The MaxMD Clinical Gateway Solution (CGS), consists of a collection of APIs, rules engine, databases, workflow processes, and implementation guides to enable enterprise wide consumption of high-quality clinical data information to support all clinical information data needs of a payer. The CGS enables cost-effective, minimal provider abrasion clinical data information acquisition.
- Registry / Repository: Real time database that consolidates data from a variety of clinical sources to present a codified structure from disparate data sources. The Registry / Repository allows a unified view of a single patient. It is optimized to retrieve data for a single patient and identify a population of patients with common characteristics. Disparate data types in our Registry / Repository include: clinical laboratory test results, patient demographics, pharmacy information, radiology reports and images, pathology reports, hospital admission, discharge and transfer dates, ICD-9 codes, discharge summaries, and progress notes.
- Transformation Engine: Health information exchange engine with a one-to-many interface that codifies clinical data for optimal entry into the Registry / Repository enabling standardized Queries, Reporting and data extraction for payer specific needs.
- Content Rubric Engine: Real-time rules engine to interrogate standardized clinical data at point of entry into the clinical Registry / Repository. The Content Rubric Engine contains rules that address the entire spectrum of payer needs: CDA syntactical accuracy, C-CDA Implementation Compliance, C-CDA Community (best practices) Compliance, and Payer and Provider Specific rules. The rules engine service as a clinical data informational quality control mechanism to accept only clinical information that meets the payers’ requirements. Clinical information that does not meet the quality threshold is returned in real-time to the submitter with the reason the information was rejected.
- TX Log : Separate Registry / Repository log database. The transaction log contains an history of all clinical data received, whether Accepted or Rejected. The log for all Rejected clinical information includes all the reasons the clinical information was Rejected.
- APIs for Payer BPM Integration and Orchestration: Collection of FHIR based APIs for ease of integration into a payers’ core claim adjudication engine and other payer-based solutions that need to consume and integrate the clinical data information in a standardize enterprise-wide method. Additional, APIs are utilize to consume payers’ request for clinical data information via the Communication Request Task.
- Communication Request Task Engine: Workflow engine to consume and facilitate payers’ request for provider/patient specific clinical information needs. The Communication Request Engine electronically automates the request for clinical information needs in standardized formats. The engine keeps tract of all open and closed clinical data information requests.
- PMEHR Implementation Guides: Practice Management/Electronic Health Records specific implementation guides to enable optimized, no change in workflows provider/health system on-boarding. A test environment is provided to test the quality of the clinical data information per the rules contained in the Content Rubric engine.
- Mobile App: Ancillary iOS and Android patient application for the patient enable cloud access to his/her clinical data information. The mobile app modular architecture allows the app to be consumed into a broader payers’ mobile app. The mobile app integrates fully with the Clinical Gateway Solution and can consume directly clinical data information from the providers who have delivered service to them for submission into the payers Clinical gateway Solution.