Guest post by Stephen Cobb, senior security researcher, ESET.
HIPAA’s privacy and security rules are often labeled as being burdensome and restrictive. The rules are increasingly criticized as ineffective and people wonder how an organization can be HIPAA compliant and still suffer a breach of protected health information.
A medical approach to answering that question might be to think about infection prevention and control. Infection control protocols exist to prevent the spread of infectious diseases. However, a patient can get infected at a hospital or clinic that has such protocols in place. The reasons for such anomalies include lapses in conformance to the protocol and inappropriate protocol relative to potential infection vectors.
Such language maps closely to the demands of healthcare data protection, which could be described as the prevention and control of unauthorized access to protected health information. Clearly there is a need for healthcare organizations and their employees to fully comply with “policies and procedures that are appropriate to the threats.” Getting people to comply requires organizational commitment from the top down, backed by the adequate equipping and educating of staff at all levels.
But what if those policies and procedures are not appropriate to the threats? What if the infection vectors are different from those you trained to defend against, or the threat agent more virulent than you supposed? That’s where a lot of health data security breaches occur, in that gap between established practices and emerging threats. The difference between being “HIPAA compliant” and “secure” often comes down to underestimating threats. Continue Reading
Healthcare leaders from across the nation are renewing calls for the Centers for Medicaid and Medicare Services (CMS) to shorten the meaningful use (MU) reporting period in 2015 and provide more program flexibility, citing concerns with lower-than-expected Medicare numbers and continued reports detailing nationwide difficulty in meeting federal guidelines for electronic health records (EHR) requirements.
According to newly released CMS numbers, less than 17 percent of the nation’s hospitals have demonstrated Stage 2 capabilities. Further, less than 38 percent of eligible hospitals (EHs) and critical access hospitals (CAHs) have met either stage of meaningful use in 2014, highlighting the difficulty of program requirements and foretelling continued struggles in 2015. And while eligible professionals (EPs) have until the end of February to report their progress, only 2 percent have demonstrated Stage 2 capabilities thus far.
Officials from the American Medical Association (AMA), College of Healthcare Information Management Executives (CHIME), Healthcare Information and Management Systems Society (HIMSS) and Medical Group Management Association (MGMA) called the results disappointing, yet predictable.
“Meaningful use participation data released today have validated the concerns of providers and IT leaders. These numbers continue to underscore the need for a sensible glide-path in 2015,” said CHIME president and CEO Russell P. Branzell, FCHIME, CHCIO. “Providers have struggled mightily in 2014, in many instances for reasons beyond their control. If nothing is done to help them get back on track in 2015, we will continue to see growing dissatisfaction with EHRs and disenchantment with meaningful use.”
CMS data required by Congress indicate that more than 3,900 hospitals must meet Stage 2 measures and objectives in 2015 and more than 260,000 eligible professionals (EPs) will need to be similarly positioned by January 1, 2015. Given the low attestation data for 2014 and the tremendous number of providers required, but likely unable to fulfill, Stage 2 for a full 365-days in 2015, healthcare leaders have pressed for a shortened reporting period in 2015, mirroring the policy of 2014.
We live on a small planet in a vast universe. Our ability to communicate globally has excelled at a lightning pace. I live in Miami, Florida, but I have spoken on this topic from many cities around the world. Within seconds my thoughts can be reported around the globe. This is a new era for innovation, communication, technology and science advancement that fosters a very rapid dissemination of new ideas from basic sciences to advanced technologies.
Back in the early 1970s there was great excitement about the new IBM mainframe system. The purpose of this new computer in the bank I worked in was to keep track of several thousand accounts and mortgages. The system filled an entire floor of the building with multiple modules. Storage was on spinning steel with magnetic tape backup and memory needed was 28mb. It was basically the equivalent brainpower of a Nematode worm or bacterium, but one that kept accurate records and basic computations without the mistakes of a human bank teller. In 1984, the Mac computer was introduced, but the computing power was the same as the room full of IBM mainframes.
Today, because of advances in materials science and miniaturization we carry in our pockets small “supercomputers.” Computing power has advanced from microbe level intelligence to that of a small mammal like a mouse. Based on predictions of computer pioneer Gordon Moore more than 20 years ago this trend should continue; Moore’s Law, which has proven fairly accurate states that computing power doubles about every 18 to 24 months. Today’s cell phone computers are close to monkey intelligence now and human intelligence in less than a decade. We are almost there today with some cell phone chips containing over two billion transistors. It is estimated that in less than a decade all the intelligence of mankind can be on a chip.
