Roman Khmaladze

Context & Role

The Washington Healthplanfinder is the state's health-benefits eligibility and enrollment system. The CMS Eligibility Solution program integrates Non-MAGI Medicaid programs to support federal ex parte renewal compliance, across a multi-agency landscape (WAHBE, DSHS, HCA) under state IT oversight. I serve as the independent, state-side architect — technical governance, vendor-deliverable oversight, and architecture decision ownership.

Signature Contributions

• Surfaced a systemic data-model limitation affecting ~162,000 dual-eligible individuals, reframing a vendor "no-impact" recommendation into an explicit, governed decision escalated to the steering committee.
• Drove redesign of the eligibility-service response from a person-level to a program-level structure across MAGI/Non-MAGI and QHP programs.
• Authored state-owned canonical artifacts — risk register, interface inventory, ecosystem and data-flow diagrams.

Approach

Sole architect and developer — owning the full domain model, data schema, API/UI contracts, and the development methodology itself. A design-first, human-governed pipeline in which an AI agent does the typing inside hard, auditable boundaries while architecture, contracts, and acceptance remain entirely under human control.

Highlights

• Production-grade output at high velocity with rework approaching zero; zero-deviation ships the norm.
• Anchored by a ~2,500-line living domain model and a ~4,000-line schema definition.
• Contract-first development — regenerating the OpenAPI contract and typed frontend bindings before any frontend work, eliminating a whole class of integration errors.

Scope

A cloud-based, multi-tenant RIS spanning patient scheduling, clinical and nursing workflows, radiologist reporting, DICOM/PACS integration, prior-authorization case management, and role-based access control — with sole responsibility for architecture, data modeling, API design, frontend, infrastructure, and testing strategy.

Scale & Outcomes

• 208+ API endpoints across the full operational surface; 37 database tables.
• ~2,000 automated tests held to a strict zero-regression standard.
• 8 user roles with full backend authorization; 45 access-gated frontend routes.
• Live DICOM Modality Worklist push to a PACS at patient check-in — real integrations, not mocks.

Role & Approach

Lead Enterprise Architect, acting as an independent appraiser rather than a vendor pushing a platform. I structured a three-phase appraisal and ran separate discovery tracks for the analytics and ICT communities, drawing current-state evidence from structured workshops, first-person analyst narratives, and direct artefact analysis.

Key Contributions

• Independently surfaced that the core problem was a missing orchestration layer, not just infrastructure — which became the strategic backbone of the appraisal.
• Delivered an even-handed Azure-native / AWS-native / platform-independent comparison, scored against the agency's own criteria.
• Initial Review accepted by the EPA lead; target-state architecture aligned closely with senior ICT's own vision.

What I Built

The full clinical module suite — administrative, scheduling, care-plan, full PHR, nursing, provider, e-Rx, speech-recognition, patient-consent, e-Lab, e-Radiology, and reporting — with native iOS and Android provider and PHR apps developed in parallel. I architected the entire platform and directed 36 engineers across three teams (mobile, backend, frontend).

Outcome

• Led the product to ONC Health IT Certification under the Meaningful Use program.
• Integrated HL7 v2/v3 via Mirth Connect, clinical decision support, medication knowledge bases, and clearinghouse connectivity.
• The clearest proof of a parallel-delivery pattern: a certified EMR delivered over a decade while holding a principal architecture role at a major payer.