Patient Experience Engineering for Provider Revenue Cycle Management Leader
Overview.
Our client is a US-based leading provider of revenue cycle management services and solutions to healthcare providers. Its EHR-agnostic patient access and care coordination solutions support thousands of providers and sites of care across the US. Patient scheduling and referral management is a key component of the healthcare revenue cycle management process and is often a pain area for referring providers and health systems.
The EHR-agnostic patient experience platform allows patients to search for physicians, schedule appointments, and complete their onboarding across all care settings, resulting in an improved experience and streamlined workflows for patient scheduling and access teams.
The Customer’s patient experience solution needed a revamp of its existing patient scheduling and pre-registration capabilities to allow a user/patient to perform appointment scheduling and registration in a “single window”.
Before this initiative, the Customer was helping patients perform the 2 functions separately, resulting in many operational challenges for the patients and the providers at the time of the patient’s visit to the provider’s care site. Also, the process of sending an Order packet to their financial clearance center for scheduling and registration was broken. Moreover, the UI of the application had to be built to perform the “single window” operation.
Coforge Solution
Coforge worked with the Customer as the app development partner for this initiative and introduced 2 teams to individually focus on improving and stabilizing the core foundation of the platform, along with delivering the business outcome of a “single window” operation.
To deliver the business outcome, the Coforge team performed the following activities.
Refactor the existing monolithic components into deployable services to enable the “single window” application development.
Development of application functionalities across services such as Patient Demographics capture, Eligibility and Benefits determination, Cost Estimation, Coverage exceptions, Authorization exceptions, Medical Necessity, Financial Counseling etc.
The work involved the adoption of microservices and domain-driven design principles.
The Coforge team revamped the core of the application across the following areas.
Built a DevOps pipeline for this development.
Consolidate the middleware platform to SoftwareAG
Built new Framework components on .NET Core V3+
Migration to Linux servers for the application tier
Introduction of Elastic infra, e.g. Kubernetes management, on Customer’s existing IBM/Skytap Cloud platform
Migration to NoSQL from existing MS SQL Server database
Application performance improvement
Driving the migration of applications from the current IBM/Skytap environment to AWS and the adoption of serverless architecture.
The Impact
Leveraged multiple Coforge’s capabilities such as Application engineering and legacy modernization with microservices design, integration services redesign, DevOps, QA Automation, Cloud adoption (IBM to AWS), Infra (app servers and databases) migration to drive synergies and offer cost and productivity improvement benefits to the customer
Introduced outcome-based development with the introduction of development SLAs for releases and sprints, providing better cost and operational efficiency for the engineering team.
