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Healthcare Integration Case Studies

Integration Solutions Across Virtually Every Area of Healthcare

PilotFish Case Studies – How Our Software & Strategies Defeat Every Healthcare Integration Challenge

Healthcare Integration is hard. Nevertheless, we’ve been able to solve every integration challenge with an unparalleled track record of successful implementations. PilotFish has helped leading clients across the healthcare ecosystem implement pragmatic, modern integration strategies and achieve interoperability fast.

With PilotFish, companies have surmounted the challenges of HL7 Interfaces and X12 EDI integrations, legacy systems, problematic EHR integrations, broken processes, proliferating standards, new technologies, limited resources, and more.

Browse through our case studies to view in detail how we have helped a representative set of organizations solve their integration challenges to improve patient care, implement systems faster and improve revenues. You’ll see how the flexibility that we have architected into our integration engine solutions allows us to adapt to any environment and requirement and to changing industry data standards. It also enabled us to leverage new technologies to provide opportunities for greater operational efficiencies, gains in productivity and better system performance.

PilotFish Middleware is being leveraged throughout the healthcare ecosystem – by payers, providers, equipment vendors, cloud services, exchanges and other entities that need to deliver “interop-capable” solutions. Using a simple, graphical Automated Interface Assembly Line, you connect anything to anything – including legacy and new technology that have been developed using different data models, designs or architecture. The PilotFish eiPlatform is compatible with all major databases, operating systems, data formats and communication protocols.

We invite you to let us prove we can do the same for your organization.

Healthcare Financial Analytics

PilotFish Healthcare Data Integration Analytics Case Study

Accurate real-time data is critical to successful healthcare financial analytics and operational decision making. In this case study, discover how PilotFish was the game-changer that powered real-time data integration. Automatic data reconciliation and auditing were ensured from data ingestion to transformation. HL7, Custom Validation, Empowered Financial and Clinical Results >

Categories: HL7 Integration, Analytics Integration, Message Testing & Validation

Enhanced HL7 Healthcare Delivery

HL7 Healthcare Integration Automation Solution Case Study with PilotFish Technology

PilotFish’s HL7 integration solution, proven to be interoperable in any HIE ecosystem, allowed this leading Healthcare company to leverage automation and incorporate customer-specific rules for advanced validation. PilotFish’s built-in flexibility made meeting their business requirements and making changes far easier and faster. Plus, its support for HL7 interface reuse further fast-tracked their implementations. HL7 Automation, HL7 Workflow, Customized Validation, Data Mapping >

Categories: HL7 Integration, Message Testing & Validation

Easy Migration from Sunsetted EDI Claims System

Health Insurance EDI Workflow Example with PilotFish

Deep expertise in EDI claims processing averted a crisis for this HMO and delivered fast, easy migration from a sunsetted EDI system. New compliance capacity arrived with PilotFish’s unique EDI SNIP Validation Processor. In this case study, discover how partnering with PilotFish modernized the payer’s EDI claims processing system and compliance infrastructure. EDI 837, EDI 835, SNIP Types 1-7, Compliance, Claims Management >

Categories: X12 EDI Integration, Claims Processing Integration

EDI Workers’ Comp Claims System

EDI 837, EDI 835 Batch Claims Process with PilotFish Platform

Robust, modern EDI Integration Solution replaced current sunsetted EDI integration system end-to-end. The company gained advanced SNIP validation of types 1-7 with superior accuracy, efficiency, and scalability. Faster cost-effective closure of workers’ comp claims improved profit margins. See how top EDI technology and EDI expertise delivered. EDI Workers’ Comp Claims System >

Categories: X12 EDI Integration, Claims Processing Integration

Healthcare Data Integration

Healthcare Data Integration Case Study with PilotFish

Payers, providers and service partners struggle to navigate the disparate processes, standards and systems required to integrate social care, behavioral health care and medical care. Learn how a transformative leader moved forward to tame complexity and ensure seamless data interoperability. HL7 FHIR, X12 EDI, Care Delivery, Claims >

Categories: HL7 Integration, X12 EDI Integration, Claims Processing Integration

Healthcare Claims Accuracy Solution and Payment Integrity

Healthcare Payer Integration Workflow Using PilotFish Middleware

Extensible software, a forward-thinking approach, and the ability to run billions of claims across policies, networks and markets from one platform deliver lower costs and higher quality for healthcare payers. Learn about this new hybrid, cloud-based central platform aiming at all aspects of payment integrity – claims accuracy, eligibility and verification, prior authorization, pricing and plan optimization, and more. HL7 FHIR and X12 EDI Integration > Core Capability for Claims Accuracy >

