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Doctors Increasingly Texting, But HIPAA Protection Lacking

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A new study of physicians working at pediatric hospitals has concluded what we might have assumed anyway — that they prefer the use of SMS texting via mobile phone to pagers. What’s worrisome, however, is that little if any of this communication seems to be going on in a HIPAA-secure manner.

The study, by the University of Kansas School of Medicine at Wichita, asked 106 doctors at pediatric hospitals what avenues they prefer for “brief communication” while at work. Of this group, 27 percent chose texting as their favorite method, 23 percent preferred hospital-issued pagers and 21 percent face to face conversation, according to a report in mHealthWatch.

What’s interesting is that text-friendly or not, 57 percent of doctors said they sent or got work-related text messages.  And 12 percent of pediatricians reported sending more than 10 messages per shift.

With all that texting going on,  you’d figure hospitals would have a policy in place to ensure HIPAA requirements were met. But in reality, few doctors said that their hospital had such a policy in place.

That’s particularly concerning considering that 41 percent of respondents said they received work-related text messages on a personal phone, and only 18 percent on a hospital-assigned phone. I think it’s fair to say that this arrangement is rife with opportunities for HIPAA no-nos.

It’s not that the health IT vendor world isn’t aware that this is a problem; I know my colleague John has covered technology for secure texting between medical professionals and he’s also an advisor to secure text messaging company docBeat. However, not much is going to happen until hospitals get worried enough to identify this as a serious issue and they realize that secure text message can be just as easy as regular text along with additional benefits.

In the mean time, doctors will continue texting away — some getting 50-100 messages a day, according to one researcher — in an uncertain environment.  Seems to me this is a recipe for HIPAA disaster.

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November 2, 2012 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare Devices  HealthCare IT  HIPAA Breaches  HIPAA General  HIPAA Lawsuits  Medical Privacy  mHealth  Security Rule
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Access To Clinical Data Too Easy Via Phone

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Lately, I’ve had reason to be in touch with my health insurance company, my primary care doctor and multiple specialists.  In speaking with each, what I’ve noticed is that the data they collect to “protect my privacy” isn’t likely to do a good job. And I’ve been wondering whether an EMR can actually help tighten up access.

When I called to discuss clinical matters, both the payer and providers asked for the same information: My date of birth, my street address and my name. As far as I know, folks, you can get all of that information on a single card, a driver’s license.  So, anyone how finds or steals or has access to my wallet has all the info they need to crawl through my PHI.

So, OK, let’s say providers and payers add a requirement that you name the last four digits of your social security card.

There’s a few problems with that approach. First, anyone who has your wallet may well have your Social Security Card.  Second, storing patients’ SSNs in the clear in an EMR is an invitation to be hacked, as the SSN is the gold standard for identity theft. Third, if you want to store them in a form that only allows the last four digits to be read, that’s another function you need to add to your system.

So, what’s the solution? Would it work to have patients identify which doctor they see (something a thief wouldn’t know) or a recent treatment or procedure they’d had?  Probably, although some patients — forgetful elderly, or the chronically ill with multiple providers — might not remember the answers.

Seems to me that when there’s universal use of patient portals by both providers and payers, this problem will largely go away, as patients will be able to be looking at their own records when talking to providers. This will make a more sophisticated security screening possible.

But in the mean time, I’m troubled to know that my payer and several of my doctors use a security method which can be so easily compromised.  Do any of you have suggestions as to what those offices might do in the interim between now and when they have a useful portal to offer?

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October 26, 2012 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  EMR Security  HealthCare IT  HIPAA General  Security Rule
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EMR Uptake, Windows 8 Based Tablet, and Medical Errors – Around HealthCare Scene

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Hospital EMR
EMR Uptake By Doctors Slowed By Lack of Time And Knowledge, Not Just Cash
Small practices are the ones having the hardest time implementing EMR. However, it isn’t just because of the hefty cost involved. Lack of time and knowledge also appears to be a big issue. There is a lot of time that has to be invested when selecting an EHR, and small-practice doctors have their hands full with other projects. There is also a lack of HR personnel available to help implement EHR as well.

Attending CHIME 2012 Fall CIO Forum
John recently attended the CHIME 2012 CIO Forum and was able to listen to Farzad Mostashari speak. He spoke on health IT, and why it needs to be used. John describes this event as the “Who’s Who” Of Health IT.

Vendor Hopes To Create Market For Windows 8-Based Tablet EMR
Microsoft has been hard at work creating a Tablet called Surface. There is an EMR that has been developed for Surface as well, and the big news is that it will be loaded with Windows 8. While most healthcare IT is run by either iOS or Android, Microsoft may be stepping up their game with Windows 8. Only time will tell how successful this will be, but so far, things look positive.

