Falls Church, VA, July 8, 2009 – Standardized requirements for one health insurance plan to electronically send Personal Health Record (PHR) data to another health insurance plan, called the Personal Health Record (PHR) Transfer Between Health Plans Technical Report, 005050X274, was released by the Accredited Standards Committee (ASC) X12, providing monumental interoperability among insurance companies assisting consumers.
“This Implementation Guide provides a standards-based mechanism to electronically send PHR data from a predecessor to a successor health plan,” said Dan Kazzaz, Chair, ASC X12. “It provides needed support to health plans in the role of maintaining longitudinal PHRs for individuals and moving PHRs from health plan to health plan whenever individuals' or companies’ health plan coverages shift.”
This implementation guide builds on the pioneering work of the Blue Cross and Blue Shield Association and America’s Health Insurance Plans (AHIP) in their 005010 implementation guide of the same name. The document brings together work of several standards-setting organizations to describe the business process, message structure, data elements and examples and includes a glossary.
“This announcement by ASC X12 is good news for consumers who, when they change coverage, want to transfer their PHRs to their new health plans and continue with all of the advantages that PHRs bring with them,” said AHIP President and CEO Karen Ignagni. “We are pleased that the new standard builds on the work of AHIP and BCBSA, which was designed to be consistent with that of the standards organizations, and to be a building block for their future efforts,” Ignagni said.
“BCBSA believes the increased use of personal health records will allow consumers to take a greater role in their own healthcare and ultimately improve quality and health outcomes,” said Scott P. Serota, BCBSA president and CEO. “BCBSA is proud of its partnership with ASC X12 and other organizations to promote the use of PHR standards.”
The Healthcare Information Technology Standards Panel (HITSP), a cooperative partnership between the public and private sectors has named ASC X12 and Health Level Seven (HL7) standards in their Interoperability Specifications. The Personal Health Record Transfer Between Health Plans Technical Report benefits from ASC X12 and HL7 standards. This implementation guide for ASC X12’s Patient Information Transaction Set 275 describes a standard method to encapsulate an HL7 Plan-to-Plan Personal Health Record Data Transfer (P2PPHR). Neither the ASC X12 guide, nor the HL7 guide are standalone documents. The X12 guide relies on the HL7 guide, which relies on and references other HL7 documents.
X12 standards provide robust acknowledgments at several levels, from transmission to implementation guide adherence. HL7 standards provide a thorough collection of clinical-based data elements and a rich vocabulary gleaned from other well-known standard coding systems, such as, SNOMED, CPT, and LOINC.
Applications of this standard include:
• When an employer or coverage sponsor changes from one health plan to another, the new health plan may request the prior plan to transfer PHR information of covered individuals.
• When an individual changes jobs and elects coverage under a new health plan, he may request the transfer of PHR information for covered individuals. The prior health plan, with the individual's authorization, will transfer the PHR information to the new health plan.
• When an individual or subgroup of individuals changes from one health plan to another, the new health plan may request the prior health plan to transfer the PHR information of those covered individuals.
The combination of X12 and HL7 specifications incorporate Clinical Document Architecture (CDA) Release 2 (R2)-defined eXtensible Markup Language (XML) in the 275 transaction to delineate the data elements that are supported by health plan claims, administrative functions, clinical actions, medications, providers, facilities, and other data directly entered by individuals into their PHR.
About ASC X12
Celebrating 30 years of Business Process and Technical Expertise in the Development and Adoption of Electronic Data Exchange Standards The ASC X12, chartered by the American National Standards Institute (ANSI) in 1979, develops EDI standards and documents for national and global markets. With more than 315 X12 EDI standards and increasing X12 XML schemas, ASC X12 enhances business processes, reduces costs and expands organizational reach. Members include standards experts from health care, insurance, transportation, finance, government, supply chain and other industries. To participate in ASC X12’s vital standards-setting role, visit www.X12.org, or call 703-970-4480.
The Data Interchange Standards Association (DISA), Secretariat to ASC X12, is home for the development of cross-industry e-business interchange standards that help organizations improve business methods, lower costs and increase productivity. DISA provides administrative and technical support to ASC X12. For additional information, visit www.disa.org, or call 703-970-4480.