Categories: HL7 Integration, X12 EDI Integration, Claims Processing Integration

X12 EDI Specialty Health Insurance Integration

X12 EDI Transaction Workflow with PilotFish Integration Platform

A leading organization that provides health services was experiencing rapid growth and planning to double its size over the next five years. Enhancing its data integration solution was critical to growth projections, improved efficiencies, and reduction of potential risks to its high-volume information processing capabilities. PilotFish provided the client with a cost-effective product replacement path and enhancement of its current solution.

The PilotFish Assembly Line approach ensured that going forward each interface was configured in the same way and updated easily. Leveraging PilotFish’s integration solution with its specialized X12 EDI features ensured robust data integration and accurate validation critical to achieving its goals.  Benefit Management Solution: EDI 271, 837, 834 Integration and more >

Categories: X12 EDI Integration, Claims Processing Integration

EHR HL7 Medical Device Integration

EHR Medical Device Integration with PilotFish Software


This medical device portfolio of products requires a robust HL7 interface and data integration architecture for nearly real-time EMR integration. Discover how this leading developer of mobile health solutions and remote cardiac monitoring services leveraged PilotFish Integration Solutions to support the development of disruptive monitoring technologies. See the advantages of this customizable and configurable platform in delivering seamless reporting and services. HL7 FHIR EMR HIS ORU >

Categories: HL7 Integration, Medical Device Integration

Quality Analytics

HL7 Messages, FHIR, API Healthcare Case Study

Under new contracts as a Hospital Quality Improvement Contractor (HQIC-CMS), the firm targeted quality improvement assistance to hospitals in response to the opioid epidemic and patient safety. Rapidly integrating HL7 feeds of EMR data from Epic, Cerner and others from over 30 hospitals to meet tight deadlines was the first requirement. The second was finding a cost-effective integration solution that would fall within their existing contract parameters. HL7, FHIR, API Integration >

Categories: HL7 Integration, Analytics Integration, Government Integration

Hospital HL7 ORU Integration

HL7 Integration Case Study with EHRs and Hospital Lab

Lab result alerts from this hospital’s LIS were a persistent pain point for providers. Alerts were so frequent that they were unmanageable, veering on becoming meaningless. PilotFish’s HL7 Interface Engine was leveraged to solve this immediate HL7 ORU challenge. The partnership with PilotFish also positioned the lab for further CPOE implementations. See how PilotFish, the lab and IT architected a single report solution.  HL7 ORU Alerts, Hospital LIS and CPOE >

Categories: HL7 Integration

Healthcare Revenue Recovery Solution

Revenue Recovery for Hospital Case Study

 “A chain is only as strong as its weakest link” applies to X12 EDI data integration and delivering revenue recovery solutions. This company’s processes using advanced data science tools got bogged down by a weak link – EDI data intake. Their home-grown parser just couldn’t handle ingesting millions of EDI 835 and EDI 837 transactions. PilotFish’s eiConsole for X12 and its built-in EDI parser surpassed the client’s home-grown parser across every metric. The big winners in this PilotFish-led revenue recovery automation process were the client’s hospital system customers. EDI 835, EDI 837 and Revenue Cycle Management (RCM) >

Categories: X12 EDI Integration,  Claims Processing Integration

EDI 834 and 837 Claims Integration

EDI 837 & EDI 834 Benefit Processing

This full-service third-party benefits administrator is a leader in the self-funded employer benefit health and wellness plan space. The company provides employers with strategic benefits plan design, cost-effective benefits administration as well as reporting and analytic services. With PilotFish as a partner, they have been able to capitalize on plan, utilization and claims data to help their customers balance and control the costs of providing benefits. In this case study, discover how PilotFish’s Integration Engine solution and deep expertise in EDI healthcare data exchange helped them modernize their IT capabilities and reduce costs. EDI 834 and 837 Claims Integration >

Categories: X12 EDI Integration,  Claims Processing Integration

NCPDP Integration Solution

NCPDP Integration Solution for TPA

TPAs leverage NCPDP standards for information exchange to process and administer employee healthcare and pharmacy benefits and claims. In order to manage and drive down healthcare costs, employers turn to TPAs to create and administer employee benefits plans. Learn how this leading TPA implemented the PilotFish Integration Solution to automate and standardize processes vital to meeting their client demands and their own aggressive growth targets. NCPDP Integration Solution >

