Authored by: Jennifer Behnke
2020...a year full of both expected and unexpected changes that affected everyone. With industry regulations thrown our clients’ way, at HLX we choose to stay heads up on the new challenges brought on by the Cures Act. As we round out December, we got together to write down what we accomplished as a team through determination, resilience, and hard work. So, here’s a highlight of our TOP 10 achievements and news worthy mentions we’re so proud to share. Feel free to let us know what positive wins you had this year; we’d love to celebrate with you!
Our TOP 10 of 2020
Since we’ve been members of the Da Vinci Project since its inception, HealthLX is now proud to be under contract to provide reference implementations for some of the main use cases aligned to the CMS Interoperability Final Rule. Having already provided open-source projects for payer-to-provider use cases, notifications, and Patient API, we will continue to create open-source projects which illustrate mobile access to the patient API as well as payer-to-payer use cases.
A MAJOR announcement in healthcare history was released to the public on March 9, 2020 - the ONC’s Cures Act Final Rule. The Cures Act was passed by congress in an attempt to start to unravel the opaque schemes that are so common in the healthcare system today. By July 1, 2021, most health plans in the United States must enable member access to their records through an API or risk enforcement actions. HealthLX’s mission has always been to radically improve healthcare interoperability by embracing innovative approaches to data integration. Given we’ve been at the forefront of understanding these new regulations through our work with the Da Vinci Project, we’ve created a platform and workflows specifically to handle these new requirements to help payers with their compliance. A very exciting time to give power to patients!
A website that accurately depicts who we are, describes how we help payers achieve their interoperability goals, lists who our partners are, and shares our thoughts around the Cures Act final rule, was an important mission for us in 2020. With a refreshed design that matched our brand identity and an easier navigation for visitors, we hit our goal to stand out. Check it out!
Partner ecosystems in the healthcare industry are vitally important for payers, providers, and patients, but also for vendors. This year, we put a heavy focus on partnering with strategic health plan consultants who are helping customers with their compliance and interoperability issues around the Cures Act mandates. By leveraging a group of hand-selected system integrators (SI), we are able to further our mission to radically improve healthcare interoperability. We consider our partners an extension of our team and excited to have brought on six partners this year. In addition, in an effort to boost cross-party communication and access to materials, we created an easy-to-use portal for all partner engagements. Learn more about our SI partnerships.
Our founder, Will Tesch, was asked to speak for the second time at this year’s fourth annual Healthcare Economics Summit put together by Concordia University Wisconsin’s Batterman School of Business and the Remedium eXchange Think Tank. At this year’s Summit, a collection of healthcare experts came together to share their thoughts and expertise on how to reform healthcare in America. Will specifically spoke on “Disruptive and empowering new regulations for patient ownership of medical records – Perspective from a HealthTech solutions provider,” a topic he’s very passionate about.
In August, we announced a free, educational resource called FHIR Starter Pak (FSP) to help healthcare payers jumpstart their path to compliance with the CMS Interoperability and Patient Access Final Rule. The FHIR Starter Pak is a fully contained FHIR server and FHIR data repository with CSV templates. With FSP, payers can better understand the data elements that make up each FHIR resource, and how each element could be derived from their existing data. Payers can also run queries and see how each data element will present when it is queried through the FHIR server. The FHIR Starter Pak is available as a Docker image for easy installation and includes documentation for configuration. If your a payer interested in this resource, visit www.fhirstarterpak.com to sign up and access the download.
HealthLX was thrilled to be named a Preferred Vendor for the Association for Community Affiliated Plans (ACAP) this year. We are uniquely positioned to help small- to mid-market health plans accelerate compliance with the Cures Act phased requirements given our involvement as a founding member of Health Level Seven International's (HL7) Da Vinci Project. ACAP’s not-for-profit safety net health plans collectively serve more than 20 million members through Medicaid, Medicare, Marketplaces and other public health coverage programs and look for thought leaders and solution vendors who can educate and help them with their challenges. Under the Patient Access Final Rule, by July 1, 2021 most payers must enable member record exchange or risk financial penalties and we’re here to help ACAP’s 77 member organizations succeed.
Another validating moment this year was Gartner mentioned HealthLX in a few research reports. More specifically, Gartner listed HealthLX as a Sample Vendor in clinical data integration (CDI) in its Hype Cycle for U.S. Healthcare Payers, 2020 Report.* According to Gartner, “The Gartner Hype Cycle provides critical input for strategic planning by tracking the maturity levels and adoption rates of emerging payer technologies and approaches. U.S. healthcare payer CIOs should use this research to plan their investments to optimize and transform.” Not only were we mentioned in the Hype Cycle, but were noted in Gartner’s “Prepare for CMS Interoperability and Patient Access API Compliance for U.S. Healthcare Payers” research note and “Clinical Data Integration: Acceleration Presentation for Healthcare Payers.”
*Gartner, “Hype Cycle for U.S. Healthcare Payers, 2020,” Mandi Bishop, Jeff Cribbs, Bryan Cole, 5 August 2020.
Given the demand for interoperability solutions driven by the Cures Act mandates, we knew we needed to add to our leadership team to ensure our engagements with payers are kickstarted on the right foot. Ngan MacDonald joins as VP of Healthcare Business Solutions Architecture having worked for Blue Cross Blue Shield Association, Trexin Consulting, and Health Care Service Corporation (HCSC). She has 20+ years of experience providing technical and business leadership for information strategies and solutions implementation; both with large and small cross functional teams and we’re thrilled to have her at HealthLX. Ngan has deep healthcare industry knowledge and has started to share her perspectives in a new video series - Chats with Ngan. Welcome to the team, Ngan!
To round out the year, we launched version 3.3 of our core platform! With payers looking to cross the finish line on compliance without incurring unnecessary costs, spending the time to build their own custom solutions, or replacing legacy systems, the release is timely. In addition to an enhanced security infrastructure for FHIR/CMS protocols, other features new in HealthLX 3.3 include an enhanced FHIR Server and a feature that allows technical professionals to import heavily-customized action components directly into the platform. Health plans can now rely on the HealthLX 3.3 platform to import CCD and 837 file formats and process them into FHIR resources. Part of the HealthLX commitment to interoperability is continually enhancing our platform to help our customers accelerate toward their goals, which is why we continually work to improve our offerings. Learn more.
And there you have it! I hope you enjoyed our recap and have the urge to reflect on your wins from the year. Cheers to a healthier, happy, and cheerful 2021!