Meaningful Health IT News
Medical harm explained, in graphics and Farzad style

Medical errors cause far more deaths than many people realize. This gripping post describes how medical harm ranks in comparison to other causes of death in the US, talks about the story of Dr. Farzad Mostashari’s mother, and how correction is needed in hospitals and the care of ill patients.

Smart Phone Health Care
Managing Pain With New WebMD App

WebMD has recently released a new app that is designed to help people figure out where they have pain, and what might be triggering it. This is an innovative way for patients to be able to tell their doctors what they are experiencing, with evidence backing it up. The app is free and available for the iPhone.

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October 21, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare  Healthcare Devices  HealthCare IT  HIE  HITECH  Hospital EHR  Hospitals  Patient Advocacy
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Data Capture, Electronic Data, and Interoperability — #HITsm Chat Highlights

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Topic One: When can we seriously say the data being captured and stored in EHRs is leading to new opportunities for patient care?

Topic Two: Do hospitals prioritize complete data capture for max reimbursement or for an aid for clinicians in patient care?

#HITsm T3: Does electronic data entry really take more time than paper notes? What can improve speed?

 

#HITsm T4: Interoperability. What can be done to increase awareness of the CCD and CDA standards designated for data exchange?

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October 20, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  EMR Implementation  EMR jobs  EMR Security  EMR Technology  Healthcare  HealthCare IT  HIE  HITECH  HL7  Hospital EHR  Meaningful Use  mHealth  PHR
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Doctors Expected To Get “Meaningful Choices” From Patients On HIE Data Use

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Making sure the clinical data flowing through HIEs is seen only by those patients designate is a tricky problem.  But according to the ONC, it’s a problem doctors need to take on and manage, according to recent guidance from the organization.

ONC’s logic is as follows:

As key agents of trust for patients, providers are responsible for maintaining the privacy and security of their patients’ health information. In turn, patients should not be surprised about or harmed by their provider’s collections, uses, or disclosures of their health information. 

In other words, patients should be given a “meaningful choice” as to how information is shared, rather than simply signing broad treatment-related disclosures.

And as ONC sees it, the treating professional is responsible for educating patients enough to give them meaningful awareness of their options, including how information will be shared and with whom, as well as obtaining and tracking the patient’s choice.

This strikes me as a pretty ambitious expectation to have of doctors, who in most cases need to do little to explain information sharing to patients. Educating them on the broad range of places data could go, under which circumstances, and the extent to which patients can opt in or out of such sharing, strikes me as a very large task.

I’m not saying that I think ONC’s recommendation is an unwise one.  In most cases, the doctor — who’s most likely to be the treating professional — is really the only person who’s in a position to do this kind of education.  Not only is the doctor the person the patient trusts, they’re also in a position to review how well patients have understood on an ongoing basis.

All that being said, it’s still a pretty complex lesson to teach. I hope someone, perhaps ONC itself, develops online self-education for patients which a doctor can simply offer during the visit.  Otherwise, I think the “meaningful choice” concept will be hard to pull off.

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October 19, 2012 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare  Healthcare Interoperability  HealthCare IT  HIE  HIPAA General  Medical Privacy
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Wireless Health Data Collection Innovations Getting Hot

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This week, psfk.com and pharma partner Boehringer Mannheim published a list of the week’s top innovations in healthcare. All were interesting, but I was particularly intrigued by a couple which continue to stretch the boundaries of wireless medicine.

One innovation example comes from a German research team, which has developed a tiny chip (a two-millimeter device much shorter than an eyelash) which can sample blood sugar levels by testing tears or sweat. The chip is equipped to transmit the results wirelessly to providers, as well as sending patients alerts to their wireless phone.  Even cooler, the chip can be powered wirelessly through radio frequency, keeping it charged for weeks or even months.

Another entirely cool innovation comes from U.S. high school student Catherine Wong, who has invented an ECG made of off the shelf electronic components which can broadcast results wirelessly.  The device, which could make ECGs available to to the two billion-plus people without access to healthcare, picks up heart signals, then transmits them via cellphone to a healthcare provider.  The cellphone connects to the ECG using Bluetooth, and heart rhythms display on  a smartphone screen thanks to a Java app.

As readers know, the idea of broadcasting test results to remote providers via wireless devices is not a new one. The idea is so hot, in fact, that the FCC is holding a public meeting on September 24 to discuss how to accelerate the adoption of such approaches. (The event will be live streamed at http://www.itif.org/events/recommendations-mhealth-task-force at 2PM Eastern Standard Time.)

After watching projects like these germinate for a number of years, I’m thrilled to see more innovation arising in this sector of the mHealth space. Inventors, keep it coming!

