Insurers Buy Tools For HIPAA

With the first HIPAA deadline approaching, the number of approaches insurers can take to become compliant is narrowing.

"Opening up a legacy system at this point to rewrite code to make it compliant, would be a major expense and would take a long time," says John Carpenter, worldwide healthcare industry manager, Microsoft (Redmond, WA).

It is also a little late to begin replacing legacy systems, especially at large health insurers. "Some companies have looked at HIPAA as an opportunity to replace legacy," says Michael Haymaker, global healthcare market development, Sun Microsystems (Palo Alto, CA).

Replacing older legacy systems will not only make compliance with this year's HIPAA transaction standards easier, but it will also make meeting next year's security standards easier since many newer technologies have encryption, passwords and role-based access functionality built in, he says—such as Sun's Solaris-based servers. "However, I haven't seen many insurers recently decide to completely replace older systems."

Instead, companies are using technologies like HIPAA translators to route transactions between systems. "Most people agree that systems will use XML to exchange data," says Microsoft's Carpenter. Microsoft, which offers the Biztalk Accelerator for HIPAA, has partnered with Compuware Corp. (Farmington Hills, MI) and Washington Publishing Co. (Rockville MD), the publisher of the X12N Implementation Guides adopted by HIPAA.

Greg DeBor, partner, global health solutions, Computer Sciences Corp. (CSC, El Segundo, CA), says there are a variety of tools that can help with HIPAA compliance, such as Sterling Commerce's (Dublin, OH) GENTRAN, SeeBeyond's (Monrovia, CA) e*Gate Integrator, Sybases's (Emeryville, CA) PaperFree and Mercator's (Wilton, CT) Integration Broker.

Other general EDI products in use include webMethods' (Fairfax, VA) Integration Platform, IBM's (Armonk, NY) MQSI, and Biztalk. "These tools tend to be used by the large payers because they need to do the heavy lifting," DeBor says, adding most programmers are already familiar with them because the products are prevalent in the marketplace.

Greg MacSweeney is editorial director of InformationWeek Financial Services, whose brands include Wall Street & Technology, Bank Systems & Technology, Advanced Trading, and Insurance & Technology. View Full Bio