Evolute has been contracted by New Directions Behavioral Health to build a solution using Microsoft BizTalk for transitioning to HIPAA 5010 as well as to enhance existing HIPAA support to include referral and approval (278) transactions in order to bring the company to HIPAA 5010 compliance.

With the upcoming deadline for the HIPPA 5010 mandate as the driving factor, New Directions needed a timely and robust solution to ensure compliance. With this need in mind, New Directions chose Evolute to develop and implement its SureClaim solution, which converts HIPAA 5010 transactions into electronic documents that are human-readable and machine-readable. In addition, Evolute’s solution processes claims quickly, efficiently, and more accurately via a portal, providing physicians and organizations improved efficiency, productivity, and data accuracy through lowered payment turnaround time, reduced rejected claims, and improved patient relations.

Mark Duman, Manager of Database and EDI Systems at New Directions, easily chose Evolute to implement its SureClaim HIPAA 5010 solution. “We chose Evolute as our BizTalk solution because we wanted a solution to comply with HIPAA 5010 requirements that was designed, developed, and implemented by experts,” said Duman. “We’ve watched BizTalk continue to improve over the years, and its ability to integrate multiple systems allow for more flexibility than the previous system we had.”

Founded in 1995, New Directions Behavioral Health serves 5.4 million across the nation. It offers managed behavioral health care, employee assistance, organizational consulting and health coaching to clients such as Blue Cross and Blue Shield Plans, employer and union groups and third-party administrators. The company is accredited by NCQA as an MBHO and by URAC for health utilization management and case management. New Directions’ services have earned national recognition and awards for innovation and best practices and is collectively owned by three Blue Cross and Blue Shield Plans and subsidiaries or affiliates of those plans. For more information on New Directions, visit the company’s website at www.ndbh.com.

About Evolute Consolidated Holdings
Evolute Consolidated Holdings, Inc. (Evolute) is a Denver-based consulting firm that develops highly effective integration solutions and delivers consulting services specifically for Microsoft technologies and platforms. With a staff of Microsoft platform experts offering several years of experience in health care, public health, financial services, government and manufacturing industries along with years of experience developing Microsoft technologies, Evolute provides cost-effective solutions to help you to connect, facilitate, automate, and present the information you need when and where you need it. For more information about Evolute, please visit www.evolutechi.com.

The purpose of this paper is to describe the methodology and architecture required to implement a Regional Health Information Organization (RHIO) with Microsoft® BizTalk® Server 2006.

Download PDF

When the 5010 requirements came out, we realized that we would need to upgrade to the latest version of BizTalk and use the .Net platform. We determined that we needed assistance and tried a couple of other consultants, with lackluster results, prior to finding Evolute. Evolute proved to have the BizTalk experts with the HIPAA transaction experience that we needed. They came in, quickly picked up on our needs and how we work, offered a solution that fit us well, and brought a level of knowledge and skill needed with the new version of BizTalk. And one of the best parts is that they are providing training to our programmers along the way, which will enable us to maintain, modify, and build out as needed!”

Roy Newcomb, Director of Information Technology
DAKOTACARE

Evolute Implements HIPAA 5010 Solution at DAKOTACARE

GREENWOOD VILLAGE, CO, May 13, 2011 Evolute is working closely with DAKOTACARE in the development, design, mapping, and implementation of its HIPAA 5010 solution using Microsoft BizTalk Server, a state-of-the-art solution that provides exceptional handling of payment processing, supply chain visibility, improved patient tracking, clinical activity monitoring, multi-channel interaction, and near real-time decision support.

With the deadline for HIPAA 5010 and ICD-10 compliance fast approaching, DAKOTACARE realized the need for BizTalk experts was necessary and selected Evolute to take the lead on providing the solution to timeliness compliance.

