Posted on

General health checks did not reduce morbidity or mortality – here come the studies!

[preamble]
Here it comes – the studies stating how all the testes and ideas that we were engrained with are now false. No scientific basis just a push for the political agenda – health care rationing!. READ ANIMAL FARM!!!!!!!!

This is how we save money on healthcare – we stop going to the doctor! And when we get really ill, we are told we can only have such and such tests and procedures and we can only see a nurse or proxy provider. Meaning – we will not be able to detect diseases early and manage them – we will detect them to late and simple die. Death = cost savings. Treatment and prevention = more money!

Horrible – but can it be explained any way?

Once again – where are the doctors shouting about this? Where are the societies screaming at the top of their lungs – WRONG!!!!!!!

The sound of silence is deafening and we the people believe what we here – hence we don’t here you  doctors so it must be TRUE!!!!!

Look at the trend:
Mamograms are not effective
PSA tests are not effective
Annual exams are not effective

The trend is to retrain the population in believing we do not need these hence we artificially reduce healthcare costs. It took years to train us to eat an apple a day, go to the doctor for our yearly exam, the 4 food groups (now morphed into a complex ridiculous food pyramid that no one understands),Reading – Riting – Rithymic and now the institution of marriage between man and women – all gone!

Look at the problems we are having and look at what is going on in the country – all the result of this “Hope and Change”

Well – I HOPE IT CHANGES!!!!

Again – DOCTORS WHERE ARE YOU ? Perhaps you need a free meal to discuss the possibility of discussing this?
[backtopost]

Excerpt from report
http://onlinelibrary.wiley.com/o/cochrane/clabout/articles/EPOC/frame.html

General health checks are common elements of health care in some countries. These aim to detect disease and risk factors for disease with the purpose of reducing morbidity and mortality. Most of the commonly used screening tests offered in general health checks have been incompletely studied. Also, screening leads to increased use of diagnostic and therapeutic interventions, which can be harmful as well as beneficial. It is, therefore, important to assess whether general health checks do more good than harm.

We aimed to quantify the benefits and harms of general health checks with an emphasis on patient-relevant outcomes such as morbidity and mortality rather than on surrogate outcomes such as blood pressure and serum cholesterol levels.

We included 16 trials, 14 of which had available outcome data (182,880 participants). Nine trials provided data on total mortality (155,899 participants, 11,940 deaths), median follow-up time nine years, giving a risk ratio of 0.99 (95% confidence interval (CI) 0.95 to 1.03). Eight trials provided data on cardiovascular mortality (152,435 participants, 4567 deaths), risk ratio 1.03 (95% CI 0.91 to 1.17) and eight trials on cancer mortality (139,290 participants, 3663 deaths), risk ratio 1.01 (95% CI 0.92 to 1.12). Subgroup and sensitivity analyses did not alter these findings.

We did not find an effect on clinical events or other measures of morbidity but one trial found an increased occurrence of hypertension and hypercholesterolaemia with screening and one trial found an increased occurence of self-reported chronic disease. One trial found a 20% increase in the total number of new diagnoses per participant over six years compared to the control group. No trials compared the total number of prescriptions, but two out of four trials found an increased number of people using antihypertensive drugs. Two out of four trials found small beneficial effects on self-reported health, but this could be due to reporting bias as the trials were not blinded. We did not find an effect on admission to hospital, disability, worry, additional visits to the physician, or absence from work, but most of these outcomes were poorly studied. We did not find useful results on the number of referrals to specialists, the number of follow-up tests after positive screening results, or the amount of surgery.

General health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although the number of new diagnoses was increased. Important harmful outcomes, such as the number of follow-up diagnostic procedures or short term psychological effects, were often not studied or reported and many trials had methodological problems. With the large number of participants and deaths included, the long follow-up periods used, and considering that cardiovascular and cancer mortality were not reduced, general health checks are unlikely to be beneficial.

