Secure Voice-AI Agents for a Real-Time Pharmacogenetics Platform
Industry
Healthcare
Geography
US
Timeline
2 Months
Improving Patient Outcomes Through DNA-Driven Prescribing
A leading pharmacogenetics company working alongside Pharmacy Benefit Administrators (PBAs) to proactively prevent adverse drug reactions (ADRs). Their platform delivers real-time genetic insights at the point of prescribing, transforming complex DNA data into actionable treatment recommendations.
It integrates seamlessly with PBM, EMR, and pharmacy systems, with the ambition to reduce ADRs by more than 50%
Background & Context
Drug coverage and pharmacogenetics (PGx) testing decisions communicated to patient care teams and providers often face fragmented communication, resulting in delayed denial notifications, uncertainty around alternatives, and heavy administrative overhead.
The client partnered with PBAs to streamline this communication by introducing secure, intelligent voice-AI agents that could:
Authenticate providers during outbound calls before disclosing sensitive denial or PGx information.
Deliver denial notifications with alternative recommendations drawn directly from the platform's APIs.
Provide research-backed explanations by referencing published studies and white papers to build trust with providers.
Solution
We built two secure voice-AI agents for a pharmacogenetics platform working with PBAs. One to authenticate providers during outbound calls, and another to deliver denial notifications with API-powered alternatives, reinforced by RAG-driven insights from published studies.
Provider Authentication Agent
- Built a voice-AI agent to validate provider identity during outbound calls.
- Prevented disclosure of sensitive information until verification was complete.
- This Agent would then seamlessly transfer the call to the second agent below.
Denial Notification & Alternatives Agent
- Created a second voice-AI agent to proactively notify providers of drug denials.
- Delivered alternatives directly from system APIs, ensuring accuracy and timeliness.
- Integrated RAG over research papers and white papers to provide contextual support, improving provider confidence in the decision and alternatives.
PGx Report Support
- PGx summaries were generated from the client’s existing tools.
- RAG surfaced relevant published studies and guidelines to reinforce and explain the denial and alternative recommendations.
Outcomes
Secure Communication Outbound calls authenticated providers before sharing sensitive info.
Timely Notifications Providers received real-time denial updates with actionable alternatives.
Knowledge-Backed Guidance Research-backed references supported denial and alternative recommendations.
Operational Efficiency Reduced manual intervention, easing communication between PBAs and providers.
PBAs Reduced administrative overhead and improved provider trust.
Providers Gained clarity and confidence in denial and alternative workflows.
Patients Benefited from faster, safer prescribing decisions informed by PGx insights and credible evidence.