Roy Newcomb, Director of Information Technology at DAKOTACARE, discussed his choice of working with Evolute, stating:

We originally built our version 4010 solution ourselves using BizTalk 2002 and VB6, but when the 5010 requirements came out, we realized that we would need to upgrade to the latest version of BizTalk and use the .Net platform. We determined that we needed assistance and tried a couple of other consultants, with lackluster results, prior to finding Evolute. Evolute proved to have the BizTalk experts with HIPAA transaction experience that we needed. They came in, quickly picked up on our needs and how we work, offered a solution that fit us well, and brought a level of knowledge and skill needed with the new version of BizTalk. And one of the best parts is that they are providing training to our programmers along the way, which will enable us to maintain, modify, and build out as needed!

DAKOTACARE is South Dakota’s largest and only statewide HMO, serving over 131,000 members nationwide. The network includes over 98% of the state’s physicians and pharmacies, all of South Dakota’s hospitals, and many other types of providers such as psychologists, chiropractors, optometrists, and surgical centers. Over 131,000 members and 4,150 physicians across 200 communities participate in the DAKOTACARE family.

About Evolute Consolidated Holdings
Evolute Consolidated Holdings, Inc. (Evolute) is a Denver-based consulting firm that develops highly effective integration solutions and delivers consulting services specifically for Microsoft technologies and platforms.  With a staff of Microsoft platform experts offering several years of experience in healthcare, public health, financial services, government and manufacturing industries along with years of experience developing Microsoft technologies, Evolute provides cost-effective solutions to help you to connect, facilitate, automate, and present the information you need when and where you need it.  For more information about Evolute, please visit  www.evolutechi.com.

For more information, Press only:

Debbie Deaton, Evolute, (303) 349.5150, DebbieDe@evolutechi.com

PROBLEM – SPECIFIC REQUIRED CAPABILITY

Notifiable conditions are defined by local Administrative Codes. Various reporting entities including clinics, hospitals and laboratories, have responsibilities under the code to report occurrences of notifiable conditions or events and specific data about each case. Currently, reports are made to one of 35 local health jurisdictions (LHJs). Epidemiologic investigations are performed and reports of confirmed or presumptive cases are sent to the state Department of Health (DOH). For nationally notifiable conditions, DOH submits reports to the Centers for Disease Control and Prevention (CDC). Under the NEDSS initiative, the CDC has supported development of integrated, standards-based, secure electronic reporting systems for notifiable conditions. Many of the standards for WEDSS development are drawn from CDC standards, including the use of HL7 messages to transmit data between entities.

CURRENT SYSTEM AND THE PATH AHEAD

The component of NEDSS that is focused on data interchange is currently called EDI-PH (Electronic Data Interchange – Public Health). The goal is to be able to receive notifiable condition data from approximately 200 clinical laboratories and approximately 100 hospitals (including multiple feeds from many hospitals, e.g., inpatient, outpatient, emergency department) and then to redistribute the information electronically in the format desired to the organizations (LHJs and DoH programs) that need it to do the work of public health. Using Microsoft’s Server products as a platform will enable an enterprise strategy to be put in place that accommodates current as well as anticipated needs.

BENEFIT TO STATE’S DEPARTMENT OF HEALTH

The system will allow internet transmission of Public Health data, and will replace paper as the primary means of communication. The solution will provide better monitoring and auditing capability and is architected to support future initiatives within the DoH such as the inclusion of private health care providers. The existing staff will be able to augment an elegantly simple but sophisticated system which is greater in scope than what they have today. A system which also conforms to CDC requirements.

The community at large will be less subject to disease or bioterror outbreaks based on the amount of information communicated and the speed of alert notification to the DoH.

Evolute is a technology consulting firm based in Colorado. Proven leaders in business process integration in healthcare, Evolute also offers business intelligence, portal and .NET development and technical training for business and government entities. Evolute’s collaborative approach to creating agile technologies consistently boosts client profitability and user satisfaction. Evolute is also a Gold Certified Microsoft Partner and a Tier 1 managed healthcare partner.

