Going Live with Your HIE Integration

This guide outlines the complete, multi-phase process for moving your integration from the development environment to a live, production-ready state.

The Go-Live Path: From Testing to Production

The path to go live involves four mandatory phases. You must complete each phase before proceeding to the next one.

Phase 1: Development and Testing

Your first step is to build and test your integration in our developer environment. You must ensure that all API workflows are correctly implemented in your system. This includes:

• Authenticating and managing API tokens.
• Successfully using the HIE Registries API to search for patients, facilities, and professionals.
• Integrating all interventions and billing processes with the Claims and Preauths API to ensure accurate claim information and invoice details.
• Handling all API responses, including successful calls and error codes.

Phase 2: User Acceptance Testing (UAT)

Once your integration is done, you must schedule a User Acceptance Testing (UAT) demo with the HIE integration team.

For this demo, you will use a UAT instance of your application to demonstrate all core HIE workflows from end to end. A successful demo is mandatory to proceed.

UAT Checklist

The UAT demo is structured around the three Social Health Authority (SHA) funds. Your integration must successfully demonstrate all workflows associated with each fund end to end.

• 1. Primary HealthCare (PHC) Fund Workflows:

  • Patient Search: Find a patient using the Registries API.
  • Eligibility Check: Confirm the patient's coverage status.
  • Start Visit (Capitation): Initiate a CAPITATION service type.
  • Claim Management: Add, retire, and switch interventions on an active visit.
  • Submit Claim: Add billing lines, diagnoses, and submit the final claim.

• 2. Social Health Insurance Fund (SHIF) Workflows:

  • Full Eligibility: Check benefits and specific interventions coverage.
  • Start Visit (Outpatient/Inpatient): Initiate an OUTPATIENT or INPATIENT visit using the full OTP consent process.
  • Pre-Authorization:
    • Create a "Normal Preauth" request.
    • Submit specialized pre-auths (e.g., Surgical, Oncology, Renal) with all required additional data.
    • Cancel a pre-auth.
  • Claim Management: Add, retire, and switch interventions on an active visit.
  • Submit Claim: Submit a complete claim with all required billing lines, diagnoses, and attachments.
  • Inpatient Discharge: Correctly use the discharge_inpatient workflow.

• 3. Emergency, Chronic, & Critical Illness Fund (ECCIF) Workflows:

  • Emergency Visit: Initiate an EMERGENCY service type.
  • Submit Emergency Claim: Demonstrate the submission of an emergency claim with all required documentation.

Phase 3: DHA Certification

After a successful UAT demo, our team will submit your results to the Digital Health Agency (DHA) for review.

DHA provides the final, formal certification that approves your system as a production-ready HIE integrator. This certification is non-negotiable and may require additional reviews or documentation.

Phase 4: Production Launch

Once you are certified by DHA, you will be granted Production Environment Credentials.

With these credentials, you can go live with your integration and begin rolling out your HMIS solution to healthcare providers.