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“It’s time to get connected” per the office of the National Coordinator for Health Information Technology. “Begin participating in 2011 and 2012 to earn the maximum incentive – up to $44,000 for Medicare and up to $63,750 for Medicaid!” “Certified EHR technology can help improve the quality of health outcomes and the efficiency of healthcare, while providing privacy and security safe guards.”
American Medical News January 31, 2011
from Merriam-Webster’s Dictionary
a : the quality or state of being apart from company or observation : seclusion b : freedom from unauthorized intrusion <one's right to privacy> 2 archaic : a place of seclusion 3 a : secrecy b : a private matter : secret 1
from Merriam-Webster’s Dictionary
1: marked by intimacy or willingness to confide <a confidential tone> 2: private, secret <confidential information> 3: entrusted with confidences <a confidential clerk> 4: containing information whose unauthorized disclosure could be prejudicial to the national interest — compare secret, top secret
from Merriam-Webster’s Dictionary
1: the quality or state of being secure: as
a : freedom from danger : safety b : freedom from fear or anxietyc : freedom from the prospect of being laid off <job security> 2 a : something given, deposited, or pledged to make certain the fulfillment of an obligation b : surety 3: an instrument of investment in the form of a document (as a stock certificate or bond) providing evidence of its ownership 4 a : something that secures : protection b (1) : measures taken to guard against espionage or sabotage, crime, attack, or escape (2) : an organization or department whose task is security
Medical Office Patient Privacy
Patient Physician Staff Other healthcare entities for “continuity of care” Billing Insurance company State: Dept. of Health NJ-DYFS, legal Federal: HHS, OCR, HIPAA privacy and security RHIO/regional health information organizations HIE/health information exchange
The Health Insurance Portability and Accountability Act (HIPAA) of 1996
Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other important purposes. Security Rule specifies a series of administrative, physical, and technical safeguards for covered entities to use to assure the confidentiality, integrity, and availability of electronic protected health information. Covered Entities
Healthcare providers & business associates (electronic billing transactions) Health plan (insurance company) Healthcare clearinghouse
HIPAA Security Rule
Risk analysis and management Administration safeguards: security management process and personnel Information access management Workforce training and management Evaluation Physical safeguards: facility access and control, workstation and device security Technical safeguards: access control, audit control, integrity control, transmission security
Federal Penalties For HIPAA Violation
Civil Money Penalties. OCR may impose a penalty on a covered entity for a failure to comply with a requirement of the Privacy Rule. Penalties will vary significantly depending on factors such as the date of the violation, whether the covered entity knew or should have known of the failure to comply, or whether the covered entity’s failure to comply was due to willful neglect. Penalties may not exceed a calendar year cap for multiple violations of the same requirement. $100 to $50,000 or more per violation Calendar Year Cap $1,500,000
Criminal Penalties. A person who knowingly obtains or discloses individually identifiable health information in violation of the Privacy Rule may face a criminal penalty of up to $50,000 and up to one-year imprisonment. The criminal penalties increase to $100,000 and up to five years imprisonment if the wrongful conduct involves false pretenses, and to $250,000 and up to 10 years imprisonment if the wrongful conduct involves the intent to sell, transfer, or use identifiable health information for commercial advantage, personal gain or malicious harm. The Department of Justice is responsible for criminal prosecutions under the Privacy Rule.
Expensive equipment, software and support
First year EHR “best case” $46,680 per physician (Modern Health 03/11)
Changes ALL established workflows ALL staff requires extensive and expensive ongoing training Doctor in solo practice becomes IT help desk Privacy risks, data breaches, huge potential penalties Malfunctions costing time and money No ongoing revenue stream to pay for EHR after 2014 Study Looks For, Can’t Find Much Evidence of E-Health’s Benefits Wall Street Journal Health Blogs January 21, 2011
Are electronic health records (EHR) keeping you from recognizing patient depression?
EHRs are generally thought to improve health care by allowing better coordination of care and increased accuracy in diagnosis and treatment. But the UF study raises questions about how computerized records systems could affect mental health care. EHRs have forced primary care physicians (PCPs) to focus on the computer screen, and a new study from the University of Florida indicates that this trend may be keeping PCPs from recognizing and properly treating some cases of depression. Practices still using paper records appear to be diagnosing and treating more cases of depression than PCP practices using EHRs, according to results of a study led by Jeffrey S. Harman, PhD, of the University of Florida and published recently in the Journal of General Internal Medicine.
