Turning to the cloud for HIPAA 5010 and ICD-10 compliance PDF Print E-mail
Written by Tom Sullivan, Government Health IT   
Thursday, 07 July 2011 21:44
Distant thunder rumbles across the HIPAA 5010 and ICD-10 horizon. That's the sound of cloud computing services gliding toward healthcare organizations. Cloud computing has already caught on in other facets of healthcare IT – and as providers and payers prepare to meet the pending mandates, hosted services could prove a viable option.

Whether called cloud computing or Software-as-a-Service (SaaS), the hosted model “certainly provides some potential for organizations dealing with both HIPAA 5010 and ICD-10 conversion efforts,” explains Kent Sacia, a principal and healthcare technology consultant at Milliman. “SaaS can provide a distinct advantage to organizations dealing with many changes, such as regulations. The model is lightweight to the end-user client and consolidates change requirements into functional models that are independent of the clients own IT processes.”

Indeed, HIPAA 5010 and ICD-10 vendors are starting, albeit slowly, to tout cloud computing services. When 3M Health Information Systems and the Trizetto Group inked a partnership in mid-March under which TriZetto will inject 3M's ICD-10 Code Translation Tool into its own TriZetto Advantage 10 Services, the companies said that two new services harnessing 3M's tools will become available in the second quarter of this year, as SaaS-style applications. In an interview with ICD10Watch, HighPoint Solutions vice president of healthcare, Pam Ruebelmann, revealed the company's intent to issue this summer a pre-release version of an ICD-10 appliance, the functionality of which HighPoint is also considering offering as a cloud-based service. And Precyse Solutions newly-appointed director of ICD-10 program management and compliance, Cortnie Simmons, says that Precyse is working to make a range of coding tools and natural language processing technologies available as SaaS wares.

As providers and payers either upgrade services, such as business intelligence and analytics, around a core administration platform or replace legacy applications to meet HIPAA 5010 and ICD-10 mandates, cloud resources will be attractive in some instances.

Healthcare organizations, for instance, “could use a SaaS service to model the impact of ICD-10 and provider contracts,” says Greg Larson, TriZetto's associate vice president of services product management. “Few payers will invest in episodic solutions like this because they don't use it everyday, but a SaaS model provides the ideal on-demand environment for a payer to evaluate contracts as needed.”

Contract modeling is one area ripe for the cloud's fluidity, and a service that TriZetto will offer, but it is hardly the only potential resource for HIPAA 5010 and ICD-10 that will emerge as healthcare organizations scramble to comply with 5010 by January 1, 2012 and ICD-10 by October 1, 2013 – and  more vendors will likely turn to the cloud to better meet prospective and existing customers' demands.

Last Updated on Thursday, 07 July 2011 21:54
Top 5 HIPAA 5010, ICD-10 hurdles PDF Print E-mail
Written by Tom Sullivan, Government Health IT   
Thursday, 07 July 2011 21:38

It's no secret that the government mandated dynamic duo - that being HIPAA 5010 and ICD-10 - requires changes enormous in both number and scope. What's not as well understood is all the challenges they present.

HIPAA 5010 carries at least 1331 modifications spanning all 9 standard electronic transactions, while ICD-10 adds five times as many codes.

The most significant hurdle healthcare organizations face on the path toward both HIPAA 5010 and ICD-10, however, can be whittled down to the “T-word,” as in “testing.” All three panelists agreed on that, during the Preparing for the Future: 5010 Implementation webinar in late March; they included representatives from Blue Cross and Blue Shield of Florida, Tampa General Hospital, and PNC Healthcare. Thus, a provider, payer, and clearinghouse.

Testing might be the single most important challenge that HIPAA 5010 and ICD-10 pose, but it's neither the only nor the first. Here's a list of the top five.

1. Education
Increasing awareness of technological and process changes that the new mandates will create is not only a huge undertaking but perhaps the foundation of project success. In the case of Blue Cross and Blue Shield of Florida, that means making sure that some 1,300 trading partners are included, according to George Vancore, an IT systems integrator within BCBS Florida's regulatory mandates and compliance program office.

“We need to do a great deal of education to make sure everyone understands the changes, both internally and externally,” adds Pamela Grosze, vice president, manager healthcare operations payer services, PNC Healthcare.

2. Engagement of vendors and partners
Providers are ultimately responsible for compliancy, says Gale Scott, the HIPAA transaction compliance administrator at Tampa General. But providers cannot succeed alone. Scott recommends getting firm delivery dates from vendors as a start.

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ICD-10 Corner

9 benefits of ICD-10

1. Measuring the quality, safety and efficacy of care
2. Designing payment systems and processing claims for reimbursement
3. Conducting research, epidemiological studies, and clinical trials
4. Setting health policy
5. Operational and strategic planning and designing healthcare delivery systems
6. Monitoring resource utilization
7. Improving clinical, financial, and administrative performance
8. Preventing and detecting healthcare fraud and abuse
9. Tracking public concerns and assessing risks of adverse public health events

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