KPi-Tech helped a US based Healthcare Provider with FHIR R4 based integration between EMR and Patient Access Solution

Business Vertical:

Healthcare IT

Region:

USA

Main Challenge:

EMR Integration

Overview

The client is an US based ambulatory Electronic Medical Record (EMR) provider. To reduce costs and maximize profits insurance companies are increasingly denying claims as well as coverage to patients treating chronic or persistent in - this puts an extra burden on Health Care Providers to manage operating costs. This factor enabled EMR application provider to adopt, such as Patient Access solutions, to properly analyze denied claims.

Business Need

The ambulatory EMR application provider wants an integration with Patient Access solution, a revenue management platform that can assist its clients increase cash flow and financial performance, save operational expenses, and improve patient experience.

Challenges

  • It is necessary to integrate admission data cross these two EMR and Patient Access Solution so that payers are immediately notified of admissions, preventing claims from being processed slowly and lowering reimbursements.
  • However, integration of EMR and patient access solution is challenging due to the lack of data standardization
  • The Patient data (ADT- admission, discharge and transfer) must be available, discoverable, and understandable to PAS. Further, to support automated clinical decision support and other machine-based processing, the data must be structured and standardized.

Solution

KPi-Tech integration experts came up with a solution to use Mirth Integration engine to acquire data from EMR and use FHIR (Fast Healthcare Interoperability Resources) to transmit data. FHIR aims to simplify implementation without sacrificing information integrity.

The EMR system using MIRTH aimed to provide a way to talk to the patient access solution in FHIR R4 and transmit admission data (ADT). The Mirth interface engine pulls patient demographics add/update information from the EMR.

  • In mirth, a channel is created that polls data every 5 mins from the EMR database for newly added or updated patient demographics.
  • Mirth FHIR connector was used to convert the incoming data into FHIR Standard message.
  • A single FHIR message is created by combining different FHIR resources into a bundle resource.
  • Some of the FHIR resources used for this integration are:
    1. Message Header
    2. Patient
    3. Practitioner
    4. Episode Of Care
    5. Encounter
  • Once the bundle is created it is sent to FHIR Server (AIDBOX) via API (Application Interface).

AIDBOX stores the patient demographics in (FHIR R4 format), both EMR and AIDBOX database are in sync. Webhooks are created in AIDBOX that sends patient Add/Update notification to Vendor (Patient Access Solution).

FHIR Integration
EMR Integration Workflow

Technology Stack

  • Mirth Connect
  • FHIR R4
  • Java Script

Result

FHIR along with Mirth offered a fast and easy way to share information to Patient Access Solution in a standard way. It has resulted in reduced scheduling costs and improved patient access.

FHIR messages are readable by humans and are modular, enabling specific elements to be shared and the ability to eyeball whether you’ve received what you expected.

Additional benefits include:

  1. Improved the average monthly reimbursements
  2. Better connect with patients throughout the administrative process, promoting an enhanced patient experience from scheduling to billing.
  3. Improve patient satisfaction and financial performance
  4. Completing check-in paperwork from home.

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