Leading Healthcare provider needed a content repository to store and manage the electronic medical records containing Claims and Supporting Attachments that were sent by providers (Doctor’s Office, Hospitals, etc.) and by other member plans. This system would enable the client to automate their medical record exchange in a secure manner that is mandated by Federal Regulations (including HIPAA).

The objectives were to

1. Create a FileNet P8 based content repository and database to store and manage medical records, claims and other supporting documents
2. Enable a FileNet P8 based workflow integration to process messages being sent and received via the internal system
3. Provide connectivity to external claims management systems using Web Services
4. Provide connectivity to external Imaging System for export and import of claims and supporting documents using FileNet P8 Records Crawler
5. Provide connectivity to outsourced agents using a secure Citrix enabled FileNet Web Application

Our Solution

• Initially implemented a custom image repository using Network File Server and Oracle Database Server for storage and management of electronic medical records containing Claims and Supporting Attachments.
• Designed and developed a JSF based J2EE web application to allow Claims and Customer Support Users to be able to search, retrieve, view and process Claims and Attachments from Custom Repository. This web application also provided XML web services and JMS MQ based connectivity to customer's existing Attachment Processing Application
• Migrated about 1.5 million documents and indices from the Network File Server and Oracle Database Server to IBM FileNet P8 4.5 System
• Later the JSF based J2EE web application was also enhanced to enable workflow automation for review, approve and submission of medical records to in-house custom application from IBM FileNet P8

Technologies Used

• IBM FileNet P8 4.5 Content Manager, IBM FileNet P8 4.5 Business Process Manager, IBM FileNet P8 4.5 Application Engine, IBM FileNet Capture – Scan/Index/Document Processing, IBM FileNet Records Crawler
• IBM WebSphere Application Server 6.1, IBM WebSphere MQ Services 6.1
• XML Web Services, Java J2EE – JDBC, JAAS, JMS, Java Servlets, JSF, JSP
• Sun Solaris 10 OS, Windows 2003 Server OS
• Oracle 10g Database Server, EMC Centera Network Storage

Benefits of the solution

• Centralized image repository for electronic medical records
• Instant access to electronic medical records for user to process claims and provide customer support 24/7
• Reduction in time for processing claims and attachment request from other member plans
• Automated processing of misrouted claims and attachments with less or no delay