Edifecs Continues Work to Solve Healthcare IT Interoperability Challenges

Demonstrates Patient to Payer Forms Information Sharing through the HL7 FHIR Server

BELLEVUE, Wash. – October 9, 2015 – Edifecs, a global health information technology solutions company, today announced the company’s successful participation at HL7’s Structured Data Capture FHIR Connectathon August 12th and plans to participate in the payer Connectathon at the HL7 Plenary and Workgroup meeting in Atlanta, Georgia, October 3 and 4. Edifecs participated in the August event focused on Structured Data Capture (SDC) and successfully demonstrated patient access to eligibility inquiries via a mobile device. Edifecs delivers interoperability to reduce the administrative costs of healthcare while improving patient engagement and timeliness of data.

HL7 FHIR continues to offer more capabilities for the healthcare community. SDC is a new domain that the FHIR community is exploring with the potential to accelerate interoperability. Edifecs has focused on aspects of FHIR SDC that drive administrative simplification, maintain compliance with industry mandates such as Operating Rules while increasing patient engagement for both payers and providers including:

  • Automation of manual processes. Streamlining the ability for providers to verify eligibility and for patients to understand the cost of healthcare.
  • Extending existing electronic automation to the edge of the enterprise and of the healthcare ecosystem.  Ensuring that data collected via web forms is governed by the same data validation rules as electronic processes reducing risk, increasing confidence in compliance activities and reducing infrastructure costs.
  • Enabling patient engagement. Extending common queries and responses to mobile devices using the structured data capture profile enables organizations to accelerate mobile health programs, increase patient and member satisfaction and pilot new programs by extending automation processes.

Edifecs demonstrated two major use-cases during the HL7 FHIR SDC Connectathon. During the first demonstration the team created an eligibility request form and populated it into the FHIR Server. In practice, this will allow a care coordinator to create a patient questionnaire and order procedures, and when loaded to the server the questionnaire is accessible for patients on a hosted web page. The second demonstration included the completion of an eligibility request form intended to receive medical coverage information from a payer. This process provides a patient access to a mobile HL7 FHIR SDC questionnaire where information about a procedure is submitted to a health plan, the health plan then has the ability to transform the FHIR JSON request to HIPAA 270 and send back a FHIR response via a mobile page that shows the corresponding coverage per each requested procedure. 

For both cases the Edifecs team implemented customized web UI for mobile devices that allowed for the creation, completion and management of questionnaires; business workflows through Edifecs XEngine Server which facilitates the transfer and mapping of eligibility requests to and from payers; and integration between the eligibility form and payer’s system.

“Edifecs is an avid supporter of the HL7 FHIR initiative and developing interoperability standards industry-wide,” said Sunny Singh, president and CEO of Edifecs. “This technology offers a new standardized and efficient way to handle the back-end clinical, financial and administrative processes that will ultimately save the industry millions and improve healthcare data exchange among all trading partners.”

About Edifecs

Edifecs develops innovative, cost-cutting information technology solutions to transform the global healthcare marketplace. Since 1996, Edifecs technology has helped healthcare providers, insurers, pharmacy benefit management companies and other trading partners trim waste, reduce costs and increase revenues. More than 350 healthcare customers today use Edifecs solutions to simplify and unify financial and clinical transactions. In addition, Edifecs develops supply chain management solutions to support worldwide customers in non-healthcare industry segments. Edifecs is based in Bellevue, WA, with operations internationally. Learn more about us at www.edifecs.com.