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 |