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Jim Whicker, CPAM WEDI Chair Intermountain Healthcare

Jim Whicker, CPAM WEDI Chair Intermountain Healthcare. Introduction to WEDI Workgroup for Electronic Data Interchange. CORE PURPOSE Improve the quality of healthcare through effective and efficient information exchange and management. WEDI MISSION

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Jim Whicker, CPAM WEDI Chair Intermountain Healthcare

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  1. Jim Whicker, CPAM WEDI 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

  11. Two annual conference • 17th 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

  13. WEDI - Affiliates

  14. 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

  16. Contact information • WEDI Offices12020 Sunrise Valley Drive, Suite 100  Reston, VA 20191 • Executive Vice President/CEO - James A. Schuping, CAE  703-391-2716; fax 703-391-2759  e-mail - jschuping@wedi.org • Vice President Education & Industry Outreach - Kristin Fettermanphone:  703-391-2714 e-mail - kfetterman@wedi.org • Vice President Administration & Member Services - Lisa Berrettaphone:  703-391-2743 e-mail - lberretta@wedi.org • Vice President Regional & NPI Education/Operations - Ann Marie Railingphone: 703-391-2718 email:AMRailing@wedi.org • Assistant Director Programs & Services - Patti Brownphone:  703-391-2717 e-mail - pbrown@wedi.org • WWW.WEDI.ORG

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