HIPAA

In September 1996, following substantial efforts at general health care healthcare reform subsequent to the 1991 IOM report “The Computer-based Patient Record:” (Ref A3), the Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) (PL-104-191) with a section on “Administrative Simplification” to mandate common conventions for electronic exchange of Medicare claims and other administrative information with respect to federal healthcare programs. It was recognized that these conventions for information in the Resource Management dimension of the Health Information Domain  would stimulate activity to address the issues relevant to implementing a common conceptual model for the EHR, which is the common source of much of the HIPAA-mandated data (see EHR Overview: EHR Structure Issues section of this Website). The HIPAA Transactions and associated Privacy/Confidentiality requirements became mandated 15 October 2003 for all electronic systems and large healthcare practices in the US. The challenge remains regarding how to achieve wide understanding of how the HIPAA Transaction information is integrally related to that information contained in the EHR and how to transform healthcare business practices so that this Resource Management administrative information is transparently generated during the activities of Patient Care. Currently in 2003 the emphasis remains on transforming primarily the paper administrative forms into electronic transactions and testing and stabilizing those computer applications.