API Management Solution Strategy for a Fortune 500 Client

Situation

Client
The client is one of the largest health benefits companies in the United States. Through its affiliated health plans, the client delivers a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services
Challenge
Customer wanted to adhere to The Interoperability and Patient Access final rule (CMS-9115-F) by modernizing
their IT Platform
Objective
Customer wants to implement FHIR so that solution is compliant with The CMS Interoperability and Patient Access final rule establishes policies that break down barriers in the nation’s health system to enable better patient access to their health information
Need more agile integration platform to address dynamic business and consumer centric needs

Solution

Technology
Client had existing Apigee gateways that allowed onboarding of the vendors.
The aim was to make this FHIR compatible and more secure, simple and provide as a self service
Approach
Radixlink Consultants provided API technology consulting, API Solution designing and
implementation to the enterprise-wide FHIR
Enabled API Governance ; design and run-time, for the program
Implemented over 20+ APIs across Patient, Drug, and Insurance Plans

Results Achieved

  • FHIR APIs enabled significant savings per month by providing member data directly to Consumer Portals over various systems and providers.
  • With Healthcare Interoperability, the ability to move medical records were seamless across patient, providers and payees
  • Consumer Reach has objectively increased with availability of enterprise data over various channel
  • Provisioned platform for shift from “Consumption centric” metrics to “Commercialization enabled” , thus
  • benefits from monetization aspects of APIs

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