CAQH released its latest Index, quantifying that shifting manual administrative tasks in U.S. healthcare processes to electronic workflows could achieve over $20 billion in annual savings. Increased automation, particularly in electronic prior authorization (ePA) and claim status inquiry, is expected to drive cost reduction and efficiency improvements.
The Michigan State Medical Society reported updates from CMS and various health plans regarding changes in reimbursement policies and the standardization of electronic data exchange. Key focus areas include comprehensive interoperability standards and FHIR-based prior authorization processes.
Kriv AI deploys a FHIR R4 native patient engagement platform on AWS HealthLake and Bedrock in eight weeks. This system addresses federal interoperability mandates, such as the ONC Cures Act and CMS-0057-F, supporting care gap closure for IDNs, payers, and ACOs.
1upHealth provides a RESTful API fully supporting FHIRยฎ to facilitate programmatic access to electronic medical record data. This allows patients and authorized third parties to access comprehensive health information, including demographics, labs, and medications, in compliance with the CMS Interoperability Rule.
The author audited the US CMS National Provider Directory (NDH) and revealed significant flaws in its data quality and structure. Key issues include inconsistencies in organizational records, endpoint references, and contradictions between code systems, highlighting serious problems with foundational industry data.
This article explains Oracle Health (Cerner)'s multi-layered API ecosystem. Developers must use the Millennium API for core clinical workflows while leveraging the FHIR R4 API for standardized interoperability.
The US CMS proposed mandating enhanced interoperability requirements for the prior authorization process of drugs, aiming to strengthen data exchange between providers and payers. This mandates electronic system support and greater information transparency.
Onyx's IDR ingests clinical data from multiple sources like EHRs and HIEs, normalizing it into a single longitudinal patient record. This enables payers to identify previously unseen care gaps and high-risk members, facilitating proactive outreach and quality improvement.
With support from the CDC Foundation, Los Angeles County Department of Public Health is modernizing its public health data flow. This effort aims to collect and analyze lab reports in real-time, improving outbreak tracking and decision-making.
This article explains the impact of required FHIR (Fast Healthcare Interoperability Resources) compliance by 2026 on healthcare practices. Due to regulations like the Cures Act and CMS mandates, it highlights the necessity of bridging interoperability gaps in patient data access, care coordination, and prior authorization workflows.
Mandated by CMS regulations, health plans must digitize medical policies and implement FHIR APIs. However, the article argues that mere digitization is insufficient; policy must be reconstructed as 'executable logic' to achieve automated prior authorization decisions.
This document details the resource definition for 'Organization' based on HL7 FHIR standards. It outlines how basic data regarding healthcare facilities and related groups, such as corporate identifiers and locations, can be structured and exchanged.
Elation explains that its EMR system's API adheres to the HL7 FHIR R4 specification, meeting the requirements for the ONC Certified 'Standardized API for Patient and Population Services'. The guide provides information for partners and customers (trusted developers) integrating the API into their workflows, detailing steps from sandbox testing to production use.
Major healthcare payers have committed to standardizing and electrifying the prior authorization process for medical services. This initiative aims to accelerate patient access to care while significantly reducing administrative burdens on providers.
Healthcare organizations face challenges due to inconsistent terminology used for diagnoses and tests. A FHIR Terminology Server addresses this interoperability hurdle by providing standardized vocabularies like SNOMED CT and LOINC through a single API.
This article introduces a course package designed for mastering FHIR (Fast Healthcare Interoperability Resources) fundamentals, extending through integration with real-world Electronic Health Record (EHR) systems like Epic and Cerner. Participants will learn core FHIR concepts, understand the SMART on FHIR specification, and receive practical US EHR integration guides.
This course aims to teach participants the fundamentals of Fast Healthcare Interoperability Resources (FHIR) and how to build practical FHIR workflows using Corepoint. Attendees will gain hands-on skills, such as converting HL7 messages into FHIR resources and performing data operations using RESTful APIs.
This service provides synthetic (dummy) patient data conforming to multiple standards, including FHIR R4 and HL7 v2.4. This enables the testing and integration validation of Electronic Health Record (EHR) systems and interface engines without accessing real patient information.
Hauer Power offers HIPAA and GDPR compliant healthcare software engineering from Poland. Utilizing standards like FHIR R4 and HL7 v2, the company specializes in building systems for US and EU healthcare companies, including EHR integrations, patient portals, and telemedicine platforms.