Tag Archives: healthcare

Accidental Violation of HIPAA Compliance

Patient information secrecy is of utmost importance for any healthcare organization and medical professionals due to the risk of being compromised, exposed or accessed. With initiatives and innovation in healthcare IT space by various federal agencies (particularly CMS) and health care providers throughout the country over the years, have embraced healthcare IT innovations to secure healthcare data.

Most providers even today use conventional processes to send and receive medical referrals which could lead to an accidental violation of HIPAA (Health Insurance Portability and Accountability Act of 1996) rules which sets the standards to the use and share of patient-related information to ensure security.

In best practices, referrals are managed by referral coordinators who are in charge of sharing patient information, setting appointments and ensuring closure of the referral loop. The referral coordinator and other staff may be committing HIPAA violations in the following manner:

1. Triplicate Forms– Commonly, medical referrals are conducted using triplicate forms and it contains patient identification information. Such forms are circulated to the Specialists’ office and a copy is kept at the PCP’s office.

2. Patient Information Faxing– Hospitals and clinics relay a lot on faxing. Patient information for referrals are sent via faxes and it is not uncommon for providers to misplace such documents.

3. Use of Personal Portals and Storing Devices– For the ease of communication healthcare providers and referral coordinators repeatedly make use of their personal communication devices or portals like emails, cell phones etc.

According to HIPAA, all those above scenarios fall under the category of accidental violation of HIPAA regulations and such violators are subject to a penalty ranging from $100 dollars to $50,000 per violation depending on how the violation is categorized as.

It is not rare for providers to find themselves in these circumstances like many have in the recent past. Some due to negligence don’t comply with HIPAA regulations and on the other side of the spectrum for criminal activities involving staff misuse. Providers could take immediate actions against this issue and cut their risk in half.

a. Educating your staff on the threat to patient information, HIPAA violation and penalties involved.
b. Establishing standard procedures for staff to follow while dealing with medical referrals.
c. Likewise establishing security infrastructure to secure health data in hospital servers and cloud.

In the long run, these measures will not be enough. These methods do not have the capacity to manage large numbers of medical referrals and providers cannot divert much of their resources to maintain an IT team when there is always a shortage of helping hands.

Healthcare providers need to move away from paper triplicate forms and fax machines and embrace Referral Management Solution.

HealthViewX Referral Management Solution is a comprehensive, multi-channel solution that is secure as it is functional.

Redesigning the Healthcare Delivery Model To Suit The Future

The WHO predicts that in the decades to come to the population of people above 65 will surpass that of children under 5 years of age. Analyzing the current trends, it can be concluded that many of these senior citizens are prone to have one or more chronic conditions.

Chronic conditions could mean more expenses for the payers and more pressure to the system. This is a volatile situation, where the social and demographic changes resulting will have a negative impact on efficiency and per capita cost factor.

To cope with this rise in senior population with chronic conditions, healthcare systems will have to manage the following:

1. Adding human resources:
Perhaps the most obvious but the most important step to adapt is to invest in human resources. It has been observed that human interactions cannot be substituted, healthcare delivery centers who focus on having optimum qualified resources in their care delivery system have more often proved to deliver the better patient experience.

2. Precision Medicine:
Precision medicine is understanding and acknowledging that different patients react to medication and treatment differently due to genetic disposition. Treatment and medication must be engineered to get the best result as possible.

Connected devices and health monitoring equipment that aids in gathering patient information near to real-time helps best possible health outcomes achievable even in the most complex scenarios.

3. Overcoming impending shortage of healthcare professionals:

The proportion of healthcare providers to that of the population is already less than ideal. This trend is said to continue even as the number and necessity of patients multiply. Healthcare providers must find a way to bridge the gap between demand and supply in healthcare. One way to do it is to create new models of care delivery using technology to stretch help across geographic distances. Telemedicine is a viable option available for healthcare professionals to augment their services in order to do more with less time and resources.

4. Holistic Medicine:

Decades of focus on specialization has made healthcare professionals see a disease or its symptom as an isolated case, and the patients are considered cured by only removing the disease. In practice, a person might be suffering from multiple health issues and a simplified isolated view might do more harm than good to a patient.

