanding of the-flow. This process helped us recognise unnecessary steps so we could simply or remove it.

Problems solved in the re-design

The redesigned focused on few major problems found after interviewing 7 super users and 3 new users. The idea was to decrease error and increase quality so RPH (pharmacist) wor efficiency is increased. They both are related as what cases are created by tech and info. gathered is what RPH work on it and solve later. SO mistakes here costs their time and quality later.

1. Work quality measured with time

4. Error in entries

2. Lack of accurate information

5. More pend to cases

3. Lesser clicks

6. Information overload

1. Work quality measured with time

Timer/watch not visible
Work quality measurement due to error was assigned 20% more
Work quality measurement due to time taken to solve the case was assigned 30% less

2. Lack of accurate information
4. Error in entries

Information bifurcated and broken into more meaningful pieces.
Error message indication if they go wrong sometimes.
“Help text” for users to help correct their errors.

5. More pend to cases

Cases are pend to when technicians are unsure of their actions and they pend it to other seniors to take care of it.

Pend to option available only when it is an edge case identified by the system.
As the pressure to solve the case ASAP reduces, the user behaviour to look at the problem some more time will be increased.
Introduced pausing points where users are made to double check the inputed information.