Configuring and extending stages, statuses, and work queues

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Configuring and extending stages, statuses, and work queues

Description Design inputs and details for configuring and extending stages, statuses, and work queues
Version as of 8.5
Application Pega Product Composer for Healthcare
Capability/Industry Area Healthcare and Life Sciences

The Pega Composer for Healthcare application provides a robust capability to manage various entities such as benefits, networks, product templates, products, and plans. Out-of-the-box, PCS provides various life cycle stages for each of these entities. Within each stage, the application also assigns predetermined statuses to these entities as they progress through each stage. And to complete the infrastructure setup, PCS also provides several work queues where these entities are held for processing.

Pega-provided case management features are extensively used to achieve life cycle management. Each PCS entity, for example benefit and product template, undergoes this life cycle process. For example, a typical healthcare benefit configuration undergoes various stages in its life cycle before it is available for consumption in the actual marketable and salable health plans. This progression of a benefit or any PCS entity through various stages typically starts with a concept or idea. It traverses through various internal and external reviews and approvals before it is available in production (salable). It is finally retired when it is no longer used. Similarly a product template, product, or plan undergoes this life cycle.

Rather than being a linear, serialized process, a plan or product configuration is made up of many processes, tasks, policies, and supporting content. Furthermore, a plan as a whole, continues to change throughout its life cycle due to both internal and external events. Because of inheritance among product template, product and plans, the values can change for any of these entities, which qualifies as an internal change. Also due to regulatory changes, the plan repository might need to be updated, which is an example of an external change. Adding to the challenge, there are often several configurators, product managers, and other internal and external parties who collaborate on any given plan or benefit configuration.

Therefore, this customizable, stage-based, life cycle management provides better control over the business process and improves the consistency, effectiveness, and visibility of process-handling, thereby decreasing cost and improving quality.

Life-cycle, stage configurations such as changing the stage names, skipping the stages, jumping across the stages, and skipping approvals are business-friendly. You can configure and extend when rules, decision rules, and flow rules.

Life-cycle stages, statuses, and work queues

Stages in PCS

You can customize each of these stages and add more stages by using the extensions provided.

For example, you can move benefits from Development to Production after approval and eliminate the Implementation stage, thereby reducing the overall time for configuring each entity. For more details on the various stages in PCS, see Life cycle management.

You can also skip a specific stage from the life cycle for all entities by using the SkipDevelopment or SkipImplementation configuration rules. You can access these configuration rules by clicking Configure > Product Composer System > Business Rules in Dev Studio.

For example, if the client wants to reduce the total number of stages in the application and skip the Implementation stage, you can make the change shown in the figure below.

Skip Implementation stage

This ensures that all new entities created in PCS directly move from the Development stage (after approval) to the Production stage. The Implementation stage is skipped per the above configuration.

Statuses in PCS

Out-of-the-box, PCS provides detailed statuses for each of the entities. The statuses are based on the stage of an entity. For example in the Development stage, each entity has the statuses of Dev-Initiation, Dev-PendingApproval, and Dev-Approved.

The statuses of the PCS entities also drive many of the validation and processing rules. For example, for the flattening process, you can control which entities to flatten based on the status and stage of the entity. You can also add other statuses.

Work queues in PCS

Several out-of-the-box work queues are available in PCS. Having a foundational knowledge about them is very important. As shown in the Life cycle stages figure above, the respective entities move to different work queues based on their stage and status. In the following table, each column describes the work queues in the stage.

PCS work queues based on stage
Development Implementation Production Retirement
Dev_Initiation Impl_Initiation Prod_Initiation
Dev_PendingApproval Impl_PendingApproval Prod_PendingApproval Retire_PendingApproval
Dev_Approved Impl_Approved Prod_Approved

Some other out-of-the-box work queues are listed below. You can access all these work queues from the Manager portal.

Other PCS work queues
Sr No Work queue Description
1 Pending Auto Flatten Entities Contains all the flattening jobs
2 Document Approved Stores the approved SBC documents
3 Custom plan work queue Holds incoming requests for custom plans (input through API)
4 Entity Save Failed Stores the entities that could not complete the save process
5 PCS Product Admin Stores the list of all products
6 Pending Import Stores the list of entities which are pending the import process
7 Plan Update Failed Stores the plans that could not complete the update process
8 Update Pending Approval Stores the entities pending approval

You can add more processing for entities after the entities are moved into one of these work queues. The work queues act as a holding queue between the stages of the application. For example, if the business team wants to run the quoting process between the Development and Implementation stages, you can create a new quoting flow that intakes the plans from the Dev_Approved work queue. After the processing is done for the quoting, the plans are stored in the Impl_Initiation work queue. This allows the standard processing of the PCS application to work as is, and still allows you to add more steps or business flows per the organizational needs.

Extension for implementation teams

You must have a clear understanding of the out-of-the-box stages, statuses, and work queues. Knowing how to make changes by using the extension rules allows you to rapidly customize PCS to meet the needs of the business. Out-of-the-box, PCS provides the following decision rules to facilitate the customization. You can access these rules by clicking Configure > Product Composer System > Business Rules in Dev Studio.

Customize stage, status, wb.jpg

For example, the business might want to add a work queue, such as Pending-Quote, to PCS before moving the plans to production. By using the above decision rules, you can quickly re-use one of the work queues or add a new one. For more details about updating work queues, see Creating a work queue .

Similarly, you can rename or remove any of the stages from the flow by using the Customize stage names decision rule. For example, if the client team prefers the name Ideation instead of Development, you can change the name by using the Customize stage names decision table as shown below.

Change stage names.jpg

For more details about changing status, see Standard rules and extension points.