The HIPAA Security Rule: implications for biomedical devices

The HIPAA Security Rule, with which hospitals must become compliant by April 2005, is broad in scope. Some aspect of this rule will affect virtually every function and department within a healthcare organization. The functions and departments that deal with biomedical technologies face special challenges due to the great diversity of technologies, the variety of data maintained and transmitted, and the risks associated with compromises to data security--combined with the presence of older technology and the absence of integrated expertise. It is essential that hospitals recognize this challenge and initiate steps now to implement appropriate information security management.     

Straight talk: new approaches in healthcare. Are you ready to send HIPPA-compliant transactions? Your cash flow is at stake. Panel discussion

The deadlines are looming for compliance with the transaction and code set requirements set forth in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If your hospital filed for an extension in October 2002, you need to begin testing transactions by April 2003 and sending transactions by October 2003. But don't rely on your technology vendors to give you the ability to send compliant transactions. While vendors can provide the correct computer data format, they can't gather the correct information. If you can't send a compliant transaction, the Centers for Medicare and Medicaid Services could reject your claims, drying up a big percentage of your cash flow.     

National Provider Identifier (NPI) planning and implementation fundamentals for providers and payers

Federal HIPAA legislation mandates that the National Provider Identifier (NPI) be fully implemented across all healthcare entities between May 2005 and May 2007, or 2008 for small payers. Starting May 2005, healthcare providers will be eligible to obtain an NPI and use these numbers to submit claims or conduct other transactions specified by HIPAA. By 2007, the NPI must be used in connection with the electronic transactions identified in HIPAA. Today, individual payers assign unique identification numbers to healthcare providers, and, in most cases, payers assign multiple identification numbers to healthcare providers and their "subparts." As a result, providers have multiple payer-specific identification numbers. The NPI is a unique, 10-digit federal healthcare provider identification number that will be used by all healthcare providers and payers and other healthcare entities involved in administrative and financial transactions associated with health service events and related activities. This article will use software and data experts' knowledge as well as the authors' NPI implementation readiness assessment work to review the impact to both payers and providers, including hospitals, clinics, and other service entities. The authors will suggest planning, budgeting, architecting, and data management solutions for payers and providers to achieve the optimal administrative simplification goals intended by the NPI, without compromising data integrity and interoperability objectives across the service spectrum of the healthcare enterprise.     

Healthcare information security. The threats and the safeguards--and how to manage them

As more and more hospitals have begun storing patient information in electronic form, data security has become a hot topic. With the passage of the Health Insurance Portability and Accountability Act (HIPAA) in the United States, as well as other security legislation across the globe, even more attention has been focused on the subject. In this article, we discuss the various types of security threats faced by healthcare institutions, from external attacks via the Internet to internal violations resulting from malice or simple carelessness. We also discuss what you can do to maintain the privacy and integrity of your electronic records--not only the computer-based safeguards that are available, but also the internal systems and procedures you need to have in place. We tell you how to go about setting up (or beefing up) your institutional security system. And we describe the security efforts being made around the world by governments and standard-setting organizations. This article also includes an extensive glossary of computer-security terms and a listing of useful data-security Web sites.     

Regulation of health information processing in an outsourcing environment

Policy makers must consider the work force, technology, cost, and legal implications of their legislative proposals. AHIMA, AAMT, CHIA, and MTIA urge lawmakers to craft regulatory solutions that enforce HIPAA and support advancements in modern health information processing practices that improve the quality and cost of healthcare. We also urge increased investment in health information work force development and implementation of new technologies to advance critical healthcare outcomes--timely, accurate, accessible, and secure information to support patient care. It is essential that state legislatures reinforce the importance of improving information processing solutions for healthcare and not take actions that will produce unintended and detrimental consequences.     

HIPAA compliance for clinician texting

The HIPAA privacy and security rules need not act as an obstacle to efficient communications, but keeping texting compliant requires planning and diligence.     