A Major Glitch for Digitized Health-Care Records
BY STEPHEN SOUMERAI AND ROSS KOPPEL
WSJ - September 17, 2012, 7:25 p.m. ET “Savings promised by the government and vendors of information technology are little more than hype.”
In two years, hundreds of thousands of American physicians and thousands of hospitals that fail to buy and install costly health-care information technologies—such as digital records for prescriptions and patient histories—will face penalties through reduced Medicare and Medicaid payments. At the same time, the government expects to pay out tens of billions of dollars in subsidies and incentives to providers who install these technology programs. The mandate, part of the 2009 stimulus legislation, was a major goal of health-care information technology lobbyists and their allies in Congress and the White House. The lobbyists promised that these technologies would make medical ...
EHR Digital Health Data Privacy?
03/27/10 - 61,000 medical records stolen from laptop in employee's parked car from Cincinnati Children's Hospital Medical Center 02/27/11 - Mass. General to pay $1M to settle privacy claims 02/16/11 - West Virginia Attorney General Darrell McGraw today announced actions by his office and the Charleston Area Medical Center (CAMC) to secure the private information of 3655 patients affected by a data breach on a website set up for CAMC 02/12/11 - Health Records Stolen From Van, 1.7 Million People Affected in NYC 02/05/11 - About 2,400 Medi-Cal recipients in San Francisco had their names, Social Security numbers and other identifying information breached as part of an employee dispute at Human Services Agency of San Francisco, officials said. 01/30/08 - Horizon Blue Cross Blue Shield of New Jersey has notified its members that an employee laptop computer containing personal information -- including Social Security numbers -- for about 300,000 individuals was stolen January 5, 2008 from Newark, NJ building. 04/14/06 - Stolen laptop contains personal information on about 38,000 members from Aetna
http://datalossdb.org/incidents/274-stolen-laptop-contains-personal-information-on-about-38-000-members http://www.databreaches.net/ http://www.informationweek.com/news/security/showArticle.jhtml?articleID=206100526
Data Breach Sparks Worry
Hack Attack at Card Processor Compromises Thousands of Accounts
WALL STREET JOURNAL: BUSINESS - March 30, 2012 A card-processor security breach hits MasterCard and Visa, putting cardholders at risk Concerns about credit-card security heightened Friday after a little-known Atlanta company disclosed it had been hit by hackers, potentially exposing hundreds of thousands of account holders to fraud.
Small health organizations not prepared to secure data, survey finds
American Medical News
News in brief - March 12, 2012
More than 90% of small health care organizations have experienced a data breach, but only 30% said they had adequate resources to make sure privacy and security requirements are met, according to a survey by Ponemon Institute, a health data consultant. For the study "Data Security in Small Healthcare Organizations," published Feb. 16, Ponemon surveyed 708 organizations with 250 or fewer employees and found that many are not placing enough emphasis on meeting security requirements. Just 31% said organization owners and managers view privacy and security as a top priority. Thirty-five percent said no one in the organization has overall responsibility for protecting patient data, and 48% said negligent employees with access to data were the biggest threat.
Health Data Breaches Up 97% in 2011
Redspin, Inc. report calls for tougher HIPAA standards, regular security audits, and more employee education
Redspin’s 2011 PHI Breach Analysis, relied on information from the Department of Health and Human Services' documents of health data breaches recorded between October 2009 and November 2011. The analysis showed that of 385 breaches of protected health information during this period, 39% occurred on a laptop or other portable device, 25% occurred on a desktop PC or server, and 60% resulted from malicious intent such as theft or hacking. Last year saw an unprecedented level of data breaches carried out by hackers and other unauthorized individuals who either stole or unlawfully snooped into the private health records of patients. According to recently released research from Redspin Inc., in 2011 breaches of protected health information (PHI) increased 97% over 2010. The numbers also show that 19 million patients' health records were affected, and 59% of all breaches involved a business associate.