5. Leading cause and concentrated efforts

In the coming years and even now, termination of a patient’s life is more likely to occur due to traceable lifestyle choices or practices than from any infection or diseases. For example the relation between obesity and disease has for long been proven beyond any doubt, furthermore, obesity and related illness will increase the cost of treating a patient. Therefore a concentrated effort to reduce obesity can bring about a positive result in reducing the possibility of heart disease and stroke.

Like obesity, scientific observation can identify key causes of a disease and healthcare providers can make a concentrated effort in reducing the causes in a population.

These are the most important steps a healthcare provider will have to consider in improving healthcare outcomes.

The transition to a more technology involved healthcare delivery management can tremendously help providers be agiler and more effective with necessary amendments.
Healthcare strategies must be relooked to have a more holistic & flexible approach not only to accommodate CMS led changes but also to benefit the entire population.

Era of A Personalized Care

Humans differ in terms of DNA & Genome Composition. This factor may not necessarily surface as a disorder or a disability but will create variations in the manner each person responds to drugs and treatment for a disease or a condition. In any given population, there is a chance that a group exists who do not respond to any given medication in the desired manner.

Personalized medicine is the practice of designing and conducting medicine tailored to suit an individual patient’s needs with procedures, drugs and treatment approaches. Personalized medicine has been the war cry for many healthcare reformists for decades, but now there is more likelihood of the general healthcare practice widely adopting the idea because of the following reasons.

Change in regulation
Change in attitude
Healthcare technology
The current model is ineffective

Change in regulations:

The US healthcare regulations are changing giving way to implement the new methodology of care delivery and management. The provider reimbursement is being made flexible allowing healthcare professionals the space to adopt their practice for the benefit of each individual. Change in regulations also will lead way to alterations in the structure of organizations; the organizations will be revamped to be more collaborative and serve a population that is demanding quality and services that match any other industry’s methodology.

Change in attitude:

Providers of today have many tools at their disposal and partially due to this reason providers are more willing to embrace change and improve the lives of those whom they serve. The complexity that the modern medicine requires and the practice of handling a large amount of data is almost impossible to manage and generate result without healthcare IT.

Healthcare Technology:

Healthcare Technology is improving and evolving tremendously, allowing both providers and the patients not only to keep track but actively engage in Care Management. The data that is collected by connected devices and the quality of information that is gathered by hospital systems allows for an in-depth analysis of healthcare conditions and concerns.
For those not residing in cities, Healthcare IT means fast care with the focus on those suffering from chronic conditions. In personalized medicine, Healthcare IT can be used to gather personal information and monitor the effects of treatment and medication, and also play as a channel to direct personalized care.

The current model is inefficient:

The current model is inefficient and rigid to incorporate the necessary changes that need to be made to accommodate all the variations required in care delivery. The results are varying and the outcome cannot be accurately predicted. The healthcare sector now works under the assumption that reaction to a medication or procedure is the same for every individual. This is a risky assumption and one which is costing the public their health and money.

Personalized medicine is the future of healthcare, it is the next big idea that is going to shape healthcare delivery for the times to come incorporating technology. We at HealthViewX understand this, and we are determined to create healthcare delivery tools that collect useful patient information to help providers make choose the right path always.

Profiting From Chronic Care Management

Chronic patients care requirements are different when compared to regular patients. In case of chronic patients, the provider should create, and maintain continuous yet flexible care delivery model to accommodate various healthcare requirements. Until the recent past, the provider’s reimbursement plans for Medicare was not flexible enough to hold all the post and pre ER visit care that is necessary for health and well-being of people with chronic diseases.

Chronic Care Management CMS has given providers the needed elasticity and space to work best with their chronic patients. Under the scheme, providers can charge CMS for 20 minutes of non-hospital, non-face-to-face care that they give to patients over a month. This is a great leap in the right direction but given the strict parameters of the program, many providers are concerned that being a part of it will do more harm than good financially. But here are a few steps that can ensure the greater chance of financial success.

Start with the program
Design a standard approach
Employ resources
Review

Start with the program

Yes, this is the less obvious but important step, less obvious because no provider would want to get into a program with outcome unknown. Chronic Care Management has a few unique features such as only one provider shall charge for CCM services. This means by the time a provider makes his mind and assigns resources their patients would have already gone to a different provider.

It is also true that the program and the approach with which it is designed is rather new in the industry today and it will do good for providers to understand and be used to the change.

