MIDTECH PARTNERS, INC CASE STUDY
Situation MidTech Partners, Inc. Helps University of Utah The University of Utah Health
Sciences Center requires new Health Sciences Center Achieves HIPAA integration system to achieve
HIPAA compliance. Compliance
Solution University of Utah Health Sciences Center achieves HIPAA MidTech implemented BizTalk and compliance and automates manual processes by using BizTalk Server improved business processes while
creating a foundation for future with HL7 and HIPAA accelerators for BizTalk ? Server from growth. Microsoft?
Result Overview ; Rapid Implementation
; Business Process improvements ; Commitment to Patient Care and University of Utah Health Sciences Center (UUHSC) officially began with the opening of the Increased Market Share University of Utah Hospital in July of 1965. Since then, UUHSC has developed into a variety of ; Enterprise-wide EAI facilities including Community Clinics, the School of Medicine, Academic Colleges, and various institutes and centers. UUHSC excels in education, research, patient care and Products & Technologies community outreach throughout Utah and the Intermountain West. As its adopted mission the ; Microsoft .NET Passport UUHSC has concentrated efforts on tertiary care, burns, trauma, and transplants — the ; Microsoft SQL Server 2000 medicine of the future. ; Microsoft ASP.NET ; Microsoft BizTalk Server 2000
Currently, UUHSC conducts 150,000 ADT transactions per day, and a total of 400,000
transactions per day using an interface engine known as Impact from Sybase (formerly the
independent software company, NEON and CAI). These are HL7 standard transactions
(Health Level 7), commonly used to integrate data among disparate applications as well as
between hospitals and other providers/partners (such as labs).
As the costs for interface support and maintenance of the existing system began increasing,
because of Impact’s cumbersome development environment and manual intervention,
UUHSC began to search for something better, and something that could also easily tackle the
problem of managing HIPAA compliant claims transactions, acting as both a payer and
provider in the UUHS environment. Recognizing the need to cut development costs while
maintaining the ability to easily integrate future transactions and business interfaces into their
IT infrastructure, UUHSC turned to Microsoft and MidTech Partners to help implement a better
interface engine solution. In the new system, these steps will be automated through the
Microsoft? Integration Broker, BizTalk Server (BTS).
All of the endpoint systems which currently utilize the Sybase Impact software to send data
and the systems which receive that data were identified. No functionality has been identified
which would not be included with the basic Microsoft ? server 2004 product used in
conjunction with the HL7 and HIPAA Accelerators.
Discussions revealed that additional interfaces are expected including supply chain
management, retail pharmacy, pharmacy operations (orders / dispensing / inventory relief).
For claims processing, also identified was a need for an external database which will be act as
a repository for HIPAA transactions which pass through the BTS engine. Each claim will need
to create a record and this record will be updated by the acknowledgement to include the transaction ID assigned by the remote system. This transaction ID will be required when resubmitting claims which have rejected. This database will contain enough detail about claims and responses / remittances to allow for the creation of query screens to quickly inquire on the known status of all processed claims as well as the dynamic generation of 276 (claim status inquiry) transactions.
UUHSC asked MidTech to provide validation of their plans and strategy which included use of Microsoft technology. This was to include BTS and both the HL7 and HIPAA Accelerators for BTS. MidTech presented a working system based on a findings / assessment engagement, written specifications and verbal requirements provided by UUHSC provided during on-site interviews. HIPAA compliancy required the ability to produce compliant X12 HIPAA governed transactions, including future variations, as well as leverage existing transactions through a transition period. The system also needed to be scalable to address future needs for automation, and provide a comprehensive environment for all business process needs including access from member and provider locations.
Since HIPAA compliance has been mandated, the first project was a jumpstart implementation to automate the claims processing in BTS. The diagram that follows depicts the flow for the implementation. Their first step was to take a sample set of claims forms and implement these with a preliminary group of trading partners. The second step is not only to incorporate more data exchanges into their existing business processes (i.e. 997 acknowledgements; 270 health care eligibility requests, etc.), but to implement these to all of their trading partners. Subsequent work has leveraged BTS to integrate internal applications through HL7 and proprietary message formats. Next phase work will focus on the significant value offered by BTS by leveraging its out-of-the-box integration with Office, SharePoint and other MS tools to bring value directly to the business users through user workflow, business activity monitoring and business intelligence capabilities.
; Find a cost-effective solution to meet existing and future business requirements ; Provide infrastructure to allow business to business (B2B) data transfer between themselves and their community of 1,600 healthcare providers and their patients ; Provide a foundation to allow them to quickly bring up new trading partners and interfaces ; Provide reliable transmission and storage of data
; Add the functionality of retrieving data from their data warehouse to facilitate weekly reporting and to represent a ―total view‖ of the entire life cycle
; Leverage the chosen interface engine to become an enterprise integration platform to provide common services and eliminate high development and maintenance costs ; Leverage the platform to provide comprehensive Business Activity Monitoring and Business Intelligence solutions
BizTalk Server offers a powerful, easy-to-use development tool for building new interfaces; future interface development should take even less time. UUHSC can now enjoy the benefits of an integrated interface engine solution that is equipped to take advantage of XML Web services and .NET functionality.
Rapid Implementation: The jumpstart implementation by UUHSC and MidTech Partners
achieved HIPAA compliance for claims in a limited timeframe of just six (6) short weeks – they
may want to debate the date!
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Business Process improvements: Utilizing SQL Server in conjunction with BTS, the
immediate benefits UUHSC achieved by implementing this solution included the elimination of manual steps, better error tracking visibility, auto generation of document definitions (schemas) and overall a more accurate view of the entire process life cycle. The bottom-line is if a message fails, it can be tracked and reviewed within BTS.
Commitment to Patient Care and Increased Market Share: The day-to-day transactions
with their trading partners will be automated to better serve the provider collections process thus allowing better focus on patient care. UUHSC’s transactions will be more secure based on Microsoft technology and products being deployed. The result to UUHSC will be much better positioning for growth in a very competitive field.
Enterprise-wide EAI: A wrap-up session was conducted for UUHSC, provided by MidTech and Microsoft on-site at UUHSC, to discuss system expansion through additional product offerings, best practices, and knowledge transfer. The BizTalk Server platform provides the infrastructure for future EDI HIPAA needs and Enterprise-wide EAI, which can further expand to bUSINESS pROCESS aUTOMATION (BPA), business process monitoring (BPM) and portal/content management. Ultimately, BTS provides a scalable and reliable long-term integration platform for UUHSC.
MidTech Partners is an technology integration services company in Denver, Colorado. Proven leaders in business process integration, we also offer business intelligence solutions, portal development, and BizTalk training. Founded in 2002, our collaborative approach to creating agile enterprises consistently results in satisfied clients and quality solutions.
7000 S. Yosemite Street
Centennial, CO 80112
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