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The HIPAA Opportunity
Aside from avoiding penalties, compliance with HIPAA
yields an edge that can help grow the business
by
Marc Grimm
Director, Business Development
Enterprise Integration Solutions
Pitney Bowes Document Messaging Technologies
Every
problem is an opportunity.
The
conventional wisdom concerning HIPAA -- the Health Insurance
Portability and Accountability Act -- is that the new Federal
rule is an obligation targeted exclusively at health care
related firms, and that non-compliance can bring swift and
severe punishment.
The
reality, however, is much different. Compliance with the requirements
of HIPAA also presents an opportunity for all firms -- regardless
of their industry or size -- to differentiate themselves on
the basis of integrity and privacy, and use customer messaging
to create a powerful competitive advantage and help grow the
business.
Indeed, the leaders and innovators in the customer messaging
industry are already doing exactly that.
To
be sure, HIPAA is targeted at firms in the health care and
insurance industries, and its scope and requirements are comprehensive
as well. In a nutshell, HIPAA was enacted in response to complaints
from consumers who were being denied or had great difficulty
obtaining health care insurance when changing jobs or legal
status, such as a divorce, due to pre-existing medical conditions.
HIPAA
Opportunity
Originally,
the intent of the law was to assure the easy portability of
health care data so insurance coverage could be more quickly
and easily provided to anyone with a status change. In essence,
it was intended to restrict the ability of health care insurers
to reject an individual for insurance coverage based on pre-existing
medical conditions.
As
such, the initial focus of the Act was on data in digital
form - on creating a common database with a standard set of
communications protocols and codes which would facilitate
the exchange of health care data electronically -- i.e., Electronic
Data Interchange (EDI).
For
managers of data centers in firms that needed to comply with
HIPAA, the challenge was hardly overwhelming. For example,
at each step in data processing they needed to:
- Assure
that access to the data is authorized
- Confirm
that the routing is correct
- Assure
that the content is accurate
- Document
the process
- Account
for the data.
For the
vast majority of modern firms, these steps were already underway
or they could be accomplished very quickly. These are the
same actions that print/mail finishing managers will have
to take, which we'll discuss later.
Privacy
and Security
However,
the focus of HIPAA was broadened considerably when public
concern about the privacy of health care data overtook the
issues related to the security and interchangeability of digital
data and the Act's definition of Protected Health Care Data
was altered.
As initially
proposed, the definition was "any identifiable health information
that is, or has been electronically transmitted or maintained
by a covered entity."
But as
finally adopted, the definition was broadened to include "any
individually identifiable health information in any form ...
that is held or transmitted by a covered entity."
This simple
change shifted the focus of HIPAA away from data in 'bits
and bytes' form exclusively and now encompassed data in all
its forms, including the physical 'pages and piles' format
involved in downstream processing and ultimately received
by consumers. And that change placed managers of the customer
messaging function squarely in the center of the action.
For most
businesses, complying with the original 'digital' requirements
of HIPAA was relatively easy. After all, virtually every business
already maintains a secure data center. Procedures for limiting
access to data, such as secure servers, fire walls and pin
numbers have been around for years.
Plus,
firms are already in compliance with stringent government
rules concerning the security and accuracy of data, such as
those issued by the SEC and other state and Federal regulators.
So businesses are fully adept at assuring the security of
customer and business data in electronic form, and they have
been for years.
But the
need to extend that same level of data security and privacy
to the print/mail finishing center -- and possibly even to
individual mail pieces throughout the postal mail stream --
caught more than a few firms unprepared. And it has presented
the innovators in our industry with an opportunity to differentiate
themselves on the basis of quality, superior customer service
and mail piece integrity.
After
all, there is no doubt that privacy is a top concern of virtually
all consumers today. The recent and rapid growth of the Internet
and the associated fear of 'electronic snooping' and identity
theft has only heightened that concern.
