I also found the article interesting. They simply avoided the internet
issue altogether and used their existing private network. So, how do
the other 2 Million players in the Healthcare market take advantage of
this network?
Well, it might be easier to start our own America On-Line, but call it
HIPAA On-Line (HOL) and you don't get true Internet Access. Only
Healthcare Organizations responsible for HIPAA and other Healthcare EDI
transactions will be given access. I'm sure AT&T, WorldCom and Sprint
would be happy to layout the infrastructure for another HOL Internet.
While were at it, let's just make it only support the newest IPv6
technology with a Napster like application protocol. (Hey maybe UUNET
would support this too!) Instead of $21.95 per month, we'll charge
$34.95 per month (to cover IPv6 and additional security features) -
additional IPv4 Internet Access would be an additional $9.95 per month.
For those of you fortunate enough to make the Seattle meeting, be sure
to bring your napkins, I'm sure you'll be able draw this up over a few
drinks and if you can get it up and running in less than 60 days you'll
be one up on NEHEN. Just think, if you took all the current investment
in private network connections from VANS, CH's, Payers, Providers, I'd
bet you could easily justify the expense to create a HOL ("You've got
Interchanges") IPv6 network infrastructure. :)
Not to knock the NEHEN efforts(they solved an immediate business
problem quickly, easily and cost effectively), if they had built it on
IPv6 and established a routing standard that could support the entire
healthcare industry(including small players that cannot afford fiber
links), then they would be way ahead of this routing team. I am curious
to know what the "Gateway" is using to managing the "peer-to-peer"
routing over TCP/IP - I wonder if it's a simple DNS service or a truly a
Napster like service. If every Healthcare institution decided to build
this out - in the end we would have HIPAA On-Line and a Napster like
clients as the primary interface in every covered entity.
The biggest obstacle with the HOL Network is getting the Trading
Partner Agreements established to ensure we address each parties
fiduciary responsibility and that the Govt. doesn't shut us down for
improperly sharing PHI without paying copy right(or should I say
Informediary) fees.
All kidding aside, it is possible isn't it? Would a Napster like model
work better than a DNS model? (Are they one in the same? I'm not
familiar with Napster, never caught the music collection fever)
-RB
>>> "William J. Kammerer" <[EMAIL PROTECTED]> 02/11/02 11:17AM >>>
David Frenkel shared with us a case study of the New England Healthcare
EDI Network in Baseline Magazine, at http://www.baselinemag.com/ . It's
replete with the usual journalistic hype and errors (I love it when
they
always put the "dot" in "ANSI x.12"). I'm still scratching my head over
"[even] though the data may move unencrypted between gateways, because
the lines are private, the data generally is encrypted when it moves
inside a network."
But, anyway, I digress: the thing that made the biggest impression on
me was that NEHEN participants rely on a single means of communicating
with one another, viz. direct socket-to-socket TCP/IP network
transmission. Eliminating communications options vastly simplifies
things. This is obviously easier to do on a semi-proprietary network
between a few big players who can afford special software.
Peter Barry has suggested before that we need to specify "addresses" in
"three arenas": "dial-up (easy), Internet (easy), and private network
(not so easy)." He went on to describe the attributes of an address,
including "questions of media, packaging, security, and communications
capabilities. For example, a given address might have attributes to say
dial-in/login-script-X/security-A/ASCII-file-no-label/filename-path-sche
me-3, or something like that. Another might say
Internet/security-B/ebXML-scheme-1/etc."
What scares me if we don't limit the communications protocol
possibilities, is that we could end up with a spiraling list of
permutations. How do you describe - in a mechanical fashion - something
like "use Kermit over a direct dial-up connection to 8005551212"? Do
you also have to describe the modem mumbo-jumbo of 7-bit vs 8-bit and
even or odd parity? I vaguely recall that was the junk you had to worry
about when using pre-Internet BBSs or Compuserve.
Now that there's the Internet, I set my modem and dial-up connection
once, as specified by my ISP, and have forgotten about it, thankfully.
I now have a single digital dial-tone, which works for e-mail (secure
or
insecure), file uploads and downloads, and surfing the Web. And when I
start getting fancy, like doing web services using SOAP, it's still the
same dial-tone: never again will I have to fuss with a modem unless I
change my entry ramp to the Information super-highway (moving to DSL or
cable, or changing ISPs). I hate modems and I hate printers.
Even Kepa hinted at all the possibilities his DNS "directory" will have
to handle, using examples like 8005551212.phone.hipaa.net and
kermit.8005551212.phone.hipaa.net, adding nonchalantly "[the] sky is
the
limit. As long as we have some standard way to name them. We may need
to 'create' such a standard." That's exactly what I'm afraid of!
Let's assume for now that we'll be forced into supporting all the
"legacy" dial-up connection types - to assuage fears of the open
Internet's security "problems," what with some means of describing
scripts, logins, passwords, modem-settings, etc. etc. Then does anyone
know of any OASIS, W3C, IETF, etc. effort for devising XML files to
describe all communication capabilities of a partner? The ebXML
Collaboration Protocol Profile (CPP) specification only supports the
common internet protocols (and then, only if ebXML Messaging services
is
used for packaging payloads - which could include HIPAA EDI). I want to
see something that says "this is a dial-up using Kermit with this phone
number." Surely someone has devised a schema for describing
communication capabilities. There's no sense in us reinventing the
wheel.
William J. Kammerer
Novannet, LLC.
+1 (614) 487-0320
