Jay Kotecha

Healthcare systems

Healthcare Data & EHR Integration Consulting

Healthcare integration fails quietly and expensively. A lab result that never reaches the chart, a claim rejected for a reason the clearinghouse describes only as a segment error, an interface that has been dropping a percentage of messages for weeks without anybody noticing. By the time it surfaces it is usually a revenue problem and a clinical one at the same time.

I spent three years at eClinicalWorks as a Technical Account Manager owning database operations for US medical practices, debugging electronic claims in ANSI X12 837P and 837I formats, and resolving HL7 interface issues for lab data across multiple EHR systems.

Where I can help

Why claims and interface work needs specific experience

X12 and HL7 are unforgiving formats with long histories, and the error messages they produce are rarely a description of what is actually wrong. A rejection that names one segment often originates from a value written several steps upstream, and a valid-looking HL7 message can still be discarded by a receiving system whose expectations differ from the specification in ways that are documented nowhere.

Working these problems for US practices means the diagnosis has to account for the whole path — what the practice entered, what the EHR generated, what the interface transformed, and what the receiving system was willing to accept.

Working with practices and with vendors

Much of this work is establishing which party owns the defect, with evidence solid enough that the responsible side accepts it. That was a substantial part of the role at eClinicalWorks: setting up and running escalated client calls to reach a resolution quickly, rather than letting a ticket circulate between organisations.

The same skill turned out to transfer directly to enterprise integration work at LinkedIn and Workday, but healthcare is where the consequences of getting it wrong are most immediate.

Common questions

Do you work with a specific EHR platform?

My hands-on experience is deepest with eClinicalWorks environments, where I owned database operations and interface troubleshooting for US practices. The underlying formats — HL7 and X12 837 — are shared across EHR platforms, and most of the diagnostic approach transfers.

Can you help with HIPAA compliance?

I am not a compliance consultant and would not advise on your HIPAA programme. I have worked inside environments handling protected health information and understand the operational constraints, but formal compliance assessment needs a specialist.

We are a healthcare software company rather than a practice. Is that in scope?

Yes, and often a better fit. Interface and claims problems tend to be more tractable when the people reporting them can also change the code.

Have a problem that fits this?

Tell me what is failing and what you have already ruled out. I will tell you honestly whether I am the right person for it.

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