Outcome Healthcare has developed an extensive healthcare architecture over the years to best equip HIEs to handle patient data securely, accurately, and quickly.
Prebuilt connectors are included for both HL7 and CDA and other formats may be integrated through the use of an integration engine. If the data is found to meet the standards set and is not filtered, the message is transformed to and sent to the FHIR backend for ingestion. Some improvements during this process can include codeset mappings, removal of sensitive data and filtering of bad or incomplete data. Every transaction that is successfully ingested by the FHIR CDR is logged in an audit trail. If a transaction causes an error, it can be tracked and reviewed via reports / alerts. Through the development of these tools, Outcome Healthcare is able to ensure that every message received from any given participant will be carefully processed and ingested with a full audit trail attached.
If a patient has already been created previously, a new message successfully ingested will add all available data from the given data source to that patient’s profile in the Portal; allowing for providers to get additional insight into their patient. Meanwhile, if an HL7 ADT message is received for a patient with no previous history, a new patient is created in the Outcome HIE Platform and populated with any data that the ADT contains. The Outcome HIE Platform also leverages the Postgres database for data on consent, patient groups, and other important information that was previously mentioned. If a CDA is received for a patient, in addition to the data being ingested the document itself is connected to that patient and stored accordingly in the Document Registry / Repository.
When a participant initiates a Document Query for a given patient, the FHIR CDR is accessed. If the patient exists in the system, a FHIR JSON object is returned which contains all of the patient’s historical documents. Any documents that are from the participant that is querying are filtered out in order to avoid providing duplicate data. A summary document of all the patient’s historical data is also generated and made available. After returning the list of existing documents, a Document Retrieval message will follow from the participant requesting a specific document. The document in question is then retrieved from the Document Store, securely encoded, and sent back to the participant.
Each patient is stored in the CDR via a FHIR JSON object that contains all of their data. Whenever a new message is received for a patient, a call is made to the CDR to retrieve their patient record. The patient record is updated with the new data and displayed in the Portal.
The patient data in the CDR automatically replicated to a FHIR based Data Warehouse in Google Big Query. This Data Warehouse is accessed to generate reports on what type of data in ingested, the volume of data ingested, what participants are sending data, and more. These reports can be used internally or sent to data consuming participants. Furthermore, the Data Warehouse is used to facilitate bulk data extracts by data consumers — preventing strain on the CDR.
HL7 FHIR compliant Health Information Exchange allows for the seamless, real-time flow of data between stakeholders for:
- Inpatient Electronic Health Records
- Ambulatory Health Records
- Lab Information Systems
- Radiology Information Systems
- Emergency Department Information Systems
- Cardiac Emergency Information Systems
- Picture Archiving and Communication Systems
- Patient Accounting / Billing
- Perioperative Information Systems