Tech-Driven Transformation for Business Success

The project focuses on the onboarding process for pharmacies with a pharmaceutical distribution company. When a new pharmacy joins, it submits detailed customer and prescriber information to the distributor. The distributor then performs a comprehensive background check to ensure the pharmacy and its prescribers meet necessary standards for trust and compliance.

The background check involves gathering external reviews from platforms like Google, based on the prescriber’s name and address. If negative reviews are identified, the system delves deeper, collecting additional reviews from multiple sources and summarizing the findings. This process is repeated for both the pharmacy and prescriber. To help flag potential red flags, the system uses predefined, configurable tags or keywords.

Beyond review aggregation, the system analyzes patterns to detect irregularities, such as a prescriber repeatedly prescribing the same medication to multiple patients. This forms part of a fraud detection mechanism. With machine learning and AI capabilities, the system summarizes the reviews and helps in making decisions about onboarding the pharmacy or prescriber, minimizing the need for manual intervention.

This review and validation process ensures that the company makes informed, compliant decisions, safeguarding customer relationships. However, it is a complex system as it also involves validating prescriber NPIs (National Provider Identifiers), adding another layer of scrutiny and compliance.

A major challenge in the project was coordinating with multiple vendors to integrate their systems, ensuring smooth data flow while maintaining stringent security protocols. The sensitive nature of the data required robust measures for secure transmission and processing. Managing multi-vendor teams, designing an intricate solution, and using machine learning algorithms to automate decisions without human oversight significantly added to the project’s complexity, making it both technically challenging and essential for improving operational efficiency and compliance in the onboarding process.