Greetings,

I think the discussion was not centered around the need for 3rd party
certification, most people that I talk to believe that it is an essential
part of the testing process and will save much time and money during trading
partner testing. This comes with a caveat, that unless all the various
software vendors involved in the certification process interpret the
element-by-element rules the same way interoperability will not be achieved
during trading partner testing the way it should. A covered entity will
think they are compliant based on a company X interpretation of the rules
only to find out that the community they will be testing with uses a company
Y interpretation. This will cause rework on behalf of the covered entities.
The same holds true when the trading partner then tries to test with a
company Z interpretation and so on, and so on. I don't think it is right to
push the interoperability problem to the covered entities, unless of course
each certification company lets them know up front that even though they
will get a certification, it won't mean much when the covered entity
participates in a different trading partner community that may have
different interpretations. To my knowledge, no vendor currently agrees with
any other vendor assessment of transaction readiness. There are many covered
entities dealing with this exact problem today.

I believe that what people were saying is that without a "standard"
certification that is PORTABLE across infrastructures, the use of the term
certification should be used with caution. Just using the word certification
denotes to the covered entity a certain expectation that will not be able to
be met. If you look at any other IT vertical outside of healthcare, you will
see that certification is used in a much more stringent context that all
vendors must comply to the same set of conformance tests to be called
certified. For instance, If you were going to create a third party product
compatible with Windows XP, you must meet Microsoft's criteria prior to
receiving a "seal of approval", you cannot use another other interpretation
of Microsoft implementation rules to certify. Otherwise a consumer will buy
a version of say QuickBooks only to find out that it doesn't work with
Windows XP because it was tested by a third party that believed it
interpreted the rules set forth by Microsoft when it was really just their
best guess of what Microsoft meant. Do you see where this will lead the
entire industry astray. I don't think covered entities have the extra time
nor extra money, much less the patience to deal with these problems. Another
issue on this note is the subject of test files, you cannot run just one
file or a small sample through a certification process. There is very little
education going on right now to let covered entities know just how many test
files need to be created to prove compliance and the need to retain these
files for regression testing going forward. We are dealing with billions of
dollars worth of revenue, comprehensive testing solutions should be the norm
not the exception. I have a white paper written by a large and well-known
certification company (that certifies much of the desktop software everyone
uses today) clearly detailing the process of certification to a standard,
it's stringent and detailed nature and purpose and will gladly share it with
anyone that asks.

You stated "There are a few ambiguous exceptions, which have been discussed
tirelessly, and we'll all maintain flexibility on those items in testing, so
that trading partners can work it out."  Why push the problems to the
covered entities, when the software vendors can work it out among themselves
and save the trading partner communities all the headaches? This is not that
difficult to do, it just entails cooperation from all interested parties on
behalf of covered entities to ensure they have as smooth a transition as
possible in October 2003, after all, the vendors will be making quite a bit
of money from HIPAA  transaction remediation efforts.

Another point is the separation of testing types from internal testing
phases. Wouldn't an entity have to test all these requirements during unit,
system, and user acceptance testing phases? The process is integral
throughout all the testing phases. One of the major goals during software
development is to achieve what is called phase containment, which means
finding and correcting errors or ambiguities prior to the next phase
starting. Ideally, you don't want to find unit test errors during user
acceptance testing, etc. If you waited until after internal testing is
believed to be complete to get an assessment you would be guaranteed much
rework and miss the project timelines. These topics should be seen as
complimentary not separate.

To me, the word certification should mean that you can be certified that
types 1-6 testing is complete and portable. If it is not then just say
partially certified or use a different term instead, at least that way the
covered entity will know to allocate more time, resources and budget for
further testing and rework down the road. A certification can and should be
used to denote that an entire organization, or even system, is entirely
compliant with a given set of standards. I believe the end goal should
always be to achieve interoperability between trading partner communities
and given the current climate this does not exist.

Some comments hit the nail on the head. First; the time is now to get
something done and I believe there is a significant group of concerned
individuals and organizations (HCCO) trying to assist the industry in this
regard and we could use all the help we can get to complete this ambitious
initiative. Secondly, I agree that 3rd party certification is extremely
important and very needed, it can and should be used as a means to relieve
much of the testing burden of covered entities and that of their trading
partner testing readiness and will provide a significant ROI for those
covered entities that utilize such a service.

