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Pervasive Speeds HIPAA Compliance for Per-Se Technologies

  • July 01 2004, 1:00am EDT

REVIEWER: Tim Hannan, manager of programming and development for Per-Se Technologies Inc.

BACKGROUND: Per-Se Technologies is the leader in Connective Healthcare solutions that enable physicians and hospitals to achieve their income potential by creating an environment that streamlines and simplifies the complex administrative burden of providing healthcare. Per-Se Technologies' customers include 2,000 healthcare organizations and 47,000 physicians across the United States. Per-Se Technologies also supports hospital customers in the United Kingdom, France, Canada, Saudi Arabia and Australia.

PLATFORMS: Intel-based server running Windows 2000 Server.

PROBLEM SOLVED: Focusing on delivering healthcare management solutions that meet the market demands for seamless integrated systems, Per-Se Technologies is working to ensure success for our clients by providing products and solutions that already meet the new HIPAA transaction standards. Per-Se Technologies chose Pervasive in the process of initiating our new Real-Time Services Suite of e-Health products to give healthcare organizations real-time access to insurance data, including the largest payer list available on the Internet today. We needed a transformation interface that would enable us to move data from our proprietary format into HIPAA compliant data formats for submission to our payer connections. We also needed to be able to accept HIPAA transaction sets from the payer connections and bring that data into our systems for reporting and distribution to our clients. Pervasive has given us the ability to create a seamless interface for bidirectional transformation of data according to HIPAA standards without writing code, letting us concentrate on the very important aspect of payer specific data validation. We have fully integrated Pervasive's Integration Engine into our Real-Time Services system, providing us with the critical capability to document the data transformations and easily edit these maps to accommodate any changes that may be made to future HIPAA requirements.

PRODUCT FUNCTIONALITY: Per-Se Technologies gains HIPAA connectivity with Pervasive's highly visual, easy-to-use code-free design interfaces, native EDI support for bidirectional transformation and intuitive Document Schema Designer for designing, editing and validating EDI subsets for all ANSI ASC X12N standards. Pervasive's prepackaged healthcare schemas allow us to map the client data to our data efficiently and effectively, enabling quicker and more reliable client implementations and making us better able to respond to changes in file formats. Because HIPAA failed to address many of the practical operations of EDI, Pervasive enables Per-Se Technologies to adjust to any format and any source in real time. Without Pervasive's built-in capabilities, we would have to resort to the expensive, insufficient and time-consuming process of writing custom data transformation code.

STRENGTHS: Pervasive's event-driven environment provides our developers with a very flexible integration tool that provides unlimited capability to format and validate data while it is being mapped, and the ability to handle any validation errors or accommodate any changes that may be made to future HIPAA transaction sets.

WEAKNESSES: Error messaging was initially pretty weak, but that has been solved in subsequent releases. The product is easy to pick up, and it is easy to gain basic functionality; but it is difficult to master and to take advantage of all the advanced features.

SELECTION CRITERIA: We looked at Microsoft BizTalk and Orion Rhapsody, but chose Pervasive based on its overall value and tailored solutions that will help us meet the regulatory compliance requirements for our industry, which was a major consideration in our decision. This product did absolutely everything we needed and had integration functionality specifically designed for the healthcare industry.

DELIVERABLES: With Pervasive's visual Map Designer, conversion maps were created to take data from the proprietary formats into HIPAA 270 benefit inquiry transaction sets for delivery to the payer. When the payer sends back HIPAA 271 eligibility response forms, Pervasive takes that data and maps it to a SQL staging database for reporting purposes.

VENDOR SUPPORT: Vendor support has been great. We call an 800 number and never get a busy signal. We always get a solution or a straight answer to our problem. Pervasive support consistently follows up on open cases and really seems to care that we get a satisfactory resolution to our issues. They are good at answering both simple and complex technical questions.

DOCUMENTATION: What is presented is good, but it doesn't seem complete. We would like to see more documentation or examples devoted to an entire application process or scenario and not just the features.

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