Rightsizing HIPAA security compliance for smaller organizations

The HIPAA security and privacy requirements are specifically designed using guidelines rather than hard and fast standards. These guidelines provide flexibility in scaling solutions for small to large organizations to address the law as well as to accommodate advances in technology. However, this very flexibility causes a quandary for smaller organizations because it's unclear how far an organization can scale back and still meet the law's requirements. This is particularly problematic in the security area, where over 20 guidelines permit a wide range of interpretation. This article addresses how much is enough and how to make defensible decisions in HIPAA implementation for smaller healthcare organizations.     

Health integration cost cutting

By combining several traditional approaches to integration with newer innovations, healthcare organizations are finding that problems such as HIPAA remediation and providing secure online access to patient records can be resolved by leveraging integration projects across the enterprise. In the current cost-cutting environment, the projects that get done are those that can be justified by direct impact on additional revenue, can show significant cost savings and extremely fast return on investment, and meet regulatory requirements.     

Security measures required for HIPAA privacy

HIPAA security requirements include administrative, physical, and technical services and mechanisms to safeguard confidentiality, availability, and integrity of health information. Security measures, however, must be implemented in the context of an organization's privacy policies. Because HIPAA's proposed privacy rules are flexible and scalable to account for the nature of each organization's business, size, and resources, each organization will be determining its own privacy policies within the context of the HIPAA requirements and its security capabilities. Security measures cannot be implemented in a vacuum.     

A new privacy framework for the management of chronic diseases via mHealth in a post-Covid-19 world

Aim

New challenges are being faced by global healthcare systems such as an increase in the elderly population, budget cuts as well as the ongoing Covid-19 pandemic. As pressures mount on healthcare systems to provide treatment to patients, mHealth is seen as one of the possible solutions to addressing these challenges. Given the sensitivity of health data, the rapid development of the mHealth sector raises privacy concerns. The aims of this research were to investigate privacy threats/concerns in the context of mHealth and the management of chronic diseases and to propose a novel privacy framework to address these concerns.

Subject and method

The study adopted a modified version of the engineering design process. After defining the problem, information was gathered through literature reviews, and analyses of existing regulatory (privacy) frameworks and past research on privacy threats/concerns. Requirements for a new framework were then specified leading to its development and comparison with existing frameworks.

Results

A novel future-proof privacy framework was developed and illustrated. Using existing regulatory frameworks for privacy and privacy threats/concerns from research studies, privacy principles and their resulting requirements were identified. Furthermore, mechanisms and associated technologies needed to implement the privacy principles/requirements into a functional prototype were also identified. A comparison of the proposed framework with existing frameworks, showed that it addressed privacy threats/concerns in a more comprehensive manner.

Conclusion

This research makes a valuable contribution to protecting privacy in mHealth. The novel framework developed is an improvement on existing frameworks. It is also future-proof since its foundations are built on regulatory frameworks and privacy threats/concerns existing at the time of its deployment/revision.

     

Leveraging HIPAA to support consumer empowerment

The consumer empowerment movement needs to provide consumers with more access and control of their healthcare records. The premise of this article is that there is a fundamental market shift towards consumer empowerment--and technology is the driving force. We contend the results will satisfy the intent of the HIPAA mandate. Two restrictions impede the market from moving toward real consumer empowerment. First, managing one's own health history record is difficult because the complete record is segmented in disparate systems that are difficult to integrate. This is because unique identifiers and consistent coding are nonexistent. Second, security and control of patient identifiable health information is still evolving. There is no consensus among providers for Internet security, as we can see by all the legislative privacy bills trying to address the issue. HIPAA is both a legislative mandate and an enabler of the next healthcare paradigm. Providers must comply with the HIPAA mandates for electronic data interchange (EDI) code sets, administrative simplification, and privacy and confidentiality protocols. By recognizing HIPAA as part of a consumer-driven movement, organizations can incorporate empowerment strategies into a planning process that creates consumer options in healthcare and leverages HIPAA compliance to benefit both providers and consumers. This article suggests methods for meeting HIPAA compliance through innovative consumer empowerment methods.     

