Hospice Pharmacy Solutions (HPS)

Digital transformation reduces medication approval times by 80%.

Hospice Pharmacy Solutions, a leading Pharmacy Benefit Manager (PBM) for hospice care, sought to:

Overhaul their customer service experience and existing tooling to minimize medication approval times
Decrease medication claim rejections
Minimize inbound phone calls/faxes

SeeSaw Labs defined, designed, and developed an entirely new customer service issue tracking system alongside a customer-facing product that allows customers to take prescription requests and processing times in their own hands.

Services Provided

Product Strategy
Product UX & UI Design
Product Development
Interim CPO

Technology Used

React
2FA
NX
HIPAA Compliant Implementation
Azure Cloud Infrastructure

Results

Medical approvals are 5x faster
Customer cost per patient reduced 15%
HPS can now provide more services with less personal resources and allow room to scale more efficiently

The challenges

Behind the competition on automated workflows

Existing CSR process not scalable or sustainable

Wants to keep hospice customer’s PPD as low as possible

Reduce calls into the help desk, maximize efficiency

The vision

SeeSaw Labs provided short-term and long-term recommendations to tackle the challenges HPS faced.

Bridge the no-call-needed medication approval workflow gap

Spike a technical POC around embedded e-prescribe implementation

Start saving and aggregating all data, interactions around recommendations, and consultations

Implement med review automation

Maximize efficiency and user experience for client facing platform

User research and personas

SeeSaw Labs conducted user surveys and interviews to make user-centric decisions for each user type. Based on the findings, 10 user personas were developed, and solutions were curated from their biggest pain points.

Connie

Help Desk Employee

I want to be able to do my job quickly, efficiently, and correctly.

Goals & Expectations

"Fire fighter"
Quick to resolve issues
Have streamlined process that are simple
Shepherding issues to completion

Pain Points

Communication gaps with fragmented information
Turnaround time
Training and education
Process variability and needlessly complex processes
HIPAA compliance

Heather

Hospice Approver

I want streamlined communications, timely decisions, and prevent patient care delays.

Goals & Expectations

Takes responsibility for cost mitigation
Have the right information to make data-backed decisions
Ensure the patient gets the right med
Needs centralized communications between all parties
Needs recommendations for alternative medications and support for alternative orders/documentation outcomes

Pain Points

Missed calls
Hard to open encrypted email
Methods of outreach
Responsiveness and communication delays
Incorrect approval process where wrong person was contacted
Unwanted or unapproved changes

Jimmy

Patient Family

I’m overwhelmed and I just want to do what’s best for my loved one.

Goals & Expectations

Not pay for meds out of pocket and minimize costs
Be informed about what’s going on with the patient and be able to inform pharmacy
Minimize stress
Continue patient comfort

Pain Points

Education on hospice life for loved one
Must conform to formulary

Establish high-level wireframes and workflows for user frustrations

Customer journey mapping based on user research insights enabled us to identify the most frustrating experiences by persona. Focusing on areas where pain often resulted in calls to customer services, or a loss of funds delivered the highest business value.

Sample finding: Medication approval

Why do we want to improve this? What are the frustrations?

To help resolve medication requests that were rejected by the PBM adjudication process
Streamline approvals/denials
Provides hospice approver a “resolve anywhere, anytime, with no phone call” option

How did we do this?

Push notification alerts
HIPAA compliant authorization for access
Authorization code confirmation
Direct access to specific approval request and all the details in one place

What did we implement?

Easy access to primary information needed to approve
Able to one-click approval
Transparency into the entire conversation history around request and ability to add others for consultation
Quick and easy action buttons for added assistance
Information and no-call-needed chat dialogue
Feedback when completed and access to past resolved tickets
Visibility for all actions and notes on med approval

Why SeeSaw Labs

A reliable partner from beginning to launch

User research and personas

Customer journey mapping

Product mapping and architecture

Development and user testing

Launch support after completion

What our client had to say

“SeeSaw Labs’ work exceeded all of my expectations. They’ve helped us think differently about what it means to define a product, to know what problems to solve, and to understand what a customer needs. When we get into actual development, the success metrics will be around time and budget. In terms of general project evaluation, SeeSaw Labs hit all of their milestones and deliverables on time and with high quality."

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