Healthcare Interoperability Cloud

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achieving compliance with these mandates means investing in costly, disruptive, and time-consuming updates to outdated legacy systems and infrastructure.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 (HIE): a data management and integration platform designed to enable strategic interoperability and support your digital health strategy.

Your Foundation for Strategic Interoperability.

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. Automate shared workflows, adapt to market changes, ensure ongoing compliance, and deliver better member experiences and outcomes. The road to strategic interoperability starts here.

The Edifecs Healthcare Interoperability Cloud eliminates data barriers to help healthcare organizations:

Manage complexity

Enable future-proof interoperability

Cleanse, correct, standardize, and move 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.

Incomplete, Fragmented insights

Complete, Unified insights

Without Edifecs

With Edifecs

Data Standards + Interoperability Leadership

Best in KLAS: CMS Interoperability - 2024

Ready for the Future of Interoperability?

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

News & Insights

Fueling Your FHIR: The Keys to Strategic, Complete, and Compliant Interoperability

In this webinar, learn actionable insights and a blueprint to help health plans achieve strategic interoperability success.

Learn More ❯

From EDI to FHIR: The Evolution of Healthcare Interoperability

Adopting FHIR standards doesn’t have to mean overhauling your tech stack.

Learn More ❯

True Interoperability: The Key to Transforming Healthcare

Download this white paper from the 2023 Best in KLAS in CMS Payer Interoperability winner, Edifecs, to: • Learn about the four levels of interoperability and how your organization and the rest of the industry stacks up • Discover how effectively achieving on the quadruple aim is dependent on enacting true interoperability • Find out how your organization can leverage investments in interoperability to accelerate the adoption of value-based care and automate shared workflows, like prior authorization, to improve collaboration, experience, and outcomes

Learn More ❯

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