Responding
to this growing consumer concern about privacy, proactive
businesses are now seizing the opportunity to comply with
HIPAA -- not just because it is required by law and to avoid
the penalties for non-compliance -- but because it is 'just
good business sense' to assure the quality and privacy of
customer messages. Indeed, compliance affords these innovators
with a dramatic way to 'stand out from the crowd' of lesser
firms that have not yet achieved messaging integrity.
In effect,
for these innovative firms the acronym HIPAA stands as much
for High Integrity Processing and Accountability as it does
Health Information Portability and Accountability.
And they
are aggressively promoting the fact that they offer the highest
level of messaging privacy and confidentiality available as
a way to attract customers, build stronger relationships and
grow the business. Which, after all, is the fundamental reason
the business exists in the first place.
Responding
to the Challenge
Although
the Act encompasses the health care industry - including providers,
such as physicians and hospitals; health care plans, such
as insurers; and health care information clearinghouses and
related entities known as business associates -- insurers
are a primary customer messaging focus. That's because insurers
produce the greatest volume of physical documents such as
enrollment kits, EOBs, checks, and claim status letters.
So for
managers of customer messaging centers that need to comply
with HIPAA -- or those who want to use compliance as a step
in helping to grow the business -- the primary concern is
on complying with the Privacy and Security requirements of
the Act. In plain English, these rules:
- Define
the type of health care data that is protected by the Act.
- Specify
the need to obtain patient consent prior to the use of health
care data.
- Outline
policies and procedures to ensure the security and accuracy
of the data.
- Prohibit
both the accidental and intentional unauthorized disclosure
of data.
- Outline
the need to establish a documented 'Chain of Custody' for
the data and documents.
- Set
both civil and criminal penalties for non-compliance.
For example,
under the provision for Security and Accuracy of Data, the
Act requires firms to adopt security policies and procedures
- encompassing both physical and technical safeguards -- that
prevent any unauthorized disclosure. And it defines unauthorized
disclosure as either intentional and fraudulent or unintentional,
accidental and even unnecessary.
Another
key section of the Act concerns the 'Chain of Custody' of
health data or documents. Here the Act permits only the minimum
level of access to the data/document that is necessary to
carry out approved actions and processes. Plus, the Act stipulates
that the firm must document who has had access to the data
and for what reason.
Another
key section of the Act concerns addressability. Patients may
ask health care providers and plans to communicate health
information to them by "alternative means" or at "alternative
locations." The print/mail finishing center needs to take
great care in considering this when employing address hygiene
solutions.
Although
HIPAA does not mandate any specific solution, technologies
that become widely adopted -- such as file-based processing
for assured mail piece integrity -- could evolve into de facto
industry standards as competitive pressures force other firms
to adopt similar strategies. And there is ample evidence that
is already happening.
For example,
until recently many high volume mailers focused primarily
on the print/mail finishing component of customer messaging
in isolation.
But there
is now a growing awareness of the benefits of managing the
entire 'life cycle' of the customer message as an interrelated
five-step process that encompasses all the activities related
to message creation, production, distribution, receipt and
database updating.
As a result,
innovative firms, such as the ones employing 'closed-loop'
or ADF-style processing and insertion control technologies
like Pitney Bowes' Direct Connect for assured mail piece integrity,
are well on their way to assuring message privacy, compliance
with the Act, and the use of customer messaging as a strategic
tool to help grow the business.
Although
HIPAA does not mandate any specific solution, technologies
that become widely adopted -- such as file-based processing
for assured mail piece integrity -- could evolve into de facto
industry standards as competitive pressures force other firms
to adopt similar strategies.
Still,
it bears repeating. At each step in the messaging process:
· From updating the customer database,
- To
transferring data to applications,
- To
manipulating the print stream for value-added processing,
- To
composing documents,
- To
managing print resources,
- To
distributing data and messages electronically,
- To
printing and inserting documents
- To
sorting completed mail pieces;
HIPAA
requires that steps be taken to assure the privacy and accuracy
of health care-related data. But good business sense and the
growing demands of consumers suggest that the same level of
security and protection be afforded to all confidential customer-related
data.
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