This paper analyzes the method and training of a self directed risk assessment methodology entitled OCTAVE (Operationally Critical Threat Asset and Vulnerability Evaluation) at over 170 DOD medical treatment facilities. It focuses specifically on how OCTAVE built interdisciplinary, inter-hierarchical consensus and enhanced local capabilities to perform Health Information Assurance. The Risk Assessment Methodology was developed by the Software Engineering Institute at Carnegie Mellon University as part of the Defense Health Information Assurance Program (DHIAP). The basis for its success is the combination of analysis of organizational practices and technological vulnerabilities. Together, these areas address the core implications behind the HIPAA Security Rule and can be used to develop Organizational Protection Strategies and Technological Mitigation Plans. A key component of OCTAVE is the inter-disciplinary composition of the analysis team (Patient Administration, IT staff and Clinician). It is this unique composition of analysis team members, along with organizational and technical analysis of business practices, assets and threats, which enables facilities to create sound and effective security policies. The Risk Assessment is conducted in-house, and therefore the process, results and knowledge remain within the organization, helping to build consensus in an environment of differing organizational and disciplinary perspectives on Health Information Assurance.