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Patient Services

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Updated on May 10, 2021

Patient services provides healthcare organizations with capabilities for patient care and engagement, for example, scheduling, rescheduling, or canceling appointments. The following sections include important topics to review when implementing patient services.

Pega Customer Service Implementation Guide Pega Customer Service Implementation Guide Pega Customer Service Implementation Guide Pega Customer Service Implementation Guide

The following figure shows the Interaction portal when you are using Patient services.

Patient services example
Patient information displayed in the Interaction Portal when using Patient
                    services

Healthcare organizations that engage patients in their contact centers can select the Patient Services bundle during application creation. By including the Patient Services bundle when using the New Application Wizard, your new application can include relevant Microjourneys, such as scheduling, supporting data types, interaction composites and headers, as well as customer search and verification questions.

For more information, see the New Application wizard.

Access groups

When you create your application with the Patient Services bundle, the New Application wizard copies default access groups into the implementation layer and appends the organization name that you identified to the access groups.

The following table lists the default access groups that are copied into your application:

Access groupRule nameDescription
Patient Services CSR

CUSTOMERSERVICEHC:

CSPATIENTSERVICESCSR

A contact center representative operator
Patient Services Manager

CUSTOMERSERVICEHC:

CSPATIENTSERVICESMANAGER

A contact center manager
Patient Services Admin

CUSTOMERSERVICEHC:

CSPATIENTSERVICESADMIN

A system administrator or a highly skilled developer. The default portal is Dev Studio.
Patient Services AUTHOR

CUSTOMERSERVICEHC:

CSPATIENTSERVICESAUTHOR

A business analyst. The default portal is App Studio.

These access groups include the CSHC:PatientServicesUser role, which in turn includes the PatientServicesUser privilege. This is important because many rules within the Interaction portal look for that privilege in order to display patient service or member service pages and capabilities.

For more information, see Creating an access group.

Rules that refer to the PatientServiceUser privilege

Many rules within the Interaction portal look for the PatientServiceUser privilege, which is included in the CSHC:PatientServicesUser role in order to display patient service or member service screens and capabilities.

Add the CSHC:PatientServicesUser roles if you create new access groups for your Patient Services implementation. Also, refer to this when rule in the visibility if you create a new section, such as in the composite, or change business logic that is related to Patient Services.

Rule nameClass nameDescription
CPMCompositeTabsPegaCPMHC-WorkUse this section rule to display the composite tabs in healthcare interactions.

You can conditionalize the display of the patient composite tabs when an interaction is launched for a patient.

CPMServiceItemInfoWork-Use this section rule to display smart information (information displayed when you hover over an ID) for recent cases.

You can conditionalize the display of patient-related information when a case is launched for a patient.

CSInteractionHeaderPrimaryInfoPegaCPMHC-Work-InteractionUse this section rule to display the basic customer information in the Interaction header.

You can conditionalize the display of patient or member information in the header during a patient interaction.

SearchHeaderPegaCA-WorkUse this section rule to display the header bar for searches in a research interaction.

You can conditionalize the display of the Patients tab during a patient interaction.

Patient Services data pages

When implementing Patient Services in Pega Customer Service for Healthcare, you get the out-of-the-box data pages that are included with the out-of-the-box Microjourneys and other assets. Use the data pages listed in the following table to connect your Microjourneys, composites, and interactions to your data sources.

For additional information, see data pages. For information about the Microjourneys, see Customer Service for Healthcare Microjourneys.

Data pageClassDescription
D_MemberDataList PegaHC-Data-Party-Member Patients by search criteria (same data type used for all types of consumers, including members and patients)
D_GetAppointmentsByPatientPegaHC-Data-Appointment Patient's appointments
D_GetSocialDeterminantsListByMemberPegaHC-Data-SDOHPatient's Social Determinants of Health determinations
D_PatientBill PegaCA-Interface-Transactions Patient's paid, unpaid, and payer pending bills
D_MemberPolicyDetails PegaHC-Data-Policy Patient's coverage information
D_ProgramsListPegaCPMHC-Data-ProgramsNavigation programs in which a patient is enrolled
D_TrialsListPegaCPMHC-Data-TrialsMedical trials in which a patient is enrolled
D_GetAssociatedPatientsPegaHC-Data-Party-MemberOther patients associated with the customer
D_GetAvailabilityOfAProviderEmbed-PegaHC-Participant Provider's appointment openings
D_PractitionerListPegaHC-Data-Party-Provider-PractitionerAvailable or associated practitioners

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