Advancing Healthcare Interoperability with Building Blocks

A prominent Fortune 500 healthcare payer with a nationwide presence,
embarked on a mission to elevate data management, network efficiency, and
clinical decision support (CDS) for superior patient care.

1949

Founded

1325

Employees

13+

Operations

Challenges

Creating an effective healthcare system requires navigating complex challenges. We can ensure that patients receive the best possible care by addressing these
challenges.

ZZ
Data Silos
Fragmented data hinders comprehensive patient insights and effective Clinical Decision Support (CDS).
ZZ
Access to Comprehensive Data
Real-time, network-wide data access was essential for robust CDS and patient care.
ZZ
Smart Risk Adjustment
Precise risk management was imperative for optimizing high-risk patient care.
ZZ
Cost-Efficiency
Balancing cost reduction with quality maintenance was a critical objective.
ZZ
Regulatory Compliance
Adhering to standards like HL7, FHIR, ICD, and USCDI was mandatory for compliance and data integration.
ZZ
At-Risk Population Forecasting
Preparing for at-risk populations was essential to enhance population health outcomes.

Solutions

Data Retrieval and Standards Integration
Aggregating diverse data sources and incorporating HL7, FHIR 4.0, and USCDI for eamless data sharing and CDS
compliance.
Data Normalization and APIs
Standardizing data formats and facilitating data exchange through FHIR-compliant APIs, benefiting CDS and other applications.
Privacy Management and Data Quality
Ensuring data privacy, regulatory compliance, and eliminating duplicates and inconsistencies for accurate records
and effective CDS.
Terminology Support and Enriched Data
Using medical code sets for precise data classification and enhancing data with contextual information to improve CDS and decision-making.
Clinical Data Exchange and EMR Integration
Streamlining data sharing through industry standards for CDS and other applications, while pushing data to EMR systems via ΑΡΙΣ to support CDS and workflows.
Provider Network and Authentication
Expanding connections for improved interoperability and collaboration with over 100 providers and ensuring secure data access through OAuth 2.0 and OpenID, benefiting CDS and other applications.
Secure Data Exchange and Interoperability
Our team used standardized protocols for secure data exchange, vital for CDS and workflows, and leveraged FHIR standards to ensure compliance and interoperability.
Results
  • Comprehensive Patient Views
  • Real-time Insights
  • Reduced Burdens
  • Enhanced Provider Relations
  • Efficient Data Processes
Conclusion:

Through the strategic implementation of interoperability building blocks, our client successfully overcame their challenges and achieved their mission of enhancing data management, network efficiency, clinical decision support, and, most importantly, elevating patient care to new heights.