Carving a path forward for more integrated healthcare systems

In part two of this series, we discussed how healthcare interoperability mandates can be used as an opportunity to modernize, scale, and create value. APIs hold immense potential, not just in helping us secure data at a more granular level but also as engines for innovation.

But it’s not lost on me that much of our industry data is already built around file and portal-based exchanges, as MFT processes and EDI flows; it would be onerous to have to redo everything all over again.

So, how do we carve a glidepath from current data exchange practices such as MFT, B2B/EDI, and HIEs to a FHIR API-enabled future?

We don’t need to get rid of what we already have

Ultimately, we want to arrive at a single pane of glass that offers a full view of all your APIs. But you don’t have to get rid of all these other things you have, because they’re in good shape. They work, they’re secure. It simply makes more sense to plug them into that API ecosystem.

API marketplaces enable self-service for developers. They come to your marketplace, search for the API they need to build their product, and can easily subscribe and securely get access.

But APIs aren’t the only digital assets used in a healthcare organization – and not everything has to be an API. Here lies the value of combining an API marketplace with hybrid integration.

Hybrid integration: meshing the old with the new

As we know, a significant portion of healthcare data today is exchanged via EDI flows and MFT. These technologies aren’t going anywhere anytime soon: instead, they’re learning to coexist and integrate with APIs.

At the same time, a typical healthcare file data ecosystem today is a growing web of apps that create ever more data silos.

Practitioners need to go beyond “where is my file?” to “where is my data?” – because the data itself, contained in MFT files, APIs, or otherwise, has become a critical currency today.

Here’s what that might look like.

A sample MFT-API hybrid integration in healthcare

It’s not really the best use of an API to exchange large amounts of data with everyone. Maybe our closest partners with strong Internet connections and the right IT teams could support a long, live transaction while an API moves megabytes of data from one organization to the other.

But what happens if that didn’t get across correctly? After a few retries, most organizations with API gateways are going to stop that process so that it doesn’t tie up resources, assuming something is wrong.

MFT may be a better candidate for this use case – with an API layered on as the digital real-time signal that a file needs to be exchanged. Imagine, for example, that a patient’s new health plan asks the old health plan to share all the data related to their new member.

The former health plan can share a link to pick it up from their managed file transfer solution, and they both can enjoy managed file transfer’s benefits like retries to manage workloads, processing the workload on a reasonable schedule, etc.

Both plans have confidence it will be delivered, and they keep records for a week or so to enable them to solve any problems.

It’s a more cost-effective solution to preserve what was effective in the “old world,” enabling us to find our new partners and communicate in a real-time way where it makes sense.

Intelligent MFT secures, moves, manages, and simplifies file transfer integration so data is delivered in the right format – when it’s needed, where it’s needed.

Integrating events, automating workflows

New applications and services promise to solve healthcare challenges and make our lives easier, but integrating them into our ecosystems can prove challenging.

Amplify Integration makes it possible to extend existing MFT processes to other enterprise applications – no coding required. It offers an automated approach to orchestration and message transformation, allowing you to integrate all your applications and support additional patterns like events.

The way we work in the healthcare field is already changing. MFT technology has traditionally been used for secure transmission of insurance claims data between healthcare providers and payers.

But many payers are starting to use asynchronous event-based systems to handle events like claim submissions, adjudication decisions, or payment notifications. How does that compute with existing systems and processes?

Too often, processes are only automated to a single step. A claims file lands somewhere until someone goes to find it. The more we can cut down on “dwell time,” the more we’ll be able to eliminate non-value-added time.

With Amplify Integration, a payer could build drag-and-drop integrations to notify someone or even take action on the data contained in this file. Now, you’re able to automate a single piece of work instead of just one step in the process.  You may have wondered how to integrate streaming data from a registration process or a monitoring process. Now you have a simple, visual way to process streaming data.

Securely manage your integrated healthcare system with Axway

Integration as a path forward to value

Brokering between the new and what we already have allows us to preserve our investments and remain efficient. At the same time, it allows us to innovate and go faster when it comes to things that need to be real-time or experience-driven.

I think we’re only starting to scratch the surface, and integration platforms as a service (iPaaS) will play an increasingly valuable role in healthcare as this integration complexity grows.

It all comes down to a CIO’s fundamental need: teams are backlogged enough as it is. Combining an API marketplace with new integration patterns makes it possible to automate existing processes and deliver new innovative experiences to customers and partners.

Beyond that, we can create more value: healthcare employees must be able to easily curate and organize digital experiences, doing more with less.

Free up headroom so your team can take on new projects. Seize the opportunity of healthcare interoperability regulations to empower employees to build and monetize new experiences.