CVS Health

The organisation

CVS Health is one of the largest healthcare companies in the United States, operating thousands of CVS Pharmacy retail locations alongside prescription fulfilment, clinical services and long-term care pharmacy operations serving millions of patients nationwide. The Fortune 10 organisation runs one of the country's largest pharmacy benefit management platforms, processing hundreds of millions of claims annually, and was in the midst of a multi-year initiative to modernise its pharmacy operations technology onto the Microsoft Power Platform.

The challenge

When the team joined the programme, delivery was in serious trouble. A team of around 20 people had been building on Power Platform for some time, but timelines were slipping, business stakeholders were losing confidence, and no architectural leader was setting standards. Developers made independent decisions that produced inconsistent data models, redundant flows and integration approaches that would not scale. The business had begun questioning whether Power Platform was even the right choice for a programme underpinning pharmacy claims, patient census and clinical operations at national scale.

The solution

The team embedded a Solution Architect directly into the programme, taking ownership of technical direction, setting architectural standards, and working shoulder-to-shoulder with the existing development team to both upskill them and deliver the most complex components personally. Over an 18-month engagement, the team helped design, build and ship three mission-critical solutions: an end-to-end pharmacy claims case management platform with a central dispatcher architecture and event-driven automation; a patient census and demographics system supporting long-term care operations with RPA and AI Builder integration; and a clinical operations hub giving pharmacists real-time drug formulary, prior authorisation and MTM guidance through 15 Copilot Studio agents. The resulting architecture layered Model-Driven Power Apps, Copilot Studio, 250+ Power Automate flows, Azure API Management, 50 Logic Apps, custom PCF controls, Dataverse and Azure Service Bus into a coherent, governed platform integrating with 10 pharmacy backend systems. The team's architect represented the team in vendor discussions, solved technical challenges Microsoft's own product teams later validated as innovative, and left behind development patterns the team now runs independently.

How we ran it

1. 01

   Embed architectural leadership

   Placed a Solution Architect into the struggling programme to own technical direction and set standards from day one.

2. 02

   Build shoulder-to-shoulder

   Worked directly alongside the existing 20-person team, both delivering complex components and upskilling developers.

3. 03

   Deliver three mission-critical platforms

   Shipped claims case management, patient census, and clinical operations & drug information solutions across 18 months.

4. 04

   Establish a scalable layered architecture

   Defined patterns for orchestration, APIM-mediated integration and Dataverse-centric data management now used as team standards.

The result

Within 18 months, delivery moved from off-track to consistently on-time and on-budget, restoring stakeholder confidence in both the team and the platform. The team's architecture now underpins 250+ Power Automate flows, 50 Logic Apps, four Model-Driven Apps, 15 Copilot Studio agents and 10 PCF controls, integrated across 10 pharmacy backend systems. The development team is now self-sufficient, working to patterns the team established, and the platform's capabilities have expanded well beyond the original scope.