Resources

Hybrid. A central index holds identities, consent and a record locator, while detailed records can stay at the source facility and be fetched on demand. Selected data can also be stored centrally in the FHIR repository where policy allows.

No. The integration gateway connects to what is already running — HL7 v2 feeds, FHIR APIs, database extracts, CSV or SFTP drops — and translates them into the platform's standard model.

Yes. The platform deploys on a government sovereign cloud, an empanelled public cloud region, or on-premise infrastructure, using the same containerised build.

Secure, documented APIs that link the exchange to national systems such as health ID, insurance scheme, provider and facility registries, so eligibility and identity checks happen automatically.

The EMPI combines deterministic rules on strong identifiers with probabilistic and machine-learning scoring on names, date of birth, sex, phone and address. High scores link automatically; borderline scores go to a human data steward.

The patient. Every request for data is checked against a consent artefact that specifies purpose, requester, data types and time window. Patients can review and revoke consent from the app.

Encounters, diagnoses, lab results, imaging reports, prescriptions, immunisations, allergies, discharge summaries and other clinical documents, represented as FHIR R4 resources.

The terminology server maps local codes to SNOMED CT, LOINC and ICD. AI proposes mappings; trained coders approve them before they go live.

Yes. Every read and write produces an immutable audit event recording who accessed what, when, and under which consent.

ASC X12 005010 transaction sets — 270/271, 276/277, 278, 834, 835, 837P/I/D, 820 and 999/TA1 — plus NCPDP D.0 for pharmacy and FHIR-based claim bundles for national claims exchanges.

Yes. The gateway handles FHIR claims, payer-specific JSON or XML formats and flat files, and maps them to a common internal claim model.

Files are validated against SNIP levels 1–7 before submission. Rejections and 999 errors are turned into plain-language messages and routed to the right billing work queue.

Most partners are configuration rather than code: envelopes, IDs, companion-guide rules and transport. Timelines depend mainly on the partner's own testing cycle.

Yes. Because EDI sits on top of the HIE, supporting evidence such as discharge summaries or lab reports can be pulled from the record and attached to a prior authorisation or claim.

No. AI suggests matches, codes, summaries and risk scores; clinicians, coders and data stewards review and decide.

De-identified or federated data only, under the data-governance rules agreed with the programme owner. Identifiable patient data is not used to train shared models.

Yes. Each output carries its supporting evidence — the highlighted text span for a code, the field-level weights for a patient match, or the contributing factors for a denial-risk score.

Each model has a model card and is monitored for accuracy, drift and bias across groups, with scheduled reviews and a rollback path.

Yes. Each AI service is enabled per tenant and per workflow, so programmes can adopt them gradually.

Programme owners in government, insurers and TPAs, and hospital finance teams — anyone who has to set a budget, a premium, a package rate or a reserve and defend it.

Directly from the exchange: enrolment (834), claims and payments (837/835) and coded clinical data from the HIE. That removes the months usually spent collecting and cleaning extracts.

No. The platform automates data preparation, triangles, projections and scenario runs; qualified actuaries set assumptions, review results and sign off reports.

Yes. Scenario tools show the cost and budget effect of changes such as adding packages, revising rates, expanding eligibility or shifting inflation assumptions.

Experience dashboards update as claims flow through the exchange; formal reserving and pricing reviews run on the cycle your governance sets, typically monthly or quarterly.

It is designed to work with ABDM building blocks — ABHA, HIP/HIU flows, consent management and the HPR/HFR registries. Formal integration approval is completed with the relevant authority for each deployment.

Yes. The core is standards-based, and national profiles — identifiers, consent rules, claim formats — are configured as plug-in layers.

FHIR R4 is the primary version, with R5 support where national guides require it and conversion between versions at the gateway.

The platform is built to align with ISO 27001, ISO 27799, HIPAA and India's DPDP Act controls. Certification status for a specific deployment is shared during the briefing.

Programme owners usually set participation models. Small facilities can connect through a lightweight web portal or a partner EMR, with no dedicated integration hardware.

Through a patient app or portal where they can view records from all connected providers, share them, and manage consent.

Yes — through standard lab result feeds, e-prescription APIs, or file upload via the partner portal.

Usually with a pilot district or a hospital network plus one payer, which proves identity matching, consent and claims flows before wider rollout.

Early wins — ADT alerts, shared lab results and electronic eligibility checks — typically arrive in the Connect phase, before the full platform is in place.

Either Vaisara Innovations operates it as a managed service, or the programme's own team runs it after a structured knowledge transfer.

In-country, in the hosting environment the programme owner chooses. Data is encrypted in transit and at rest.

Through OAuth 2.0 / OpenID Connect and SMART on FHIR, with scoped access tokens and consent checks on every call.

The core runs active-active across zones with a separate disaster-recovery site, so exchange traffic fails over to another zone or the recovery site while data stays replicated.

Continuous monitoring of audit logs and access patterns, with anomaly alerts routed to a 24×7 operations team.