Industry: Healthcare

An application for care gap management amongst the underserved communities

0 Engineers
0 Months
0% Increase in Speed of Delivery

Services

Rapid Application Development, Product Engineering, Data Infrastructure Modernization

Technology

AWS Neptune, React.js, Node.js, Lambda Functions, PostgreSQL, Snowflake

Location

Chicago

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Overview

The product is being developed for Federally Qualified Health Centers (FQHCs) within the United States, which receive financial aid from the government. Received funds are managed by third-party insurance companies, and FQHCs are required to report on their performance. Using resources such as Amazon Web Service Neptune, Node.js, and React, we developed a system to assess an FQHC’s operations. The Centers now have access to accurate daily measures, and they can track which patient (if any) lacks medical attention.

Challenges

The Chicago-based client is developing a digital product for the Federally Qualified Health Centers (FQHCs), whose primary purpose is to help underserved communities. They receive funds from the US government, which allocates a specific budget to such organizations across the country.

But FQHCs don’t get the money directly from the government. Instead, the state designates insurance companies to act as intermediaries. The health organizations thus obtain their funds according to the services they provide.

An FQHC needs to meet several requirements set by the federal government and paying entities. Hence, they receive funds depending on their performance of each one of these requirements.

This process requires complicated calculations that are set up in such a way that clinics struggle to meet them and provide accurate performance measures and accountability. As a result, the numbers fall short, and the FQHC is underpaid.

Another complication is that the calculations do not consistently occur on previously scheduled dates, e.g., every six months. On the contrary, the insurance company decides when to conduct audits. Therefore, the clinic can’t make a previous estimation on how they are doing before the next audit.

In the healthcare industry, confidentiality is vital, so few subject matters experts are available. Additionally, although some physicians were willing to cooperate with the project, they were not aware of the FQHC requirements. It took the team nearly three months to study the data and develop possible solutions.

Technical Challenges

The team was asked to create a platform to help the Federally Qualified Health Centers from US to complete this process. It was a start-to-end project in which TechVariable was to design the architecture and develop the software, involving engineering, testing, and DevOps.

Solutions

Amazon Web Services (AWS) Neptune was chosen as the graph database. This technology is relatively new; hence it has little documentation. The Tech Variable team sat down with Amazon experts to learn the technology and make a meaningful contribution.

The following modules have been created:

  • Connection to different EHR systems. From these systems, the data is consumed and enriched with ETL pipelines.
  • A quality control engine that resolves the HEDIS Ids and UDS to different codes.
  • Thanks to this, the platform can estimate gaps in patient treatment. It also estimates performance based on KPIs.
  • Through an integrative approach, it can be estimated which requirements are particularly more important for a given FQHC.
  • A social data module monitors health inequality and categorizes them under population sub-groups. With this system, health centers will have enough social data to recommend the appropriate treatment.

Need a custom software application for your business?

We at TechVarible do acknowledge that one size will not fit all. Hence, we work in collaboration with you to identidy, analyze & then develop a solution that fulfils your needs.

Either we will define the functional scope of your project to estimate the timeline and budget or you can create your own agile team from among our recources.

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High Level Design Architecture

The Result

Tech Variable developed a beta version currently used by five of these health centers. The FQHCs have access to daily accurate performance measures, thanks to this software. As a plus, they can track which patients have a gap in their medical attention and address those needs. This translates into a fairly remunerated job and no losses.

Modules Implemented

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