HealthAsyst built prior authorization module for a leading ambulatory EHR in the US, which is
one of the early adopters of Electronic Prior Authorization (EPA) for prescription drugs.
A leading EHR vendor in the US required a partner with knowledge of eco-system and business processes across the value chain, to integrate in a comprehensive yet optimized way.
A remote patient monitoring system that applies automated techniques to aggregate high-resolution diagnostic and therapeutic data from bedside monitors of ICU patients and presents meaningful data to care givers.
Customer had committed to make the application available, at their user conference within a year. Regulatory requirements and customer demands had diverted their existing team to focus on maintaining the legacy application. Developing for mobile platform also meant need for a new skillset, which the customer did not have. Further there was no possibility of scope reduction, as the solution would not find much use with limited scope.
The customer proposed a solution where the customer assumes the risk and pays the provider entire portion of the patient responsibility (post adjudication), for a nominal fee. The recovery of patient responsibility is now handled by the customer instead of the provider.
While working with multiple care givers who were part of ACOs, the customer realized that achieving a coordinated workflow based on the defined care plan, was a big challenge. Also, integrating the data from multiple sources and reconciling it in a timely manner, at the point of care system, was difficult. Standard terminologies were not maintained even within the different systems of the customer. The care coordination platform would allow risk stratification and predictive analytics for patients participating in the co-ordinated care model.
The EDI claims engine used by the customer was built on a legacy platform. It neither had the documentation nor the original development team that developed it. Therefore, every modification was a herculean task. The system was not easily configurable, had business rules hardcoded, and had deprecated/redundant code. Additionally, a large number of rules resided with its partner clearing house. The customer continued using a cross-walk provided by the clearing house due to the complexities involved in migrating the system from 4010 to 5010. The above factors resulted in unwarranted dependency on the clearing house and slow responses to regulatory and customer change requests.
The customer wanted to implement a HealthAsyst Patient engagement product for radiology departments called RadAsyst. The exchange of information between client RIS and RadAsyst had to happen in HL7 format through secured channels. There was a lot of unstructured information to be sent which demanded special considerations.
The customer was conducting a research project in the area of ICU patient care, with the objective of enabling preventive care through proactive monitoring of patient data. The solution has to collect enormous amount of data from medical devices in the ICU, analyze, interpret and sent the data back to the display system for timely patient alerts.
A large Provider organization wanted to implement a leading EHR across its 53 sites within 9 months. Owing to the scale of the facilities affected due to the implementation, the switch-over
had to be completed within one weekend.
To adapt to new changes and to provide innovative solution, the client had developed iPad applications to access EHR workflows. This is expected to help the doctors tremendously in complying with the requirements to implement and use EHR for preventive healthcare. However, quality assurance of EHR Workflows on iPad including workflows, user-experience, business validations and interfaces, was in fact, a challenging task for the customer.
The Department of Health and Human Services’ (HHS) mandate for healthcare organizations to transition from the old ICD-9 code set, that has been in use for over 30 years, to the new, more complex ICD-10 code set has placed a tremendous burden on all healthcare organizations who must use this new medical coding system.