Posted on

Medical Liability Caps are Coming – Hello NY WAKE UP – YOUR DESTROYING DOCTORS!@

[preamble]
Just returning from Texas, i can attest that tort reform works! So why New York are you still not on the bandwagon? Is it that too much money is being made by lawyers and members of our government? On one hand you tout reform for physicians and on the other you don’t pass bills that will actually help lower malpractice premiums and stop the greedy lawyers from suing physicians out of practice.
WAKE UP NEW YORK!

Doctors – stop speaking in silence – its deafening! Tell us the problems, don’t allow “them” to speak for you – they are not on your side!
WAKE UP DOCTORS!
[backtopost]

Slowly the Country Turns Toward reform………………………..

Sleepless Nights Are Over In Kansas

On October 5, the Kansas Supreme Court handed physicians a huge victory issuing a long-awaited opinion upholding the state’s $250,000 cap on noneconomic damages in medical liability lawsuits. In its 5-2 ruling, the court said the legislature’s decision to enact the cap was rationally related to a valid legislative purpose – to ensure the availability of quality health care and affordable malpractice insurance for Kansas health care professionals – and therefore did not violate the state constitution. This is the second time Kansas’ high court has upheld the cap which was first enacted in 1988.

The ruling comes a little over a month after Missouri’s Supreme Court overturned Missouri’s $350,000 cap on noneconomic damages.

Mixed Rulings In Other States

Overturned in Missouri
In late July, the Missouri Supreme Court overturned the state’s $350,000 cap on noneconomic damages passed in 2005. The chief justice said the state’s 1820 constitution grants citizens an “inviolable right” to a trial by jury and the cap on damages violated that right by removing a jury’s ability to decide the magnitude of damage.

Upheld in Louisiana and Texas
The Supreme Court of Louisiana reaffirmed in March this year the state’s $500,000 limit on total damages (both noneconomic and economic) and held that it applies to all health professionals including nurse practitioners. Lower courts had issued mixed opinions on the constitutionality of the cap and said it should not apply to nurses. Louisiana’s cap, enacted in 1974, is one of the oldest in the country. Under the cap, physicians who contribute to the state’s Patient Compensation Fund are responsible only for the first $100,000 of a liability judgment. The Fund covers the remaining $400,000, with no limit on future medical expenses.

In Texas, a federal judge ruled earlier this year that Texas’ $250,000 cap on noneconomic damage should stay in effect. The landmark cap was passed twice in 2003 – first by the Texas legislature and then by Texas citizens who went to the polls and approved a ballot measure a few months later affirming the constitutionality of the cap under the state constitution. Plaintiffs challenged the cap in federal court in 2008 on four grounds: right to trial, due process, equal protection and right to petition.

Still Pending in Florida
In Florida, physicians await a ruling from their Supreme Court on the $500,000/$1million limit on noneconomic damages passed in 2003. The 11th U.S. Circuit Court of Appeals ruled last year that the cap does not violate the federal Constitution but also said the Florida Supreme Court should address the issue under the state constitution.

Posted on

Why Things Are As They Are and How People Are Truly Blind To The REAL World

I had an interesting heated discussion this weekend with a group of physicians. Lovely people, good doctors. During dinner, the discussion leaned towards business and politics.

I found it quite interesting how they were attacking businessmen like myself stating I don’t pay enough taxes and how everyone needs the best healthcare no matter what their status.

I commented to them that they work for a company and have never ran a business or started one. Nor have they had the “pain” of making payroll. They both work for a hospital and are completely insulated from the world of the business person that give them their job.

As the conversation progressed, they adamantly advised that all people deserve top healthcare and so many people don’t have it or access to proper care. One even gave an example fo a person with no money  working 12 hours a day that broke their arm. Because of their minimal insurance, they only were able to have it set properly but never returned for followup visits. Their comment was that if I paid more money and paid for their healthcare, this person would have had a special care coordinator assigned to them and would have had a better outcome.

