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1. X12 and HL7 Interoperability Presented March 19, 2004Kathleen Connor, Fox Systems Inc
2. Kathleen Connor Fox Systems Inc
2 National Standards Interoperability HIPAA and a number of federal health initiatives, including NHII, CHI and EHR are accelerating the adoption of health care data standards, including X12 and HL7
However, interoperability issues arise when health care systems send, receive, store and process data that come from multiple data standards
3. Kathleen Connor Fox Systems Inc
3 Key Issues If these standards are not interoperable, if semantics do not align, then systems will map these standards differently
As a result, data will not be comparable and our national health goals will be compromised
Yet achieving interoperability among data standards is not a trivial endeavor
4. Kathleen Connor Fox Systems Inc
4 Topics to Consider We need to understand
The roles of X12 & HL7 in achieving National Health Care goals
Note: although not the in the scope of this presentation, everything said applies to NCPDP as well!
The Interoperability “Problem Space” as made evident by real-life examples, and
Why Interoperability Matters
5. Kathleen Connor Fox Systems Inc
5 ASC X12N X12 HIPAA transactions are used to transmit financial and administrative information by many of the same health care entities that use HL7:
Health care providers, hospitals, and insurers
Intermediaries who process electronic health care transactions, such as financial institutions, billing services and clearinghouses; and
Health care purchasers, such as Medicare and Medicaid
6. Kathleen Connor Fox Systems Inc
6 HL7 HL7 message and information structures (HL7 specifications) are used by many of the same health care entities that use X12 HIPAA transactions, including
Providers, hospitals, insurers, and research institutions
Producers of health care products
Public health and regulatory agencies
7. Kathleen Connor Fox Systems Inc
7 Mixing X12 and HL7 Many health care entities use both X12 and HL7 to communicate health information
An episode of health care may involve several HL7 messages and X12 transactions running sequentially or concurrently, all communicating about the the same health care “objects” or events
8. Kathleen Connor Fox Systems Inc 8