Evolute Gears Up for International Market Expansion

GREENWOOD VILLAGE, CO, February 28, 2011 – Sales Force Expansion to Match International Growth Targets

Evolute Consolidated Holdings announced today its intention to move into the international market. With the recent and extensive expansion of its sales force, Evolute is fueled for further international sales growth in order to continue the momentum triggered by moving its headquarters to Colorado last year.

“Evolute’s goal is to enhance health care solutions such as HIPAA 5010, HIE and care coordination by bringing in knowledgeable consultants and subject matter experts, allowing scalable growth and return on investment to clients,” said Debbie Deaton, Vice President of Sales and Marketing. In addition to entering the international market, Evolute plans to focus on increasing services and solutions offered in the current US market in order to maximize growth.

Evolute Consolidated Holdings develops integration solutions and offers consulting services specifically for Microsoft technologies and platforms in the health care industry. Evolute’s solutions build “upon customers’ current systems and approaches while providing advanced capabilities in research, management and health care,” said Deaton.

###

About Evolute Consolidated Holdings
Evolute Consolidated Holdings, Inc. (Evolute) is a Denver-based consulting firm that develops highly effective integration solutions and delivers consulting services specifically for Microsoft technologies and platforms.  With a staff of Microsoft platform experts offering several years of experience in healthcare, public health, financial services, government and manufacturing industries along with years of experience developing Microsoft technologies, Evolute provides cost-effective solutions to help you to connect, facilitate, automate, and present the information you need when and where you need it.  For more information about Evolute, please visit  www.evolutechi.com.

For more information, Press only:

Debbie Deaton, Evolute, (303) 349.5150, DebbieDe@evolutechi.com

OVERVIEW

The Alameda County Public Health Department (PHD) provides partial reimbursement to healthcare providers who provide emergency healthcare to its poor and indigent community who are not covered by Insurance or Medicaid. This program is funded through Senate Bill 12/612 (1988). Healthcare providers submit paper claims to the Alameda County PHD using the HCFA 1500 format. These paper claims are then manually keyed into the Alameda County Adjudication system (SB12). Claims are adjudicated based on contractually defined rates for procedures and on the amount of funds available. Alameda County PHD was faced with HIPAA compliance regulations and other compelling technical reasons to select Microsoft’s BizTalk Server product as a solution for solving a complex set of claims transaction issues.

CHALLENGE

The primary challenge faced by Alameda County in the initiative to move to an EDI model for claim submission and remittance advice was the static nature of its SB12 custom built adjudication system. SB12 is a custom application created with Microsoft Visual Fox Pro that runs on top of a Microsoft SQL Server 2000 database. Alameda County does not have a support agreement with the developer of this system. These circumstances posed a serious challenge in moving to an EDI and HIPAA compliant model because the 837/835 EDI transactions required the storage of additional data fields that were not needed when processing paper claims.

SOLUTION

Evolute Partners was contracted by Microsoft to assist in the deployment, which included the following critical claims transactions:

Inbound 837: Evolute created a BizTalk Map using the Washington Publishing company Schema provided with the BizTalk Accelerator for HIPAA and a custom schema that matched the format of the file required by SB12 for successful import of claim data into the adjudication system. Evolute was able to incorporate the additional information from the 837 that is required on the outbound 835 by storing several unused fields on the current SQL tables.

Outbound 835: Evolute designed and implemented a solution for the outbound 835 process that is fully automated. Evolute, along with help from Alameda County PHD employees, created a Microsoft SQL Server stored procedure that extracted the data necessary for the creation of the 835 to be invoked by the BizTalk Adapter for SQL Server. Using the schema generated by the BizTalk Adapter for SQL server as an input schema and a sample 835 schema provided with the HIPAA Accelerator as an output schema Evolute created a map to allow PHD to generate individual HIPAA compliant 835 transactions for each EDI-enabled payee/trading partner.