My comment was – “You have great jobs making over $400k a year, you have 2 expensive cars, 2 regular cars, beautiful house with a pool, a private school for your child, a beach house and you go on vacation regularly. You are truly living the American dream,. I have an idea – Reduce your salary to $100,000, put your son i public school, sell your cars and by a Prius smart car, sell your house and move to an apartment in the projects so your medical skills can be donated to the needy and you are right in the heart of the issue and finally, go find this person that YOU TREATED with the broken arm that works 12 hours a day and did not come back for additional treatment, and personally take care of them with your own time and money.

You cannot look at me with disdain when you are reaping the benefits of being a physician and working for a hospital and government clinic. Never created jobs and never had to make payroll – hence, if you want me to give more, how bout you start with yourself?
If you do the above,m I will follow suite and both together can start a trend. Lets redistribute your wealth and see how you feel.

Their comment – “You just don’t understand you businessmen ruined this country And singing “coum by ya” and loving all is how it should be.”

Needless to say – the conversation became unpleasant  – but It was their home and I did back off.

This is the state of America and the state of our politicians – they speak with forked tongue and out both sides of their mouth.

If you have seen the movie Casablanca – you may remember the scene where the police chief closes down the bar for gambling – he was “shocked, shocked there is gambling in this establishment” right after an employee gives him his roulette winnings and he says “thank you” while he is closing down the bar.

And so it is – these people believe WE not THEM should distribute our wealth.

 

 

Posted on

People to Albany – Hold The Pay Raise Please – You Are Not That Good

[preamble]
Pay for Performance – The act of compensating an individual or a company based upon their performance in the job and or tasks given. The better the performance, the more they can be paid, the worse the performance the less they get paid.

Albany score board:
Higher taxes
Attack on businesses
High unemployment
Theft, Graft & Non Disclosure
No Accountability
Protecting their own at the expense of the people they serve

Do you really feel our government deserves a pay raise? Do you feel they are doing a good job? Do you really beleive you are going to be better off in a year or at the least have a job?

I suggest they stop embarrassing themselves and not even think of a pay raise with the state of the economy and perhaps consider a pay decrease – yes a decrease for a job horribly done. They will keep taking advantage of us if we keep acting like sheeple!
[backtopost]

 


	Gov. Andrew Cuomo wants a hike in the minimum pay before lawmakers get a wage increase.

Photo by AP

Battle over decriminalizing marijuana is also on Gov. Cuomo’s agenda.

ALBANY — Gov. Cuomo has a message for state legislators: You want a pay raise? First, take care of the little people.

Though lawmakers have been clamoring for their first hike since 1999, Cuomo vowed Tuesday to block any salary increase until “the people’s agenda” is resolved.

“I would not even consider — even consider a pay raise — unless the people’s business was being done in a thorough, responsible way,” Cuomo told reporters.

Included in that agenda, he said, are a minimum wage hike and Cuomo’s proposal to decrminalize small-scale marijuana possession.

The Legislature is in recess until January but speculation has swirled around the Capitol that the Assembly and Senate will reconvene after Election Day to give themselves a raise.

Cuomo, who has argued that state agency heads also deserve more pay, said the priority should be on other matters.

“If there is an opportunity for the Legislature to act, I’m going to be looking for them to act on the people’s agenda,” Cuomo said. “I understand they may have an interest in a pay raise. I’m interested in a people’s agenda and that’s what the session would be about.”

Cuomo supports a raise in the minimum wage but has not specified how big an increase he wants.

Assembly Speaker Sheldon Silver (D-Manhattan) has sponsored legislation to boost the wage from $7.25 to $8.50 and link future increases to inflation. Silver also supports pay raises for lawmakers.

“We thank the governor for focusing on important issues like raising the minimum wage, which has been a top priority for Assembly Democrats and should be a part of any special session later this year,” said Silver spokesman Michael Whyland.

Cuomo says his marijuana proposal would correct an inconsistency in state law that deems the possession of 25 grams or less of pot as a violation but the public display of weed as a misdemeanor. The problem, he has said, has been exacerbated by the NYPD’s stop-and-frisk tactics.

