Background
In the wake of New York Health Equity Reform (NYHER) being approved under the section 1115 demonstration waiver of Medicaid Programs, the healthcare in New York state is adapting to higher quality of health services with an aim to lower health disparities.
NYHER focuses on covering all low-income citizens and people with pressing social needs. The approved services in NYHER are based on clinical and Health Related Social Need (HRSN) data exchanges among the Healthcare Ecosystem Partners, Social Care Networks and Other Ecosystem Partners.
This requirement led us to implementing a Community Referral Exchange which not only exchanges data bidirectionally but also converts different types of files into FHIR resources, thereby facilitating seamless and efficient closed loop referral exchange among different types of organizations such as SCN, CBOs, healthcare providers etc.,
Solution Implementation
The CRE project, slated to launch on April 1st, 2024, signifies a pioneering step in healthcare data management. It converts HL7 V2, Flat Files, and JSON into FHIR Resources (JSON), employing Mirth Connect for conversion and NextGate for ID aggregation. This not only facilitates seamless data exchange but also prevents patient data duplication across care networks. The solution is implemented in 2 phases:
Bi-directional data exchange of patient profile information including Screening and Referrals information.
Send referrals to another Social Care Network (SCN) when services are unavailable within the originating SCN (off-network referral).
Send the Social Care data of eligible members to the NYeC data lake.
Business Benefit
Scalability
CRE's modular design ensures it can accommodate the expanding network of participants and the escalating volume of data exchanges, critical for adapting to New York's diverse and growing healthcare needs.
Extensibility
Designed with future-proofing in mind, CRE can integrate new healthcare standards and technologies, ensuring longevity and adaptability in a rapidly evolving sector.
Reliability
Adherence to USCDI and FHIR R4 standards guarantees the reliability of CRE.
Cost Efficiency
By reducing administrative overheads and enhancing patient outcomes, CRE offers significant cost savings.
Compliance
CRE's commitment to compliance extends beyond current regulations to encompass rigorous data privacy standards, including HIPAA. The platform's security measures and compliance certifications are pivotal in establishing trust within the healthcare community.
Technology Stack
The technological backbone of CRE comprises leading-edge tools and technologies, including Postgres, Redis, Mirth Connect, Next Gate. This robust stack ensures the platform’s reliability, performance, and adaptability to the dynamic landscape of healthcare data management.
Conclusion
CRE offers a new age solution for data exchange, data conversion, bi-directional data flow and closed loop referrals, ensuring scalable, reliable, and cost-effective implementation of NYHER for healthcare ecosystem of NYS. CRE is built as a highly customizable solution, which can be extended to any EHR in future.
Aigilx health specializes in developing Interoperability solutions to create a healthcare ecosystem and aids in the delivery of efficient, patient-centric and population-focused healthcare.
