Learn how Agnos deployed its expertise in healthcare technology and business process optimization to help the client bring together providers, patients, and insurance companies in bringing the clinic to the patients.
Agnos assisted the client in offering its healthcare providers a comprehensive platform where hardware and software are perfectly aligned to make their practice more profitable, modern, and efficient.
Chronic conditions are one of the leading causes of death and disability in the United States. Many of these conditions, especially when mismanaged, can lead to painful symptoms.
Often, the biggest challenge that doctors face is getting patients with chronic conditions to come to the doctor’s office for the treatment of these diseases, and also for the treatment of related conditions.
These conditions if left untreated can result in extreme pain and suffering for the patient and can result in emergency room visits or hospital admissions/readmissions which drive up the cost of healthcare and may lead to worse healthcare outcomes or lower quality of life. These conditions, if left untreated, can also lead to death which is the ultimate price to pay for a medical condition that is treatable.
But what if there were a way to bring the clinic to the patient versus having the patient go to the clinic? Wouldn’t this enable doctors to heal patients and help them avoid pain and suffering and even death at a much lower cost?
- Our client is a distributed medical practice that provides healthcare services to patients at their homes, enhancing the quality of life and minimizing barriers to accessing the best medical care.
- The client receives referrals from healthcare providers (doctors and hospitals) and payers (healthcare insurance companies), and hence, face the challenge of managing multiple referral mediums such as Faxes, phone calls to call centers across the world, referrals from 3rd party portal, etc.
- The client uses an evidence-based strategy and a customized healing medication regimen to solve healthcare inequities and financial inefficiencies.
- Coordinating appointments with patients to ensure that everyone receives high-quality care and taking care of any administrative patient needs or questions.
- The system is designed for users such as patients and healthcare providers, clinicians, practitioners, primary care doctors, patient care coordinators, and referral providers.
Problem Statement
Providers, especially Primary Care Physicians, struggle with how to bring care to patients who need it the most on a timely basis. Doctors struggle with how to bring Technology-enabled specialized healthcare services to patients wherever they reside rather than having the patients come to the Doctor’s office. Doctors struggle with helping patients heal quickly when the patient’s condition requires daily or even weekly care because again this requires multiple visits per day or week to the doctor’s office.
Our client created a system for users including patients and healthcare professionals, clinics, practitioners, primary care physicians, patient care coordinators, and referral providers to address the obstacles faced by healthcare workers, but there were problems with the system as follows:
- The client’s legacy EMR (Electronic Medical Record) system was a third-party SaaS solution that wasn't well aligned in terms of people, process and technology being aligned to result in operational excellence and patient satisfaction.
- Our client had Integration challenges with many other platforms.
- Maintaining the data in the legacy system was challenging.
- Most of the jobs required manual processing, and the outdated system was unable to automate the processes.
- Due to the manual processes required and the lack of system integration, the time between the beginning of a referral and the beginning of actual care was taking much longer than necessary and negatively affecting patient outcomes.
- The client’s engineering team was in the process of deploying Custom Off the Shelf (COTS) EMR, however the enhancement of features or addition of new features were difficult.
Proposed Solution
Agnos deployed its expertise in healthcare technology and business process optimization to help the client bring together providers, patients, and insurance companies in bringing the Clinic to the Patient. The system that Agnos helped build manages all the elements of bringing the clinic to the patient such as managing Patient Intake, Healthcare Insurance Eligibility Checks, Healthcare Insurance Authorization for Treatment, Appointment Setting, Patient Care Coordination, Caregiver Training, and Deployment for Home Visit, Telehealth/Caregiver Home Visit, Encounter Notes, Patient Experience Feedback, Healthcare Insurance Claims Submission, Remote Monitoring, Artificial Intelligence, Machine Learning, Patient Self-Services, and Portal, and Automated Follow-up until the Health Outcome was accomplished.
Agnos worked with their client to build a state-of-the-art system that reduced the time from physician referral to 1st treatment from 2 weeks to 2 days. This included the following solution definition:
- Consolidated referral mediums (Faxes, Phone Calls to call centers in US & India, Own/3rd party portal) and referral sources (Insurance companies, referring providers, etc.).
- Tasking / Inbox solution – Task Management System was developed to manage the tasks.
- Patient registration (Capture demographic and insurance info) and batch validate coverage for active patients.
- Process status reporting and performance reporting (Efficiency and effectiveness).
- Eligibility checks to determine current insurance coverage, coverage phase, patient responsibility, contractually agreed constraints to be respected in care delivery, etc. (Integration with Availity).
- Support for non-clinical intake forms/questionnaires.
- Capture patient authorization/consent.
- A Document Management System (e.g., to archive faxes, CCD Generation).
- Permissions/Access management.
- Configurable workflows using a Workflow Management System.
- Existing Data Migration.
- Existing Users Migration.
- Integration with multiple external systems.
Business Outcome
At Agnos, we are obsessed with the Desired Business Outcomes (Technology is only a means to the end!)