The GOP-controlled Senate balked at both the pot bill and the minimum wage hike, refusing to pass either.

Scott Reif, a spokesman for Senate Majority Leader Dean Skelos (R-Nassau County) shrugged off Cuomo’s comments Tuesday.

“Sen. Skelos and the governor have not discussed any issues related to a potential special session,” Reif said.

Gov. Cuomo said he will “not even consider” a pay raise for the Legislature unless lawmakers agree to:  Increase the state minimum wage to $8.50.

————————-

Perhaps it goes without saying it has been a bad week for the state Legislature, but there could be a silver lining for taxpayers: The recent torrent of lawmakers’ alleged and wrongful conduct just might be enough to deny them an expected post-election pay grab.

Gov. Andrew Cuomo, who spent part of the week fielding questions about a hush-hush, six-figure settlement paid to settle sexual harassment claims against an Assembly Democrat, and still more time addressing freshly minted corruption charges against a Democratic senator from Queens, took the wind out of any pay-raise talk for lawmakers, whose base $79,500 salary has been unchanged for more than a decade.

“I think it makes it harder to communicate that and convince the general public,” Cuomo said during a conference call with reporters, as reported by the Daily News. The support of the popular Democratic governor would be key to pushing through any raise; top executive branch officials have gone without raises for as long. Cuomo noted that most polls show the public has been unsympathetic to the lawmakers’ plight, opposing any increase; no doubt that disdain has been solidified by recent events.

Assembly Speaker Sheldon Silver, D-Manhattan, roundly criticized for his handling of the sexual harassment claims brought by Lopez staffers, called it a mistake Tuesday to authorize, as he did 2 1/2 months ago, payment of a secret, $103,080 settlement of claims against Assembly member Vito Lopez, D-Brooklyn.

Silver said the decision to settle the claims without public disclosure was the “wrong one from the perspective of transparency”; on Wednesday he took matters a bit further, saying the Assembly has written to counsel “in any previous settlement” asking to be released from “any confidentiality clauses that may exist.” Cuomo, for his part, said the state’s Joint Commission on Public Ethics should “get the facts” on the allegations against Lopez, who has denied any wrongdoing.

In an unrelated embarrassment, state Sen. Shirley Huntley, D-Queens, was arrested Monday on felony charges of falsifying business documents, conspiracy and tampering with an Attorney General’s Office investigation into the finances of a nonprofit she founded. In a partnership with state Comptroller Thomas DiNapoli’s office, Attorney General Eric Schneiderman investigated Huntley’s nonprofit Parent Workshop Inc., ultimately alleging that the charity funneled nearly $30,000 of public money to the senator’s aide and to a niece.

Posted on

Social media and patient privacy lessons ripped from the headlines

[preamble]
Social media is dangerous and will cost institutions millions to manage and be sued over. What is to stop a nurse or doctor from innocently posting something that happened in a hospital or their practice on social media just to tell his family and friends? In the past, it was spoken at the dinner table (possibly) and rarely went beyond the house. Now any innocent or non so innocent breach of information is immediately transported around the world to billions of people. And what of the data? What is private information? Is posting “a patient had a smell body in my office today” or describing a situation that happened and making comments on it. Is this private? An invasion of privacy? Only the lawyers will decide and today when you can sue for anything and get money form it – i would be very worried – heck I would be scared. Hence my suggestion to medical institutions – STAY OFF SOCIAL MEDIA – you cannot control it nor can you control people.
[backtopost]

You can’t make this stuff up. Sometimes, the greatest lessons come straight from the headlines.

FierceHealthcare readers often write in with questions about patient privacy in the evolving world of social media. That includes our Fierce editors, who have questions of their own about the increasingly gray areas of what’s right and legal.

With that in mind, FierceHealthcare examined what hospitals are doing to ensure patient information stays safe, especially as they and their patients use social media even more.

Notorious cases of patient privacy violations via social media

Remember these scandals in recent history?