Design a standard approach

Like all programs CCM would benefit from a standard approach, it will make it easier for providers to alter and adapt it later. A standard approach will also make billing easier & less troublesome. The main idea here is to spot what works best for a practice and if it doesn’t then how it can be changed to arrive at the result that the provider hopes to achieve.

Employ Resources

Provider/ Practice must designate and assign a resource for CCM program. Resources which include human can achieve the objectives better if the program is taken seriously and not like a side assignment without any defined parameters. In most cases, resources are already available and assigned to chronic patients care but adjustments need to be made so that such systems will meet the program parameters.

Review

This step is evident and for the right reasons. The review can help in understanding the causes of malfunction if any. And what is required to make it right and more importantly to know the aim of the exercise – that is improved care quality, is achieved. The introduction of this program CMS has laid the groundwork for healthcare industry’s transformation into a quality based industry in which profitability has linked quality and vice versa. Schedule a demo with us to learn more about Chronic Care Management.

Mobile Health Technology

Mobile phone usage is tremendously increasing day by day. So as a purpose of it, every industry has been reinventing their way of functioning to accommodate the changes mobility has brought in. When people start experiencing new things they become addictive to innovative technology. This transition has also affected healthcare industry on a massive scale.

Current day Health Care system faces many problems such as shortage of nurses, a fewer number of physicians and not to forget about implications of MACRA new physician payment method. It is becoming increasingly tough to operate without relying on technology.

Increase in demand has maximized the need for innovation around mHealth. It is an incredible advancement showing enormous positive results, removing the barriers of the olden days.

Digital transformation in healthcare is great, but the question is “Does technology foster customer to engage in their own health?”

Today, people have numerous options and are confused to pick out one healthcare app on the market. As on date, there are thousands of medical apps listed in mHealth space, which can be accessed from anywhere.

It is beyond certainty that mobile health will help improve care delivery and impact patient outcomes in the near future with a more reliable, and near to real-time data which makes it efficient. However, there’s a security risk attached to it while managing data from different applications.

Data integration is challenging, especially when there is more than one data source. It should be the providers call to choose an optimum health application, and induce patients to use it instead of letting patient choosing according to their choice and leaving compatibility a matter of concern.

Surveys say physicians are reluctant to recommend the use of health applications to their patients. Adapting quick changes is not an easy step for doctors.

Of course, it is neither been easy for patients. Following are some of the benefits of mHealth:

1. Patient engagement

Mobile apps are user-friendly and come free of cost but success ratio to engage patient is relatively less. People have easy access to health tools via smartphones but are not willing to learn to make full use of it.
Progress is possible only when patients show real interest in improving their health. Unless patient’s show dedication there will not be any positive results, and intervention of health applications may not yield desired results.

2. Better Clinical Support

Clinical Decision Support process becomes easier after the integration of EMR with mobile technology. Traditional system has more complexity in the integrated workflow of clinicians. Now, with the use of apps, clinicians can recommend drugs, diagnose and treat patients, and also be aware of current practice guidelines, which reduces their burden of work.

3. Better Communication

Though patients and doctors have face-to-face interactions, problems are not communicated effectively. Improper and non-scientific communication of symptoms makes it difficult for doctors to diagnose the disease.

Also, people with one or more chronic diseases face difficulties in meeting their doctor’s post-discharge. With the help of wearable synced with mHealth apps, doctors can track progress, and also deliver appropriate guidance to ensure they are healthy.

4. Improved Practice Workflow

Doctors can view their patient record instantly anytime, anywhere, and can send the right patient data to specialist during referral process.
Clinically integrated EHR helps a physician to effectively use it in and out of the network. Physician practice workflow becomes convenient and efficient with technology enhancement.

5. Access to Information

Patients can access their health information from portal through mobile apps, and view their record online, download or transfer. Providers can communicate with patients electronically to remind about their meetings with the physician, prescription refill etc.

6. Enhanced Care

Mobile health helps in monitoring patients after they get discharged.
Patient’s 30 days post discharge is the critical time of recovery, and which can avoid possible readmission. Patient health app opens doors to insightful information which can be used to enhance care quality significantly.

Interestingly, mHealth is a fortune that healthcare industry hasn’t utilized to fullest of its potentials.