RESULT

Evolute Partners was able to design a solution that enables the Alameda County PHD to receive and process the HIPAA compliant claims in the timeframe required and under tight budget constraints. The Microsoft integration platform is powerful enough to enable additional integration initiatives and will serve the Alameda County PHD well into the future. The community is better served by more efficient processing and less administrative overhead.

Evolute is a technology consulting firm based in Colorado. Proven leaders in business process integration in healthcare, Evolute also offers business intelligence, portal and .NET development and technical training for business and government entities. Evolute’s collaborative approach to creating agile technologies consistently boosts client profitability and user satisfaction. Evolute is also a Gold Certified Microsoft Partner and a Tier 1 managed healthcare partner.

OVERVIEW

Faced with numerous additional interfaces required to connect to new applications but limited resources to develop them, WilMed Healthcare (WilMed) evaluated their existing interface engine investment. They elected to replace their old engine with Microsoft’s BizTalk Server because the Microsoft product, with its .Net platform and SQL Server integration, fit well with their network infrastructure. It also required a comparatively moderate financial investment.

WilMed Healthcare selected Evolute Partners to help with training, installation, and development because of Evolute’s expertise in both healthcare and BizTalk Server implementation. Evolute implemented a solution that jump-started WilMed and prepared them for future needs.

SITUATION

WilMed Healthcare, located in Wilson, NC, is a community hospital with 317 licensed beds. WilMed uses an integrated and proprietary product, MEDITECH for their Hospital Information System (HIS). Their integration requirements were minimal because their core HIS met most of their ancillary departmental needs, thereby limiting the use of other best-of-breed ancillary systems.

However, the hospital is focused on the further development of the Electronic Medical Record (EMR) as the primary location for patient data. This requires additional interfaces to be developed with specialized departmental system, primarily in the clinical areas .This greatly increased WilMed Healthcare’s system integration requirements and WilMed needed to develop numerous interfaces very quickly.

Because there were few in-house skills to develop interfaces using the old interface engine, WilMed Healthcare evaluated new interface engines. WilMed Healthcare chose BizTalk Server because they had already invested in the .Net development platform and needed additional functionality that BizTalk Server could provide. According to Janie Baker (Systems Supervisor at WilMed Healthcare), “There were things that were not supported on the previous interface engine that we are now able to accomplish with the BizTalk Server.”

SOLUTION – PATIENT BASED ORCHESTRATION (PBO) MODEL

Evolute Partners drew upon extensive knowledge of the healthcare environment and BizTalk Server. Evolute Partners presented a design based on requirements provided by Wilson Medical Center, which included the use of Microsoft’s BizTalk Server and HL7 Accelerator, along with a system that addressed future needs.

Evolute’s plan included a unique BizTalk Server implementation model along with a custom training and mentoring program that helped WilMed Healthcare become selfsufficient.

Perhaps the most groundbreaking aspect of Evolute’s plan was the BizTalk Server implementation itself. To ensure proper data sequencing, which can be a challenge in BizTalk Server implementation, Evolute created a unique BizTalk Server implementation model they called Patient Based Orchestration (PBO).

With PBO, an orchestration instance is created for each new patient when an Admissions/ Registration transaction (ADT) occurs through the interface, so each orchestration exists for one patient only. After the orchestration starts, messages are delivered in the order received for each patient. This created a unique ability to connect data analysis, rules, and alerts to patient activities and ensure that patient care models occur within stated guidelines and that care goals are met.

WilMed Healthcare now can access correlated information that was previously unreachable because any transaction passing through BizTalk Server is combined and interpreted in a single long running state-aware transaction log. This is an added benefit to Evolute’s BizTalk Server implementation. Not only are disparate systems seamlessly connected, but the PBO model creates a unique opportunity for WilMed to dramatically improve patient care.

In addition to the BizTalk Server installation, Evolute developed WilMed’s initial interfaces. Evolute also provided formal education to WilMed’s IT staff in a weeklong class led by developers extremely familiar with both BizTalk Server and the healthcare environment. After training, WilMed began working with the interface engine with guidance from Evolute. This highly productive mentoring approach ensured skills transfer was accomplished very quickly.

