Industry: Healthcare
Background :

Health Information Exchange allows health care professionals and patients to access and securely share a patient’s medical information in an electronic format. Currently there are two main format HL7 and CCD with an emerging format known as FHIR.

Problem :

A healthcare insurance company realized that Electronic Health Records (EHR) could be much more valuable for all stakeholders, especially patients, if insurance data were integrated into the records. The absence of critical insurance data in EHR’s has been a long-time problem for healthcare professionals. Among many unique data elements in the Insurance company databases, the “Gaps in Care” and “Current PCP” are very valuable to the overall record. If insurers could contribute the key elements of their data into the ultimate EHR, it would enhance patient care, better support providers, and drive improved informatics data throughout the network. These are all important benefits to insurers as they focus on improving care and lowering overall costs.

Solution :

Eixsys built a exchange gateway that enables Payers to send the unique and important patient data elements directly to the HIE for integration into the patient EHR’s, thereby enhancing the records with vital information. These so-called “enhanced CCD’s,” raise the quality of all patient EHR’s so that gapsin information are filled in. This allows physicians, patients, and other providers with access to these records the opportunity to deliver the very best treatment and diagnoses at the point-of-care.

Result :

By proactively sharing key unique data to the HIE’s and their partner providers via patient EHR’s, the Insurance Payer demonstrated their willingness to collaborate with its partners in order to improve the quality of healthcare. So, in addition to the cost and patient benefits, the Insurance company improved its profile and standing with the entire healthcare community, drawing new physicians and members to its network.