Healthcare Interoperability Cloud

Security. Flexibility. Scalability.
Combining our EDI, FHIR, and Smart Trading platforms for seamless connection.

Compliant and Future-Proof Interoperability

When it comes to offering patients and members a comprehensive, efficient, and connected experience, healthcare lags far behind other industries. Interoperability mandates like CMS-0057-F and CMS-9115-F are meant to give patients greater visibility into and control over their care—but for many payers and providers, achieving compliance with these mandates means investing in costly, disruptive, and time-consuming updates to outdated legacy systems and infrastructure.

The Edifecs Healthcare Interoperability Cloud is the next frontier in healthcare information exchange: a data management and integration platform designed to enable strategic interoperability and support your digital health strategy.

Edifecs Cloud Solutions diagram

The Road to Strategic Interoperability Starts Here.

The future of healthcare is a system that places members at the center through seamless collaboration, alignment, and trust. The first step in driving transformation is for payers to adopt a more strategic approach to interoperability, a concept rooted in the understanding that promoting seamless data exchange—not just between an organization and their own members and partners, but across the entire healthcare ecosystem—is as essential to an organization's long-term viability as compliance with regulatory requirements. A strategic approach to interoperability not only capitalizes on the benefits of FHIR, but integrates FHIR standards with existing data protocols like EDI to ensure payers maximize their previous interoperability investments.

The Edifecs Healthcare Interoperability Cloud combines our EDI, FHIR, and Smart Trading platforms to seamlessly connect systems, processes, organizations, and people across the entire healthcare ecosystem. Advance digital health capabilities, adapt to market changes, ensure ongoing compliance, and deliver better member experiences and outcomes.

Healthcare Interoperability Cloud Solutions

EDI Gateway
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FHIR Gateway
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Smart Trading
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The Edifecs Healthcare Interoperability Cloud eliminates data barriers to help healthcare organizations:

Manage complexity

Enable future-proof interoperability

  • Cleanse, correct, standardize, and exchange data with support for existing HIPAA 278 transactions and evolving CMS interoperability/FHIR mandates
  • Leverage a combined FHIR and EDI SaaS solution with a robust suite of vendor-managed APIs and capabilities designed to support evolving legislation
  • Seamlessly integrate FHIR data into existing systems via a low-/no-code integration engine
  • Ensure ongoing compliance with CMS-9115-F and CMS-0057-F via a complete set of required APIs for:
    • Payer-to-Payer Data Exchange
    • Provider Directory
    • Patient Access
    • Prior Authorization
    • Provider Access

Maximize efficiency

Minimize high-cost, low-ROI implementations and maintenance

  • Enrich and seamlessly move data from multiple format types to a single standardized FHIR format through a unified gateway
  • Facilitate the required sharing of data with third-party developers through a web-based developer portal
  • Enable additional types of data exchange and associated business use cases with out-of-the-box and ongoing updates and implementation guides
  • Reduce administrative workloads and costs associated with unnecessary prior authorization submissions

Intervene early

Get the right insights for better outcomes

  • Deliver a more holistic and comprehensive view of patient health histories directly to the provider’s EHR for more informed care decisions
  • Effectively retrieve data from internal systems for faster and more targeted reporting and analysis
  • Capture more data from the member’s previous plan to improve care coordination and identify and correct care gaps

Meaningful Intervention and Member Empowerment

As an industry-leading interoperability vendor and founding member of Da Vinci, Edifecs powers holistic strategic interoperability by connecting systems, processes, and people across the healthcare continuum.

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Incomplete, Fragmented insights

Complete, Unified insights

Without Edifecs

With Edifecs

Data Standards + Interoperability Leadership

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Best in KLAS: CMS Interoperability - 2024
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Ready For the Future of Interoperability?

Achieve ongoing compliance and long-term strategic interoperability with the Edifecs Healthcare Interoperability Cloud.

All About Strategic Interoperability

The Transformation Imperative Playbook
A playbook for connected, collaborative, and intelligent healthcare transformation.
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Going Beyond Compliance with Edifecs’ FHIR® Gateway
See how Edifecs’ FHIR Gateway solution helped a health plan not only achieve compliance with CMS-9115-F, but allowed the plan to fully maximize the benefits of implementing FHIR APIs as well.
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The Digital Health Transformation- Redefining Interoperability
The Digital Health Transformation: (Re)Defining Interoperability
It’s time to change the way we think about interoperability.
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