RESULT

With the unique implementation method, jump-start interface development, and a custom training program, Evolute successfully launched WilMed Healthcare into the “best of breed” technology it required. Now new applications can be fully integrated using internal IT resources. As Janie Baker states, “We bought BizTalk Server for its ability to allow us to move from using outside resources [consultants] and develop them internally.”

As a bonus, WilMed Healthcare can address quality initiatives and care guidelines through the Patient Based Orchestration model.

Evolute is a technology consulting firm based in Colorado. Proven leaders in business process integration in healthcare, Evolute also offers business intelligence, portal and .NET development and technical training for business and government entities. Evolute’s collaborative approach to creating agile technologies consistently boosts client profitability and user satisfaction. Evolute is also a Gold Certified Microsoft Partner and a Tier 1 managed healthcare partner.

Brown & Toland Medical Group (BTMG) provides quality healthcare to its 200,000 patients. The San Francisco-based IPA offers a variety of disease management and quality improvement programs, as well as physician-based authorization, access to a comprehensive network of physicians and facilities, and a standards-setting performance metrics system for its physicians.

BTMG patients have access to the largest network of independent physicians in San Francisco and northern San Mateo counties — more than 1,600 physicians, board-certified in 43 different specialties, practicing at UCSF Medical Center, UCSF/Mount Zion Medical Center, California Pacific Medical Center, St. Mary’s Medical Center and Saint Francis Hospital.

SITUATION

BTMG believes that, patients receive the best medical care when physicians — not administrators — make medical decisions. Under BTMG’s contracts with eight HMOs, including one HMO for seniors, the primary care physician is authorized to refer his or her patients to a specialist without waiting for HMO approvals. To stay true to this model, BTMG must rely on an effective system to tie together the different data sources that exchange patient medical information using the ANSI X12 Electronic Data Interchange (EDI) standard. The requirements also included mandatory Health Insurance Portability and Accountability Act (HIPAA) Compliance.

BTMG uses Electronic Data Interchange (EDI) – the electronic transfer of information in a standard format between trading partners. BTMG receives approximately 4,000 inbound claims (837’s) each day, which are sent from their clearinghouses and direct submitters, typically via a file transfer protocol (FTP) connection. BTMG manually takes those claims and loads them into their IDX claims processing system. They also receive scanned HCFA 1,500 paper claims from their RRI scanning system in NSF format. BTMG was taking these files, manually logging them in, performing some nominal validations then loading them for transformation processing in the Mercator Integration Broker (MIB). MIB then translated the 837 into ANSI X12 format and output it as a Flat file, which was in turn manually uploaded in their IDX System.

BTMG needed a cost-effective interface engine solution and asked Evolute to provide validation of its plans and strategy. The plan included use of Microsoft technology and was to include BTS and HIPAA Accelerator for BTS. Evolute presented a working system based on verbal requirements provided by BTMG.

HIPAA needed to produce compliant X12 HIPAA governed transactions, including future variations and leverage existing transactions through a transition period. The system also needed to address future needs for automation and provide a comprehensive environment for all business process needs including access from member and provider locations.

SOLUTION

Since HIPAA compliance has been mandated, a jumpstart implementation was required to automate the claims processing in BTS. The diagram that follows depicts the flow for the implementation. Their first step was to take a sample set of claims forms and implement these with a preliminary group of trading partners. The second step is not only to incorporate more data exchanges into their existing business processes (i.e. 997 Acknowledgements; 270 Health Care Eligibility Requests, etc.), but to implement these to all of their trading partners. Subsequent work will leverage BTS to integrate internal applications.