Categories: X12 EDI Integration,  Claims Processing Integration, Analytics Integration

COVID-19 Reporting Integration

HL7 Interface Implementation Case Study Summary

PilotFish helped this state’s Department of Public Health meet the challenges of quality reporting of an enormous amount of COVID-19 surveillance data to the Centers for Disease Control and Prevention (CDC). Critical data normalization, validation and standardization was performed speedily on incoming data from hundreds of systems and, in turn, was transformed and reported out to the CDC’s numerous receiving systems. HL7 COVID-19 Data Reporting: Benefits of Infinite Flexibility and Extensibility >

Categories: HL7 Integration, Government Integration

Claims Processing in Real-Time

Case Study - Pharmacy Claims Processing

Innovative technology, as well as extensive implementation and integration experience, delivered a winning solution to meet a client’s demanding pharmacy benefit delivery requirements. Learn how this organization, that offers claim processing services, was able to leverage these services and technology to reduce its implementation times by 75% – from 16 weeks to just 4 weeks. Claims Processing in Real-Time >

Categories: Claims Processing Integration

EDI 834 Integration

Case Study - EDI 834 Integration

Strategic use of data and analytics by this leading third-party administrator (TPA) is critical to delivering value and innovation to its growing employer client base seeking new ways to manage rising healthcare costs and improve employee health. See how PilotFish’s Healthcare Integration Solutions and its eiConsole for X12 EDI provide a competitive edge. EDI 834 Integration >

Categories: X12 EDI Integration

Rapid EMR Integration Advances PCMH Model

Case Study - Rapid EMR Integration Advances PCMH Model

Learn how PCMH organizations that must deal with CCDs, other complex XML formats, and highly variable data achieved EMR integrations at record speed with lower cost outlay. All of the potentials of healthcare coordination are made possible by health registries, health information exchanges (HIEs), and electronic health records (EHRs). Leveraging automated processes and attendant productivity, PCMHs can now quickly evaluate and report on care quality and create a unified view of each patient’s health picture. Rapid Integration Advances PCMH Model >

Categories: Analytics Integration

Population Health Integration

Case Study - POP Health Interface Engine Delivers Big Returns

Learn how Population Health enabling technologies helped a Community Health Organization to harness population health data from multiple sources to achieve the linked goals of value-based care: improving quality, lowering population health costs and improving patients’ experience of care. Using data of all types – clinical, financial, administrative, claims – is fast becoming one of the highest priorities for efficient and scalable Population Heath efforts. Accelerating Population Health Capabilities >

Categories: Analytics Integration

Clinical Reference Lab Integration

Case Study – Integration of Clinical Lab Data a Success

Real-time data integration and ensuring data integrity was critical to the success of a newly-acquired division of a clinical testing laboratory which performs hundreds of thousands of tests every day and deals with massive volumes of data from many disparate systems. Extremely tight timelines, new systems being developed in concert with the implementation of PilotFish and a lack of IT infrastructure from the acquired firm posed a unique set of challenges. The client relied on PilotFish as their preferred partner for the underlying technology along with their outsourced services team to implement the solution. Moving Targets No Longer Test Lab Integration Limits >

Categories: Lab Data Integration

Automated Message Testing and Validation

Case Study – Automated Message Validation in Data Exchange

Electronic data exchange between trading partners has become an imperative for commercial organizations and public institutions alike. To remain relevant, cost-competitive or even viable, companies must replace manual processes with automated solutions. For larger entities, in particular, the digitization of business-to-business communication entails the planning, development, testing, and deployment of point-to-point connections with dozens of, in some cases thousands of, discrete trading partners. This backlog of time-consuming interface work creates a resource strain and expense that challenges even the most well-staffed and well-funded information technology teams. In this case, the study learned how PilotFish has dramatically reduced the man hours, calendar days and budget hours required to successfully onboard electronic trading partners using the innovative eiTestBed framework. Ending Painful Trading Partner Implementations >

Categories: Message Testing & Validation

Solution Provider Integration with EHRs

Case Study - Healthcare Food Management System Integration

Message delivery is critical when impacting patients and serving tens of thousands of meals daily in acute care settings across the USA. Reliably reaching the right patient at the right time and patient safety are paramount. Real-time integration with HL7-based EHRs and admissions, discharges, transfers and order changes is crucial. Learn how a leading food services provider found a real partner in PilotFish to ensure that implementation of its new cloud-based food and nutrition management system was pain-free to its client base and provided a lasting foundation for growth. High-Volume, Complex HL7-EHR Integrations Now “No Problem” >

