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Medical Data Impact to Financial Health, Disability and Job Protection – #HITsm Chat Topic

Posted on November 7, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 11/10 at Noon ET (9 AM PT). This week’s chat will be hosted by Kimberly George (@kimberlyanngeo) from @sedgwick on the topic of “Medical Data Impact to Financial Health, Disability and Job Protection.”

Short term disability, the Americans with Disabilities Act (ADA), the Family Medical Leave Act (FMLA) and similar leave of absence programs – including workers’ compensation – are designed to ensure the employment and income of the American worker is protected at a time of illness or injury. Regardless as to whether an employee is seeking wage reimbursement, a leave of absence, or a job accommodation, sufficient, accurate and timely medical documentation is required.

But what happens when accurate medical documentation is not received? Is incomplete? Or not received on a timely basis? The request for benefits is placed in a pending or denied status, wages are not paid or significantly delayed, and challenges mount for the patient.

While the burden to submit medical records, and supporting documentation falls to the patient, there is an uptick in payer and employer interest to help solve for the challenges of obtaining sufficient medical information on a timely basis. Medical documentation often requires diagnosis, subjective and objective medical information, including an assessment of functionality pertinent to the patient’s physical capabilities. This functional assessment is often defined by the benefit plan, law, and the employer’s policy.

Receipt of medical information on a timely basis is a major factor in the denial of disability benefits for people seeking support for a disability, leave of absence or workers compensation claim. Number one reason for a reversal of the denial is late receipt of the medical documentation.

The objective of this chat is for #HITsm community to share their insight, ideas and opinions about the identification, collection, and sharing of a patient’s medical and functional status with proper release of information to the payer directly. Quite simply, how can technology, process, policy and people speed up the process so patients and payers have the medical records needed to make accurate, timely and fair benefit decisions?

Reference Materials:

Join us as we dive into this topic during this week’s #HITsm chat using the following questions.

Topics for This Week’s #HITsm Chat:

T1: What issues, obstacles and/or missing capabilities prevent or hinder an individual’s ability to collect their medical records? #HITsm

T2: How are patients impacted when benefit approval requires medical documentation and medical records are not available? #HITsm

T3: How can patients, support networks, employers, government or others support the capture, storage & retrieval of medical records? #HITsm

T4: What technologies and/or new approaches can assist w/ capture, storage & retrieval of medical record data? #HITsm

T5: What reasonable policy and/or regulatory changes could be implemented to accelerate & expedite benefit processing on behalf of consumers? #HITsm

Bonus: What stakeholders, resources, & companies should be engaged to assist w/ building & delivering a medical records collection solution? #HITsm

Upcoming #HITsm Chat Schedule
11/17 – MACRA/MIPS: Chutes & Ladders 2.0
Hosted by Jim Tate (@jimtate) from EMR Advocate and MIPS Consulting.

11/24 – Thanksgiving Break!

12/1 – Using Technology to Fight EHR Burnout
Hosted by Gabe Charbonneau, MD (@gabrieldane)

12/8 – TBD
Hosted by Homer Chin (@chinhom) and Amy Fellows (@afellowsamy) from @MyOpenNotes)

12/15 – TBD
Hosted by David Fuller (@genkidave)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Is HIPAA Misuse Blocking Patient Use Of Their Data?

Posted on August 18, 2015 I Written By

Anne Zieger 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.

Recently, a story in the New York Times told some troubling stories about how HIPAA misunderstandings have crept into both professional and personal settings. These included:

  • A woman getting scolded at a hospital in Boston for “very improper” speech after discussing her husband’s medical situation with a dear friend.
  • Refusal by a Pennsylvania hospital to take a daughter’s information on her mother’s medical history, citing HIPAA, despite the fact that the daughter wasn’t *requesting* any data. The woman’s mother was infirm and couldn’t share medical history — such as her drug allergy — on her own.
  • The announcement, by a minister in California, that he could no longer read the names of sick congregants due to HIPAA.

All of this is bad enough, particularly the case of the Pennsylvania refusing to take information that could have protected a helpless elderly patient, but the effects of this ignorance create even greater ripples, I’d argue.

Let’s face it: our efforts to convince patients to engage with their own medical data haven’t been terribly successful as of yet. According to a study released late last year by Xerox, 64% of patients were not using patient portals, and 31% said that their doctor had never discussed portals with them.

Some of the reasons patients aren’t taking advantage of the medical data available to them include ignorance and fear, I’d argue. Technophobia and a history of just “trusting the doctor” play a role as well. What’s more, pouring through lab results and imaging studies might seem overwhelming to patients who have never done it before.

But that’s not all that’s holding people back. In my opinion, the climate of medical data fear HIPAA misunderstandings have created is playing a major part too.

While I understand why patients have to sign acknowledgements of privacy practices and be taught what HIPAA is intended to do, this doesn’t exactly foster a climate in which patients feel like they own their data. While doctor’s offices and hospitals may not have done this deliberately, the way they administer HIPAA compliance can make medical data seem portentous, scary and dangerous, more like a bomb set to go off than a tool patients can use to manage their care.

I guess what I’m suggesting is that if providers want to see patients engaged and managing their care, they should make sure patients feel comfortable asking for access to and using that data. While some may never feel at ease digging into their test results or correcting their medical history, I believe that there’s a sizable group of patients who would respond well to a reminder that there’s power in doing so.

The truth is that while most providers now give patients the option of logging on to a portal, they typically don’t make it easy. And heaven knows even the best-trained physician office staff rarely take the time to urge patients to log on and learn.

But if providers make the effort to balance stern HIPAA paperwork with encouraging words, patients are more likely to get inspired. Sometimes, all it takes is a little nudge to get people on board with new behavior. And there’s no excuse for letting foolish misinterpretations of HIPAA prevent that from happening.