1 jim whicker, cpam wedi chair intermountain healthcare introduction to wedi workgroup for...

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1 Jim Whicker, CPAM WEDI Chair Intermountain Healthcare Introduction to WEDI Workgroup for Electronic Data Interchange

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1

Jim Whicker, CPAMWEDI Chair

Intermountain Healthcare

Introduction to WEDI

Workgroup for Electronic Data Interchange

2

CORE PURPOSE Improve the quality of healthcare

through effective and efficient information exchange and

management

3

WEDI MISSION To provide leadership and guidance to the

healthcare industry on how to use and leverage the industry’s collective

knowledge, expertise and information resources to improve the quality, affordability and availability of

healthcare.

4

A non-profit organization, started in 1991 by HHS Secretary Louis Sullivan

Statutorily named in the HIPAA enabling legislation as an advisor to the US Department of Health and Human Services

1993 WEDI report– http://www.wedi.org/public/articles/full1993report.doc

5

Topics that appear to be on the forefront: Workers Compensation!! HIPAA Version 5010 ICD-10 Implementation Timeline Real Time Adjudication Standard Acknowledgements Standard Health ID Card Electronic/Personal Health Records Health Saving Accounts Ongoing input to industry to help improve 835

and other transaction adoption rates

6

Who are we? Individuals (including an eMembership), Providers, Health Plans, Government

Organizations, Standards Organizations, Vendors, etc.

How does it affect you? Direct contact with Government officials, testimony regarding industry issues and

recommendations Forum for facilitating improvements in information exchange and management Resolution of implementation issues Education and training programs Assisting healthcare leaders to define, prioritize, build consensus and make decisions Ensure thoughtful development and implementation of healthcare industry standards,

policies and regulations A primary catalyst for the identification, communication and resolution of obstacles that

impede the growth of information exchange and management within healthcare

7

Other benefits: Opportunities to network Access to industry leaders White papers to help understand and implement Forum to ask questions and be made aware of issues before

they affect you As advisor to HHS – input carries significant weight in

HIPAA related regulations

8

Membership is a broad mix of:

Payers: • National (United, Aetna, AHIP, Wellpoint, etc.)• Government (VA, Tricare, CMS, state Medicaids, etc.)• Blues, local TPA’s, etc.

Vendors/Clearinghouses:– GE Healthcare, Siemens, Availity, Emdeon, MedAvant, CareMedic,

American Express, Bank of America, Ingenix, Edifecs, EDS, Epic, IBM, PriceWaterhouseCoopers, etc.

9

Providers:• Large national provider organizations

– AMA, AHA, ADA, MGMA, Kaiser, LabCorp, National Home Infusion etc.

• Regional provider organizations– Allina, Mayo, Intermountain Healthcare, BJC, Geisinger,

Providence, Catholic Healthcare West, Trinity Health, etc.

• Individual/Local providers:– Cincinnati Childrens Hospital, Montifiore, Cleveland Clinic,

Georgetown University, Vanderbilt University, etc.

10

List Serve Examples:–      Various 835 workgroups–        Transaction Acknowledgements–        Business Issues–        Claims Attachments–        Coordination of Benefits Claims and Remittances–        Health Savings Accounts–        NPI–        Privacy and Security–        Testing, Transactions, Translations, Code Sets

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Two annual conference17th Annual WEDI National Conference

Hyatt Regency Baltimore on the Inner Harbor Baltimore, MD May 19-22, 2008 

WEDI Fall Conference Renaissance Esmeralda Resort and Spa Palm Springs, CA November 17-20, 2008

Policy Advisory Groups (PAG’s) and Hearings as needed

Workshops, Webinars/Audio-casts as needed

Committee conference calls

Testimony, recommendations to Federal Agencies

Etc.

12

WEDI - Affiliates

ID Idaho HIPAA Coordinating Council www2.state.id.us/dhw/hipaa/

IN Indiana HIPAA Workgroup www.indianahipaa.org/

IA Iowa HIPAA SNIP www.iowasnip.org

MA Massachusetts Health Data Consortium www.mahealthdata.org

VA VaHIMSS-MAHI www.vahimss.org

MO Missouri SNIP (MOSNIP) www.mosnip.com

NC NCHICA: NC Healthcare Information & Communications Alliance

www.nchica.org

NE Nebraska SNIP www.nesnip.org

13

WEDI - Affiliates

NJ NJSHORE: New Jersey Strategic HIPAA www.njshore.org

NM NM CHILI: New Mexico Coalition for Healthcare Information Leadership Initiatives

www.healthlinknm.org/nmchili

NY GNYSNIP, Greater New York SNIP Consortium

NY-Upstate UNYPHIED Project: Upstate New York Professional Healthcare Info. & Education Demonstration Project

www.unyphied.org

OH OHIO for EDI: Ohio HIPAA Implementation Organization www.ohiohipaa.org

OR Oregon & Southwest Washington Healthcare, Privacy & Security Forum

www.oregonhipaaforum.org

GA, FL, SC SHARP: Southern Healthcare Administration of Regulatory Programs

www.sharpworkgroup.com

UT UHIN: Utah Health Information Network www.uhin.com

WA,OR,WY,MT

CHITA: Community Health Info. Technology Alliance Foundation for Helath Care Quality

www.chita.org

WI HIPAA-COW www.HIPAACOW.org

PR & US VI Puerto Rico Healthcare Information Communications Alliance

HI HHRC: Hawaii HIPAA Readiness Collaborative www.hhic.org

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Why? Good Electronic Data Interchange standards which promote efficient

exchange of accurate data contribute to better healthcare and reduce costs More input means better standards Don’t assume “Someone is taking care of it” Contribute your knowledge Influence - need to be there early in the process Learn about changes that are coming in standards, technology, business

models, regulations, code sets Improve own use of standards by better understanding Communicate with subject matter experts in industry Provides opportunities to join focus groups and pilots Builds relationships with representatives from other industry sectors Promotes mutual understanding of EDI problems and needs

15

Who should participate? Not just “techies” - Also need expertise to

participate in the process with experience in business processes clinical data needs regulatory processes and requirements marketing

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Contact informationo WEDI Offices

12020 Sunrise Valley Drive, Suite 100  Reston, VA 20191

o Executive Vice President/CEO - James A. Schuping, CAE  703-391-2716; fax 703-391-2759  e-mail - [email protected]

o Vice President Education & Industry Outreach - Kristin Fettermanphone:  703-391-2714 e-mail - [email protected]

o Vice President Administration & Member Services - Lisa Berrettaphone:  703-391-2743 e-mail - [email protected]

o Vice President Regional & NPI Education/Operations - Ann Marie Railingphone: 703-391-2718 email: [email protected]

o Assistant Director Programs & Services - Patti Brownphone:  703-391-2717 e-mail - [email protected]

WWW.WEDI.ORG