Healthcare Industry

In 1996, HIPAA (The Health Insurance Portability and Accountability Act) mandated that healthcare providers and payers (patients, insurance entities, organizations) exchange electronic administrative messages (including claims, authorization, eligibility) in a common format.  However, it did not include rules or guidelines for how the data is to get from point A to point B. 

Current efforts towards "harmonization" aim to take the best of the current standards and to develop a high-level plan flexible enough to implement for the many providers, payers, and communication paths inherent in our complex healthcare system.  The standards being evaluated are:

	Format/Enveloping - ANSI ASC X12 (cross-industry messaging, standardized transaction sets), NCPDP (National Council for Prescription Drug Program - interactive messaging, pharmaceutical messaging, adjudication), HL7 (Health Level 7 - broadcast messaging, scientific data and notations).
	Security/Encryption - public/private key, digital signature.
	Transport/Communication - SMTP, FTP, HTTP, ebXML, AS1, AS2, AS3.

Currently, David Darnell represents ANSI ASC X12 on HITSP, the Healthcare Information Technology Standards Panel - the goal of the Panel is the "harmonization" of healthcare standards.  Through this harmonization process, security, flexibility, and interoperability have been key points for evaluation inclusion - e.g., HIPAA's Conformance Certification Organization (HCCO) has sponsored "eBusinessReady" interoperability certification.  Systrends solution components - Transaction Transporter T²™ software and our ECtrends™ Service Bureau - provide the security, interoperability, flexibility, and scalability required by healthcare trading partners.

Transaction Transporter offers:

	Security - encryption, authentication, digital signature.
	"Any-to-Any" transport processing - including ebXML, FTP, SMTP, HTTP, and AS1/AS2/AS3.
	Interoperability - a centralized platform to manage many transaction types.
	Scalability - to multiple parties within the healthcare industry.
	In-house or hosted implementation.

ECtrends Service Bureau offers:

	Clearinghouse functions - transaction store-and-forward; mail-boxing and delivery; and centralized validation, reporting, and archival.
	Point-to-point connection.
	Modular solutions based on each client's requirements.
	Complete transaction management - standards additions, updates, maintenance.
	Trading partner setup, testing, rollout, administration, and maintenance.