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September 25, 2012 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Filed Under: Biometrics  EHR  Electronic Health Record  Electronic Medical Record  EMR  EMR Technology  Health IT Startups  Healthcare  Healthcare Devices  HealthCare IT  mHealth
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Inaccurate EMR Data, Patient Engagement, and Studycure: Around Healthcare Scene

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EMR and EHR

Primary Docs See Hope For Stronger Financials With EMR

A recent study revealed that 51 percent of doctors felt the EMRs would help solve their problems. In fact, some believe that it will help them financially as well. Their theory? Better coding and documentation will lead to more efficiency and reduction of costs. Is this a worth-while belief, or are these doctors setting themselves up for disappointment?

EMR Data Often “Innaccurate” Or “Missing”, Study Says

EMR adoption is expected to reach nearly 80 percent of healthcare organizations by 2016. This may come as a relief to some who believe that EMRs eliminate data errors that come with paper-based systems. However, EMRs may not be as accurate and complete as everyone might hope. Symptoms on patients who die quickly may not be recorded, and accuracy can depend on if a patient was treated at night or during the day. Teamwork may be the solution to eliminating EMR-based errors.

Hospital EMR

Your Facebook-like Health and Status Feed

Should healthcare practices integrate a social media-like system, incorporating real health time and status feeds, into clinical workflow? In theory, it would be a great idea. However, as with Facebook and Twitter, not every status gets read. This may get information out quickly, but maybe not to who needs to see it.

Happy EMR Doctor

Patient Engagement in the Digital Era

Patient Engagement has gone from eye-to-eye contact to Googling health questions. While this may seem like patient engagement is becoming less personal, it can be positive. Patients can be more involved in their health care, and take control of it. Dr. Michael West discusses that and more in his article this week.

Smart Phone Health Care

Studycure: Experiment Your Way to Better Health

Need some extra motivation to meet goals? Studycure is part social experiment, part motivation, and aims to help people meet their health goals. By implementing a texting program that sends reminders throughout the day and questions concerning your goal, it analyzes after a certain period of time if the methods used to meet a goal are being met. Goals are customizable, can be shared with friends and family, and others goals can be tracked and used as inspiration.

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September 23, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Filed Under: EHR  EHR Stimulus  Electronic Health Record  Electronic Medical Record  EMR  Healthcare  HealthCare IT  Healthcare Social Media  HIE  HITECH  HL7  Hospital EHR  mHealth  PHR
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EHR Reimbursement, Health Data Security, and Innovation – #HITsm Chat Highlights

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Every week, HL7 Standards, hosts a #HITsm Tweet Chat and poses four questions “on current topics that are influencing healthcare technology, health IT, and the use of social media in healthcare.” It’s always a great discussion and also a great chance to meet a wide variety of people that are passionate about healthcare IT.

In case you missed it, or are curious about what went on this week, we’ve put together the list of topics with some of the best responses for each topic. There were some interesting topics this week, as well as some great responses. If you have any opinions on any of these topics, feel free to continue the discussion in the comments. This chats take place every Friday at 11AM CST. You’ll find members of Healthcare Scene regularly participating in the chat under some of the following Twitter accounts: @techguy, @ehrandhit, @hospitalEHR, and @smyrnagirl.

Topic One: Politics #EHR reimbursement will likely reach $20 billion. Why is this big govt initiative exempt from critics?

Topic Two: Health data security: What does health data security look like and how is it different than financial data security?

Topic Three: Clash of the #Health IT Titans: What is most beneficial patients, #HIEs or #ACOs? 

Topic Four: Innovation in #healthIT: What are some examples of innovative groups/ideas that may disrupt the current system? 

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September 22, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  EMR Implementation  EMR jobs  EMR Technology  Health IT Startups  Health Startup Incubators  Healthcare  HealthCare IT  Healthcare Social Media  HIE  HL7  Hospital EHR  Hospitals  mHealth  PHR
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Verizon Hopes To Be Secure Healthcare Network For All

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If you’re like me, you might be wondering how carriers are  looking at their role in the healthcare business — and whether some of their talk about mHealth is just noise.  (I’ve always seen mHealth as a space ripe to be be dominated by applications developers and device manufacturers, not carriers.)

To get my head straight, I recently had a conversation with Dr. Peter Tippett, chief medical officer and vice president of Verizon Connected Health Care. In it, he changed my view of what Verizon is doing in mHealth, and moreover,  what ground Verizon specifically hopes to own in healthcare over the next several years.

When I think Verizon I think switches and routers and cables, not consumer-facing applications and medical devices. And before I talked to Dr. Tippett, I assumed that Verizon’s main healthcare efforts likely involved going head to head with other wireless/wireline connectivity players for connectivity business in some form.

Well, think again.  Verizon’s Connected Health Division, says Tippett, is aiming to set the bar much higher.

