A Look Inside WEDI and its Collaboration with the Health IT Industry

By Charles Stellar, President and CEO, Workgroup for Electronic Data Interchange (WEDI)
Twitter: @WEDIonline

Every healthcare encounter is a collaboration: between patient and provider, physician and lab tech, patient and support staff. Each participant in the healthcare spectrum plays a vital role that supports quality outcomes.

The Workgroup for Electronic Data Interchange (WEDI) has been facilitating the needs of the health IT industry since its creation in 1991 by the secretary of Health and Human Services. During our 25-year history, WEDI has worked to remain on the forefront of every major health IT issue facing our industry.

WEDI brings together key organizations from across the healthcare spectrum, leveraging the industry’s collective technology, knowledge, expertise and information resources to improve the movement, quality, security and cost-effectiveness of healthcare information. Our membership represents a diverse cross-section of the healthcare industry, including health plans, providers, standards organizations, IT vendors and government entities.

Making progress, one issue at a time
Working collaboratively through policy advisory groups (PAGs), technical advisory committees (TACs) and open forums, WEDI receives input from stakeholders on significant issues facing the industry, distilling that input into actionable recommendations for change.

Through its membership, WEDI has:

  • Developed the foundation of administrative simplification provisions within the Health Insurance Portability and Accountability Act (HIPAA) in 1996
  • Produced a Health ID Card guide required for use by the Centers for Medicare & Medicaid Services (CMS) in Medicare Managed Care Part D and used by some commercial health plans
  • Through our ICD-10 workgroup, developed comprehensive educational resources and a coding and testing website that supported the successful transition to the new code set
  • Partnered with government agencies including CMS, OCR, and ONC on numerous industry health IT education and outreach initiatives
  • Testified multiple times before federal advisory bodies on important health IT issues
  • Established dozens of workgroups focused on established topics such as transactions and security and emerging issues including payment models and genomics

A strategy for the industry
WEDI’s strategic plan for 2017 ensures our key initiatives are driven by our strategic priorities—collaboration and outreach, our advisory role, knowledge and excellence, and sustainable growth.

As the industry struggles with challenges regarding prior authorization, multiple initiatives have emerged focused on important, but differing, priorities. In our role as industry convener and adviser, WEDI recently launched the Prior Authorization Council, an industry forum where each participating organization can share their results, learn from their colleagues, and identify areas of common ground for innovation.

The National Committee on Vital and Health Statistics (NCVHS) once again requested testimony on the Health Plan Identifier (HPID). Based on feedback from our membership obtained through several policy advisory groups, technical advisory committees, and sessions held during conferences, WEDI’s recommendation is the HPID is not needed and, specifically, should not be used in the standard transactions.

WEDI members have the opportunity to influence the direction of health IT policy through participation in WEDI’s many workgroups and subworkgroups. Topics cover the gamut of everything related to the use of health information technology to improve healthcare information exchange, enhance quality of care, improve efficiency and reduce costs. From workgroups on health plan ID, genomics, data exchange, payment models, security and privacy, among so many others, there’s a place for everyone’s input as a WEDI member to drive real change and bring impactful insights to the industry. Some such initiatives currently and recently underway include:

  • The Prior Authorization Subworkgroup has created the Prior Authorization Challenges and Best Practices whitepaper, due to be released soon by WEDI. This document will outline industry challenges related to prior authorization workflows, transaction implementation, and process automation and offer best practices suggested by the Subworkgroup. The document will also provide sample workflows that illustrate how the concepts outlined in the best practices could be implemented.
  • The Remittance Advice and Payment Subworkgroup has created the Barriers to Adoption of the ERA and EFT Transactions whitepaper, also due to be released soon by WEDI. The purpose of this paper is to identify barriers to adoption of the HIPAA-standard ERA and EFT transactions (835 and CCD+), to discuss in detail the reason behind these barriers, and to suggest steps that providers, payers, trading partners, and vendors can take to eliminate the barriers and implement the transactions.
  • The Innovative Encounters Workgroup has published the Introduction to Telehealth Codes. This issue brief provides introductory information on codes for telehealth services, development of codes for telehealth services, and challenges with telehealth coding.
  • The Payment Models Workgroup has published Electronic Payments: Guiding Principles. The purpose of this principles document is to establish a consensus-driven set of principles that each impacted stakeholder can review and adopt in an effort to drive adoption of ACH EFT while at the same time establishing guidelines for the use of alternative payment options.
  • The Genomics Workgroup has published Maximizing the Potential of Genomic Information to Improve Care Coordination and Health Outcomes. This whitepaper explores how genomic information could optimize clinical genomics care coordination, including how genomic data can be leveraged to improve health and care at both individual and population levels. It examines a number of clinical situations and life stages during which genomic information is generated, how health care providers access and use that data, the infrastructure needed for effective use of the data and the financial drivers of genomic data use for improved health care.

Member-focused, member-driven
At the core of the organization, WEDI benefits its members with insightful education programming tailored specifically to meet the needs of healthcare IT executives, managers and other related professionals.

The face-to-face networking opportunities with members and sponsors enable a collaborative forum to share solutions that address critical business opportunities and challenges. WEDI provides a multitude of networking opportunities throughout the year with industry experts, decision-makers and peers within the government and healthcare sectors.

Members also have access to a comprehensive knowledgebase featuring information on health IT best practices, methodologies, and data exchange models. Materials include white papers, issue briefs and webinars that help member organizations readily adapt to rapidly evolving business environments and regulatory requirements.

Our membership base receives regular updates on regulatory, legislative, and standards changes, as well as industry news.

To learn more about how WEDI is bringing positive changes to the healthcare IT industry, visit the WEDI website.