Applying your corporate compliance skills to the HIPAA security standard

Compliance programs are an increasingly hot topic among healthcare providers. These programs establish policies and procedures covering billing, referrals, gifts, confidentiality of patient records, and many other areas. The purpose is to help providers prevent and detect violations of the law. These programs are voluntary, but are also simply good business practice. Any compliance program should now incorporate the Health Insurance Portability and Accountability Act (HIPAA) security standard. Several sets of guidelines for development of compliance programs have been issued by the federal government, and each is directed toward a different type of healthcare provider. These guidelines share certain key features with the HIPAA security standard. This article examines the common areas between compliance programs and the HIPAA security standard to help you to do two very important things: (1) Leverage your resources by combining compliance with the security standard with other legal and regulatory compliance efforts, and (2) apply the lessons learned in developing your corporate compliance program to developing strategies for compliance with the HIPAA security standard.     

No more paper tiger: Promise and peril as HIPAA goes HITECH

The HITECH Act, passed in 2009 by the federal government, deepens the concerns for patient privacy faced by healthcare organizations subject to HIPAA. This article examines the law and demonstrates that healthcare entities are facing greater duties to safeguard patients' protected health information, as well as severe civil and criminal penalties should they fail to do so. In recognition of this heightened liability, healthcare entities must reassess their methods for handling patient data and take action in key areas to ensure that risk is contained.     

Telemedicine in daily practice: Addressing legal challenges while waiting for an EU regulatory framework

Telemedicine is revolutionising conventional healthcare thanks to countless technological devices that allow patients to remotely access a huge range of care services. In the coming years, the spread of telemedicine will arguably redesign the geography of EU healthcare, with main repercussions on the organisation of the Member States’ health systems and the extent of health protection in the EU. Given the current lack of an EU regulatory framework for telemedicine, this analysis aims to explore the most relevant acts issued in the field of (conventional) healthcare in order to assess their suitability for telemedicine services. In the conclusion, the need for an adequate regulatory framework of telemedicine in the EU will be discussed, in order to sustain its spread in daily practice and to guide patients and healthcare professionals towards a safe use of these innovative services.     

Implementing HIPAA security in a membership organization

The upcoming HIPAA security regulations are forcing a change in business and operating procedures that many, if not most, healthcare organizations are ill-prepared to tackle. Of all healthcare organizational structures, membership organizations will most likely face the greatest number of obstacles in preparing for and implementing the HIPAA security regulations. This is because the membership organization as a whole must find a way to accommodate the disparate technologies, business and operating methodologies and processes, and available, limited resources of its individual member organizations, and integrate these into a uniform implementation plan. Compounding these obvious difficulties is the unique challenge of enforcement authority. The individual member organizations are autonomous business entities, whereas the membership organization as a whole merely acts as an advisor or consultant, and has only limited enforcement authority over any individual member organization. This article explores this unique situation in depth. We focus on PROMINA Health System, a nonprofit healthcare membership organization that consists of five disparate member healthcare organizations. We examine the challenges PROMINA has encountered in its quest to institute an organization-wide HIPAA security program and its methodology for accomplishing program implementation.     

Compliance with HIPAA security standards in U.S. Hospitals

With the widespread use of computer networks, the amount of information stored electronically has grown exponentially, resulting in increased concern for privacy and security of information. The healthcare industry has been put to the test with the federally mandated Health Insurance Portability and Accountability Act (HIPAA) of 1996. To assess the compliance status of HIPAA security standards, a random sample of 1,000 U.S. hospitals was surveyed in January 2004, yielding a return rate of 29 percent. One year later, a follow-up survey was sent to all previous respondents, with 50 percent replying. HIPAA officers'perceptions of security compliance in 2004 and 2005 are compared in this article. The security standards achieving the highest level of compliance in both 2004 and 2005 were obtaining required business associate agreements and physical safeguards to limit access to electronic information systems. Respondents indicated least compliance both years in performing periodic evaluation of security practices governed by the Security Rule. Roadblocks, threats, problems and solutions regarding HIPAA compliance are discussed. This information may be applied to current and future strategies toward maintaining security of information systems throughout the healthcare industry.     

