Once BSG had collaboratively worked with the client to scope and size the project, including defining the supporting business case for investment, business stakeholders and end-users were engaged to construct journey maps and user personas to guide detailed analysis and design work.

BSG initially reviewed how best to align the new system’s UI and user experience (UX) to user expectations and requirements.  This is part of an ongoing process to ensure an intuitive and low effort user experience.  In developing iteratively and visually (key Agile principles), the team developed a series of wireframes and prototypes to conceptualise how complex functions and concepts would practically perform, to build buy-in and real commitment from all stakeholders in the future look and feel of the system.

The wider medical claims ecosystem is vast and complex and comprises information for members, schemes, procedure details, doctors, hospitals and medications.  Therefore, when a decision about authorisation or claims processing is made, the system needs to reference information from a variety of data sources quickly and effectively, as all stakeholders want immediate, real-time decisions and feedback. This means the rules governing the system must be robust enough to handle all permutations and exceptions.  Besides sourcing and processing authorisation data, the system must interface with the claims submission networks such as hospital and pharmacy interfaces, as well as the domain-specific look-up data that informs the system’s decision-making.  Taking known and envisaged complexities into account throughout the development process has been an ongoing process for BSG, to ensure stakeholder expectations can be met.

The baseline architecture was the starting point for all future enhancements, with BSG part of a broader team working on this.  The component framework, into which the system’s core functionality could be built, was developed first and an element of this framework required determining how each of the system’s numerous components and databases would communicate with each other.

Through an Agile approach the BSG project team was able to focus on smaller and more manageable sections of the system, deliver incrementally and iteratively on small sections, meet expectations and requirements and show continuous understanding of this broad domain.

Another first for the client was the introduction of continuous integration servers, build processes and test driven development—as a continuous integration and parallel processing environment was integral to deploy the new system.