The consequences of this for mankind are enormous and could prove to be one of the greatest tools for scientific, medical and human advancement.
This is already happening. I became an early tinkerer in the development of apps for computers and published some of the first online medical textbooks and first medical books in the newer interactive ebook format. My role as a developer was unique until earlier this year (2014) when attending a developers’ conference and hearing the CEO of Apple Computer Tim Cook state through an Internet broadcast that he was welcoming the nine million app developers from around the world. He proudly stated that this was a 47 percent increase from the previous year.
It should come as little surprise to me that no matter the healthcare sector — long-term care, ambulatory or in patient, for example – most of the worries faced are the same or very similar. Many of the same levels of attention is given to many of the highly complex usual suspects – interoperability, health information exchange, accountable care, HIPAA and even mandates like meaningful use. The murmurs of those working here are often similar and there is a fairly deep collective holding of the breath in regard to advancements or developments in these areas regarding the blowing winds of how these and other issues sway constituents throughout the marketplace.
The general sentiment of individuals, those leading large hospitals and multi-location care facilities, who express their opinions and concerns to organizations like HIMSS, to name one, are the same as the concerns voiced by many of the attendees at PointClickCare’s annual user meeting, to name one, in Orlando Nov. 2-5, 2014. These same sentiments also are expressed at variety of other meetings of the minds throughout the US in similar constituent groups or with vendor and other allegiances.
Educational and work sessions held at these gatherings always have the same look and feel; the same as those expressed at PointClickCare’s Summit 2014. Engagement, connection, care; ACOs, HIEs, and managing their relationships; EHRs, interoperability, and managing this relationship and the flow of information (or doing so when the information does begin to flow); and change management strategies that provide guidance and advice for … managing change.
The information exchanged in venues such as these and the sessions themselves are valuable, of course, and needed to fill an enormous information void. Most importantly, these healthcare education sessions draw together folks seeking guidance and those needing insight, as well as provide a dash of leadership at times when much seems to be lacking. Finally, these educational sessions – quick and concise as many of these sessions may be – alleviate fear during a scary and tumultuous time in healthcare.
High-demand healthcare providers have no good system in place to drive differentiating value at the time of patient scheduling. With an increase in demand and reduction of time, doctors need to be smarter about how they run their business. Some doctors need to prioritize based on completing a specific surgery. Others need to prioritize based on the greatest opportunity for high reimbursement. But through it all doctors need to maintain a full schedule and optimized revenue while keeping their patients happy and loyal.
Opargo focuses on delivering incremental value to healthcare providers through schedule optimization. Opargo’s patent pending solution takes into account healthcare insurance payment rates, office and procedure activities, historical practice demand and availability to calculate incremental value. This perishable inventory model is similar to how scheduling and payment has been managed for many years in the travel industry to optimize yield for airlines and hoteliers. The Opargo SaaS system seamlessly integrates with a practice’s existing calendar and revenue management systems to make it easy to install and manage.
Elevator pitch
Dr. Aaron Lloyd, co-Founder, president and chief medical officer
Opargo delivers incremental revenue to healthcare providers through schedule optimization. Opargo helps healthcare providers optimize the value of time.
Product/service description
Healthcare providers have previously used a “first come first serve” or “look and book” calendar approaches to schedule patients. This is also how airlines booked passengers in the past. However, as airlines started to incorporate revenue management principles at the time of booking, they saw significant increases in revenue and long-term corporate value.
Opargo is a patent-pending solution that integrates reimbursement rates, reimbursement timing, referral sources, visit types, historical demand and more to determine the value of each visit for healthcare providers. High-value visits are given prioritization to ensure patients don’t look for other providers, as wait times greater than two weeks cause patients to “shop around.” By ensuring high value patients don’t leave, healthcare providers have seen up to a 20 percent increase in annual revenue.
However, there are benefits to the patients of healthcare providers using Opargo, too. First, all patients are seen and no one is denied medical care due to type of insurance. Opargo ensures all patients are seen at the right time. Second, Opargo leverages its proprietary algorithm to ensure patients are seen by the most qualified provider. This helps patients get the most optimal care from the optimal provider as soon as possible.
Bookings made in Opargo’s cloud-based application are automatically passed into practice management systems to ensure all down-line processes remain in-tact. Currently, Opargo integrates with GE Centricity practice solution, Greenway PrimeSuite and AthenaHealth.
