Healthcare Interoperability Accelerator

About This File

Overview:

The lack of seamless data exchange in healthcare has historically detracted from patient care, leading to poor health outcomes and higher costs. The recent CMS rule established polices that break down barriers in the nation's health system to enable better patient access to their health information, improve interoperability and unleash innovation, while reducing burden on payers and providers.

The new policies mandate that Payers make personal health data available via application programming interfaces (APIs) to third-party app developers and to exchange such data with other payers: Patient Access API: Provide access to patient health records; Provider Directory API: Provide access to provider directory; Payer to Payer Data Exchange: Send/receive patient health records.

Support Details

The list of Supported Versions represents the TIBCO product versions that were used to build the currently released version of this accelerator. We expect newer versions of the TIBCO products will also work. Please see the wiki page for the accelerator for possible further details around product versions.

Accelerators are provided as fast start templates and design pattern examples and are supported as delivered. Please join the Community to discuss the use and implementation of the Healthcare Interoperability Accelerator.

Reference Info:

Increasing global healthcare data stored in multiple databases/formats/systems of record makes the secure, seamless exchange of it difficult. Patient demand for transparent records-of-health access anywhere, anytime along with time-sensitive and urgent government mandates such as, in the US (US ? Interoperability and Patient Access final rule CMS-9115-F) are compelling payers/providers to deploy an accelerated digital transformation agenda to meet these demands.

The Interoperability and Patient Access Final rule

The Healthcare Interoperability Accelerator helps payers meet these CMS mandates while building a modern healthcare architecture to provide better healthcare and increasing their revenue stream.

Business Scenario

TIBCO can help Payers become compliant with the Interoperability mandates.

Value Drivers	Business Benefits
API Driven Architecture Create/host/manage APIs & provide a developer portal	Seamlessly connect data sources and requests through APIs
Data Transformation Access & convert source data to FHIR	Facilitates integration in real-time with producers & consumers of data
Data Governance & Management Clean, accurate & secure data policies & procedures	Produces 360o view of patient, providers & members
Data Virtualization Unifies versions across all data sources & types	Access controls & one true source

Typical Use Cases

As A/AN	I WANT TO	SO THAT?.
member/patient	See my clinical history (diagnostic reports, lab orders/results, vital signs, etc.)	I have access to all my clinical history from all the providers on a single mobile app or web portal.
member/patient	See my encounters	I can see information about my interaction with healthcare providers on a mobile or web app of my choice. I can have a record of the purpose of my visit, the type of visit (ER, inpatient, office, etc.)
member/patient	See the cost of drugs	can see the brand and generic prescription drugs covered fully or partially by my plan. I have access to the cost of the medication as per my plan, deductibles, coinsurance, and copay.
member/patient	Have access to my claims and their status	I can see the status of my claims, deductibles, out-of-pocket, copay, coinsurance, and EOBs.
member/patient	Search for a provider	I can search for a provider based on gender, specialty, language, distance, plan, etc.
provider (physician or hospitals)	Make clinical and encounter information available to patients/members	Patients/members can access their medical history in a seamless way.
payer (health plans)	Make claims and formulary information available to patients/members	Patients/members can access medical and pharmacy benefits, EOBs, etc.

Concepts

FHIR: Fast Healthcare Interoperability Resources (FHIR, pronounced "fire") is a standard describing data formats and elements (known as "resources") and an application programming interface (API) for exchanging electronic health records (EHR},

Benefits and Business Value

In compliance with the 21st Century Cures Act
Accelerate source data to FHIR resource mapping to create FHIR resources
Implementation of FHIR APIs
Unifying siloed data from different environments into a single data layer using TIBCO Data Virtualization and managing Master data is TIBCO EBX.
Reduced development time

Technical Scenario

As A/AN	I WANT TO	SO THAT?.
solutions engineer/developer	Convert a patient record in the database into a FHIR patient resource	I have patient data in the form of FHIR patient resource.
solutions engineer/developer	Parse FHIR patient resource	Use parsed FHIR patient resource in downstream processing (logging, saving in the FHIR server's repository, etc.)
solutions engineer/developer	Persist FHIR patient resource in the FHIR server?s repository	The 'Patient Access' API can be used to query patient resource from the FHIR server
solutions engineer/developer	Update FHIR patient resource	The changes to patient resource (address, phone, etc.) reflect in the FHIR server?s repository. Updated changes are available for querying via patient API.
solutions engineer/developer	Delete FHIR patient resource from the FHIR server?s repository	The FHIR patient resource is deleted from the FHIR server.
solutions engineer/developer	Develop a nightly job to load clinical, claims, formulary, encounter and provider resources in the FHIR server	Make clinical, claims, encounter, formulary and provider data available via 'Patient Access' and 'Provider Directory' API.
solutions engineer/developer	Convert a HL7v2 Admit/Discharge/Transfer (ADT) message to FHIR patient and encounter resources. ADT events are quickly made available via 'Patient Access' API and 'Encounter Access' APIs	Convert a HL7v2 Admit/Discharge/Transfer (ADT) message to FHIR patient and encounter resources.
solutions engineer/developer	Convert FHIR Patient and Encounter events to HL7v2 Admit/Discharge/Transfer message. ADT events can be sent to adjudication/measure systems.	Send ADT events to adjudication/measure systems via API.
solutions engineer/developer	Data virtualization of provider directory data sources	I have Provider 360° view
solutions engineer/developer	Do master data management of provider information	Updated and verified provider information is always available via 'Provider Directory' API.
solutions engineer/developer	API management of 'Patient Access' and 'Provider Directory' APIs	Patient Access and Provider Directory APIs are secured and have quotas and policies in place for the access of APIs

Machine Requirements

This Accelerator demonstrates the capabilities to address the CMS mandates. In order to run this Accelerator, the following are the minimum recommended guidelines for installation:

Operating System	CPU	Memory	Disk
Windows 10/2016 64-bit	Minimum 8 cores, more will give better performance	Minimum 24GB, more will give better performance	Minimum 30GB

For AWS deployment, the minimum configuration is:

AMI	Instance Type	Storage	Security
Microsoft Windows Server 2016 Base	m4.2xlarge 8 vCPUs, 32GB RAM	Minimum 30GB	Open port 8080

Distribution

The accelerator distribution is a ZIP file. Within the zip is a Quick start guide that includes installation and configuration details. NOTE: the distribution does NOT contain any of the required underlying software packages. The end user is responsible to have licensed the underlying software in order to run this Accelerator.

TIBCO Software Requirements

The accelerator has the following runtime software dependencies. The following components are mandatory for all installation types: TIBCO Software dependencies:

Third-Party Software Requirements:

Software	Source	Purpose
MySql database	https://www.mysql.com/	Use this as the data source to import data to FHIR server.
Apache Tomcat	https://tomcat.apache.org/	Use this to host EBX server and FHIR server webapps.
FindBugs Annotations jar	https://mvnrepository.com/artifact/com.google.code.findbugs/annotations/...	TIBCO ActiveMatrix BusinessWorks Plug-in for HL7with FHIR is dependent on this and this will be required during installation.

Note that the versions specified here were current as of the date of release of the Accelerator on the TIBCO Community. In most cases using later versions is expected to work, but the installation scripts may need to be adjusted, and the code may need to be recompiled on the newer versions.

Sign In

Healthcare Interoperability Accelerator HCIA_1.0.0

1 Screenshot