- Our client has experienced never before seen Operational efficiency which has drastically reduced missed patient appointments and meaningfully increased revenue.
- Our client can now get customized patient data views and can deliver timely, efficient value-based insights-driven care.
- Patient intake & check-in time reduced by 15- 20 mins.
- Reduced paperwork saving staff time by 10-15 mins for each patient.
- By easily accessing weekly schedules for doctors and clinicians, Patient Care Coordinators (PCC) can easily reschedule or cancel appointments as needed. Previously, PCCs manually had to search through spreadsheets.
- Electronic prescriptions for patients.
- View the medications that were e-prescribed through the EMR portal.
- Change the resources that the prescription application generates.
- Faster searches built with a search engine are also used for de-duplication.
- Reduced delays in scheduling patients’ SOCs (Start of Care).
- Our client has become a more agile and adaptive business due to using configurable workflows that can quickly adapt to the client’s changing business needs.
- The quality of care provided by physicians is consistently improved through guided treatment paths.
- This client went from providing specialized care typically within 2 weeks of Physician Referral to within 2 days of the Physician referral. As a result, 91% of patients can heal within the authorized duration of treatment.
- Patients are now able to fill in all required forms through their mobile devices, which get directly uploaded to many different EHR (Electronic Health Record) systems.
- Agnos built this entire system using the FHIR standard (Fast Healthcare Interoperability Resources) thereby enabling seamless integration and interoperability between multiple different healthcare systems.
- The system also helps accomplish the Quadruple Aim by reducing manual tasks, automatically scanning, and adding referrals, as well as automatically updating patient records.
- Healthcare Insurance Coverage Validity and Authorization are automatically checked and synchronized between the Patient, Doctor, and Healthcare Insurance Company and their respective Patient Health Record System and Electronic Health Record System (EHR).
Why Agnos?
- We have a significant amount of contributions in the Healthcare field.
- We have built patient-facing Applications.
- We have developed provider-facing applications for both single-specialty and multi-specialty hospitals.
- We have built applications for SaaS vendors.
- We have provided Enterprise healthcare solutions for medical practices.
- We have built the payer version of the Patient App in collaboration with a company.
- We have extensive experience with FHIR and also HL7 v2, integration with Epic / Cerner, and CMS Blue Button 2.0.
- We have experience in implementing FHIR using GraphQL.
- We have experience in using HAPI (Health API).
- We have experience in implementing FHIR using the cloud (Azure, Google Cloud, AWS).
- Agnos brings global turn-key teams of highly skilled healthcare technology practitioners including Product and Project Management, Business Analysis, UX Design, DevOps, Quality Assurance, and Software Engineering.
- We develop cloud-native and cloud-first applications.
- Agnos adopted GraphQL for the agility of front-end implementations and to establish a common enterprise data graph.
- We adopted responsive designs with a mobile-first approach.
- Our founders have experience and expertise in two significant domains namely Business Consulting and Engineering. They can assist you with all your business needs.
- We are fiercely independent and transparent and give back to our customers in the form of service credits and any form of compensation we may receive from our strategic alliance partners. Based on our Gain Share model, we don't make money unless you realize the desired business outcomes we collaborate with you to define.
- We started implementing FHIR for our clients even before it was recognized and used commonly. We have built accelerators based on FHIR. Our internal data models are based on FHIR. We not only think in FHIR, but We also speak FHIR.
- Our interoperability implementations at CareCloud have been referenced by Google Cloud's Healthcare API teams
- Our products are honored by the CARIN health alliance to achieve CMS Interoperability guidelines.
- We have Health Insurance Portability and Accountability Act (HIPAA) compliance.
Agnos Engineering Team
We are building a Customer-obsessed culture at Agnos. We pride ourselves on having an insatiable desire to gain deep-dive industry and domain knowledge and marry that expertise with truly world-class software delivery. It is our passion to "Co-Build" with our customers so that we build Better Software Faster at the Lowest Cost possible... Together!
About Agnos
Agnos was established in 2012 with a mission to empower businesses with next-gen, end-to-end agile software development services. Take a look at the Industries that Agnos serves and the IT Services we deliver, We combine human creativity with cutting-edge technologies to benefit society and shape an accountable business.
Agnos Value Proposition: Agnos has Top-Gun IT resources from across the globe and across industries that deliver the highest quality software quickly, at an extremely affordable price.
Our Competitive Differentiation: Our “secret sauce” is our hand-picked global team of technologists and consultants that are simply the “best” at what they do. Through our global partnerships, we now have an army of over 20,000 (our bench) worldwide, from the United States to Argentina to India to Ukraine and beyond. We can truly offer a “follow the sun” software engineering delivery platform.
Our Core Values: Agility, Trust, and Quality. As our customers will attest, we are obsessed with relentlessly pursuing the projects we undertake in a timely fashion, maintaining the highest quality standards, and keeping the trust of our customers, employees, and partners.
