Driving Cashless Care Adoption Through End-to-End Healthcare Platform Modernization

About the Client:

A technology-driven healthcare company transforming care delivery in India by integrating health plans, providers, and patients through data and digital tools. With a vision to make healthcare completely cashless, they began by building a cashless OPD ecosystem and specialized corporate employee health plans.

Background:

India’s OPD system was fragmented, with patients juggling multiple touchpoints across hospitals, labs, pharmacies, and insurers, often operating in isolation. The lack of coordination not only led to administrative inefficiencies but also delayed care, increased costs, and reduced patient satisfaction.

The client envisioned a platform that would simplify and digitalize every step of the healthcare journey, from appointment booking and consultation to claims processing and payments — all while ensuring compliance, data security, and accessibility for every user.

Challenge:

The client faced several structural and operational challenges that limited the scalability and adoption of cashless OPD services:

  • Fragmented Operations: Lack of integration between patients, doctors, labs, pharmacies, and insurers.
  • Manual Processes: Paper-based claims, billing, and onboarding workflows led to errors and long turnaround times.
  • Low Interoperability: Disconnected systems made it difficult to share or validate patient and claims data.
  • Limited Transparency: Patients and corporates had minimal visibility into claim status or healthcare spending.
  • Security & Compliance Risks: Handling sensitive PHI and financial data required a platform that ensured regulatory compliance and auditability.

The client needed a role-aware, interoperable digital infrastructure to unify all stakeholders and bring efficiency, transparency, and security to OPD operations.

BizAcuity built an end-to-end digital healthcare platform that seamlessly connected patients, doctors, labs, pharmacies, insurers, and corporate administrators. The solution was designed with scalability, security, and interoperability at its core, leveraging AWS and modern web frameworks.

  1. Technology & Design Framework- The solution architecture and design principles were grounded in the client’s requirements and best practices outlined in healthcare system design:
  • Accessibility & UX: The frontend was built using React.js and Next.js, enabling responsive design, server-side rendering, and improved SEO for patient and corporate portals. Applications were deployed to Amazon S3 with CloudFront CDN to ensure global low-latency access and HTTPS-based security. GitHub Actions automated deployment workflows.
  • Authentication & Role Management: Amazon Cognito managed all user identities, supporting multi-factor authentication, corporate SSO integration, and federated login. Role-Based Access Control (RBAC) ensured each user type (patient, doctor, lab, insurer, admin) accessed only relevant data.
  • Data Security & Compliance: AWS WAF protected the platform from common web exploits. End-to-end encryption, AWS KMS for key management, and secure IAM policies ensured PHI compliance and data confidentiality.
  • Workflow Integration: Each module from consultation, claim, billing, or onboarding, was mapped to a digital workflow using FastAPI (Python) microservices deployed on Amazon EKS (Elastic Kubernetes Service). These services communicated via internal APIs and were secured by AWS 

Application Load Balancer (ALB). HAPI FHIR (Spring) was implemented as the clinical data backbone, ensuring FHIR-compliant interoperability across healthcare data sources.

  • Performance & Scalability: The EKS-managed Kubernetes cluster auto-scaled based on traffic and resource utilization. The backend microservices leveraged Redis for caching frequently accessed data and Amazon RDS (PostgreSQL) for persistent storage. Separate schemas were maintained for FHIR and non-FHIR data, ensuring logical separation and compliance.
  • Interoperability: By adopting HAPI FHIR, the platform enabled smooth data exchange with external systems using standardized FHIR APIs. External integrations (labs, pharmacies, insurers) were managed through dedicated FastAPI connectors, deployed as independent pods within EKS.
  • Clinical Decision Support: Integrated with HAPI FHIR, built-in alerts and contextual data allowed healthcare providers to make informed decisions during consultations and claim reviews.
  • Usability Testing & Feedback: Continuous usability testing with doctors, corporate admins, and claim processors refined workflows, minimizing clicks and reducing onboarding friction.

B. Platform Components- BizAcuity built a cohesive system comprising multiple specialized portals:

  • Onboarding Management Portal – automated onboarding and document verification for doctors, labs, and corporates.
  • Doctor Coordination Portal – handled inquiries, appointment scheduling, and feedback collection.
  • Lab Services Coordination Portal – managed lab test inquiries, scheduling, and service coordination.
  • Insurance Claims Management Portal – digitized claim review, approval, and tracking workflows.
  • Financial Management Portal – enabled real-time transaction monitoring, reconciliation, and payment setup.
  • Corporate Client Administration Portal – provided policy management, utilization analytics, and renewal tracking for employee health plans.
  • Business Administration Portal – delivered system-wide monitoring, analytics, and configuration tools.

Together, these modules created an end-to-end digital healthcare infrastructure that automated complex workflows, ensured interoperability, and improved data transparency across the ecosystem.

Outcome:

Operational Efficiency

  • 60% reduction in onboarding time through automation and workflow integration.
  • 40% faster insurance claim turnaround with digital approvals and real-time alerts.
  • Reduced manual reconciliation errors through automated financial processes.

Enhanced Patient Experience

  • Patients could seamlessly schedule, consult, and manage payments via WhatsApp and the web portal.
  • Increased transparency and faster settlements built trust and accelerated adoption of cashless OPD.

Ecosystem Integration

  • Unified 10+ stakeholder roles into a single interoperable platform.
  • Enabled seamless coordination between doctors, labs, pharmacies, and insurers through standardized data exchange.

Compliance & Governance

  • Complete audit trails, encryption, and access control ensured full PHI compliance and data protection.
  • Strengthened accountability and traceability across all system interactions.

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