Author Archives: Anna Abraham

Currently, there are two states that allow individuals to prosecute on the grounds of medical identity theft: Colorado and California. Georgia has just signed a bill for the House of Representatives to amend their current identity fraud laws to include medical identity fraud for jurisdiction and prosecution purposes. This is a step forward for Georgia which has the second highest rate for identity fraud in the country. The most identity theft complaints come from Florida, which receives twice the amount of complaints received in Georgia.

When a healthcare information becomes digital, there is an abundance of advantages for patients, doctors and practices. In seconds, providers can target, secure, and identify all types of information about an individual to treat them better and quicker. Also, with the right tools, this information is incredibly useful for population health management (PMH) and predictive modeling when pooled together.

Other uses for health care identity proofing include:
· Secure access to health records
· Secure access to status of applied government benefits and HIE
· Identity provider enrollment
· Risk scoring of providers for fraud, waste and abuse purposes
· Risk scoring for and screening of Medicaid beneficiaries
· Improvement of clinical risk scoring and predictive analytics
· Target disease management efforts
· Increase patient engagement

However, digital strategies and electronic health records (EHRs) also create certain vulnerabilities when applied to data collection. These include overwhelming scalability especially in health care as patient records must be kept for 6 years. There are also compliance regulations, costs, and above all security concerns. Each year in America there are 1.5 million victims of medical identity theft each year, and it is in fact, the fastest growing form of identity theft. From identity and contact information to health history and finances, each patient is exposing their personal information for health care purposes and require heavy protection.

“The fastest form of identity theft is stealing people’s medical and health insurance information to defraud private and public healthcare providers. Similar to financial identity theft, this harms people and drives up the cost of healthcare as medical facilities and insurance companies compensate by increasing rates.  Potential identity thieves should consider themselves warned that this type of theft and fraud will be severely punished and not tolerated in our state,” said Sen. Judson Hill (R – Marietta) and sponsor of the Senate Bill 170 in Georgia.

Vulnerabilities and Security issues:
· Many healthcare organizations don’t have sufficient resources or data security experts dedicated to data security, and those that do don’t do yearly audits. 52% of the organizations that conduct one of these audits discover a security breach as a result.
· Compliance Regulations with HIPAA modifications
· Consequences for the Patient include Ruined credit, Loss of health coverage, Inaccurate records, Legal troubles, Higher health premiums, etc

Whether or not identity proofing in a healthcare setting is practiced with each patient, many could agree that other priorities can easily come first. In general, providers do one-on-one relationship basis identity proofing. However one-on-one relationships are not always possible, or a patient may wish to hold an “anonymous” identity. In these cases the provider doesn’t need to know the patient attached to the identity just that it’s the same patient that interacts with the account.

There are official level 1-5 identity proofing guidelines incorporated in technology solutions for digital identity proofing. These can include a simple confirmation of relationship by a provider to biometric captured at registration. Even though it may be a time consuming challenge for states to pass legislation on medical identity fraud as it is for most political processes, technology companies take the lead with prevention. Lexis Nexis recently spoke at the 2013 State Healthcare IT Connect Summit >>Download the Speaking Proposal Form to participate at the 2014 State Healthcare IT Connect Summit), Clint Fuhrman, Director of Government Healthcare presented with Saratu Grace Ghartey, Assistant Deputy Commissioner, NYC Human Resources Administration and Maggie O’Connell, Program Integrity Unit, Arkansas Department of Human Services.

Also, the Health Information Technology for Economic and Clinical Health (HITECH) Act now includes more protection and viewer restriction of patients’ medical records with the Health Insurance Portability and Accountability (HIPAA). Standardized regulation and technology solutions are making it clear that providers can and must incorporate precautions that secure their patients’ information to maintain the sacred patient-doctor confidentiality.

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In case you needed some inspiration or comic relief, this week the Harvard Business and Medical School released the top 10 quotes taken from their first conference last fall as a joint initiative called Forum on Healthcare Innovation.

