The Challenge

The Centers for Medicare and Medicaid Services and the Office of the National Coordinator created a new set of federal interoperability rules to improve member experiences and outcomes. These complementary rules call for clinical and administrative data to be made available digitally and on demand by authorized apps. The goal is to give members quick and easy access to their clinical and administrative data. In addition to meeting the January 1, 2021, interoperability compliance deadline, Geisinger wanted a strategy to expand its interoperability compliance work to create new capabilities.

Our Approach

nLoops collaborated with Geisinger on a comprehensive interoperability strategy and launched a consulting and advisory project coordinated by a team of subject-matter experts. To ensure that Geisinger’s interoperability investments became a technology asset in the future, we defined a strategy for meeting compliance requirements in the short term and developed a long-term approach to creating differentiated member experiences based on new interoperability capabilities.

Our teams also conducted education and visioning sessions to ensure Geisinger stakeholders understood the breadth of business processes and other operations affected by interoperability. To demonstrate the potential of interoperability and validate components of the Geisinger strategy, the teams worked to design and build a proof of concept (POC) using the TriZetto® Connected Interoperability Solution, a modular set of software-as-a-service interoperability products. We also developed a Test Mobile Application to fully demonstrate the solution’s end-to-end capability. The POC clearly showed the promise of interoperability by demonstrating the standards-based, real-time digital communication of a longitudinal view of a member’s health information from a payer’s internal systems to a mobile app created by a third party

A 360-Degree Compliance Strategy

The strategy designed by nLoops in collaboration with Geisinger has high-level cost projections for the actions required to achieve compliance. In addition, it includes implementation planning, application programming interface gateway development, data aggregation, terminology normalization, data mapping, member consent management processes, architecture design support, an orchestration hub and a requirements analysis