Patient Access API through Blue Button 2.0

The CMS Interoperability and Patient Access final rule became final on March 9, 2020. This rule is designed to make health information more easily available to patients and to improve coordination of care. CMS-regulated payers are required to implement and maintain secure, standards-based Patient Access APIs using HL7 FHIR 4.0.1 to enable patient access to claims, payment, encounter, clinical and formulary information through third-party applications.

Edifecs offers you a complete solution to comply with all payer requirements. XES Module for FHIR supports a broad array of standards-based exchanges of healthcare data and provides a package that fully aligns with the technical standards, the content standards, and the implementation guidance offered by CMS. The solution gives you the ability to conform to the CMS Blue Button 2.0 implementation guide and the CARIN Alliance Blue Button framework with CPCDS. The solution also offers out-of-the-box maps to accelerate the time to market and has the ability to consume clinical data from any internal system and match that data with the native claims and payment data at a member level. Our native services-based architecture makes that data available as a FHIR resource in the form of APIs.

With XES Module for FHIR, you get:

• One platform that covers all payer requirements
• Proven Blue Button 2.0 implementation guides that have been tested with CMS and real-world payers
• Full support for USCDI v1 and CPCDS data sets
• Pre-built maps that map from the CMS provider directory format to FHIR 4.0.1
• A shared cloud repository of artifacts and reference guides to jump-start your projects
• Patient data correlation and de-duplication capabilities built into the platform
• Flexible implementation options including on-premise, hosted, and cloud.

Our solution includes the ability to ingest, store, match, and expose patient data, enabling you to quickly meet the needs of your members and conform to the final rule. Edifecs supports a variety of capabilities that can be leveraged to empower members through open APIs based on RESTful services and SMART IG / OAuth 2.0.