An innovation platform for diffusing public health practices across a global network

Hospitals and health systems in high-income countries (HIC) develop the capacities of peer healthcare organizations around the world by diffusing clinical, quality, and public health improvement practices in lower and middle-income countries (LMIC). In turn, these HIC healthcare institutions are exposed to innovative approaches developed and used by global communities to advance care despite resource constraints in the LMIC contexts. Attention has been growing in recent years to the potential these innovations can have to improve care delivery, lower costs, and drive quality within resource-constrained communities in HIC. Often referred to as “reverse innovations,” the identification, adaptation, and diffusion of these practices face challenges in uptake related to limited evidence, perceptions of poor quality or irrelevance, and a complicated regulatory and policy environment. This paper suggests the development of an approach to improve the capacity of the healthcare organizations in the HIC as well, based on lessons learned from diffusing practices in LMIC. It concludes with the need for a knowledge platform to support innovation diffusion in both directions.     

The new informatics of national healthcare reform

The President's Health Security Act has succeeded in attracting America's attention. Several of its initiatives have been well-publicized and hotly debated in Congress. The act also includes a number of implications for healthcare informatics, and devotes an entire chapter to this subject, although this area has not received as much publicity. Every behavioral healthcare provider's information system would be significantly affected by enactment of the Health Security Act. Selected forms and data elements for the management and delivery of behavioral healthcare services would need to be standardized. Organizations of behavioral healthcare providers, managed care companies and purchasers would increasingly share selected patient and subscriber information in aggregated form, for a variety of purposes. As a result, tougher laws to protect patient data privacy will likely be forthcoming. The following article gives an overview of the informatics needs of the soon-to-be reformed American healthcare system, into which behavioral healthcare will be integrated. As part of the larger system, behavioral healthcare services and information systems will need to comply with the same guidelines and requirements, outlined below, as other healthcare providers. Preparation to meet the information demands of the evolving healthcare system will require adaptation of existing computerized information systems, utilization of new technology, consultation with the system's major shareholders and attention to continuous quality improvement processes.     

Who's minding the data: information system requirements for participating in at-risk contracts

Managed behavioral healthcare organizations that receive capitated payments to provide behavioral healthcare services for a defined population need sophisticated management information systems that allow for two-way data exchange with payors. Such systems must be able to generate data on cost per service and utilization of services by beneficiary population, while incorporating a number of subsystem capabilities. In this article the author reviews the requirements for such an information system, the various potential financial loss points that have made such capabilities essential and the specific features that are demanded--as well as offering suggestions on how to select an information system vendor.     

Straight talk: new approaches in health care. HIPAA: deadlines are looming. Are providers prepared?

This is the fourth installment in a series of group discussions by top executives on key issues in healthcare today. Modern Healthcare and PricewaterhouseCoopers present Straight Talk. This session tackles the Health Insurance Portability and Accountability Act of 1996, or HIPAA, and where providers are today in the compliance process and where they need to go. The discussion was held on June 4, 2002 at Modern Healthcare's Chicago headquarters. The moderator was Jeffrey P. Fusile, Healthcare Consulting Partner with PricewaterhouseCoopers, Atlanta. The act protects consumers' health-insurance coverage after job changes. It also mandates significant modifications in the way providers handle the submission of claims and other related transactions and provides protection for the privacy and security of patients' health information. The law requires providers to comply with regulations governing electronic transactions and code sets by October 2003--assuming they file for an extension by October 2002--and privacy regulations by April 2003. The security compliance date has not yet been determined, but it is widely agreed that much of the security rules' requirements will be necessary to honor an organization's privacy commitments in April 2003.