"Rachel possesses a rare combination of business acumen, technical expertise, project management skills, in-depth Healthcare Industry knowledge, and electronic commerce expertise. She was a valuable member of the project team, and contributed greatly to its success."    
 

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Rachel Foerster is a Senior Consultant with Boundary Information Group headquartered in Denver and the CEO of Rachel Foerster & Associates, Ltd. in Beach Park, Illinois, an independent consulting practice founded by her in 1993 dedicated to assisting the health care industry with the transition to Electronic Commerce.

She is well known within the EDI arena due to her leadership positions in several industry organizations. In addition, her 22 years of experience with Baxter Healthcare Corporation, the world's leading hospital supply company, included consulting and implementation responsibilities for EDI for Baxter and its customers. Her experience includes over 20 years designing, developing and implementing a variety of proprietary and standards-based EDI systems to support hospitals, distributors, manufacturers and other organizations for on-line, batch and interactive electronic linkages. Specific areas of focus included HIPAA, materials management and financial EDI implementations. Additionally, she has helped clients develop sound strategies and implementation plans for EDI that ensured the achievement of specific objectives.

Rachel was a U.S. designated EDI expert to the UN/CEFACT Techniques & Methodologies Work Group, where she participated in the global UN/CEFACT continuation of the ebXML™ Initiative's effort to provide a common framework to enable the consistent use of XML for global electronic business. Her distinguished career includes leading the effort to introduce the EDI standards to the health industry, past chair of the Health Industry Business Communications Council’s (HIBCC) EDI Technical Committee, active membership at the ANSI ASC X12 EDI Standards committee, which develops the standards on which HIPAA’s electronic transactions are based, and active participation in many of the WEDI SNIP work groups developing guidance for the industry as it transitions to EDI required by HIPAA. Rachel is a member of The EC Institute's Advisory Board, a cooperative venture among Data Interchange Standards Association, The Colorado Electronic Commerce Roundtable, the University of Denver and other major universities, government agencies and industries to create programs that will certify the professional abilities of electronic commerce practitioners. She is also a member of Health Level Seven (HL7), an ANSI-accredited and global standards development organization that develops specifications that enable disparate healthcare applications to exchange clinical and administrative data, and HIMSS, the Health Information Management & Systems. Rachel is also actively participating in the work of HITSP to develop harmonizing and integrating standards that will meet clinical and business needs for sharing information among organizations and systems.

Rachel has presented and conducted numerous EDI workshops and educational seminars for all levels of management for many payers, health care providers, manufacturers, distributors, national EDI associations, as well as companies in other industries and governmental agencies. These include several HIPAA Summits, the annual Data Interchange Standards Association Electronic Commerce Conference, EDI in Government, HIBCC, EDI 2000, and Inside EDI conferences, seminars sponsored by hospital associations in California, Tennessee, HCFA, NEIC, HEDIC, the Mid-Atlantic Health Congress, and the New Jersey Hospital Association’s Health, Research and Education Trust, and various regional EDI User Groups. In addition, Rachel was a member of the faculty of the Data Interchange Standards Association EDI/Electronic Commerce seminars and was formerly  an Adjunct Lecturer for Healthcare EDI at the University of Illinois, Chicago, Department of Health Information Management, College of Associated Health Professions.

Rachel has published articles in Healthcare Automation, Surgical Services, Medical Industry Information Report, Medical Products Sales, Journal of the American Health Information Management Association, Healthcare Purchasing News, EDI Forum, EDI World, and the European Medical Electronic Data Interchange Newsletter. She has authored Successfully Implementing EDI: A Project Team’s EDI Planning Guide, EDI: A Strategic Approach for Implementation, and An EDI Primer for Health Care. She is the co-author of An Executive Primer: Health Care Reengineering, and An Executive Primer: Information Technology Strategies—How to Formulate an Information Technology Strategy to Ensure Competitive Advantage. Rachel studied at Northwestern University, Evanston, Illinois, Roosevelt University and Mundelein College in Chicago.

Major consulting projects include:

·        Providing on-going health care EDI and electronic messaging standards subject matter expertise and staff support to the Council for Affordable Healthcare and its Committee on Operating Rules for Information Exchange (CORE®), a multi-stakeholder national effort which develops the health care industry’s operating rules enabling interoperability between health care providers, health plans, and clearinghouses for on-line real time insurance eligibility verification and other administrative transactions. Rachel has been a key consultant for CAQH since 2004 and has represented CAQH CORE® in several important health care health information technology efforts since the launch of CORE, such as

o   ASC X12 Standards Committee including the X12N Insurance Subcommittee’s Health Care Task Group where the various administrative transactions are developed, including those mandated under HIPAA

o   HL7 Attachments Work Group responsible for developing the various clinical document standards for the exchange of clinical documents to support health care claims, prior authorization, and clinical documentation required by the CMS Medicare Recovery Audit Contractors

o   HHS Office of the National Coordinator (ONC) work on various aspects of Health Information Technology, the Nationwide Health Information Network (NwHIN) support for the exchange of administrative transactions through its Standards & Interoperability (S&I) Framework Initiatives (e.g., CMS esMD project, provider directories) into which the specifications of both the CORE Connectivity Rule and the Integrating the Healthcare Enterprise (IHE) transport and messaging profiles (e..g, XDR) are being incorporated

o   Health Information Technology Standards Panel (HITSP) formed for the purpose of harmonizing and integrating standards that will meet clinical and business needs for sharing information among organizations and systems. HITSP’s work has now been subsumed into the ONC S&I activities

o   Support CAQH CORE’s submission for recognition as the Operating Rules Authoring Entity and the adoption of the CORE Eligibility and Claim Status Operating Rules as required by ACA Section 1104

·        Providing strategic recommendations and input to a major health plan’s strategic planning efforts for HIPAA transactions and code sets as well as conducting an overall HIPAA Compliance Project evaluation to ensure that the client’s HIPAA project was on track.