Their manifesto is as follows:
To help push the national conversation about healthcare reform beyond its usual notion of innovation, Harvard Business School (HBS) and Harvard Medical School (HMS) have formed the Forum on Healthcare Innovation, a multifaceted effort to leverage the thought leadership and convening power of the two schools to create an interdisciplinary platform with influence greater than the sum of its parts.

Here are three of the ten top quotes:
We need approaches to the solutions that aren’t just arithmetic and additive, but are in some sense logarithmic. This will require us to reach across historic boundaries and unlock the potential of collaboration across the usual disciplines. Jeffrey S. Flier, MD – Dean of the Faculty of Medicine, Harvard University

If you think about how healthcare is delivered, it’s on an ad hoc basis. Someone comes into a hospital, someone comes into a pharmacy, someone comes into a doctor. But beyond those touchpoints, the patients are on their own. There’s no real continuity of care. Christopher A. Viehbacher – CEO, Sanofi

This is not an enrollment experience anymore, it is a shopping experience. The more employees we have, the more carriers we will bring. The more competition we drive, the lower the costs will be. Kenneth L. Sperling – National Health Exchange Strategy Leader, Aon Hewitt

All ten quotes can be found on the Forbes website.

 

continue reading | via Forbes

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In three years, growth in health IT usage in the healthcare industry has skyrocketed according to Mathematica Policy Research and the Harvard School of Public Health. They’ve found in a recent study evidence of extensive evolution and implementation of IT among physician practices, academic medical centers, hospitals, etc.

The implementation of the HITECH Act, the distribution of federal stimulus funds and the benefits behind health IT and interoperability are forever changing the United States healthcare system. Here are some of the findings from the study:

Hospitals:
· 44 percent of hospitals reported having a basic electronic health record system in 2012- a growth of 17 percent from 2011
· 42 percent of hospitals reported the implementation of all functionalities required to meet Stage 1 meaningful use this past year – up from 18.4 percent in 2011 and just 4.4 percent in 2010
· 27 percent of hospitals are now participating in health information exchange initiatives – up from 14 percent in 2010

Physician practices:
· 38 percent of physician practices implemented the adoption of basic EHR functionalities in 2012

Ambulatory practices:
· 10 percent of ambulatory practices participate in an HIE – up from 3 percent in 2010

Shared data:
· 33 percent of HIEs supporting accountable care organizations and 45 percent supporting patient-centered medical homes

 

continue reading | via Healthcare IT NEWS

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The federal government has big plans to regulate the safety for patient healthcare information in the United States. The Office of the National Coordinator (ONC) for Health IT has awarded this great task to the Joint Commission.

Patient information could be a prime target for identity theft and fraud, and lately has received major concerns from the American Medical Association. Surprisingly there is little knowledge about the errors causing security issues, but analysts have recently found that risks tend to come from the way health care providers use health IT systems. A plan to answer many of these questions was proposed at the end of last year and was just approved last week. The plan outlines the steps that will be taken by the Joint Commission to improve the safety of health IT systems.

So, what are the details for the Health IT Patient Safety Action and Surveillance Plan?

- Making it easier for clinicians to report patient safety events and risks related to using electronic health records
- Collecting and analyzing data on patient safety events
- Incorporating health IT safety in post-market surveillance of EHRs
- Using the meaningful use program and the National Quality Strategy to establish and advance health IT patient safety priorities
- Incorporating safety into certification criteria for health IT products
- Investigating and taking corrective action as necessary
- Developing a strategy and recommendations for a risk-based framework for health IT
- Establishing an ONC safety program to coordinate implementation of the final plan

 

continue reading | via iHealth Beat

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An enormous security breach hit the Indiana Family and Social Services Administration (FSSA) potentially exposing personal information of 187,500 individuals. This is considered to be one of the largest breeches this year. The Indiana FSSA is no stranger to breaches. In 2012, the agency reported a missing laptop, which contained the protected health information of 757 clients.

The agency is taking immediate action to inform patients of the situation and the necessary steps to avoid possible identify theft.

