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Data-Driven Healthcare: A New Standard

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Agnos delivered a web & mobile friendly application to comply with CMS Interoperability Standards for Payors.

A new application to empower data-driven healthcare.



The Agnos My Health Record App now allows leveraging extensive data and analytics to:



  • Facilitate compliance with CMS interoperability standards.
  • Provide Payors with a new web & mobile-based tool that gives Patients access to their coverage and network information, together with their encounters, claims and clinical data.
  • Find opportunities to incorporate risk and care gap management through external health apps and wearable devices such as a FitBit.

 

Challenges

  • Patients find it extremely painful to constantly provide their medical information to multiple Providers. They also face difficulty accessing Patient information, inefficient medical and claim processes, managing care gaps and risks, and misdiagnosis.
  • Payors are challenged by accessing Patient information across varying Providers, the lack of technical interoperability between Payors and other Payors, managing Patient care gaps and risks, data standardization, and data integrity.
  • Providers are challenged by accessing patient information across varying Providers and Payors. They need to balance the pressures of providing the best care for Patients with the ever-increasing complexities of administrative, clinical and regulatory standards, and requirements.

All of this results in poor Patient experiences and outcomes.

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CMS rules, standards, and guidance


The U.S. government responded to interoperability and Patient access challenges negatively impacting Patient care outcomes by announcing that the CMS-9115-F ruling (CMS Interoperability and Patient Access) was to take effect in 2020 as part of the MyHealthEData Initiative.

  • Payors are required to make a Patient’s claims and encounter data available to Patients in a user interface.
  • They are also required to make a Patient’s clinical data available. This includes, but is not limited to, conditions, medications, allergies, and labs.
  • MA organizations, Medicaid FFS programs, CHIP FFS programs, Medicaid managed care plans, and CHIP managed care entities are required to make provider directory information available via the Provider Directory API. This API must be accessible via a public-facing digital endpoint on the Payor’s website.
  • Part D Medicare Advantage plans must also make formulary information available via the Patient Access API. In addition, Medicaid and CHIP FFS and managed care must make preferred drug lists available. 

    For more information, you can check the CMS interoperability regulation guidelines.
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Our Approach


Agnos responded to interoperability and Patient access challenges negatively impacting Patient care outcomes and addressed CMS-9115-F ruling by building the Agnos My Health Record App with the following capabilities:

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  • Plan and Coverage information.
  • Digital membership card and Payor’s contact information.
  • Availed Services List with explanation of benefits.
  • Detailed service breakdown and adjudication information.
  • Pharmacy & Provider Network Search.
  • Clinical records for: Conditions, Medications, Allergies and Labs.
  • FitBit integration for real time vitals with the ability to interface with multiple other health monitoring devices.
  • Correlation of the real time vitals to current conditions, medications and other clinic information in order to detect and notify about risks.
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Technology Stack Used

angular

React & Angular

materialUI

Material UI

jest

Jest

react

React Testing
Library

qws-1

AWS cloud
platform

json

JSON schema
tools

Security and Interoperability Standards

The web app is a Javascript application built with the React framework. The application leverages the FHIR API to communicate with FHIR enabled servers to retrieve medical records data for end users. The application is deployed in AWS Cloudfront, the content delivery network provided by Amazon.
 
The Agnos My Health Record application works with all cloud-based platforms built on the FHIR standard to enable data-driven healthcare. Agnos has teamed with world class healthcare companies such as Inovalon to harness the power of data and technology to improve healthcare. Authentication and Authorization is handled by Okta.com using the OAuth 2.0 protocol.
 
OAuth 2.0 allows Healthcare companies to securely authenticate their users via federation with their existing identity provider to allow a single sign on experience when accessing the My Health Record Application.
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Agnos My Health Record App

The Agnos My Health Record App leverages cloud-based platforms built on the FHIR standard to enable data-driven healthcare.

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  • The Agnos My Health Record App works with all cloud-based platforms built on the FHIR standard, such as the Inovalon ONE® Platform Consumer Health Gateway™, to make sure that a Payor’s health plan data is accurate, complete, and easily accessible to rapidly respond to consumer requests.
  • The Agnos My Health Record App enables a Payor’s health plan to integrate, merge, and map clinical and claims data to industry standards.
  • The Agnos My Health Record App enables adherence to specific security standards, application authentication, and consumer validation.
  • The Agnos My Health Record App enables a Payor’s health plan to immediately meet Implementation deadlines and provide rapid responses to consumer requests that would not be just expected, but will soon be required. Failure to comply will result in a penalty of up to $1 million.

 

 

 

 

Gaurav Saraf Chief Technology Officer, Agnos

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We are a global software development company that truly understands how to use the FHIR standard to improve interoperability among EHRs, devices, and information systems. We work passionately every day to boost the efficiency and productivity of operations and quality of care across the Healthcare ecosystem. The Agnos difference is our insatiable desire to marry our deep-dive healthcare industry and domain knowledge with truly world-class software delivery capabilities. It is our passion to "Co-Build" with our customers so that we build Better software Faster at the Lowest Cost possible... Together!

Gaurav has been offering technical leadership in building digital health products now for eight years. With rich experience and expertise in software development, Gaurav has helped clients successfully build and implement integrated EHR systems, Patient Intake Management Software, Health apps & systems used by Fortune 500 companies, and more. He has offered consulting services to many healthcare startups while working at Persistent Systems.

Besides leading product development teams, he likes to evangelize FHIR & solve problems in system design, micro-service orchestration, front-end engineering (web & mobile), and cross-platform development.

About Agnos

Agnos was established in 2012 with a mission to empower businesses with next-gen, end-to-end agile software development services. Take a look at the Industries that Agnos serves and the IT Services we deliver, We combine human creativity with cutting-edge technologies to benefit society and shape an accountable business.

Agnos Value Proposition: Agnos has Top-Gun IT resources from across the globe and across industries that deliver the highest quality software quickly, at an extremely affordable price.

Our Competitive Differentiation: Our “secret sauce” is our hand-picked global team of technologists and consultants that are simply the “best” at what they do. Through our global partnerships, we now have an army of over 20,000 (our bench) worldwide, from the United States to Argentina to India to Ukraine and beyond. We can truly offer a “follow the sun” software engineering delivery platform.

Our Core Values: Agility, Trust, and Quality. As our customers will attest, we are obsessed with relentlessly pursuing the projects we undertake in a timely fashion, maintaining the highest quality standards, and keeping the trust of our customers, employees, and partners.