Genomic Healthcare Management & Telehealth Platform
About Client
Industry
Healthcare
Location
USA
Project Overview
The client is a U.S.-based genomic and genetic healthcare organization providing virtual genetic consultation services to patients, healthcare providers, employers, referral partners, and other healthcare organizations across the United States.
As the organization expanded, managing the complete genomic care journey became increasingly complex. Patient registration, consent, appointment scheduling, clinical consultations, genetic test ordering, laboratory coordination, result processing, follow-up consultations, insurance, billing, and clinical documentation all needed to work together while securely managing sensitive Patient Health Information (PHI).
SculptSoft developed the Genomic Healthcare Management & Telehealth Platform, a centralized healthcare ecosystem that manages the complete patient journey within one connected system. The platform supports patients, care coordinators, genetic counselors, physicians, administrators, referral partners, laboratories, and external healthcare systems.
The solution enables healthcare teams to manage configurable referral programs, schedule consultations, create and approve genetic test orders, integrate with laboratories through Redox, automate incoming result processing, support AI-assisted result summaries for clinical review, manage Return of Results workflows, synchronize patient and billing information with AthenaHealth, and monitor operational activities through centralized dashboards.
Traditional Process
Before implementing the platform, genomic care involved several disconnected and manual processes:
01
Fragmented Patient Information
Patient registration, medical history, consent, referral information, genetic test records, and clinical documents were managed across different systems, making it difficult to maintain a complete and consistent patient record.
02
Manual Appointment & Care Coordination
Scheduling required coordination between patients, providers, specialties, appointment types, locations, referral programs, and provider availability, creating significant administrative effort for care teams.
03
Disconnected Genetic Test Workflows
Genetic test ordering, physician approval, laboratory submission, result tracking, and clinical follow-up required multiple manual handoffs between clinicians, operational teams, and external laboratories.
04
Manual Genetic Result Processing
Clinical teams had to retrieve genetic test results, associate them with the correct patient and test order, review findings, prepare clinical documentation, and determine the appropriate follow-up action.
05
Manual Patient Outreach & Follow-Up
Appointment reminders, registration follow-ups, Return of Results outreach, and other patient communications required care teams to continuously monitor cases and contact patients manually.
06
Disconnected Insurance & Billing Processes
Patient insurance, authorizations, claims, payments, refunds, and external billing information had to be managed across different systems, increasing reconciliation effort and operational complexity.
Challenges Faced
Following the traditional process, the client faced several challenges related to patient coordination, clinical workflows, system integrations, data security, and operational scalability:
01
Protecting Sensitive PHI and Genetic Data
Patient and genetic information required strict access controls, secure infrastructure, auditability, and healthcare-compliant processes while remaining accessible to authorized clinical and operational users.
02
Managing Multiple Healthcare Programs
Different referral partners required different consultations, specialties, pricing models, insurance rules, scheduling options, outreach workflows, questionnaires, and document-release configurations.
03
Integrating Genetic Laboratories
The platform needed to securely exchange genetic test orders and results with external laboratories while accurately matching patients, orders, laboratory information, and clinical records.
04
Synchronizing Multiple Healthcare Systems
Patient demographics, insurance information, authorizations, provider information, clinical records, claims, and payments needed to remain synchronized between the platform and external healthcare systems.
05
Managing Complex Clinical Result Workflows
Genetic test results could require review, correction, cancellation, additional consultation, Return of Results workflows, or other clinical actions depending on the result and patient journey.
06
Automating Clinical Workflows Safely
Automation was needed to reduce repetitive clinical and administrative work while ensuring healthcare professionals retained control over the review and approval of sensitive genetic information.
Our Solution - Genomic Healthcare Management & Telehealth Platform
SculptSoft designed and developed a secure, configurable platform that connects the complete genomic care lifecycle.
01
Centralized Patient and Clinical Management
The platform maintains a unified patient profile containing demographics, referral information, consent, clinical encounters, documents, genetic tests, payments, outreach history, and care-team information, giving authorized users a complete view of the patient journey.
02
Configurable Referral Program and Affiliation Management
Administrators can configure referral partners, consultation types, specialties, pricing, insurance rules, appointment settings, questionnaires, communication templates, outreach workflows, and partner integrations without creating separate applications for every healthcare program.