Patient information potentially leaked from the breach includes:
Patient names
Addresses
Dates of birth
Demographic data
Contact information
Types of benefits received
Monthly benefit amount
Employer information
Monthly income, expenses and other financial data
Bank balances and other assets
Medical information such as providers
Disability benefits and medical condition
Certain information about the client’s household members

Robert C. Reed president of RCR Technology Corporation said in a statement released July 1, “We at RCR Technology Corporation apologize that our actions may have caused some FSSA client information to be disclosed in error. We will do everything possible to prevent such an incident from happening again in the future.”

 

 continue reading | via HealthIT Security

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The announcement of nine of the 32 Pioneer ACOs to exit the program is insignificant to the overall value-based system according to Tom Cassels, leader of the healthcare advisory board of The Advisory Board Co. Four of the nine organizations are expected to join the Medicare’s Shared Savings Program (MSSP).

These Pioneer ACOs may find it difficult to take a down-size risk potentially involved with ACOs. Their challenging populations, risk contracts with commercial payers, self-insured employers, high-cost Medicaid plans and lack of sufficient health IT infrastructure to collect quality data that shows Meaningful Use can easily attribute to their decision to leave.

“When you have a very challenging population, and you don’t have all those levers, you might say to yourself, ‘We don’t have these tools we need in this contract to be financially sustainable.’ I think that is the case for multiple ACOs in both of the Medicare programs, and it will likely be the case for a lot of ACOs that don’t have the ability to pull those levers.”

 

 continue reading | via Information Week Health Care

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No word yet from The Department of Health and Human Services (HHS) about the white paper proposed by the Office of US Senator John Thune two months ago. The paper titled: REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health IT address concerns EHR incentive programs and Health IT in meaningful use. Although the general consensus is that the meaningful use program should continue, there are areas of EHR incentive programs that require modification. The white paper explains that these modifications could create more opportunities and benefits for stakeholders and constituents.

“The Department of Health and Human Services (HHS) had two months to review the white paper and provide the requested feedback to a letter by June 16, 2013,” states the press release from Sen. Thune’s office. “However, no comments or response has been received from HHS to date. The Senators look forward to receiving a response and working together to address stakeholder concerns.”

Areas of concern requesting feedback in the white paper are:
• Interoperability
• Cost
• Oversight
• Patient privacy
• Sustainability

 

 continue reading | via Healthcare Technology Online

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Healthcare has a history of being a lucrative business and recent projections estimate that the health IT business overall could show a dollar value of $31 billion over the next few years. Health Information Exchange is of course a key tenet of any healthcare transformation initiative outside the four walls of a hospital or physician clinic, however Health Information Exchanges (HIEs) have had a colored history in demonstrating value to stakeholders and how they will support their long term sustainability as viable business entities.
As with all big business markets, HIE entrepreneurs are emerging with demonstrated value and sustainability models. What are the key tenets for success? Where do they begin? What services and tools should the HIE provide? What kind of business plan is most effective? How should the HIE plan develop over time?
During the 2013 State Healthcare IT Connect Summit  (download speaking proprosal for 2014 Summit here ) Mark McKinney, CEO for Healthcare Information Xchange of New York (HIXNY) and Dominick Bizzarro, Managing Director for HealthShare at InterSystems discussed these questions and more with the audience. Both have experience as CEOs at HIXNY nonprofit organization, and have been involved in building numerous health IT businesses. They’ve known each other for about 18 years and share a lot in common. They’ve worked together in different companies and are now working in a provider client relationship. During their presentations, they shared what they think is the core of any successful business in health IT and answered many questions any Health Information Exchange (HIE) entrepreneur may have.
But first, let me provide a snapshot of their respective employer organizations:
InterSystems:
Privately held 34 year old Tech Company
Operational in 30 countries
Customers in 100+ countries
Still run by the founder, Phillip “Terry” Ragon
80-85% of business is in healthcare
HIXNY:
2+ million patients
25+ Terabytes of data
Over 5,000 users and 400 participating healthcare organizations
8 interoperable EMR and HIS vendors

