complying with HIPAA regualtions

HIPAA in a Nutshell

complying with HIPAA regualtions

Learn more about the landmark Health Insurance Portability and Accountability Act (HIPAA), why it was enacted, and who it applies to. (Photo courtesy of pixabay)

The following guest post on the HIPAA law was submitted by Shae Holland.

HIPAA regulations represent a major transformation in the way healthcare organizations handle information regarding their patients. All patients should understand their rights, just as all healthcare facilities must know and conform to the privacy standards. Let’s examine the ins and outs of HIPAA regulations and what they mean for you.

What You Need to Know

HIPAA is an acronym that stands for the Health Information Portability and Protection Act. It was initially passed in 1996 and was the first protective act in the United States passed on behalf of patients’ personal information.

HIPAA was designed to ensure that your healthcare information is only accessed and shared with your permission, and only in the following contexts:

● Coordinating information about your care and treatment
● Providing information to your family, significant other, or friends who are directly involved in your treatment
● Assessing the quality of care provided by the doctor or healthcare facility in question
● Relaying any information requested by law enforcement agencies

The sharing of patients’ personal information in any other context is unlawful and can lead to heavy fines and even heavier settlements — sometimes heavy enough to force an noncompliant business or facility to close. (But more on that later.)

HIPAA regulates many other areas of the healthcare industry as well. Because we’re only covering the basics, we won’t go into detail about all of them. But HIPAA also regulates

● Doctor and Patient Reimbursement
● Coding
● Security
● Care Management

Your Rights According to HIPAA

HIPAA gives you the ability to do any of the following:

● View the information listed in your health records
● Request corrections to information on said records
● Decide who can access and share your health information (and more importantly, who can’t)
● Require providers and other healthcare facilities to request permission to share your information for marketing and other non-treatment purposes
Is All of My Information Protected?
● Any information a doctor puts in your medical record
● Information stored within the computer system of your health insurer
● Billing information from your healthcare provider
● Conversations your doctor has with nurses or other physicians regarding your treatment or care

If at any time you feel that your privacy rights have been violated, HIPAA regulations allow you to file a complaint with Health and Human Services, or file a complaint directly against your insurer or provider.

Why HIPAA Compliance Is So Important

Failure to comply with HIPAA regulations can result in many negative consequences for a healthcare provider or even a small practice; these include both civic and criminal penalties. Fines can be extraordinarily hefty — in 2013, Advocate Health System of Downers Grove, IL, settled three claims of HIPAA violation for $5.55 million.

Who Has to Comply With HIPAA, and Who Doesn’t?

HIPAA does not apply to every healthcare provider, but it does apply to most of them. All healthcare workers must undergo some kind of training or education on HIPAA compliance.

Health Plans: Health insurance companies, company health plans, HMOs, and even certain programs provided by the government (Medicare, Medicaid) must follow HIPAA regulations.

Healthcare Providers: Any provider who conducts business electronically must comply with all recent regulations.

Clearinghouses: Entities that process non-standard patient information must follow these rules as well.

The following are a few of the groups who don’t need to comply with HIPAA regulations:

● Employers
● Workers Compensation Carriers
● Life Insurers
● School Districts
● Law Enforcement Agencies

Conclusion

For over two decades HIPAA has sought to improve the safety and accessibility of medical records. Compliance can be complicated and even annoying for healthcare providers and related businesses, but the benefits of additional personal information security are worth it. After all, it’s a healthcare provider’s job to protect their patients’ health; protecting their personal information and privacy is a natural addition to that duty.

Author bio:

Shae Holland is a professional copywriter with expertise on a range of topics. She’s passionate about healthy living, loves hunting, and adores her two springer spaniels.

 

big data

How Big Data is Changing Medicine

big data

Big Data is more than just a buzzword in healthcare – it is fundamentally changing care delivery as we know it. (Photo courtesy of pexels.com)

The following guest post on big data in healthcare was submitted by Chris Saviano.

Big Data is one of those buzz terms you’ll see all over the internet. Something about it sounds slightly sinister, like Big Tobacco. But Big Data is more innocuous: it’s just a term used to define large amounts of data. It can encompass any sort of data coming in, from marketing and demographics data to stock ticker data. In the terms of healthcare, that will mean electronic medical records data, aggregated research and payer information, to name a few sources. And this Big Data is changing medicine in a big way.

Improved technology

Monitors themselves are changing, thanks to Big Data. CNBC reported on a tiny heart monitor patch that can generate 30,000 pages of data on a patient’s heartbeat, and then distill it into a 15-page full report for physicians. The device is made up of a chip and two electrodes.

All of these data points are compiled into a huge database, which grows with each new patient the device monitors. The machine-learned capability gets smarter with each new addition. Then with each new set of data, that helps doctors diagnose faster.

Patient care streamlining

One of the more noteworthy ways Big Data is changing medicine is through better patient care, the heart of any good medical facility. Large amounts of data collected from patients can help doctors educate patients during treatment decisions. Having a wider set of data available helps doctors tailor solutions to each patient.

One of the biggest advantages of Big Data is that it offers a predictive model for patient outcomes. This can result in earlier diagnosis and reduced mortality from conditions like sepsis or congestive heart failure.

According to MapR: “A machine learning example from Georgia Tech demonstrated that machine learning algorithms could look at many more factors in patients’ charts than doctors, and by adding additional features, there was a substantial increase in the ability of the model to distinguish people who have CHF [congestive heart failure] from people who don’t.”