·        Providing HIPAA EDI project management support and custom staff training services to a major Blue Cross Blue Shield insurance company which has responsibility for processing the Federal Employees Program for government employees, dependents, retired military and their dependents which select the Blue Cross Blue Shield insurance option.

·        Conducting numerous HIPAA Provider Awareness Seminars for providers in three states over a two-year period for a major Blue Cross Blue Shield insurance company

·        Developing and conducting a focused HIPAA and healthcare industry workshop for a special National Institute of Standards & Technology (NIST) research laboratory to enable the decision-making for NIST standards development strategies for HIPAA electronic transactions

·        Developing and conducting customized HIPAA electronic transactions workshops focused on both the regulatory requirements and technical specifications for all HIPAA transactions for several major health plans and integrated healthcare systems

·        Assisting a major purchasing cooperative of floor covering products and services retailers to develop a strategic, tactical and comprehensive project plan along with business and IT functional requirements for the creation of a flooring industry electronic market. The client called in Rachel Foerster & Associates to assist in developing a turn-around strategy following a 2-year failed effort.

·        Developing an IT and electronic business strategy and architecture for a health care imaging products purchasing cooperative of almost 100 independent x-ray and imaging products dealers.

·        Assisting a major life reinsurance company to develop an electronic commerce business plan.

·        Analyzing and designing an automated electronic contract notification process using standards-based EDI and web-based electronic information technologies for a major medical products manufacturer and distributor.

·        Analyzing business requirements and developing EDI specifications for a leading medical technology product manufacturer as part of its worldwide J.D. Edwards conversion project. This effort also included managing and coordinating the conversion of several thousand customers from a legacy mainframe-based EDI system to an EDI/400 EDI system with minimal customer impact.

·        Developing a global EDI and product bar code strategy for the global operating division of a major international pharmaceutical manufacturer.

Prior to founding Rachel Foerster & Associates, Ltd. Rachel spent 22 years with Baxter Healthcare Corporation. A summary of her key responsibilities while with Baxter includes:

EDI/ASAP Market Manager responsible for:

·        Conducting market research and analysis to identify customer business requirements

·        Conducting market research and analysis to assess competitor capabilities

·        Identifying and developing business and functional requirements for customer facing internal EDI and pre-order processing systems

·        Providing liaison to internal IS organization representing multiple Baxter operating units for EDI and other customer-facing systems needs

·        Working with IS organization in the design, development and deployment of new and/or enhanced EDI systems, both mainframe host based as well as PC-based customer site
systems

·        Supporting 13 regionally-located field customer EDI implementation support specialists to identify new requirements, resolve problems, aid in on-site EDI systems implementation

·        Introducing X12 standards-based concepts to major software vendors in the health care industry with the goal of persuading them to implement support for EDI 850/855 PO & POA for hospital medical products ordering

·        Providing EDI training and education for corporate management, field sales force, internal IS staff, field customer support staff and customers

·        Official representative to ANSI ASC X12 Standards Development Committee

·        Official representative and Chair of Health Industry Business Communications Council EDI Technical Committee

EDI/ASAP Business Unit Liaison responsible for:

·        Providing internal consulting and liaison between several Baxter operating units and the IS organization for the development of new and/or enhanced customer-facing systems

·        Identifying business requirements for new and/or enhanced customer-facing systems

·        Managing implementation of EDI interfaces between Baxter and its customers

·        Developing functional systems requirements and work with internal IS development staff to design, develop and deploy new and/or enhanced systems

·        Official representative to ANSI ASC X12 Standards Development Committee

·        Official representative and Chair of Health Industry Business Communications Council EDI Technical Committee

EDI/ASAP Systems Project Leader responsible for:

·        Designing, developing and deploying the first mainframe-based, high-performance, integrated EDI system in the health care industry

·        Establishing and supporting communications connections to several EDI Value-Added Networks and direct real-time online communications with over 3,500 hospital customers

·        Designing, developing and deploying first use of ANSI ASC X12 EDI standards with Hospital Corporation of American hospitals

·        Designing, developing and converting mission-critical proprietary EDI systems from Burroughs large systems platform to IBM large systems platform supporting over 10,000 customer and sales force remote dial-up terminals to new platform without impact to users

·        Providing training, education and technical support to the EDI Help Desk and Customer Hotline support team

·        Official representative to ANSI ASC X12 Standards Development Committee

·        Official representative to Health Industry Business Communications Council EDI Technical Committee