Transcript TriZetto 2014 Health Conference

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Copyright © 2014 TriZetto Corporation
CareAdvance Provider: Agile
Development Collaboration
Janice Mead, RN Sr. Product Manager
CareAdvance Provider Product Owner
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Session Overview
 Agile Roles in CareAdvance Enterprise
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Product Manager
Product Owner
Scrum Master
CAE Scrum Team
 Client Collaboration
 When
 Who
 CareAdvance Provider
 Product Overview
 Agile Collaboration Case Study
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CareAdvance Enterprise Agile Roles
Product Manager
Product Owner
Scrum Master
Scrum Team
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Product Backlog Hierarchy
 Theme
 An idea that spans multiple Scrum Teams and Sprints
 May fit into a Release
 No detail
 Feature
 An idea that may span multiple Scrum Teams and Sprints
 Usually fits into a Release
 Some detail
 User Story (a.k.a. Product Backlog Item)
 Work item for a Sprint for a Scrum Team
 Complete testable piece of work
 Very detailed
 Task
 Chunk of work for team members
 When all tasks are completed and reviewed, the User Story is done
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Product Roadmap Hierarchy
Themes
Features
User Stories
Tasks
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CAE Agile Roles
 Product Manager
 Defines Roadmap - High Level Themes and Features
 Presents business need and value to the Product Owners
 Product Owner
 Writes User Stories for Features
 Prioritizes the User Stories in the Backlog
 Grooms the User Stories with the Scrum Team
 Scrum Team Members
 Grooms and Sizes the User Stories
 Commits to doing the work
 Scrum Master
 Protects the team
 Removes impediments to completing work
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Product Roadmap Ownership
Themes
Product
Manager
Features
Product
Owner
User Stories
Tasks
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Scrum Team
CAE Scrum Teams
 Clinical CareAdvance (CCA)
 Multiple Scrum Teams– logical areas of responsibility
 Case/Disease Management
 Utilization Management
 Application Workflow
 Constituents
 Content
 Rules
 Common Application Components
 Infrastructure
 Development Operations and Architecture
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CAE Scrum Teams
 CareAdvance Provider
 One Team responsible for the Product
 Value Based Benefits
 One Team responsible for the Product
 Each Scrum Team has its own backlog
 Product Owners identify inter-team dependencies
 Product Owners set the priority for their team’s
backlog
 Team and PO groom User Stories to remove
ambiguity and size the effort
 Team makes the Release and Sprint commitments
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Client Collaboration
When
Who
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Agile Development
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Ongoing Backlog
grooming
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Daily
standup
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Backlog
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Sprint
Commitments
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Sprint Plan
Sprints 1 – 5 Development
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Sprint Review
every 2 weeks
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Release
Sprint
Sprint 6 – 3 week “Hardening”
• Adding Features and grooming the backlog is an ongoing activity.
• User Stories are worked on in backlog priority order during Sprints.
• “Done” work is shown to stakeholders at the end of each Sprint.
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Release
Opportunity for Client Influence
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Backlog Grooming
Product Manager Defines Themes and Features
Product Owner adds User Stories to the Backlog; Prioritizes
 Team Grooming and Commitments
 Daily Stand-up
 Sprint Demo
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Release Review
Ongoing Backlog
grooming
Sprint
Commitments
Daily
standup
Sprint Demo
every 2 weeks
Release
Backlog
Sprint Plan
Sprints 1 – 5 Development
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Sprint
Sprint 6 – 3 week “Hardening”
Release
Client Opportunities for Input
 Theme and Features – Think Breadth
 What is the business need?
 What problem are you trying to solve?
 What is your high level workflow?
 User Stories – Think Depth
 What does the user need to do and why?
 What is acceptable functionality?
 Sprint Demo
 How does what we built so far look?
 Are we headed in the right direction?
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End-of-Sprint Demos
 Teams show off completed work
 Not a technical review
 Only pieces of the full picture
 Stakeholders are encouraged to attend
 Opportunity to give feedback
 Fail fast to allow time to respond
 Work shown may or may not be in the
release
 Complex feature work may stretch into the next
release
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CareAdvance Provider
Product Overview
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CareAdvance Provider
 Web Based provider self-service
 Interface into Clinical CareAdvance (CCA)
 Real Time Connectivity to Utilization
Management
 Provider has access to same information as
CCA User
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Member Eligibility
Provider Search
Medical Codes
Member Clinical Profile
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CareAdvance Provider
 Providers can
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View dashboard of UM cases for Provider in focus
Submit an Authorization or Referral to CCA
Obtain provider network status
Based on CCA logic
 Obtain automatic approval using CCA business rules and
work flow
 Receive notification that a specialty vendor must be
contacted
 Complete a required Questionnaire
 Send and receive case Communications
 Search for existing cases
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Home Page
 View full list of cases for the provider in focus – sort and search
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Submit a Request
 Submit Inpatient, Outpatient, or Referral requests by entering
basic information using search tools, bookmarks and templates
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Add Services
 Add Services, Extensions and Notes to the request
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Provider Search
 Search for and select Providers
 View Network status and Group Affiliations
 Add Provider to bookmarks from Search results
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Questionnaires
 Complete Questionnaires when needed for the authorization process
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Case Communications
 Communicate with UM staff
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Change Provider In Focus
 Logged in users can easily switch from one Provider to another of
their Associated Providers
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Bookmarks
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Categorize, Create and Manage bookmarks
Individual user level or across all users
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Templates
 Create templates for quick entry of frequently
encountered authorization requests
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CareAdvance Provider
Agile Case Study
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CareAdvance Provider
Agile Case Study
 Good test of Agile Software Development
 BCBSA – Electronic Provider Access
 Requires ability for Blues Out of Area
providers to submit requests electronically
 New feature to client and CAP
 Client committed to weekly meetings and
attendance at Sprint reviews
 Subject Matter Experts tapped as needed
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Steps
1. Understand the Business need
 Described by the client
2. Understand persona of the OOA provider
 May use CAP very sporadically
 Little opportunity to train
 Needs only the Basics only
3. Write high level User Stories
 Allow secure access to unknown user
 Modify User Interface
 Create “temporary” providers
4. Split large stories during CAP team grooming sessions
5. Provide end of Sprint demos
 Attended by client stakeholders
 Feedback provided
6. Add User Stories as needed during feature development
 Initial high level effort considered unknowns of this new feature
 7 User Stories grew to 15
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Recap
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Agile Roles in CareAdvance Enterprise
Client Collaboration
CareAdvance Provider
Agile Case Study
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Copyright © 2014 TriZetto Corporation
We Need YOU!
 Build better software
 End-of-Sprint Demo
 Demonstrates the results of our collaboration
 Learn about the feature in progress
 Collect valuable feedback from our clients
 Every other Wednesday
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Via GoToWebiner
Release18 Sprint 1 – Wednesday, May 21st
Release18 Sprint 2 - Wednesday, June 4th
Etc…
Copyright © 2014 TriZetto Corporation
Thank You!
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