The healthcare industry increasingly depends on complex ecosystems of organizations securely and efficiently sharing information to improve care and reduce costs. Unfortunately, these parties store and exchange data in disparate states and formats, using different standards and processes. As healthcare payers and providers work to improve data interoperability, a key challenge involves the complex format of the EDI X12 data exchange used for a variety of business functions, including claims submission, claims payment, and prior authorizations.
Combining our extensive experience in the cloud, our track record of unlocking business value for healthcare clients, and a long-standing relationship with Snowflake, Concord addressed this challenge by developing a Snowflake-based application that converts legacy X12 data to JSON format, which makes it easier to use with FHIR interoperability standards. Now available in the Snowflake Marketplace, the “EDI X12 Standard Transaction JSON Converter” is an accelerator designed to aid healthcare payers and providers working toward better data interoperability, and a more future-ready data exchange ecosystem. The new asset expedites the challenging migration process from the X12 data exchange standard to the current FHIR standard.
The FHIR (Fast Healthcare Interoperability Resources) standard defines how healthcare information can be securely exchanged and accessed. FHIR was developed in response to demands for quicker, simpler ways to exchange large volumes of health data between parties through lightweight, real-time technology.
The challenge of using X12 data is in its complexity, which potentially contains thousands of records in a single claim, and the process of ingesting all this nested information is often error prone. In addition, changes to billing processes and formats need to be factored back into X12 data ingestion, which presents multiple challenges for organizations working with it.
Concord’s Snowflake-based accelerator supports the exchange of all claims, eligibility, benefit, and prior authorization data in a streamlined FHIR standard format. The EDI X12 Standard Transaction JSON Converter process operates entirely in the Snowflake ecosystem and runs in Snowpark — Snowflake’s recently released enablement platform; no other technology is required. One big advantage of Snowpark is that it allows for complete application logic to operationally consolidate data and compute resource management directly in Snowflake.
The application consists of different user-defined functions (UDFs) that solve various healthcare dataset challenges. In short, the Accelerator ingests complex datasets, converts them into readable formats, and validates the data. From a technical perspective, the Accelerator provides a sample text file containing X12 data, along with a UDF called “x12Tojson” that converts X12 data to the JSON format. It also provides a description of elements in the data.
The process input is an X12 text file that needs to exist in the Snowflake staging area. The output is JSON data saved directly into Snowflake tables and further parsed using Snowflake capabilities.
Using the X12 Ingestion accelerator as a building block, we developed a complete application pipeline running in Snowpark that demonstrates the data modernization migration lifecycle.
More Opportunities Ahead
As the push toward FHIR standardization becomes more comprehensive, healthcare businesses will need to optimize data ingestion, storage, and exchange processes to ensure full interoperability within their operational ecosystem. Concord’s experience in healthcare and portfolio of advanced healthcare data solutions, combined with our established relationships with leading tech partners (like Snowflake) can accelerate how you realize the digital business impact of streamlined interoperability.
As Concord continues pioneering new applications for expanding technological ecosystems, our clients and their industries will continue to benefit. For example, the X12 Accelerator is available in the Snowflake Marketplace for anyone to use — at no cost. We’re dedicated to helping clients adopt new, modern tools and technologies — especially related to our expanded Cloud Engineering and Modernization capabilities. We see it as a “greater good” when Concord accelerates our clients’ digital transformations. In the end, we all benefit.
Let’s talk about how we can take your digital transformation further!
About Concord
Concord is a next-generation technology consultancy focused on experience, data, and cloud engineering & modernization. Based in Minneapolis, MN, with supporting operations across the U.S., Latin America, Eastern Europe, and India, Concord serves leading enterprises and innovators in the healthcare, technology, consumer, manufacturing & distribution, and financial services industries. With a unique combination of industry expertise, technology know-how, and project execution reliability, Concord helps its customers unlock business value by solving their most difficult data and technology problems.