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BUILDING AN ENTERPRISE ROUTING
ENGINE FOR PRESCRIPTION VERIFICATION
2
github.com/bmullan-pivotal
Barry Mullan
bmullan@pivotal.io
(617) 335 1288
www.scaledagileacademy.com/
member/bmullan
htt...
BACKGROUND
CVS
• Founded in 1963 in Lowell, MA.
Now ~ 9600 stores.
• $177bn revenue, #7 Fortune 500.
• 67% PBM revenue is ...
TRANSFORMING HEALTHCARE DELIVERY
• 80% of the population live
within 5 miles of a CVS
branch.
• 60% of health outcomes
are...
PROBLEM OVERVIEW
ENTERPRISE ROUTING ENGINE
DONEC QUIS NUNC
ARCHITECTURE PRINCIPLES
• Loose Coupling
• Self Service Enablement
• Rules Driven
• Agility & Productivity...
ENTERPRISE ROUTING SERVICE
PRE-QUALIFICATION SERVICE
QUALIFICATION SERVICE
STATUS UPDATE SERVICE
FETCH PV1 SERVICE
FETCH D...
TECHNOLOGY ELEMENTS
Grafana
(business metrics)
Business Rules Engine
Trace & MetricsPivotal Cloud Cache
MariaDB Database
S...
DONEC QUIS NUNC
BUSINESS METRICS
CHALLENGES / LESSONS LEARNED
• Healthcheck Everything!
• Database connections.
• Rules engine
• F5 iRule to switch to acti...
IMPACT
• Better Patient Experience!
• Significant Cost Savings
• Business Visibility / Control
• Realtime Query / Filter b...
DONEC QUIS NUNC
WHAT NEXT ?
THANK YOU !
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Building an Enterprise Routing Engine for Prescription Verification - Barry Mullan

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Building an Enterprise Routing Engine for Prescription Verification with Barry Mullan at SpringOne Tour 2019

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Building an Enterprise Routing Engine for Prescription Verification - Barry Mullan

  1. 1. BUILDING AN ENTERPRISE ROUTING ENGINE FOR PRESCRIPTION VERIFICATION
  2. 2. 2 github.com/bmullan-pivotal Barry Mullan bmullan@pivotal.io (617) 335 1288 www.scaledagileacademy.com/ member/bmullan https:// www.scrumalliance.org/ community/profile/bmullan Agile Metrics Data Visualization TDD, Code Design Predictive Analytics
  3. 3. BACKGROUND CVS • Founded in 1963 in Lowell, MA. Now ~ 9600 stores. • $177bn revenue, #7 Fortune 500. • 67% PBM revenue is PBM for 90m members filling 1.6bn rx per year. • Transition to healthcare provider. ◦ 2005 Introduced MinuteClinic, now 1100+. ◦ 2013 Eliminated tobacco products. ◦ 2017 Announced $67bn acquisition of Aetna Insurance. 

  4. 4. TRANSFORMING HEALTHCARE DELIVERY • 80% of the population live within 5 miles of a CVS branch. • 60% of health outcomes are determined by zip code. • Enable a continuous high value conversation with their members. • Hybrid Multicloud will be an enabler notes: https://docs.google.com/ document/d/1d- xICusg6V_Tjw_FrRbEraYP- uHW4gfmKRLexjf1lfg/edit
  5. 5. PROBLEM OVERVIEW ENTERPRISE ROUTING ENGINE
  6. 6. DONEC QUIS NUNC ARCHITECTURE PRINCIPLES • Loose Coupling • Self Service Enablement • Rules Driven • Agility & Productivity (DevOps) • Extensibility • Low cost, low effort • Ease of Use
  7. 7. ENTERPRISE ROUTING SERVICE PRE-QUALIFICATION SERVICE QUALIFICATION SERVICE STATUS UPDATE SERVICE FETCH PV1 SERVICE FETCH DPC SERVICE PULL BACK SERVICE PRE-QUALIFICATION RESPONSE QUALIFICATION RESPONSE PUSH BACK RESPONSE PULLBACK PV1 CANCEL PV1 PRODUCER CONSUMER ORCHESTRATION BRMS RULES ENGINE DRUG RULES 3RD PARTY RULES PRE- QUALIFICATION REGULATORY RETURN RULES QUALIFICATION ASSIGNMENT PULLBACK PHARMACY RULES PRESCRIPTION TYPE PRESCRIBER RULES QUEUE MANAGEMENT DATA MANAGEMENT INGESTED SERVICES ERE SIMULATOR HADOOP DATA LAKE INTEGRATION MARIADB MONITORING DASHBOARD TASK LIFECYCLE SERVICE MONITORING TASK CREATE UPDATE STATUS GET STATUS SLA / PUSHBACK / PULLBACK SERVICES EXCEPTION BATCH SLA ORCHESTRATION CLOUD CACHE (GEMFIRE) REGION REGION ARCHITECTURE
  8. 8. TECHNOLOGY ELEMENTS Grafana (business metrics) Business Rules Engine Trace & MetricsPivotal Cloud Cache MariaDB Database Spring Cloud Data FlowSpring Cloud EurekaSpring Cloud Config Spring Boot Auto Scaler Hadoop Kafka
  9. 9. DONEC QUIS NUNC BUSINESS METRICS
  10. 10. CHALLENGES / LESSONS LEARNED • Healthcheck Everything! • Database connections. • Rules engine • F5 iRule to switch to active standby • Performance testing with actual anticipated load • MariaDB replication for active standby • Be careful adopting v1 api’s. (They may go away!) • Graduated roll out
  11. 11. IMPACT • Better Patient Experience! • Significant Cost Savings • Business Visibility / Control • Realtime Query / Filter by Region, State, Store etc. • Optimize the rules for best impact. • Development Team Productivity

  12. 12. DONEC QUIS NUNC WHAT NEXT ?
  13. 13. THANK YOU !

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