Industry
Dental Care
Technologies Used
Azure Health Data Services
Azure Logic Apps
Azure API for FHIR
Key Outcomes
Achieved CMS mandate compliance
Enabled a framework and architecture for future interoperability requirements
VNB Health assisted a dental care organization implement Patient Access and Provider Directory API using Azure Health Data Services to meet CMS Mandate.
Customer Profile
The customer is a prominent healthcare insurance provider serving a vast population. With a rich history in the industry, they are committed to delivering comprehensive healthcare solutions and enhancing member experiences. The organization operates in a highly regulated environment, necessitating robust and compliant systems. Due to the sheer volume of transactions and complex nature of healthcare data, the customer handles a significant workload, demanding efficient and reliable IT operations.
Customer Situation
The customer handled 270/271 Healthcare Eligibility Benefit Inquiry transactions to verify patient healthcare eligibility, coverage, and benefits. The customer relied on custom API interfaces built on Microsoft BizTalk Server to connect with multiple insurance payers. This complex integration environment, characterized by high transaction volumes and frequent changes, was prone to instability. Updates to one payer’s interface often disrupted connections with others. To mitigate this risk, accelerate development and ease the build, deployment and testing process, the customer sought an automated solution that would enable continuous integration and continuous delivery (CI/CD) with robust automated testing.
Customer Profile
The customer is a leading dental care organization providing managed care dental plans for individualized and family-oriented dental care. Through their network of contracted dental providers, customer operates to better the oral health in Oregon communities in Washington, Clackamas, and Multnomah counties.
Customer Situation
The customer required the Patient Access API and Provider Directory API to meet the CMS interoperability and patient access final rule mandate July 2021.
VNB Solution
After reviewing the internal EHR system at the customer and mapping the requirements to the backend systems, VNB’s App and Integration team provided the solution to meet the CMS mandate using the Microsoft Azure API for FHIR and Azure Logic Apps. VNB recommended integration with the EHR using the Azure Logic Apps and creation of a patient repository in Azure SQL to enable secure access to Patient Access API.
The Azure Logic Apps-based data feed helped in synchronizing the required data for the Patient Access API and Provider Directory API from the EHR to the Azure API for FHIR.
To ensure secure access, the VNB team built an Azure Logic App based front APIs which retrieved the patient access and provider directory data from the Azure API for FHIR and enabled the customer to meet the CMS mandate seamlessly.
VNB team ensured that the technical, content and vocabulary standards in the ONC 21st Century Cures Act final rule, adopted by CMS to support these two API policies are adhered to. VNB followed the implementation guides for Claims and Encounter Data and Provider Directory Data and evaluated the solution against the same.
Customer Benefits
The solution benefited the customer as it enabled them to meet the CMS mandate. It also enabled a framework and solution architecture for future interoperability requirements enabled by Azure API for FHIR.
The Azure API for FHIR based solution helped the customer to deploy a FHIR Service and leverage the elastic scale in a compliant cloud environment powered by Microsoft Azure.
The Azure based solution also helped customer’s IT overcome the complexities of maintaining a secure and reliable management of PHI in cloud.
