Electronic data interchange (EDI) refers to a communication method which provides a way through which data can be exchanged using electronic means. Two organizations are in a position to share data electronically so long as they are in the same standards of operation. Common standards currently in use include ODETTE, EDIFCAT, X12 amongst many others. It is important to note that this method of data transfer involves the interchange of information in the computer-to-computer format and is mainly done using formatted messages which are a representation of the documents being sent (Pfeiffer, 2012). A key point to note is that the transmission of data from the sender to the recipient is basically dependent on a telecommunications mode or alternatively transporting the formatted messages physically by the use of storage media. As such, data transfer is mainly done by the use of computers with very minimal human interactions. It is only through special events like reviewing the quality of the data or determining any conditions of errors that may call for the human intervention in this situation.
The process of the electronic transaction is dependent on the usage of mapping technique. During this process, translation software is responsible for mapping the communication elements onto the required standards format to be used in the communication process. The individuals who is responsible for this processes is supposed to be acquainted with the required knowledge on processing rules and the mapping procedures. After the mapping process, the transportation of the data is the step that is supposed to follow in the electronic transaction process (Bishop & Saunders, 2013). It is important to note that in most cases, the connectivity of computers to be used in this data transportation process is supposed to be in a direct connectivity regime. This direct transfer of electronic data is dependent on the application of modems to ensure the success of the process. The use of modem-to-modem connection is not only a reliable process, but it is also a secure method that ensures data reaches the required destination without glitches along the way. This method of electronic transactions is of high speed since the transmission of data is in a continuous manner. These high speeds are a result of modems regulating the rate at which data is transmitted and also play a significant role in the timing of the transactions (Bishop & Saunders, 2013). This process is further aided by electronic messaging standards which are responsible for aiding computer networks which are incompatible to comfortably exchange data.
The HIPAA is tasked with ensuring that the healthcare delivery process is effective and efficient with the objectives of making patient undergo minimal hassles in their treatments and care reception processes. Simplification and standardization are the bases under which EDI is supposed to operate and as such, the HIPAA has been in the forefront of setting up codes and rules that electronic data transactions are supposed to follow. These codes and rules should be followed by all healthcare payers and providers to ensure that there are consistency and standardization of the care provision process (Solove, 2013). The rules and regulations that HIPAA has put in place has ensured that the rates of claim denials have reduced considerably, the overall cost of processing health information has also been minimized, health information has been secured thereby promoting the essence of privacy in the healthcare delivery process and finally, the automatic posting of payments has been quick and accurate.
Electronic Health Records are collections of health information pertaining to a particular individual and which healthcare practitioners use in diagnosing and providing the required treatment to such patients (Blechman, 2014). The main challenge with these records is that most of them can be easily accessed by unwanted individuals in most cases. Such individuals may not have been authorized to access this kind of information; a saturation that compromises the privacy of the patient. As such, the HIPAA is tasked with protecting the privacy of patients under this arrangement by enacting legislations that control the way such data is shared among healthcare providers. This move is done with the objective of ensuring that the privacy of patients is respected. On issues of reimbursement, the HIPAA Is tasked with reducing any possibilities of claim denials after treatment has been done with information gotten from the EHRs. Such a move is done so as to reduce the overall cost of processing of claims (Solove, 2013). Finally, the HIPAA in conjunction with the Health Information Technology for Economic and Clinical Health (HITECH) provide a guidance technique for meaningful use of information from EHR. The HITECH provides the guidelines that need to be followed during the electronic transmission of health information. Such a rule has got a direct effect on the way EDI should be incorporated in the healthcare delivery process.
References
Bishop, F. A., & Saunders, P. D. (2013). Methods and apparatus for conducting electronic transactions.. U.S. Patent No. 8,489,513. Washington, DC: U.S. Patent and Trademark Office.
Blechman, E. (2014). Electronic health records. U.S. Patent Application No. 14/588,304.
Pfeiffer, H. K. (2012). The diffusion of electronic data interchange. Springer Science & Business Media.
Solove, D. J. (2013). HIPAA turns 10: analyzing the past, present, and future impact.
