Banks Debra Lynn
Governors State University, I University Pky, University Park Illinois 60466-0975, USA.
J Med Syst. 2006 Feb;30(1):45-50. doi: 10.1007/s10916-006-7403-2.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was passed by Congress with two formidable tasks: (1) reform the insurance market; and (2) simplify healthcare administrative processes. From these ambitious beginnings, HIPAA has since taken on major healthcare issues including administrative simplification, security, privacy, and patient confidentiality. In November 1997, the Secretary of Health and Human Services (DHHS) introduced the proposed "standards" for what is referred to as "administrative simplification". But, establishing the standards and guidelines necessary for administrative compliance was not an easy undertaking. DHHS estimated that 400 different formats were used in the US for healthcare claims processing. Three years later (August 2000), the Final Rule for Standards for Electronic Transactions and Code Sets was published by DHHS. The rule provided for national standardization of the most common healthcare transactions and several code sets. The compliance deadline for implementation of the new transactions and code sets was set for October, 2002. In January 2001, Congress enacted The Administrative Simplification Compliance Act to provide the industry with additional time to reach compliance. Yet, recent survey results by Phoenix Health Systems and the Health Information and Management Society (HIMSS) indicate many providers and payers are not fully compliant with the security and privacy regulations mandated by HIPAA. This issue threatens the effectiveness of administrative simplification and the integrity of healthcare information. Overall, HIPAA does offer the promise of a more efficient and effective means of sharing and disseminating vital healthcare information. But, many experts have concerns that the implementation and maintenance of HIPAA standards and policies will become a financial burden for many in the healthcare industry. Although DHHS has established mandates for the healthcare industry, many deadlines have been extended and the standards of administrative simplification continue to evolve over time. Others question whether the Department of Health and Human Services is capable of spearheading an information technology revolution in the healthcare industry. Unfortunately, it may take several years before the industry is able to realize any true cost savings from administrative simplification. Yet, few can question how HIPAA has revolutionized information technology in the healthcare industry.
1996年的《健康保险流通与责任法案》（HIPAA）经国会通过，肩负两项艰巨任务：（1）改革保险市场；（2）简化医疗行政流程。从这些宏伟目标起步，HIPAA此后着手处理重大医疗问题，包括行政简化、安全、隐私和患者保密等。1997年11月，卫生与公众服务部（DHHS）部长提出了所谓“行政简化”的拟议“标准”。但是，确立行政合规所需的标准和准则并非易事。DHHS估计，美国医疗理赔处理使用了400种不同格式。三年后（2000年8月），DHHS发布了《电子交易与代码集标准最终规则》。该规则规定了最常见医疗交易和若干代码集的全国标准化。新交易和代码集实施的合规截止日期定在2002年10月。2001年1月，国会颁布了《行政简化合规法案》，为行业提供更多时间实现合规。然而，菲尼克斯医疗系统公司和健康信息与管理协会（HIMSS）近期的调查结果表明，许多医疗服务提供者和支付方并未完全遵守HIPAA规定的安全和隐私法规。这个问题威胁到行政简化的有效性以及医疗信息的完整性。总体而言，HIPAA确实有望提供一种更高效、更有效的方式来共享和传播重要的医疗信息。但是，许多专家担心，HIPAA标准和政策的实施与维护将成为医疗行业许多人的财务负担。尽管DHHS已为医疗行业制定了要求，但许多截止日期已延长，行政简化标准也在不断演变。还有人质疑卫生与公众服务部是否有能力引领医疗行业的信息技术革命。不幸的是，该行业可能需要数年时间才能从行政简化中真正实现成本节约。然而，很少有人会质疑HIPAA给医疗行业的信息技术带来了怎样的变革。
