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Intensive Reverse Engineering takes on Systems Integration

Medsphere: an RPG support success story

About Medsphere

Medsphere offers comprehensive electronic healthcare records (EHR) and revenue cycle management (RCM) solutions for inpatient and ambulatory facilities with outsourced managed IT services and SCM to improve overall patient care. When Medsphere acquired Kellison & Company, a consulting and revenue cycle management services organization based in Cleveland, Ohio, Kellison offered a range of services that included:

  • Developing fee setting policies
  • Keeping billing current with the most recent current procedural terminology code changes
  • Validating the highest level of diagnosis specificity
  • Turning around denials faster
  • Completing appeals
Medsphere-Primary-H
electronic-healthcare-records

The Problem

While the incorporation of Kellison served to expand Medsphere’s products and services to include comprehensive billing and revenue cycle management (RCM) services to laboratories in the industry, systems integration proved to be a challenge – especially considering Kellison's in-house developer was retiring and was no longer available to assist with the systems integration. As it turns out, he had barely begun the systems integration process before retiring which is why they decided to turn to Briteskies for RPG support.

Kellison was still running applications in an IBM Systems/36 environment – even though the code was a newer IBM RPG format. In addition, Kellison didn’t have a test environment established for systems integration. In fact, they hadn’t done much testing at all – only about 50 transactions had been tested when the previous developer left his post.

The Goals

  • Integrate updated provider transaction sets into the existing system with minimal manual intervention.
  • Streamline and modernize the existing code when possible.
  • Implement a test environment for this and future system integration projects.

The Result

Initially, Medsphere ran the two systems in parallel while outstanding transactions were processed on the old system. As a result, several unique scenarios presented which required the integration to go through multiple testing iterations.  During the integration project, Briteskies touched virtually every program that was a part of the new Medsphere process  – whether it was to modify a program, to test it, or to fix code.

In the end, the Briteskies team met the deadline – with the collaboration of the Medsphere IT lead. He knew the Medsphere systems and what the data needed to look like upon a successful systems integration. The result -  Medsphere was left with a clean, straightforward system integration that includes a better internal system testing process and for the users provides an improved testing environment for lab work, and streamlined a number of processes that were previously addressed manually.

system-integration

Key Project Benefits

  • Streamlined processes & reduced manual activities
  • Improved internal system testing
  • Utilizing newer code base
briteskies-medisphere-improved-functionality

The Solution

Medsphere had several unique systems of formatting requirements. While 95% of the formatting was standard and compliant, it also included data that served their purposes and wasn’t defined by the standard interface. This is where the reverse engineering became necessary. Briteskies picked up where the previous in-house developer left off. Under a stringent deadline, the newly acquired Kellison was playing catch up processing sensitive insurance data from a multitude of providers. Briteskies had to flow out the new process, look at each program individually and how they could work together, and piece together a systems integration testing (SIT) environment that cleanly separated processes – so it would not affect production systems.
"The biggest challenge was having to learn the Medsphere system quickly so we could set up a functioning test environment and development the code under a tight deadline."
- Clyde Brady, Sr. IBM i Developer

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