# JHP EOC/ANOC Knowledge Pipeline Architecture Diagram Description

This diagram should present the system as a governed Medicare Advantage plan-material knowledge pipeline, not as a standalone chatbot. The key visual message is that the AI assistant sits downstream of source documents, metadata, review, routing, and validation.

## Diagram Flow

The diagram should move left to right from approved plan materials to Outreach and Product team use.

## 1. Approved Source Materials

On the far left, show a stack of official Jefferson Health Plans Medicare Advantage source documents.

Label this section: **Approved Source Materials**.

Include:

- Evidence of Coverage
- Annual Notice of Change
- Summary of Benefits
- formulary and medication-change materials
- riders
- amendments
- plan-year benefit-change files

Add a note: **Approved plan documents remain the source of truth.**

## 2. Ingestion And Structuring

The next section should show Python processing approved PDFs and helping turn dense plan materials into smaller, searchable knowledge units.

Label this section: **Ingestion And Structuring**.

Show metadata being attached to the knowledge units:

- plan year
- Medicare Advantage product
- plan name
- market, if applicable
- document type
- section
- source page
- effective period
- review status

The diagram should show that Python helped with ingestion and table review, especially for structured plan-material comparisons. It should not imply that Python or GPT-4o replaced human review.

## 3. Governed Knowledge Layer

The middle section should show SharePoint as the central inspectable knowledge layer.

Label this section: **Governed SharePoint Knowledge Layer**.

Show structured SharePoint pages created from the approved plan materials. Each page should visually connect back to the original source PDF through a line or arrow labeled **source match** or **PDF traceability**.

Add a note: **SharePoint pages were manually reviewed.**

The visual should make clear that SharePoint made the plan knowledge easier to navigate, but did not replace the approved source documents.

## 4. Validation And Review

Above or beside SharePoint, show a review loop.

Label this section: **Validation And Review**.

Include:

- manual SharePoint-page review
- Product team review
- Outreach team feedback
- Python table review
- GPT-4o-assisted validation
- source-to-answer checks
- escalation for unsupported or ambiguous answers

Show adversarial testing generally, but do not highlight medication/formulary questions as the main use case in the diagram. Medication changes can appear as one example inside source materials, not as a featured workflow.

Useful validation examples:

- wrong plan year
- similar plan names
- missing source language
- old benefit versus new benefit
- ambiguous benefit question
- answer unsupported by source document

## 5. Copilot Studio Worktree

The next major section should show Microsoft Copilot Studio as the worktree and assistant logic layer.

Label this section: **Copilot Studio Worktree And Assistant Logic**.

The diagram should show users being routed through context before retrieval:

- Medicare Advantage
- plan year
- product
- plan
- market, if applicable
- topic area

This is one of the most important controls. The user should not visually start with a broad open-ended prompt. The worktree narrows the context first, then retrieval happens.

## 6. Access Paths

After Copilot Studio and SharePoint, show three access paths into the governed knowledge layer.

Label this section: **Access Paths**.

Include:

- Microsoft Teams
- SharePoint
- PowerApps

PowerApps should be shown as one access method, not as the sole front door. Users could access the system through Teams, SharePoint, or PowerApps depending on workflow.

## 7. Operational Users

On the far right, show the operational user groups.

Label this section: **Operational Users**.

Primary users:

- Outreach team
- Product team

Add a note: **Piloted, then used by Outreach.**

Medicare Stars should be shown as the strategic operating context, not as the only user group and not as a direct Star Ratings impact claim.

## 8. Governance And Measurement Rail

Below the main diagram, add a horizontal rail labeled **Governance And Measurement**.

Include:

- no PHI
- plan and benefit documents only
- Medicare Advantage scope
- approved source documents remain authoritative
- manual review
- source citations
- escalation for unsupported answers
- time-and-motion study
- roughly 30 to 45 seconds saved per member-service call

## 9. Program Context Annotation

Add a small annotation box:

Built as part of Jefferson Health Plans' Six Sigma training program. Cole was sponsored through the Project Management Office to attend Villanova for Green Belt training. The project was one of two Green Belt projects completed during that initiative.

Add a second small annotation:

Cole reported to the Vice President of Medicare Stars and the Chief Product Officer.

## Diagram Summary

The final diagram should communicate this idea:

Approved Medicare Advantage plan documents were converted into a governed SharePoint knowledge layer, manually reviewed, validated with Python and GPT-4o assistance, routed through a Copilot Studio worktree, and made accessible through Teams, SharePoint, and PowerApps for Outreach and Product teams. The assistant helped staff retrieve source-backed benefit answers faster without making the AI model the source of truth.