• Evolute replace BTMG’s interface engine with a solution that achieved the following:
• Found a cost-effective solution that met existing and future business requirements
• Provided infrastructure to allow business to business (B2B) data transfer between itself and its community of 1,600 healthcare providers and their patients
• Provided a foundation that allows the IPA to quickly bring up new trading partners and interfaces
• Eliminated manual steps, forcing better-automated data flow
• Performed the same functions as the MIB, while providing significant new functionality
• Added data retrieval functionality from its data warehouse, utilizing the SQL Server Adapter for BizTalk to facilitate weekly reporting and to represent a “total view” of the entire life cycle
• Provided reliable transmission and storage of data
• Leveraged BTS to integrate internal applications to eliminate high development and maintenance costs

RESULT

BizTalk Server offers a powerful, easy-to-use development tool for building new EAI interfaces; future interface development should take even less time. BTMG can now enjoy the benefits of an integrated interface engine solution that is equipped to take advantage of XML Web services and .NET functionality.

Rapid Implementation: The jumpstart implementation by BTMG and Evolute achieved HIPAA compliance for claims in a limited timeframe of just six (6) short weeks.

Business Process improvements: Utilizing SQL Server in conjunction with BTS, the immediate benefits BTMG achieved by implementing this solution included the elimination of manual steps, better error tracking visibility, auto generation of document definitions (schemas) and overall a more accurate view of the entire process life cycle. The bottom-line is if a message fails, it can be tracked and reviewed within BTS.

Commitment to Patient Care and Increased Market Share: The day-to-day transactions with its healthcare partners will be automated to better serve the provider- collections process, thus allowing more focus on patient care. BTMG’s transactions will be more secure because of Microsoft technology and the products deployed. BTMG also is much better positioning for growth in a very competitive field.

Enterprise-wide EAI: A wrap-up session was conducted for BTMG, provided by Evolute and Microsoft at the Microsoft Technology Center (MTC) in Silicon Valley, to discuss system expansion through additional product offerings, best practices, and knowledge transfer. The BizTalk Server platform provides the infrastructure for future EDI HIPAA needs and Enterprise-wide EAI, which can further expand to Business Process Automation (BPA), Business Process Monitoring (BPM) and Portal/Content Management. Ultimately, BTS provides a scalable and reliable long-term integration platform for BTMG.

Evolute is a technology consulting firm based in Colorado. Proven leaders in business process integration in healthcare, Evolute also offers business intelligence, portal and .NET development and technical training for business and government entities. Evolute’s collaborative approach to creating agile technologies consistently boosts client profitability and user satisfaction. Evolute is also a Gold Certified Microsoft Partner and a Tier 1 managed healthcare partner.

University of Utah Health Sciences Center (UUHSC) officially began with the opening of the University of Utah Hospital in July of 1965. Since then, UUHSC has developed into a variety of facilities including Community Clinics, the School of Medicine, Academic Colleges, and various institutes and centers. UUHSC excels in education, research, patient care and community outreach throughout Utah and the Intermountain West. As its adopted mission the UUHSC has concentrated efforts on tertiary care, burns, trauma, and transplants — the medicine of the future.

SITUATION

Currently, UUHSC conducts 150,000 ADT transactions per day, and a total of 400,000 transactions per day using an interface engine known as Impact from Sybase (formerly the independent software company, NEON and CAI). These are HL7 standard transactions (Health Level 7), commonly used to integrate data among disparate applications as well as between hospitals and other providers/partners (such as labs).

As the costs for interface support and maintenance of the existing system began increasing, because of Impact’s cumbersome development environment and manual intervention, UUHSC began to search for something better, and something that could also easily tackle the problem of managing HIPAA compliant claims transactions, acting as both a payer and provider in the UUHS environment. Recognizing the need to cut development costs while maintaining the ability to easily integrate future transactions and business interfaces into their IT infrastructure, UUHSC turned to Microsoft and Evolute to help implement a better interface engine solution. In the new system, these steps will be automated through the Microsoft® Integration Broker, BizTalk Server (BTS).

All of the endpoint systems which currently utilize the Sybase Impact software to send data and the systems which receive that data were identified. No functionality has been identified which would not be included with the basic Microsoft ® server 2004 product used in conjunction with the HL7 and HIPAA Accelerators.

