You leave your doctor's office with a prescription that the physician's office sends to your regular pharmacy.
At that drug store, you learn that the medicine isn't covered by your insurance plan, or that it is but costs as much as your rent. You go without.
A Kansas City team recently won an award from the Robert Wood Johnson Foundation for developing a robotic chat app that could steer you to a place where that prescription won't break your budget.
Project Helix - a collaboration of KC Digital Drive and two consulting outfits - aimed to help patients navigate the dizzying worlds where prescriptions, pharmacy prices and often inscrutable insurance plans overlap.
They created a chatbot that can take a physician's prescription and explore a particular patient's insurance plan, calculating what nearby pharmacies would charge. The chatbot also can sort out the street price of the prescription, whether it would be cheaper to buy it outside the insurance plan.
"There's this huge drop-off (of patients fulfilling prescriptions) because they don't know what to do next if something doesn't fit into their insurance plan," said Anurag Patel of Talos Health Solutions.
He worked with Aaron Deacon of KC Digital Drive and Jon Kohrs of Fresh Eggs to develop the app in response to the Robert Wood Johnson Foundation's Choosing Care Challenge. Together, they landed a third-place, $10,000 award for their chatbot.
The app isn't yet ready for a public release. Patel said complying with the privacy standards set by the Health Insurance Portability and Accountability Act still pose some hurdles. The Project Helix team is also looking to get an insurance company or large health system to partner on the app.
Their chatbot was built with an off-the-shelf framework, coding they'd like to rebuild from scratch before a public release. But Patel said there's hope of releasing it before the end of this year.
In the app, a patient tells a robot what prescription they need to fill. A script of answers, combined with information about the deductibles and coverage specifics of their insurance plan, then leads them to the most convenient or inexpensive options available.
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