By Shea
Andersen
Tribune Reporter
With a huge overhaul of the nation's health-care industry looming
large, a software company with New Mexico ties is hoping to provide
some much-needed solutions.
The overhaul is mandated by the federal Health Insurance
Portability and Accountability Act, or HIPAA, passed by Congress in
1996. It was designed to simplify the administrative aspects of
electronic health care transactions.
HIPAA mandates standard transaction codes to be used by the
health plans and health-care providers and clearinghouses that file
electronic billing and other health insurance documents. HIPAA also
mandates a level of security, privacy and confidentiality of a
person's health information as it transfers between providers.
"It's really designed to take the health-care industry into the
electronic age," says Mark Padilla, the compliance officer at
Cimarron Health Plan in Albuquerque. He's also executive director of
the New Mexico Coalition for Health Care Information Leadership
Initiatives, or NM CHILI. The group's goal is to help the state's
health-care industry become HIPAA compliant.
Padilla says other industries, such as banking, allow for
portability, security and confidentiality of information, and do so
electronically. But the health-care industry is freighted with
paperwork, he says. Padilla estimates that nearly 25 percent of the
total cost of health care goes to administrative expenses.
As implementation dates approach (HIPAA transaction standards
will be enforced by the federal government starting in October
2002), health care providers have responded with not a little fear
and loathing.
Enter Physmark Inc., a company with offices in Dallas but whose
founder and president, Dr. Jacob Kuriyan, lives in Corrales. Kuriyan
says he's hoping his company's products will help providers tame the
HIPAA hippo.
"HIPAA isn't a one-event carnival," says Kuriyan. "These issues
keep coming. As a (information technology) vendor, you have to worry
about what's down the line."
That's because the regulations aren't all coming out in one
massive package. Deadlines for various parts of HIPAA compliance are
coming out staggered year by year.
To sell software into the HIPAA remediation market, Kuriyan and
his staff first thought about trying to write software to address
each component of HIPAA as it came along, then reconsidered.
"If we had to re-write our software for every change, that's all
we'd do," says Kuriyan.
Instead, the company has introduced the HIPAA Appliance, an
off-the-shelf software system package that, he says, will be
compatible with the myriad computer systems that exist in different
organizations. It matches up with any legacy computer system still
in use by health-care providers and others. The program uses Oracle
database systems and can convert old data into HIPAA-compliant
transactions.
Although no major sales have been made yet, Kuriyan says he's in
negotiations with several state governments and health-care
providers. In one state he's dealing with, budget officers told him
the software would cut the estimated $16 million cost of becoming
HIPAA compliant to $5 million.
Padilla says that the sooner organizations can solve their HIPAA
issues and move to standardized electronic-age transactions, the
sooner they'll start saving money.
"Once the health-care industry is compliant, I have estimates of
$9 billion that could be saved from HIPAA," says Padilla. "There's a
lot of cost savings involved."
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