Discussions revealed that additional interfaces are expected including supply chain management, retail pharmacy, pharmacy operations (orders / dispensing / inventory relief).

For claims processing, also identified was a need for an external database which will be act as a repository for HIPAA transactions which pass through the BTS engine. Each claim will need to create a record and this record will be updated by the acknowledgement to include the transaction ID assigned by the remote system. This transaction ID will be required when resubmitting claims which have rejected. This database will contain enough detail about claims and responses / remittances to allow for the creation of query screens to quickly inquire on the known status of all processed claims as well as the dynamic generation of 276 (claim status inquiry) transactions.

UUHSC asked Evolute to provide validation of their plans and strategy which included use of Microsoft technology. This was to include BTS and both the HL7 and HIPAA Accelerators for BTS. Evolute presented a working system based on a findings / assessment engagement, written specifications and verbal requirements provided by UUHSC provided during on-site interviews. HIPAA compliancy required the ability to produce compliant X12 HIPAA governed transactions, including future variations, as well as leverage existing transactions through a transition period. The system also needed to be scalable to address future needs for automation, and provide a comprehensive environment for all business process needs including access from member and provider locations.

SOLUTION

Since HIPAA compliance has been mandated, the first project was a jumpstart implementation to automate the claims processing in BTS. The diagram that follows depicts the flow for the implementation. Their first step was to take a sample set of claims forms and implement these with a preliminary group of trading partners. The second step is not only to incorporate more data exchanges into their existing business processes (i.e. 997 acknowledgements; 270 health care eligibility requests, etc.), but to implement these to all of their trading partners. Subsequent work has leveraged BTS to integrate internal applications through HL7 and proprietary message formats. Next phase work will focus on the significant value offered by BTS by leveraging its out-of-the-box integration with Office, SharePoint and other MS tools to bring value directly to the business users through user workflow, business activity monitoring and business intelligence capabilities.

Objectives

• Find a cost-effective solution to meet existing and future business requirements
• Provide infrastructure to allow business to business (B2B) data transfer between themselves and their community of 1,600 healthcare providers and their patients
• Provide a foundation to allow them to quickly bring up new trading partners and interfaces
• Provide reliable transmission and storage of data
• Add the functionality of retrieving data from their data warehouse to facilitate weekly reporting and to represent a “total view” of the entire life cycle
• Leverage the chosen interface engine to become an enterprise integration platform to provide common services and eliminate high development and maintenance costs
• Leverage the platform to provide comprehensive Business Activity Monitoring and Business Intelligence solutions

RESULT

BizTalk Server offers a powerful, easy-to-use development tool for building new interfaces; future interface development should take even less time. UUHSC can now enjoy the benefits of an integrated interface engine solution that is equipped to take advantage of XML Web services and .NET functionality.

Rapid Implementation. The jumpstart implementation by UUHSC and Evolute achieved HIPAA compliance for claims in a limited timeframe of just six (6) short weeks – they may want to debate the date!

Business Process improvements. Utilizing SQL Server in conjunction with BTS, the immediate benefits UUHSC achieved by implementing this solution included the elimination of manual steps, better error tracking visibility, auto generation of document definitions (schemas) and overall a more accurate view of the entire process life cycle. The bottom-line is if a message fails, it can be tracked and reviewed within BTS.

Commitment to Patient Care and Increased Market Share. The day-to-day transactions with their trading partners will be automated to better serve the provider collections process thus allowing better focus on patient care. UUHSC’s transactions will be more secure based on Microsoft technology and products being deployed. The result to UUHSC will be much better positioning for growth in a very competitive field.

Enterprise-wide EAI. A wrap-up session was conducted for UUHSC, provided by Evolute and Microsoft on-site at UUHSC, to discuss system expansion through additional product offerings, best practices, and knowledge transfer. The BizTalk Server platform provides the infrastructure for future EDI HIPAA needs and Enterprise-wide EAI, which can further expand to Business Process Automation (BPA), business process monitoring (BPM) and portal/content management. Ultimately, BTS provides a scalable and reliable long-term integration platform for UUHSC.

