Five or six years ago I was involved in some of the original HIPAA solutions architecture projects with some of the largest health plans in the US. At that time the solutions implemented by these plans required extensive effort and investments to fulfill the needs of what I'll call "version 1" of HIPAA transaction compliance. These efforts and architectures involved costly software investments, extensive development and testing time, and the building of large support teams. Given HIPAA's infancy, we can say that these solutions (while not perfect) worked for that time. Now, as I visit with health plans, I am noticing a trend towards re-thinking these solutions in order to support the NPI requirements, the future 5010 transactions, and to also reduce the total cost of ownership of these solutions. Also, as led by the efforts of CAQH/CORE to simplify healthcare administration, health plans are also starting to embrace the notion of "HIPAA Business Simplification". With these thoughts in mind, it's a very good time for (and I strongly urge) health plans to take a very close look at Microsoft's BizTalk Server 2006 R2 as they begin to re-think their HIPAA transaction processing and EDI architectures.
Microsoft's BizTalk Server 2006 R2 not only provides robust support for processing the X12 HIPAA transactions but also provides rich business process management capabilities, flexible and detailed reporting capabilities, a business rules engine, and partner setup and management functionality to enable compliance with HIPAA transactions processing. BizTalk Server 2006 R2 enables health plans to create a powerful foundation to implement a BizTalk Server infrastructure customized to support the requirements of HIPAA. BizTalk Server 2006 R2 EDI Engine includes "in the box" functionality and tools to achieve HIPAA transactional compliance through open standards–based communication and system interoperability.Some key new features in BizTalk Server 2006 R2 that enable HIPAA transaction processing compliance include:
- EDI Engine includes inbuilt support to achieve HIPAA transactional compliance (for example, no need to install an accelerator on top of BizTalk)
- Robust configurable outbound batching of HIPAA transaction sets
- Ability to split incoming Interchange into individual transaction sets, as well as preserve entire incoming Interchange in XML format after validation
- Ability to split large transaction sets (for example, multiple claims) into smaller transaction sets
- Rich Business Reporting functionality to reconcile both technical and functional acknowledgements
Biztalk Server 2006 R2 also enables deep integration with existing line of business applications and interoperability with existing technologies found in health plan IT infrastructures including JAVA, MQ Series, WebSphere, Oracle, Sybase, and DB2. The recent release of Microsoft's ESB/SOA guidance kit and JNBridge's .NET/JMS adpaters provide a great "pre-solved solution" for deep .NET and JAVA interoperability.
More information on the Microsoft Biztalk Server 2006 R2 (Release 2) can be found at http://www.microsoft.com/biztalk/evaluation/hipaa/default.mspx. Also, you can contact me directly at hectorr@microsoft.com if you'd like to get addtiional information on how to build a HIPAA processing architecture within your organization.