Mark A Lott
President & CEO
HIPAA Testing, Inc.
www.hipaatesting.com

Executive Co-Chair HCCO - Transactions Group
HIPAA Conformance Certification Organization
www.hipaacertification.org

Office: 480-946-7200
Cell:   480-580-4415
Fax:  877-825-8309

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 -----Original Message-----
From:   Larry Watkins [mailto:[EMAIL PROTECTED]]
Sent:   Thursday, September 05, 2002 9:04 PM
To:     Julie Thompson; [EMAIL PROTECTED]; [EMAIL PROTECTED];
[EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED];
[EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject:        RE: Certifications

Many seem to be concerned about the differences of interpretation and
implementation for testing vendors.  Some seem to be convinced that entities
are better off NOT obtaining 3rd party certification than obtaining it,
because detailed element-by-element rules haven't been established, creating
a single meaning for the term 'compliant'.

I went through the 837P just to see how many 'interpretations' there are.
For most elements -- there is ONE.  Even the should vs. must issue doesn't
add that much ambiguity.  There are a  few exceptions, which have been
discussed tirelessly, and we'll all maintain flexibility on those items in
testing, so that trading partners can work it out.

The bar has already been set -- it is the X12N Implementation Guides.  Fact
is, TRANSACTIONS can be systematically evaluated to see if they comply with
the implementation guides, barring the ambiguities I already mentioned.
Granted, some vendors will do this better than others, and there are some
ambiguities.  However, the value of transaction certification from a
credible 3rd party, as the paper indicates, still has significant value.

This value is in 3 key areas (and probably more):

1) Assistance in identifying problems or issues within one's implementation,
in order to significantly reduce the number of issues or problems found when
exchanging with trading partners.

2) Removing the bottleneck of testing, where everyone has to wait until
everyone else is ready to begin external testing.

3) The use of a trusted 3rd party solution by a trading partner as a way of
scrutinizing their trading partners prior to exchanging transactions with
them.  This limits the amount of 'debugging' of each other's systems that
trading partners have to do.


I do think that we're caught in a bit of a semantic problem here as well.
The WEDI SNIP white paper simply uses the term 'certification' to indicate
that an independent 3rd party is willing to make a public statement about an
entity's transactions.  The credibility and openness of that 3rd party's
methods is crucial to this.  The only difference between this concept and
that of testing is that it is done by a 3rd party.  Perhaps this needs to be
made clearer in the paper.

Finally, Ramakrishna Pidaparti mentioned that there are some things missing
from the WEDI SNIP Transaction Compliance and Certification white paper:
"the traditional
Software Testing aspects of unit, system, integration, beta, acceptance,
stress, load, performance and automated testing."  These are very important
to the testing process, but actually come chronologically BEFORE this white
paper, which deals with the external testing/certification that occurs once
an entity has reason to believe they are compliant.  I believe it has been
suggested that a separate white paper addressing Internal Testing (which
occurs before external testing) be written.  I think this would serve the
industry well, as these are critical issues.  However, the time is NOW to
get it done.  April 16, 2003 is not far away.  Any volunteers?

Regards,

Larry Watkins
Vice President & COO
Claredi Corporation
Office: (801) 444-0339 x204
Fax: (770) 419-5295
Mobile: (770) 331-1898
e-Mail: [EMAIL PROTECTED]


-----Original Message-----
From: Julie Thompson [mailto:[EMAIL PROTECTED]]
Sent: Thursday, September 05, 2002 1:02 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED];
[EMAIL PROTECTED]; [EMAIL PROTECTED];
[EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: Certifications


Of course, there are exhaustive testing plans in progress. The covered
entitites have millions of dollars in revenue at risk.

While some vendors are available to assist them, many of their IT
departments are talented and very capable of handling these requirements.

Where the "bar" is set for acceptance is one of the challenges and will vary
from one entity to another according to there business needs. That level of
acceptance must be left to each overed entity and is not the issue here.

Comparison of one entitiies concept of HIPAA compliance .vs. another is the
key issue here. Thus, the need for an industry wide acceptance of what
defines HIPAA compliant.

Julie A. Thompson
VP EDI Solutions
http://www.concio.com

From: "Miriam Paramore" <[EMAIL PROTECTED]>
Reply-To: "Miriam Paramore" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED], [EMAIL PROTECTED], [EMAIL PROTECTED],
[EMAIL PROTECTED], [EMAIL PROTECTED], [EMAIL PROTECTED],
[EMAIL PROTECTED]
Subject: RE: Certifications
Date: Wed, 4 Sep 2002 22:41:18 -0400

My 2 cents on this topic. The undeniable reality is that every single
trading partner in healthcare today accepts the "good enough" testing
method. There are no exhaustive test plans on either side. Until now, via
third parties, there has been no attempt at certification against a
standard. We are making progress and it should be encouraged.  Perfection is
a goal.

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