Evolute is a technology consulting firm based in Colorado. Proven leaders in business process integration in healthcare, Evolute also offers business intelligence, portal and .NET development and technical training for business and government entities. Evolute’s collaborative approach to creating agile technologies consistently boosts client profitability and user satisfaction. Evolute is also a Gold Certified Microsoft Partner and a Tier 1 managed healthcare partner.

We selected Evolute because of their extensive knowledge of the BizTalk server in the Healthcare Industry. BizTalk, and our knowledge of how to use it, gives our organization a distinct advantage.”

Bill Bollig, CIO
Martin Memorial Health Systems

BizTalk Server and Evolute create smooth operation of far-flung hospital system

OVERVIEW

With 70 years of steady growth as a nonprofit hospital system on Florida’s “Treasure Coast,” Martin Memorial Health Systems (MMHS) prides itself on the quality of its patient care, doctors and small army of volunteers. However, keeping up with technology in document management from human resources through patient records was a challenge of a different sort. Integrating information to be shared among its two hospitals, three medi-centers and numerous other centers and clinics, while still meeting data security needs was a major concern.

MMHS chose Microsoft’s BizTalk Server, the business process management tool used by more than 90 percent of the Fortune Global 100, to completely replace a legacy system that had been created in the early 90s. Evolute provided its unique patient-centric program, called Patient Based Orchestration, as well as painless integration and personnel training to make the transition to BizTalk Server trouble-free and on-budget.

SITUATION

The outdated interface engine MMHS was relying upon before BizTalk Server needed a total overhaul “upgrade” in order to meet 21st century needs. Instead, the hospital system decided to scrap the old system entirely and go with Microsoft BizTalk Server.

This required a removal of the legacy system, integration with all the departments and their software applications, data formats and legacy information, and training for hospital employees and the many volunteers who provided more than 187,000 hours of time to the system annually, including in such important areas as hospital admissions and administration.
Evolute stepped in with the understanding of the healthcare industry and its needs built over years of working with hospital systems across the United States.

“Crucially important in working with any hospital system is the understanding that they will require a system that grows as they do, and meets new patient needs,” said Evolute President and CEO Joe Fabrizio. “For instance, patients are becoming more involved in their own care and demanding access to all their medical data. At the same time, keeping patient data secure is vitally important for privacy reasons.”

SOLUTION

“We selected Evolutes because of their extensive knowledge of BizTalk Server in the Healthcare industry,” said Bill Bollig, CIO of MMHS. Evolute’s Patient Based Orchestration helped MMHS improve efficiency across the entire hospital system, as well as create a base for future growth and new patient needs.

Today, MMHS can transfer information from the primary hospital information system, called MEDITECH, to ancillary systems and physician’s offices. It can create new interfaces between locations and departments internally. It can process EDI transactions to and from suppliers seamlessly, allowing the hospital to run efficiently and concentrate its efforts on patient care, knowing the administration is running smoothly.

RESULT

“BizTalk, and our knowledge of how to use it, gives our organization a distinct advantage,” comments Bill Bollig, CIO, Martin Memorial Health Systems. With Evolutes guiding the way, Martin Memorial now has a system that is easy to use, fully supported and enhanced by the Microsoft Corporation. Through Evolute, MMHS staffers and volunteers learned how to better manage the hospital systems’ data, create new interfaces, and ensure the future business process needs of the hospital will be met with confidence.

Evolute is a technology consulting firm based in Colorado. Proven leaders in business process integration in healthcare, Evolute also offers business intelligence, portal and .NET development and technical training for business and government entities. Evolute’s collaborative approach to creating agile technologies consistently boosts client profitability and user satisfaction. Evolute is also a Gold Certified Microsoft Partner and a Tier 1 managed healthcare partner.