Half a billion of processed clinical messagesWe can all agree that both are pretty impressive, but the real question is how did they get there? The organizations are leaders today, but in 1999, Hixny was very wet behind the ears and pioneering new territory and InterSystems is constantly expanding to new territories. So what guidance do they have to  share?
During Bizzarro’s presentation, he emphasized the importance of business planning and determining the organization’s purpose and strategy. He says, “Strategy is not something that can be done over a weekend. It tends to sharpen its focus over time.” He believes a written plan adds important structure to your thinking. He says it is the only way to critically think about it, and simultaneously you have sharable content for supporters and have something to look back on and measure after a years time.
When Bizzarro first entered the Not-for-Profit HIE world two statements of wisdom were at first very illogical to him, but then stuck with him throughout the years. 1st: “Your product strategy is whatever your vendor says it is.” and 2nd “Your community, our HIE.”
Bizzarro describes a not-for-profit organization just like a small businesses and says technology is there to enable it. At the end of the day, not-for-profit businesses are businesses and the same rules of business apply to them. From Bizarro’s point of view, the top 10 key Tenets for Not for Profit HIEs are:
-No money, no mission –bring in revenue no matter the source.-Encourage altruism but rely on value. Although you may hold the moral hammer, that will not sustain the trade.-Solve the right problems and adoption will follow.-Revere the early adopters – they are your best friends.
-Partner with government.
-Partner with the private sector.
-Share leadership.
-Convert stakeholders into thought-leading evangelists.
-Welcome interoperability – “a rising tide lifts all boats.”
-Plan, execute, analyze, revise — adapt.

Mark McKinney emphasized during his presentation the importance of weighing business options, then focusing on reaching important goals. From a serious business perspective, one must ask, “What do you want to do next?”, but first:
-Allow value to be cyclical –Find out what is available and what you already have and start where you can and focus even if it is small. This will give you the proof your business needs to build.
-Satisfy your mission and vision – If you want to lower costs, lower them even if your starting point is not where you thought it would be.
-Increment to get there – Test, find out what’s useful and what’s not in order to arrive to the solution. Push forward, learn from your mistakes and don’t focus on trying to get it right as you go. “Strike while the iron is hot”, he said.
Once the infrastructure is there, McKinney spoke strongly of the importance of community involvement in order to apply the right pressure to share knowledge and data. Community involvement is acquired by giving a voice to your stakeholders, members and partners by opening the governance. When this involvement is strong, then it is easier to bring more people, organizations and associations on board.
Building a business and being and entrepreneur takes time and patience, but with the right guidance, motivation and fiery spirit that both Bizarro and McKinney displayed at the Summit, success can be achieved.

See their entire presentation and Q&A at the Healthcare IT media portal:
An Entrepreneurial View on Public “HIE” Success: Moving from Vision to Value Video Archive Link

If you are not already registered to view the media portal you can do so here SUBSCRIBE TO VIEW

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The Disruptive Health Technology Institute (DHTI) is now a reality thanks to Carnegie Mellon University, Allegheny Health Network and Highmark, Inc. joining forces.  This collaboration looks to improve healthcare through the use of technology and will highlight seven key araes : infection prevention, diagnostic ultrasound, behavior change, endoscopy, chronic disease management, data mining and medical diagnostics.

“This is a distinct partnership in that health insurance companies don’t usually invest in research. We look forward to having our CMU researchers develop and share innovative health care delivery technologies that will shape the future,” said Mark S. Kamlet, CMU provost and executive vice president.

 

 continue reading | via Central Penn Business.com

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The Department of Health and Human Resources is getting set for the tidal wave of consumers regardless of their needs or language for purchasing health insurance coverage this October.  They’ve updated their portal to include call center support 150 languages as well as:

• Educational material explains the exchanges
• Ways to get reduced premiums
• How to choose a plan
• Options for the self-employed
• Qualifying for Medicaid
• Coverage with pre-existing conditions
• Preventive care benefits
• Rights and responsibilities
• And more..

Ready or ready here comes health insurance exchanges!

 

 continue reading | via Health Data Management.com

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