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I did medical billing EDI adjacent stuff with a VMS system (that ran decades past point of obsolescence). One thing - in the past the EDI integrations just had

I did medical billing EDI adjacent stuff with a VMS system (that ran decades past point of obsolescence). One thing - in the past the EDI integrations just had to be simple, the feature set was so small - there wasn't room to go totally crazy. Once they mandated full ehealth records and exploded the complexity of the medical IT side, clinician productivity (face to face with patient) went way down. Integration pain went way up. The old tab separated value row turned into GIGANTIC XML monstrosities for the smallest things - now thousands of these blobs in a document. If you put even 10,000 XML blobs in an exchange vs tab separated values - very quickly appreciated the old way of doing things. One annoying thing, even the person on other end you are dealing with lost all ability to troubleshoot issues. For some reason in some areas - no EDI in the traditional sense is being used (ie, govt contracts with idiots who build latest buzzword filled solutions - total annoyance to interact with).

commandlinefan 5y ago
Yeah, worked in medical billing for a while. It's insane. One particular example I remember was that there was one code for "blood pressure taken while patient lying down" and a completely different code for "blood pressure taken while patient sitting up" (rather than, say, one code for "blood pressure" and another for "patient position").
joenathanone 5y ago
I'm going to have to implement an EDI medical billing system soon (moving from XLS/FTP based billing, say what you will about it but relatively easy to understand and automate) and after looking over the spec, I am not looking forward to it at all. Ended up purchasing a product called Cozyroc which integrates into SSIS(SQL Server Integration Services) which can do SQL to EDI translation with a map provided, should make things easier but still not looking forward to it.
- onphonenow 5y ago
  This is all actually better nowadays. There was an in between place where CSV/TSV/FTP style systems were being taken over by vendor proprietary XML blobs for ehealth stuff when they were trying to (poorly) push ehealth. So the variety was crazy (and I'm still not sold on the huge XML style documents though I know it's "semantic"). I'm not as close to it anymore, but my big sense is that things have settled down A LOT and become more standardized. In the bigger EDI space UBL was supposed to be the XML standard that was going to crush the "old" standards - but I haven't seen it take over yet - but not close enough to space, someone else probably knows better if UBL or similar is the clear dominant player these days.

commandlinefan 5y ago

Yeah, worked in medical billing for a while. It's insane. One particular example I remember was that there was one code for "blood pressure taken while patient lying down" and a completely different code for "blood pressure taken while patient sitting up" (rather than, say, one code for "blood pressure" and another for "patient position").

joenathanone 5y ago

I'm going to have to implement an EDI medical billing system soon (moving from XLS/FTP based billing, say what you will about it but relatively easy to understand and automate) and after looking over the spec, I am not looking forward to it at all. Ended up purchasing a product called Cozyroc which integrates into SSIS(SQL Server Integration Services) which can do SQL to EDI translation with a map provided, should make things easier but still not looking forward to it.

onphonenow 5y ago
This is all actually better nowadays. There was an in between place where CSV/TSV/FTP style systems were being taken over by vendor proprietary XML blobs for ehealth stuff when they were trying to (poorly) push ehealth. So the variety was crazy (and I'm still not sold on the huge XML style documents though I know it's "semantic"). I'm not as close to it anymore, but my big sense is that things have settled down A LOT and become more standardized. In the bigger EDI space UBL was supposed to be the XML standard that was going to crush the "old" standards - but I haven't seen it take over yet - but not close enough to space, someone else probably knows better if UBL or similar is the clear dominant player these days.