The objective of technology is to drive down cost and the commoditization of a product makes it cheaper. That said healthcare doesn’t necessarily need to be a hand-crafted masterpiece. Masterpieces are beautiful, but how many people can afford them? In healthcare, people need affordable processes, procedures and results that they can attain, afford and use to improve their lives.
These are the prevailing sentiments depicted in a new colorful, moving documentary film produced by Health Catalyst. The 29-minute film, “From the Heart: Healthcare Transformation from India to the Cayman Islands,” premiered at the Healthcare Analytics Summit in Salt Lake City late last summer.
The film tells the story of Dr. Devi Shetty of Bangalore, India, who describes his multi-year mission to deliver radically lower-cost heart surgeries to those who cannot afford them in India, allowing families to choose life rather than almost certain death because of the condition. Doing so allows parents to receive affordable care that empowers them to save their young children with heart defects rather than watching them die.
“A hundred years after the first heart surgery, less than 20 percent of the population can afford it. For 80 percent of the worlds’ population, if they ever require a heart operation, they’re going to die. This is unacceptable. Healthcare has to be available to everyone on this planet with dignity and that is what we are trying to do. And it’s going to happen, I’m convinced of that. It’s going to happen in our own lifetime,” said Dr. Devi Shetty, chairman and founder of Narayana Health.
Narayana’s average cardiac hospital to perform thousands of heart surgeries per year for less than $1,400 per case – about 2 percent of the average cost for heart surgery in the US.
“Henry Ford proved that the commoditization of a product makes it cheaper, makes it better and makes it more efficient,” said Dr. Shetty. “I strongly believe that we have to commoditize the delivery of healthcare, and that is the model that Health City represents for the world.”
Dr. Shetty, who was Mother Teresa’s personal physician, replicates his work in India and takes it to the Cayman Islands where the film takes viewers where this year Shetty, in collaboration with business and government leadership on the island, opened a similar, state-of-the-art hospital, Health City, at a fraction of the U.S. cost, producing better outcomes and higher patient safety.
Electronic health records uptake in the U.S. has accelerated dramatically as a result of government initiatives and the considerable resources – both capital and time – healthcare providers have invested over the past five years. Electronic health records have become the heart of health IT, and U.S. clinicians use them on a daily basis.
Frost & Sullivan’s newest health IT analysis, “EHR Usability—CIOs Weigh in On What’s Needed to Improve Information Retrieval,” finds that as the market matures and the volume of EHR data proliferates, ensuring reliable information retrieval from EHRs at the point-of-care will become a priority for healthcare providers.
In spite of significant progress in EHR adoption, the road is paved with pitfalls for many providers. Frequently highlighted customer pain points include:
Slow and inaccurate information retrieval from EHRs, as well as difficulty in finding and reviewing data, both of which result in productivity losses for clinician end-users as well as potential risks to patient safety.
Inability to create targeted queries or easily access unstructured data such as clinician notes.
Time-consuming data entry tasks.
“U.S. regulatory authorities will take notice of the growing chorus of complaints about EHR usability, resulting in a push to devote more resources to solving this issue,” saidFrost & Sullivan Connected Health Principal Analyst Nancy Fabozzi. “Further, the high levels of end-user frustration with usability present strong business opportunities for pioneering technology vendors.”
In a blog post “written” by Dr. Karen DeSalvo (in which she refers to herself in the third person) on ONC’s Health IT Buzz blog, the national coordinator for health IT announced that she’s actually not leaving her leadership roll there to become Acting Assistant Secretary of Health even though on October 23 it was announced she was doing so.
Walking back that announcement, DeSalvo announced that she’ll be maintaining her leadership role at ONC while also serving serve as Acting Assistant Secretary of Health to battle Ebola. According to “her” blog post, she will continue to work on high-level policy issues at ONC, and ONC will follow the policy direction that she has set. “She will remain the chair of the Health IT Policy Committee; she will continue to lead on the development and finalization of the Interoperability Roadmap; and she will remain involved in meaningful use policymaking. She will also continue to co-chair the HHS cross-departmental work on delivery system reform. “
Lisa Lewis will keep DeSalvo’s seat warm in the interim, providing day-to-day leadership at ONC. Lewis served as Acting Principal Deputy National Coordinator before Dr. DeSalvo joined ONC.
In addition, as has been noted in a number of other publications, the ONC announcement likely comes as a result of concern over an exodus of leadership at the organization. The post goes on to pat a few ONC employees on the back for their leadership skills and work.