03
Appointment Scheduling and Provider Management
Patients and care teams can schedule phone or video consultations based on consultation type, specialty, provider availability, referral program configuration, and applicable location requirements. Provider specialties and licensing information can also be centrally managed.
04
Genetic Test Order Management
Clinicians can create, approve, submit, and track genetic test orders directly within the patient workflow. Order statuses provide care teams with visibility from initial request through laboratory submission and result completion.
05
Genetic Laboratory Integration through Redox
Redox integration connects the platform with supported genetic laboratories for automated order and result exchange. The workflow supports genetic test orders, patient information, result ingestion, corrected results, cancelled results, and clinical document exchange.
06
Automated Genetic Result Processing
Incoming genetic test results are validated, matched with the appropriate patient and test order, and stored within the patient’s clinical record. This reduces manual result handling while improving traceability and data accuracy.
07
AI-Assisted Automated Result Summary
The platform processes genetic test results and prepares drafted result information for clinical review. Clinicians can review, update, approve, and finalize the result information before it is released or used for patient follow-up.
08
Return of Results and Patient Outreach
The platform supports Return of Results workflows for patients requiring additional consultation or communication. Care teams can manage automated email and SMS outreach, appointment reminders, follow-up sequences, and manual outreach from centralized workflows.
09
AthenaHealth Integration
The platform integrates with AthenaHealth to synchronize patient information, insurance details, authorizations, healthcare claims, and patient payment information, helping maintain consistency between clinical and billing systems.
10
Integrated Billing and Insurance Management
Care teams can manage patient payments, insurance claims, partner billing, patient fees, coupons, refunds, and billing exceptions within a centralized workflow while supporting different payment models across referral programs.
11
Operational Dashboard and Work Queues
Dedicated dashboards help care teams quickly identify cases requiring attention, including pending laboratory submissions, unknown order statuses, Return of Results outreach, unsent visit summaries, pending result summaries, and insurance claims that have not yet been filed.
Outcome
The platform transformed a fragmented genomic care journey into a connected, automated, and compliant healthcare ecosystem, improving clinical efficiency, care coordination, laboratory workflows, and patient engagement:
Features
Patient Registration, Profiles & Health Records
Consent, Privacy & Patient Questionnaires
Appointment Scheduling with Phone & Video Consultations
Care Coordinator & Clinical Workflows
Multiple Encounter Types
Referral Program, Affiliation & Partner Management
Provider, Specialty & License Management
Genetic Test Ordering & Physician Approval
AthenaHealth Integration
Patient, Partner & Insurance Billing
Automated Result Summary
Payments, Refunds, Coupons & Program-Based Pricing
Genetic Laboratory & Redox Integration
Automated Test Order & Result Exchange
Genetic Result Management
Corrected & Cancelled Result Handling
Clinical Result Review & Approval
Return of Results & Patient Follow-Up
Email, SMS & Appointment Reminders
Clinical Document Management & External Sharing
Insurance, Authorization & Claim Management
Operational Dashboards & Work Queues
API Partner & External System Integrations
Integration Monitoring, Alerts & Error Handling
Technologies Used
Front-end
- ReactJS
- VueJS
Database and Search
- PostgreSQL
- Amazon DynamoDB
- Elasticsearch
- Amazon OpenSearch
Healthcare and Third-Party Integrations
- AthenaHealth
- Redox
- Pioneer
- Stripe
- Twilio
- Zoom
- Mailgun
- AWS Cognito
- Jotform
- SurveyJS
- Zingtree
- Interfax
Backend
- Python Flask
- CakePHP
- NodeJS
- Apache Kafka
- Faust
- RabbitMQ
AWS Infrastructure and Services
- Amazon ECS
- Amazon EC2
- Amazon RDS
- Amazon S3
- Amazon Managed Kafka
- Amazon OpenSearch
- Amazon CloudFront
- Amazon CloudWatch
- Amazon API Gateway
- AWS Lambda
- AWS Amplify
- Elastic Load Balancing
- Amazon Athena
DevOps and Monitoring
- Self-Hosted GitLab
- Prometheus
- Grafana
- Alert Manager
