Today’s health plans are still facing daunting challenges with stakeholder collaboration, system interoperability, and a changing consumer market.
As patients take on more responsibility for their care, we need to be able to give patients access to healthcare data anytime, anywhere. Health plans must now look to bridge innovative technologies and new standards (such as FHIR) with traditional backed systems. We at Edifecs are helping plans prepare for these changes by ensuring their provider networks are seamlessly connected and their care teams fully informed in order to offer the best consumer experience at the highest quality of care.
The fundamental technology that runs applications on smartphones is finally being applied to healthcare. Now, discrete data sets, such as patient observations or claims, can be shared between patients, providers, and payers, making it possible for patients to check eligibility from a mobile device or for providers to upload medical attachments and instantly receive pre-authorizations. By adopting FHIR, health plans can minimize chart reviews and implement alternative payment methods based on up-to-date performance pulled directly provider EMRs, calculating quality measures in real-time.
The spike in interest for the open HL7 (future) standard called FHIR (Fast Healthcare Information Resources) is being driven by the high costs of interoperability and lack of pricing standardization among vendors. The need for a cost effective, plug-n-play, alternative for customized file-based connections aligns perfectly with growing appetite for web-based applications. The rise of the API is finally fueling smarter modernization efforts from the new healthcare CIOs tasked to remove operational costs and drive top line revenue.
For over 20 years, healthcare companies have looked to their trusted partners, such as Edifecs, to build solutions that disrupt and move healthcare technology forward. Standards like FHIR and API-enabled web services (REST/JSON) are the future of a fully connected healthcare system. “We are recommending that health plans jump in and implement FHIR standards across their organizations. Those that do will benefit from a substantial competitive advantage in both the consumer and health plan marketplace,” Sunny Singh, President and CEO of Edifecs.
To accelerate the adoption of FHIR enabled transactions by any health plan, even those with no prior experience, Edifecs has introduced the FHIR Bridge Module. This out-of-the-box solution ensures rapid development, minimal training requirements, and, for existing Edifecs customers, reduction of the total costs of ownership of the Smart Trading platform. This complete FHIR integration toolkit includes all the necessary components for the novice programmer (as a testing FHIR sandbox) or by the seasoned expert moving a FHIR infrastructure into production. This packaged has the following components and benefits:
• Save times and money. One package with all integrated components included: design-time tool, run-time engine, and open source FHIR server (if needed).
• Drive value-based initiatives. Contains pre-build maps for HIPAA, HL7, CCD, and FHIR for easy integration of provider clinical systems to backed EDI systems.
• Integrate existing workflows. Reference implementation for all typical payer-centric use cases (Attachments, Prior-Authorization, Eligibility, Claims, Payments, and recently, quality measures)
• Competitive advantage. Quickly enable consumer applications with a standard DB with full set of XML, Schema, and JSON-based guidelines to shorten integration and reduce overall costs.
Edifecs invites you to join us as we work to bridge traditional EDI data exchanges with FHIR-based clinical interoperability in an effort to increase healthcare collaboration. As health plans move toward alternative payment methods, the FHIR Bridge can help to achieve interoperability and implement quality measures using clinical and financial data resolving several of the healthcare industry’s main business problems. To learn more on the FHIR Bridge, or get access to one of our public sandboxes to start testing, please contact us at info@edifecs.com.
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