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IBM Integration Bus and Support for X12 Transactions (i.e. HIPAA X12 837 V5010)

by on August 11, 2015

(Note:  This is an update to our post:  “IBM WebSphere Message Broker and Support for X12 Transactions” to update for IIB v10 and DFDL)

IBM Integration Bus (IIB) is arguably one of the most mature and feature rich integration platforms.  It has the capability to support any to any transformations of data that includes Fixed Length, Tab Delimited, XML, IDOC, and X12 just to name a few.

IBM has made it easy to support these formats either through wizards to import these structures into IBM Integration Bus (via copybooks, schemas, etc), though pre-built message sets or DFDL that come as part of samples, or through the ability to manually create these message sets to support your integration needs.

However, one area where many clients have had to make many difficult technical and financial decisions have been around X12.  With the new Health Care Reform, ICD-10 requirements, and V5010 of HIPAA X12 formats, there is continued pressure for clients to have a solution within IBM Integration Bus for handling these HIPAA transactions (270, 271, 276, 277, 278, 837, 850).

For those not familiar with HIPAA X12 data, following is an example:

ISA*00*          *00*          *ZZ*111111111     *ZZ*2222222222*33333333*4444*^*555555*66666666*1*T*:~

GS*HC*11111111*22222222222*20110914*4444*1*X*005010X222A1~

ST*837*00000001*005010X222A1~

[Rest of transaction tag delimited segments are removed for space – this 837 can be rather large]

SE*51*00000002~

GE*2*1~

IEA*1*666666666~

As mentioned above, X12 is supported in IBM Integration Bus and there are a few options that should be considered to be able to fully support your HIPAA transactions within IBM Integration Bus.

Option 1:  Use WebSphere Transformation Extender (WTX) and HIPAA Industry Pack for HIPAA EDI

The advantage of this option is that it is an IBM solution and as right now, WTX is currently IBM’s current direction for data mappings across its various products.  It does come at a relatively significant cost as it is an additional product license on top of IBM Integration Bus.  It does fully support the new V5010 HIPAA versions.   As of this post, WTX is NOT supported in IBM Integration Bus v10.

Option 2:  Use 3rd Party Message Sets and IBM Integration Bus Solution

TransformaTech and possibly other companies have IIB Message Sets and DFDL for the HIPAA X12 Transactions.  These can be imported and used immediately for your project needs.  These are solutions that have maintenance options as new versions and mandates come out.   These would be available within IIB regardless of having WTX or not.  The disadvantage is that if you wanted to standardized on WTX, this would be outside this environment.  Also, these Message Sets and DFDLs will be supported by 3rd Party and not part of IBM’s releases.  These Message Sets are signficantly cheaper than purchasing an entire WTX solution to support these needs.

Option 3:  Leverage External EDI Translator

Many organizations have other EDI Translators that can accept, validate, and acknowledge EDI and then transform into more standard XML that IIB can work with.  DTD’s or Schemas can be imported into IIB and the integration begins from there.  There are two main disadvantages in this solution.  (1) Does not centralize your transformations in single broker (i.e. IIB) and (2) It is not feasible for all organizations to have the means (financial, resources, knowledge, etc) to support yet another integration environment.  Especially since many organizations are looking to consolidate and standardize on specific technologies.

Option 4:  Build your own

In most cases, this is not practical.  These HIPAA transactions and requirements are complex and not only require expert knowledge in the HIPAA standards, but also expertise in IBM Integration Bus (specifically with building Message Sets in the X12 domain).  However, if you are up for the challenge, pull out the HIPAA Implementation Guides, IIB Infocenter links, and roll up your sleeves…

In summary, depending on your organization, budget, and project needs, one of the above solutions may be right for you.  The first 3 options provide solution that will provide support of current and future HIPAA X12 versions (assuming in option 2 and 3 you pick a solution that provides this support and maintenance).

It would be great to get comments and feedback on the above (or additional) options.  There are a lot of people and organizations facing the same challenges and could benefit from more collaboration.

TransformaTech

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