Architecture Consulting and FHIR Implementation for non-emergency medical transportation company

HealthcareArchitecture consulting

TECHNOLOGIES

SERVICES

Software Architecture Consulting Services

EXPERTISES

Cloud Development Services

Project Context

Solution

Outcome

About Client
Our client covers the in-home care services such as non-emergency medical transportation benefits which predict EHI exchange and integration with insurance companies and other TPAs.
Currently, the company has a market network platform that bridges caregivers and members according to benefit plans covered by their insurance providers. Besides, the platform offers functionality that automates HIT, logistics, utilization, and quality management.
In light of the latest provisions issued by the government, the client was requested to adjust the solution to the HIPAA standard. Being a third-party administrator that works with sensitive data, our client saw a chance to ensure a secure data exchange flow through FHIR implementation.
Business challenge
The data regulations issued by the government have obligated healthcare service providers and TPAs to become HIPAA-compliant which required the implementation of FHIR as a data exchange standard.
Prior to our collaboration, the company was connecting other TPAs by writing parts of custom code for each individual integration. With the rising number of third-party integrations and users, the platform could hardly get any updates without malfunctioning.
This approach has been severely limiting and slowing down the time spent on creating a profile for a new user. It also significantly decreased data exchange speed and efficiency. For instance, some clients had to wait a day or two to know if their insurance was covering the services our client was providing. Simultaneously, our client was facing financial loss caused by delayed data updates.

Solution
Prior to the discovery phase, our client's primary request was to build processes that would meet their business goals. At the same time, our client wanted the Binariks team to preserve the existing business flows. In addition, our client was looking to decrease the amount of time required to integrate and share information with third-party organizations.
Another important part of the request was related to using centralized storage to support key business processes that include data of services provided, vendors, health care information, insurance, claims, and shared healthcare data information.
Implementation
Binariks rallied both discovery and implementation teams to consult, architect, and implement the new FHIR and dispatch parts.
During the discovery phase, Binariks’ team comprised of a solution architect and a business analyst approached the client with a proposition: the envisioned solution had to enable the client to adopt FHIR as centralized health data storage and build all new solutions based on the FHIR data model.
Later this would allow it to easily interoperate with third-party organizations, accept and share healthcare information using a defined structure.
Binariks team conducted a deep-dive analysis of the problem and identified that it’s also vital to:
- Reach HIPAA compliance through the implementation of the FHIR standard
- Facilitate integration with third-party systems in FHIR format
- Prepare the product for a larger number of services
- Ensure stable product performance during an increased number of rides
- Implement OAuth authentication
- Activate Transport Security TLS 1.2

Value Delivered

As an architecture service provider, Binariks delivered a more secure and up-to-date digital solution without affecting business processes that are crucial to the client.
Now the client can enjoy automated claim submission and receive data in real-time which significantly reduces the potential loss of money.
The renovated architecture of the solution brought about numerous positive changes including secure and fast data hosting and exchange enabled through FHIR and AWS toolset. Binariks' team added authentication that made the registration of insurance companies on the platform faster and easier.
As a result of cooperation with Binariks, the client can now increase the number of active users regardless of the third-party provider plans. In a long run, this innovation decreases the monthly cost of product maintenance.

Russell Hertzberg

Owner & Chief Agile Officer, JCloud

USA

Binariks’ health technology expertise and their experience in building successful healthcare software solutions are their key differentiators. Additionally, they’re extremely strong in having a complete, thorough, and high-quality architecture discovery phase.