“The question is, ‘what happens after wireless data?’,” Dr. Tippett said. “This isn’t a two month plan, this is a strategic extension of Verizon to transform the healthcare industry using our huge capability around the world.”

On the more immediate front, Verizon has mHealth technology under development which, to my mind, would solve a difficult problem.  For five years, he says, Verizon has been developing a new mHealtlh platform which will tie together data from testing devices like blood pressure cuffs, weight scales and EKGs into an analytics engine that makes sense of it all.

“No doctor wants four glucoses a day from 1,000 patients,” Dr. Tippett says. “Just mobilizing the data isn’t enough. You’ve got to create a cloud service that can do big data analytics on it and normalize the data, then trigger the alerts to the right people — including patients.”

I’m going to keep my eye on the mHealth platform, which definitely intrigues me.

But the really big play for Verizon in this space seems to be in HIPAA-secure data hosting and exchange.  Verizon already has a massive presence around hosting, app management, security, identity management and the cloud, having added Cybertrust and Terramark (enterprise hosting) to build up its lineup.

Verizon now offers secure data sharing on multiple levels:

*  A “medical data exchange” — not unlike the exchange banks use to pass transactions back and forth — allowing any member to share information using Verizon’s security services.

* An exchange “identity layer” which is secure enough to allow Schedule 2 drugs to be prescribed. According to Dr. Tippett, 40 percent of doctors in the U.S. are already using it.

* A global network of highly-secured data centers.

Members of the medical ecosystem who use secure Verizon services can consider their HIPAA compliance and security matters handled, then focus on their core business, Dr. Tippett says. And that can scale to hundreds of millions of users on the network, he notes.

Clearly, this doesn’t sound like the broadband carrier talking — these folks are out to take business from players as diverse as Verisign, IBM and the database giants.  It makes sense to me, on the surface, but in any grand vision there are holes to be picked.

You tell me:  Does Verizon sound like it’s positioned right to become the default secure healthcare backbone?

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September 11, 2012 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Filed Under: EMR Security  Healthcare  Healthcare Interoperability  HealthCare IT  HIE  HIPAA General  HIPAA News  Interfaces  mHealth  RHIO  Security Rule
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The Immortal Life of Healthcare IT, Secure Texting Scam, and iPhone Heart Rate — Around Health Care Scene

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EMR and EHR

The Immortal Life of Healthcare IT

Patient engagement has evolved in many ways in the past century. While patients used to rely on doctors for any information regarding health care, it’s now common for patients to “diagnose” themselves, before even stepping foot into a doctor’s office. “The Immortal Life” by Henrietta Lacks, and the authors thoughts, are compared and contrasted to life nowadays.

Interview with Verizon Wireless’ Arthur Lane

A leader for mobile health solution development for Verizon’s Connected Health, Arthur Lane, was interviewed over at EMR and EHR this past week. He focuses his work on developing solutions that help with Verizon’s wireless, cloud, and security. The interview focuses on Health IT and mHealth, and what is in the works at Verizon. He discussed the benefits of mHealth, and what is to come in the future.

Hospital EMR and EHR
What Won’t Happen in #HIT By September 2013

There’s a lot going on with Health Care IT, and it seems as if we’re always hearing about the latest and greatest innovation. However, despite the leaps and bounds that are being made, we can’t expect everything in the EMR industry to be perfect by next year. Anne Zeigler talks about things that won’t be happening in #HIT over the next year, including lack of major growth in remote monitoring and no high penetration HIE.

Meaningful Healthcare It News With Neil Versel

Sampling of opinions on meaningful use Stage 2

The meaningful use Stage 2 final rules have caused quite a bit of discussion across the web since they were announced. Some good, some bad. Neil Versel compiled some of the opinions and thoughts he has discovered over the past few weeks, and created this post with some of them.

Wired EMR and EHR Doctor

The Secure Texting Scam

Medical practices may be getting offers from companies that offer “secure texting,” that won’t violated HIPAA standards. However, how secure can texting be? Dr. Michael Koriwchak talks about the “secure texting scam,” and talks about the reasons why secure texting can fail. Don’t get caught in this trap, and end up paying a large amount for a product that might not deliver what you think.

Smart Phone Health Care

Detect Heart Rate With iPhone Camera – #HITsm Chat Discovery

Finding out your heart rate is now easier than ever — simply by using the camera on your iPhone. This new way to detect heart rate requires no special equipment, beyond an iPhone 4. The app tracks the information and allows the user to view changes over time, among other features.

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September 9, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  EMR Implementation  EMR Selection  EMR Technology  Health IT Startups  Healthcare  HIE  HIPAA Breaches  HIPAA Lawsuits  HIPAA News  HL7  Hospital EHR  Hospitals  Meaningful Use  mHealth  Pharmacy
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