Increased security

MapR also reported on the security features of Big Data in healthcare. Predictive analytics help payers identify inaccurate claims and fraud. Big Data helps with this in that companies can go back into large messes of datasets for past claims and use machine-learning algorithms to detect patterns in fraud.

Key red flags in data include reusing services in short time periods, duplicate charges for healthcare across different hospitals at the same time and prescriptions filled at the same time in different locations. Through this system, companies can assign risk scores based on past behavior and find items of note in large seas of data that would have been impossible to find before.

Faster, more efficient breakthroughs

Big Data is changing medicine behind the front lines of patient care, as well. Researchers looking at gene variants made a search function for the huge sums of data they’ve pulled during gene research. The functionality is called MARRVEL (Model organism Aggregated Resources for Rare Variant Exploration) , but you can think of it as Google for the human genome. Researchers anywhere can also search the database in minutes.

Author Bio:

Chris Saviano is responsible for Business Development and Sales at PGM Billing and leads PGM’s product integration between proprietary cloud-based practice management software and integrated back office service operations.

accurate patient ID in healthcare helps increase patient safety

New Partnership with CrossChx Signals Positive Changes for Patient ID

accurate patient ID in healthcare helps increase patient safety

Announcing a new partnership with CrossChx to help expand the use of biometric patient ID tech in healthcare.

In case you missed it, on Friday we officially announced a new and exciting partnership agreement with CrossChx. Under the terms of the partnership, CrossChx  customers can easily transition their existing SafeChx biometrics solution to RightPatient, while continuing to utilize other CrossChx products such as Olive artificial intelligence.

The healthcare industry continues to suffer the ill consequences of inaccurate patient identification, jeopardizing patient safety and the quality of care. RightPatient helps to alleviate patient misidentification and instantly and accurately identifies patients by capturing their photo. This photo is linked to a patient’s unique medical record and travels with them throughout a healthcare provider’s network to ensure safety during care delivery. Plus, clinicians at hospitals that use our patient identification service have commented that they love having a patient’s photo before administering services to help humanize care delivery and help patients feel welcome instead of just thinking they are a name and a number. We love to hear this!

Take notice because the winds of change are shifting for patient identification in healthcare. More providers recognize and understand the advantages and benefits of modernizing their patient ID technology and many are taking a very close look at the advantages that our service offers. Keep in mind that implementing a biometric patient identification service offers additional advantages above and beyond patient safety – most notably improvement in revenue cycle management, increases in patient data integrity, and prevention of fraud and medical identity theft at the point of service. 

Read more about our new partnership with CrossChx here.

Have questions? Drop us an email at: info@rightpatient.com

 

 

protecting healthcare data

Healthcare Data Security: How Doctors and Nurses Access, Utilize, and Protect Your Information

protecting healthcare data

Docs and nurses need access to your protected health information (PHI) to provide you optimal care. What steps are they taking to protect that healthcare data? (Photo courtesy of pixabay)

The following guest post on healthcare data security was submitted by Brooke Chaplan.

Anyone who has been to a doctor’s office, hospital or other healthcare institution knows that these can be busy places with patients waiting to be seen and professionals bustling about to perform their duties. With all of this activity going on and various personnel involved in your care, you may wonder about the security of your medical records. Sensitive information lies within the paper and electronic files used by your medical providers. Let’s take a look at how doctors and nurses access, utilize and safeguard your healthcare data.

Confidentiality, Privacy, and Security

First, it’s important to identify the difference between three different terms that are often used interchangeably within healthcare. The concepts of confidentiality, privacy and security are related, but each has its own significant meaning with regard to balancing the needs of patients, providers, the public and other relevant parties such as insurance personnel. When discussing confidentiality in the medical field, the term refers to the duty of personnel to hold any patient healthcare data to which they have access in the strictest of confidence.

Privacy is a separate concept that has to do with an individual patient’s right to decide how personal medical information is shared and with whom. You may be familiar with HIPAA, the Health Insurance Portability and Accountability Act. This statute by the federal government states that, while a patient’s right to privacy and control of their healthcare data still exists, there are some parties to whom such data can be shared without prior patient approval. These include public health officials, health organization administration and payment providers. Finally, there is security, which is all about the protection of confidentiality and privacy of patients. It refers to the ways in which healthcare data is stored and accessed.

Medical Records and Their Use

Your medical records contain a wide range of information. Your full name and unique patient number within that particular healthcare network is stored in your records, along with demographic data like your date of birth, gender and race. Your allergies, medical conditions, lifestyle habits in addition to detailed accounts of every provider visit, lab result, prescription and referrals. Your payment, billing and insurance information are also kept in your medical records, as is your family medical history.

Organizational Policies and Procedures

As you can see, there is a great deal of sensitive and personal healthcare data kept within your individual medical records. In order to ensure the privacy and confidentiality of patient data, healthcare and medical organizations pay special attention to create structured policies and procedures regarding the way such information is handled, stored and accessed. Each network will have its own unique set of guidelines, but the matter is taken very seriously among medical providers. In fact, an entire profession known as healthcare or nursing informatics is dedicated to the management of healthcare data. Many universities also offer a masters in nursing informatics program. An informatics expert is usually employed to help organizations protect patient health information and to ensure only necessary professionals can gain access.

Healthcare providers work hard to care for your medical needs. They are also concerned with the proper care of your personal data. You can rest assured that procedures are in place to ensure the security of your private and confidential information.

Author Bio:

Brooke Chaplan is a freelance writer and blogger. She lives and works out of her home in Los Lunas, New Mexico. She loves the outdoors and spends most her time hiking, biking and gardening. For more information contact Brooke via Twitter @BrookeChaplan.