Award-Winning System Overhauls NDFP Service Application
The Ontario Government’s cancer advisor, Cancer Care Ontario (CCO) is the provincial agency responsible for continually improving cancer services within Ontario. CCO works with cancer care professionals and organizations to develop and implement quality improvements and standards. Using electronic information and technology, CCO supports health professionals and patient self-care by continually improving the safety, quality, efficiency, accessibility, and accountability of cancer services.
Challenge
Since its inception, the New Drug Funding Program (NDFP) has grown to include 103 hospitals, 31 drugs, and 65 disease indications. For every new drug introduced, the effort to create new forms, implement rules to support new and changing program and drug policies, and modify the database schema to support the existing application required significant software effort. IT could not keep pace with the changes resulting in delayed availability of new drugs to patients through the program.
Project Overview
One of the strategic services that CCO administers is the New Drug Funding Program (NDFP), which ensures that all Ontario cancer patients have equitable access to expensive, injectable cancer treatments. In operation for more than 17 years, this program now encompasses 31 drugs and 65 disease indications in 103 hospitals across the province. The current annual budget is approximately $225 million.
An Oracle Forms-based system was originally built to manage NDFP, with functionality to support eligibility and processing claims. Over time, the system could not keep up with the increasing complexity of funding criteria, additional government reporting requirements, and a larger number of drugs and eligible patients. For every new drug introduced, the effort to create new forms, implement rules, and modify the database schema to support the existing application required significant software effort. With limited resources, IT was not able to keep pace resulting in new drugs not being available to patients through the program. The current system used eligibility and claim form data from antiquated feeds or via hand-entered data from faxes. CCO desired a web-based system that would eliminate paperwork and streamline operations for its limited administration staff.
CCO decided to replace the existing system with a single, centralized, web-based portal, with functionality to optimize business processes for adjudicating eligibility and claim reimbursements. There were a number of requirements:
- Have the ability to add new drug policies without requiring software changes and deployment.
- Develop reusable components and offer a loosely-coupled service-oriented architecture
- Ensure the system is extendable to support additional program and drug policies.
- Allow efficient communication with oncology patient information systems and other physical order entry systems running at the hospitals.
To meet the needs of NDFP, Affinity Systems designed a solution that included a Business Rules Management System (BRMS) where non-technical policy administrators have the freedom to quickly define, test, and deploy rules for a policy – all without a new software release. What was required was a BRMS that had sufficient end-user capabilities and a powerful SDK to integrate the rules into the NDFP system.
For the critical BRMS component, Affinity selected InRule, the premier Business Rule Technology for the Microsoft platform.
As a result of the successful integration of InRule in the NDFP system, CCO now includes InRule in its Centre of Excellence software suite, making InRule available to other systems when complex rule development and management is required.
Benefits
- Single, centralized web-based user interface
- An agile, adaptable environment that can easily support new policies
- The InRule business rule management solution:
- Gives business users ownership of rule changes within the application
- Provides a customizable, project specific vocabulary
- Offers integrated testing
- Can be used in other applications outside of NDFP
