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InterSystems HealthShare CMS Solution Pack

HealthShare CMS Solution Pack
A Robust Solution to the Interoperability and Patient Access Challenges of CMS Rule 9115
The InterSystems HealthShare CMS Solution Pack™ provides a simplified way to meet the final rule requirements for payers and providers, supporting the rule’s use cases for 2021 and 2022:

For Payers

  • Patient Access APIs – Giving patients access to their own claims, clinical, and pharmacy benefit information (2021)
  • Provider Directory API – Online provider and pharmacy directory access (2021)
  • Payer-to-Payer Data Exchange (2022)

For Providers

  • Admission, Discharge, and Transfer Event Notifications

Use cases for CMS Solutions Pack include:

  • Patient access APIs
  • Claims data mapping
  • Clinical data mapping
  • Pharmacy benefit data
  • Authorization and authentication
  • Identity management
  • Member consent management
  • Event notifications
  • Provider directory APIs

 

CMS Solution Pack also provides a path to address broader use cases using our full InterSystems HealthShare product suite. For payers, InterSystems HealthShare provides the data and analytics required to support use cases such as HEDIS reporting and Risk Adjustment. For providers, use cases include value-based care, population management, and COVID-19 dashboards.

CMS Solutions Pack currently is available for use by customers in the United States only.

Related Product Information

Innovation with HealthShare
Healthcare as we know it is changing. Rapidly. Because we’re putting massive amounts of data to work to connect patients and providers like never before.
Matching inpatient and outpatient records with HealthShare Patient Index enabled a single view of patient data, joint ventures with other healthcare organizations, and better information flow.
The health and social care data of around 3.2 million citizens across the West Midlands has been integrated into a unified care record to improve care, making it safer and more effective.
InterSystems HealthShare Health Connect Cloud will be used to boost interoperability and integrate care across the region to help deliver on the NHS Long Term Plan
Real-time Health Information Transfer
Powered by InterSystems HealthShare and InterSystems IRIS for Health, poolprax has created an electronic patient record to streamline the treatment and care for patients with diabetes. The electronic transfer of data lets patients upload and access their blood glucose readings at any time, from anywhere. This also enables clinicians to access these measurements in real time to make informed decisions for better patient outcomes.
Presented at HIMSS22
Dr. Lyndsey Burton from AWS and our Kathleen Aller discuss the challenges and opportunities around the transfer and use of data for new innovations in healthcare. They touch upon how storing and sharing secure, real-time information in the Cloud can support and advance healthcare, security issues presented by new applications gathering data, future trends with data and the Cloud, and more.
Healthcare Tech Outlook Spotlight
InterSystems unifies disparate telehealth data, empowering telehealth providers with the data management capabilities needed for digital health workflows. That’s why Healthcare Tech Outlook featured InterSystems on the cover of the recent Telemedicine Services edition of its magazine — and a premier spot in its ranking of the top 10 telemedicine services companies of 2022.
Amazon HealthLake
Cloud-based, On-Demand Message Transformation for Amazon HealthLake By automatically translating your data from the HL7®v2 messaging format to HL7 FHIR® format, InterSystems FHIR Transformation Service accelerates analytics time-to-value for users of Amazon HealthLake. HealthLake requires the use of HL7 FHIR, the latest and most widely accepted exchange format for health information. Yet the richest stores of data in your provider, laboratory, payer, or pharmaceutical organization likely rest in other formats such as HL7v2. To bring this data in, Amazon Web Services selected InterSystems to build a validated message transformation service for Amazon HealthLake. InterSystems FHIR Transformation Service gives you a simple and cost-effective way to get the most from your data in HealthLake.
4 Considerations to Create a Better Provider Directory
4 Considerations to Create a Better Provider Directory
WEDI Presentation
The No Surprises Act (NSA) came with many new requirements for payers and providers. Some of those provisions have implications for how payers and providers share data. The Act requires providers to share advance cost estimates and estimated out-of-pocket costs for specific services with patients. Payers and their provider partners also need to make sure they have accurate provider directories so that patients aren’t “surprised” when they receive a bill for an out-of-network provider they thought was in network.

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