Breaches Affecting 500 or More Individuals From HHS.gov Website
As required by section 13402(e)(4) of the HITECH Act, the Secretary must post a list of breaches of unsecured protected health information affecting 500 or more individuals. The following breaches have been reported to the Secretary:
Occupational Health Partners State: KansasApprox. # of Individuals Affected: 1,100 Date of Breach: 5/12/10Type of Breach: TheftLocation of Breached Information: Laptop Oconee Physician Practices State: South CarolinaApprox. # of Individuals Affected: 653 Date of Breach: 5/09/10Type of Breach: TheftLocation of Breached Information: Laptop Sinai Hospital of Baltimore, Inc. State: MarylandBusiness Associate Involved: Aramark Healthcare Support Services, Inc.Approx. # of Individuals Affected: 937 Date of Breach: 5/03/10Type of Breach: OtherLocation of Breached Information: E-mail Comprehensive Care Management Corporation State: New YorkApprox. # of Individuals Affected: 1,020Date of Breach: 4/30/10Type of Breach: Theft, Unauthorized AccessLocation of Breached Information: Laptop, Desktop Computer, Network Server, E-mail
HHS list of data breaches involves about 21 million patients from 2009 - 1012
The HHS Office for Civil Rights has listed on its website 477 data breaches affecting almost 21 million patients (20,970,222), the OCR said since 2009, with 54% of those incidents linked to theft and 6% tied to hacking. TRICARE of DOD - 4.9 million records lost when backup tapes went missing. Health Net - 1.9 million records lost when hard drives went missing NYCity Health & Hospitals - theft of 1.7 million electronic medical records; AvMed Health Plans in Florida, which reported the theft of a laptop with 1.22 million patient records; and Blue Cross Blue Shield of Tennessee, which reported the theft of an external hard drive with 1.02 million records. WellPoint - 31,700 customer records via hack to a network server, according to the report. Nemours Foundation - 1.05 million records data backup tapes lost
Patient Records at Physician Practice in Illinois Held Ransom by Hackers
Electronic medical records for patients of Surgeons of Lake County in Libertyville, Ill., were recently held hostage by hackers who attacked the computer network, infiltrated and encrypted the server and sent a ransom note to the physicians demanding payment for access to the records, according to a Bloomberg report. Instead of responding to the ransom, the physicians turned the server off and notified authorities, refusing to pay. The outcome of this data breach was not disclosed, and it is not clear if the surgical center's records were backed up or recovered, according to the report.
Your Medical Records May Not Be Private: ABC News Investigation
The HIPAA Enforcement Rule
from HHS.gov website
The HIPAA Enforcement Rule contains provisions relating to compliance and investigations, the imposition of civil money penalties for violations of the HIPAA Administrative Simplification Rules, and procedures for hearings. The HIPAA Enforcement Rule is codified at 45 CFR Part 160, Subparts C, D, and E. Enforcement activities & results How to file a complaint News archive
Legal risks of going paperless
By ALICIA GALLEGOS, amednews staff Posted March 5, 2012
System breaches Modification allegations E-discovery demands EHRs and new tort claims
Electronic medical records are meant to save time and money, but they also can create liability issues for doctors.
NYCLU: e-records should protect patient privacy
Associated PressPosted: 03/07/2012
ALBANY, N.Y.—The New York Civil Liberties Union says privacy protections are needed for patients as the state develops electronic networks for sharing medical records. The advocacy group says New York has invested more than $840 million to develop electronic networks for medical records. The networks eventually will allow health care professionals and insurers to access a patient's complete medical history. NYCLU executive director Donna Lieberman says that while easily shareable records can improve medical care, they also can pose a threat to privacy. The group is proposing a series of steps to protect patient privacy, including an opt-out option for patients. The NYCLU also says that New York should prohibit the health information-sharing networks from selling patients' private health data.
NYCLU - Civil liberties group criticizes health information exchanges over privacy
A lack of standards on sharing data could put patient records at risk, according to a report.
By Pamela Lewis Dolan, AMEDNEWS staff. Posted April 10, 2012
A report by the New York Civil Liberties Union examining health information exchanges in the state questioned the legalities of the patient privacy policies in place and criticized the exchanges for not doing enough to protect patients.
Privacy, Confidentiality and Security
"You Have Zero Privacy Anyway. Get Over It” Scott McNeely, CEO Sun Microsystems, 1999.
“There can be no privacy, confidentiality or security on the internet/web for ANY DATA. Once the data leaves your office, it belongs to others.” Craig M. Wax, DO, Physician, 2008
EHR: Privacy and Security LOL
Which is most important in the practice of medicine? Privacy, confidentiality and security Insurance company reimbursement Government controls and compliance
TAKE HOME MESSAGE: Do you want your “privates” made public by the insurance industry and the government? Consider record keeping method carefully before leaping
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