Overview

The Emids client is a not-for-profit 501c3 health maintenance organization (HMO) insurance company with a consistent record of earning accreditation by the National Committee for Quality Assurance (NCQA).

Emids partnered to help them build the right capabilities that comply with Centers for Medicare and Medicaid (CMS) regulatory requirements related to Interoperability and Patient Access final rules. These regulatory requirements are applicable to the client’s LOBs – Medicaid and Duals only.

The Challenge

Developing interoperability preparedness for not only regulatory compliance but “beyond the rules” readiness.

Emids Solution

Our team performed a discovery assessment to understand as-is state and data ingestion process, data flows, technology and integration tools. We carried out a detailed assessment around FHIR integration, “Build on Cloud” solution approach, and discovered FHIR resource gaps within the current data landscape.

Results

In 10 months we helped the client meet the Patient Access API & Provider Directory API deadline of CMS mandate.

Overview

The client is one of the nation’s leading operators of general acute care hospitals. The organization’s affiliates own, operate or lease 84 hospitals in 16 states with approximately 13,000 licensed beds.

As part of a multi-year partnership, we develop and support HL7 interfaces to expedite a Promoting Interoperability Program for clinical data exchange. This program prevents delays in execution by EMR vendors to provide Public Health Reporting (PHR) services due to a lack of PHR expertise and inability to accommodate frequent changes in the regulations.

Results

Our team performed interfaces development for 6 programs supported under MU3  – Syndromic Surveillance, Immunization Registry, Immunization Query, Electronic Laboratory Reporting, National Hospital Care Survey. We successfully helped the client meet state-specific deadlines for COVID-19 case reporting and managed frequent changes in data specifications by the DOH.

Contact us to learn more about partnering opportunities.

Leveraging the AWS Cloud platform to help leading medical organization accelerate growth and cut operational costs costs

Overview

The Emids client is a leading national medical group with more than $5 billion in revenue. The group provides physician-led services, ambulatory surgery center management, post-acute care and medical transportation among other services. The client encounters more than 30 million patients annually across the U.S.

But the client faced several data challenges impeding its long-term growth.

The group’s clinical data exchange had more than 1,100 point-to-point connections to support data acquisition and had more than 600 sites reporting Medicare-Access-and-CHIP-Reauthorization-Act/Merit-based-Incentive-Payment-System data via a paper-based abstraction process. Additionally, the client was losing revenue from delayed billing caused by incomplete data as well as minimal to no internal checkpoints on data feeds.

Emids Solution

That’s where Emids was brought on to serve as a strategic data partner.

Our team adopted a consulting-led approach to identify key stakeholders, conduct interviews, understand the state of data acquisition & ingestion, clinical flows, technology and integration tools. We carried out a detailed assessment of Health Information Exchanges (HIE), Epic App Orchid, Cerner Hub and other data sources as identified by the client.

The solution was built on the AWS cloud platform leveraging S3 for storage, RedShift for data warehousing, Athena for interactive analytics and a host of other AWS services like Lamda, Glue, and Kinesis data streams.

Results

Emids became the client’s strategic data partner for more than two years, resulting in scalable FHIR-based solutions hosted on the AWS platform. This reduced effort and increased savings on operational costs.

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Top Healthcare Software Developer Creates Interoperable Portal to Help Physicians Make Timely, Informed Decisions for Patient Care

Overview

The client is a provider of the healthcare industry’s most comprehensive suite of consumer experience platforms. Its integrated software is used by payers and providers to positively impact consumer decision-making and health behaviors beyond the care setting through personalized, interactive engagement across multiple channels. Its products include a healthcare customer relationship management system, an enterprise health content management system, an enterprise patient portal and comprehensive care management technology. The company has helped more than 1,100 provider organizations influence consumers in a way that transforms financial and quality of care outcomes.

Business Opportunity

One of the client’s signature products is a web-based clinical portal used by physicians to access vital patient information stored across disparate, federated health information systems. Timely access to this data provides physicians with the insight they need to make faster, more informed decisions about how to diagnose and treat individual patients.

One of the selling points of the platform is its single sign-in that allows physicians to log into the portal and obtain a secure, comprehensive and real-time view of a patient’s health records, including information on allergies, medications, past hospitalizations, blood banks and more.

To retrieve this data, which is geographically dispersed between multiple electronic health records (EHRs), laboratory systems and other backend systems, and provide physicians with a unified view of the disparate information, the client needed to integrate patient records in the portal with more than 30 HIS systems. The multiple integration points and EHRs vendors that existed across these systems complicated this process, hampering the free flow of information and resulting in inconsistencies in the data exchanged. This caused patient records to be marred by missing data, duplicate records, gaps in treatment plans and inaccuracies—all of which had the potential to put patients at even greater risk if not corrected.

Solution

In 2015, the client enlisted emids’ help to solve these integration-related challenges. We brought broad clinical and technical expertise to the engagement, including knowledge in:

• Clinical systems and applications architecture
• Data quality and governance
• Master data management
• Interface architecture, including standards-based frameworks such as HL7 and FHIR
• Semantic interoperability

We conducted an in-depth study of the databases, schemas and data semantics used by the two primary EHR systems used—to deepen our understanding how to extract data from these systems. Then we built customized connectivity adapters for each HIS system, which included lab, pharmacy, radiology, transcription, imaging and admissions systems, to aggregate, normalize and harmonize clinical and patient data flowing between each source system and the portal. Adapters were both batch and real-time as well as bi-directional, sending out data as JSON and XML.

Interface engines, built on a Java/Spring/Hibernate framework that could be quickly configured and extended, provided secure exchange points between adapters, routing data back and forth between each HIS system and the portal as indicated in Figure 1.

Technologies Used

• Java
• Spring
• Hibernate
• MySQL
• Tomcat
• Mirth Connect 3.2

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Results

While our work with both of these engagements are ongoing, we have helped the client meet their initial deadlines for bringing these projects to fruition and transforming them from concepts into viable technologies ready for the first phase of internal testing. Our team of healthcare experience technologists, which included 50 people at peak, jumped into both projects quickly and have added value uniformly and quickly.

We understood what needed to be built to execute the projects and assembled teams with deep healthcare knowledge to help drive their development. With the population health project, we worked closely with the client to flesh out the engineering for the product and set its direction. We helped anticipate and resolve issues before they became problems, even taking the initiative to collaborate with the third-party analytics provider that came on board to keep the engagement proceeding smoothly. The client still raves about how the initial prototype of the product matched their vision and met their needs right out of the gate.

We have continued to deliver new functionality for these projects, overseeing production releases every two weeks. The NLP tool we are developing for the client has enabled them to quickly explore the impact of different scenarios for coding by changing the rules for the automatic capture of clinical data. This process used to take days, but we have helped the client shorten the turnaround to few hours.[/vc_column_text][/vc_column][/vc_row]