Categories: HL7 Integration

Medical Equipment EHR Integration Solution

Case Study – Medical Equipment Integration

The healthcare division of one of the world’s leading manufacturers delivers new out-of-the-box interoperability capability. By partnering with PilotFish, a single consistent integration approach across product lines was achieved to support a growing client base of globally-dispersed automated medication management environments. HL7 Integration Speedily Incorporated Across Global Platforms >

Categories: HL7 Integration

Data Analytics Integration in Hospital Reporting

Case Study – Data Analytics & Reporting Integration

High performance delivered! With dominant position and market share in hospitals and practices throughout the United States, the client is focused on delivering a single source provider of financial, operational and quality metrics, coupled with proprietary, value-added analytical services. This massive big data integration challenge, a tough bake-off, and implementation proves the superiority of PilotFish Integration Engine Solutions. Delivering Higher-Quality Analytics in Less Time
with Less Staff >

Categories: HL7 Integration, X12 EDI Integration, Analytics Integration

HIE and Claims Clearinghouse Integration

Case Study – HIE / Claims Clearinghouse Integration

Legacy system hangover, stressed resources and impatient customers are a cry for moving to a modern architecture and integration solution. Learn how a Healthcare Claims Clearinghouse and HIE challenged its new integration solution to re-engineer and transition its claims processing architecture in record time with no disruption to existing connections or increase in resources. A small internal team armed with the new tools and PilotFish support met every challenge. With newfound agility, the organization has responded efficiently to growth and increased transaction volumes. Lean, Lightweight Healthcare Integration Leverage at Work >

Categories: X12 EDI Integration, Claims Processing Integration

Lab Data Large-Scale Integration

Case Study – Medical Laboratory Integration

A subsidiary of one of North America’s largest labs is on the verge of being buried under a mountain of requests for interoperability from healthcare providers, insurance providers and government entities. Learn how they partnered with PilotFish to rearchitect their approach to data transformation and transmissions to reach peak integration capability. Implementation Timelines Slashed Enabling Revenue Growth >

Categories: Lab Data Integration

Revenue Cycle Management Solutions

Case Study – Revenue Cycle Management Solutions

The client is a well-established clinical laboratory billing and collection company serving companies nationwide. The organization offers cloud-based solutions which enable their client laboratories to maximize profitability through optimization of the revenue cycle and reimbursement process. The client has had (and continues to enjoy) significant commercial interest in its services. However, many of its critical business processes remained manual. This intense requirement on human resources threatened to put a cap on their growth, due to an inability to keep up with demand. Read on to learn how the client leveraged PilotFish to initiate automation. Achieving Claim Entry and Processing,
End-to-End, in 7 minutes >

Categories: X12 EDI Integration, Lab Data Integration

State Agency Enterprise Integration

Case Study – State Systems Integration

Struggling to recover from an economic downturn and a political climate that required state governments to do more with less, one of the nation’s 50 states found itself challenged to keep pace with the demands of its information infrastructure. In an example of what a successful public/private partnership looks like, the state collaborates with PilotFish to change the state’s paradigm for integrating systems. Unified Architecture Leveraging Federated Model and Reuse Speeds Implementations >

Categories: Government Integration

Since 2001, PilotFish’s sophisticated architecture and innovations have radically simplified how healthcare integration gets done. Today PilotFish offers the most flexibility and broadest support for healthcare integration of any product on the market and is system, platform and database agnostic. PilotFish’s healthcare integration suite includes support for all healthcare data formats (HL7 2.x, HL7 3.x, FHIR, CCD/CCDA, JSON, XML, X12 EDI, NCPDP, etc.) and communication protocols.

PilotFish is architected to be infinitely extensible with our Open API and flexible to meet any integration requirement. PilotFish distributes Product Licenses and delivers services directly to end users, solution providers and Value-Added Resellers. To learn more, visit our Case Studies or specific solutions like HL7 Integration or X12 EDI Integration.

PilotFish Healthcare Integration will reduce your upfront investment, deliver more value and generate a higher ROI. Give us a call at 813 864 8662 or click the button.

HL7 is the registered trademark of Health Level Seven International.
X12, chartered by the American National Standards Institute for more than 35 years, develops and maintains EDI standards and XML schemas.

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