Well Care Hospital Health Check-up

Document Classification: TCS-Confidential

 TABLE OF CONTENTS

1 Introduction ......................................................................................................................... 3
1.1 Ruleset Design ................................................................................................................ 3
2 Registration......................................................................................................................... 4
3 Appointment........................................................................................................................ 4
4 Approval ............................................................................................................................. 5
5 Acceptance ......................................................................................................................... 5
6 Agents ................................................................................................................................ 5
7 File Listener ........................................................................................................................ 5
8 Best Practices to Implement................................................................................................ 5
9 Portals ................................................................................................................................ 6
10 Reports............................................................................................................................ 6

Template Version 1.0

Effective from Mar 2018

Page 2 of 6
 1 Introduction

Wellcare hospital has health check process for the patients; Patients can book an appointment
online.

Use the Case Management concept for different stages.

1.1 Ruleset Design

Create different ruleset and versions and create the rules accordingly.
> Create rules, which are re-usable in framework ruleset
> Create rules in Implementation layer if they are only specific to the application
> Create rules in data ruleset, when they are data related rules
> Create rules related to integrations in Integration ruleset.

The Health Check up has different stages

Registration
Appointment
Approval
Acceptance

Stage Stage Title Stage Outcome

1 Registration Submit,
Cancel

2 Appointment Submit
Re-submit
Cancel

Template Version 1.0

Effective from Mar 2018

Page 3 of 6
 3 Approval Submit
Re-submit
Cancel

4 Acceptance Submit,
Reject

2 Registration
The following information are required for Patient Registration, Build the UI with following
properties

Patient First Name

Patient Last name
Patient Phone Number
Patient DOB
Patient Location

After the details are filled up, click submit to take the case to next stage

3 Appointment

To book an appointment, The patient disease should be selected and based on disease the
system should display the doctors

The UI should have a drop down of Diseases; the patient should be selecting the disease for
which he need a health check-up. Once the disease selected, the corresponding doctors displayed with a
check box to book their appointment.

The Doctors and specialist mapping should be there in another system and be retrieved through
REST connector.

Template Version 1.0

Effective from Mar 2018

Page 4 of 6
4 Approval

All the cases comes to the workbasket in this stage, one of the clinic representative will open the
case from the workbasket review the information and will either submit for acceptance or resubmit to
select an alternate doctor

Use to pega routing conept here to move the case to work list to next stage.

5 Acceptance

The cases will come to the patient; the patient should either accept or reject the case.

6 Agents

The cases which are created by user but pending with Approval worklist more than 2 days should
be Auto Rejected and send notification to patient and clinic representation.

7 File Listener

Patient Registration can also be applied through excel file where the details can be filled inside
excel and kept in a common folder, file listener will read the file as soon as it place in common folder and
create the case.

8 Best Practices to Implement

 SLA expected for escalation and notifications purpose.

 Validations handled at UI and server level.

 Error handling with proper messages.

 Styling should be accurate and skin rules used as per best practices.

 Case management followed along with proper naming conventions.

 There shouldn’t be any error in Clipboard, Tracer, Log Files

 Use PAL/DB Tracer for monitoring the performance

Template Version 1.0
Effective from Mar 2018

Page 5 of 6
  The Guardrail Score should be more than 90%

9 Portals

This application must contain 4 portals

1. Registration

2. Approval

10 Reports

Create a Report to display patients based on Doctors.

Template Version 1.0

Effective from Mar 2018

Page 6 of 6