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Challenges in Healthcare Interoperability
Multiple data formats, lack of standardization and limitations around real-time data exchange are often cited as the biggest Interoperability challenges by Health Plans.
The revised interoperability rules released by CMS and ONC under HHS are aimed at pushing healthcare industry stakeholders to share more data with each other and with patients while maintaining privacy/security.
New Policies as per CMS Final rules
- Patient Access API
- Provider Directory API
- Payer-to-Payer Data Exchange
- Dual Eligibility Reporting
- Public Reporting and Information Blocking
- Admission, discharge, transfer (ADT) event notification
- Digital Contact Information
CMS Interoperablity and Patient Access Milestones
The journey to HL7 – FHIR (Fast Healthcare Interoperability Resources) adoption would need organizations to address existing data standardization, integration and accessibility challenges with much greater focus.
Sage IT has designed a unique solution for Healthcare Payers and Health Plans to adhere to the evolving CMS Rules Provisions and enable Member 360.
Solution tenets:
- Implementation of CMS Interoperability final rule – Real Time Data exchange for Patient, Provider, Claims, Clinical, Pharmacy and Lab Data and dependent objects
- FHIR Compliant resource APIs – Secure (consent, authentication and authorization) access to members’ health data
- Hardware infrastructure that meets all FHIR standards (FHIR 4.0.1) hosted as-a-service
- Member 360 – resolving multiple member identity problem for payers
- Member Portal for Member 360 – Single-view-of-the-Member
The solution leverages FHIR APIs to manage the records of patients, practitioners and payers in an organization which can be accessed through a unified platform built on top of the underlying APIs.
Why Sage IT for your Healthcare Interoperability needs?
– Managed FHIR solution, API driven architecture
– Pre-built Patient and Provider API structures
– 60 to 90 days accelerated migration
– Cloud hosted for scalability
– Proven implementation partner (ask for case studies)
“We feel Tibco & Sage IT, have done an excellent job addressing all our follow-up questions around IO, the proposed architect supporting Data Management, Salesforce and legacy application integration, Analytics and of course, training.
We feel a partnership with your perspective organizations will get us to where we need to be, today, tomorrow and the near future. ”– Executive Team Member,
NY based Health Plan
Sage IT Healthcare Interoperability Framework
Features:
- FHIR 4.0.1 compliant with all HIPAA and HITECH regulations including Audit Assurance
- Integration with application end points in the Cloud and On-premise
- Stable integration which is fully operational 24/7
- Application and Interface Security on Cloud
- Adaptable & Scalable to accommodate future solutions
- API & Information management for data consistency & modeling across various applications
- Superior cloud data quality to discover data issues
- Cloud data management for a 360-degree view of data about key business entities from internal and external data sources
- Change control and configuration management with operational ease of use
- Easy to use interfaces that eliminate complex coding
- Integrate most CRMs/EHRs and other critical applications
- Orchestrate business processes for system to system interactions for Business Continuity management and operation resilience
If you are a payer or a health plan who is looking to implement a best of breed solution, customized and configured to your specific needs; deploy the solution in a timely and cost-effective manner; and ensure superior training to technical staff, please do write to us and share your RFPs with us – marketing@sageitinc.com or +1 214-619-2030.