> A certified nursing assistant at Kindred Transitional Care and Rehabilitation in Indiana took a photo of a paraplegic’s butt after he had a bowel movement and posted it to Facebook in May 2011, telling her coworker, “This is too funny. I need to take a picture of this,” RTV6, an ABC affiliate, previously reported. The medical facility fired her, and the nursing assistant faced a voyeurism charge.

> A physician at Westerly Hospital in Rhode Island recounted her emergency room experiences on Facebook in April 2011. Although the doctor didn’t include the patient’s name, she included enough detail about the patient’s injuries that a third party was able to identify the patient. The incident led to a guilty charge of unprofessional conduct and $500 fine by the state medical board.

> Emergency nurses and staff from St. Mary’s Medical Center in California posted a photo on Facebook of a stab victim, who died soon after the photo was taken, the Los Angeles Times reported in April 2010. Coworkers, as required, reported the event. The involved staff members were fired or disciplined, the Associated Press reported.

> Hospital employees at Tri City Medical Center in California in June 2010 allegedly used Facebook to discuss patients. Six registered nurses at the hospital were put on administrative leave, North County Times reported.
______________________________

“It’s just Facebook. … It’s just a name out of millions and millions of names.”
______________________________

> At Providence Holy Cross Medical Center in California, an employee in December 2011 posted a picture of a patient’s medical record on his Facebook account, apparently to make fun of the woman, according to the Daily News of Los Angeles. He wrote, “Funny, but this patient came in to cure her VD and get birth control.” When others scolded the employee, he responded, “People, it’s just Facebook. … It’s just a name out of millions and millions of names. If some people can’t appreciate my humor, then tough. And if you don’t like it, too bad because it’s my wall, and I’ll post what I want to.”

Who’s responsible to protect health information under HIPAA and HITECH?

One of the biggest lessons from recent cases is that patient information can be very broad.

The Health Insurance Portability and Accountability Act of 1996, better known as HIPAA for short, and Health Information Technology for Economic and Clinical Health (HITECH) Act, are patient privacy rules in which covered entities must secure protected health information (PHI).

What’s PHI? “Basically anything used to identify a patient,” Tatiana Melnik, an associate at Dickinson Wright in Ann Arbor, Mich., told FierceHealthcare. PHI can be patient names, photos of their faces or even tattoos, as well as medical conditions or location.

And who’s responsible for protecting that information? “Covered entities,” which can be hospitals, physicians, nurses, health plans or business partners that handle PHI.

“People don’t seem to understand that posting that kind of information, is in fact, a breach because they think ‘I’m one of millions. It’s very difficult to find out where I am,’ where in fact, that’s not the case,” Melnik noted. “It’s much easier than people than think to find out who someone is.”

And there are some rouge employees. “Sometimes, the person knows it’s wrong, and they’re doing it anyway,” Melnik noted.
______________________________

“People don’t seem to understand that posting that kind of information, is in fact, a breach because they think ‘I’m one of millions.'”
______________________________

Good intentions can spell trouble

Even well-intentioned providers may inadvertently violate HIPAA and HITECH. For instance, if a care coordinator who is friends with a patient on Facebook notices that her patient lost some weight and congratulates her by commenting, “I hope your diabetes has improved” without the patient mentioning her condition first, that could be a breach.

“That kind of thing, it’s very easy to make because you think you’re being friendly, and there’s no malice intended … but it’s still a breach,” Melnik said. She added that a best practice is for providers to avoid “friending” patients, although she acknowledged that’s harder to do in smaller communities.

One of the most common situations of social media fumbles are patients posting about other patients. Although it’s not a breach of HIPAA or HITECH (because patients aren’t considered “covered entities”), the hospital still has a responsibility under state law to protect patients.

For instance, if a patient wants to compliment his nurse by posting a photo, the picture could have the name of another patient’s medication in the background. Remind patients that photography must go through the public relations department. Also consider posting no-cellphone notices in the hospital.

Have a social media policy and train employees on it

The best way to spell out guidelines for employees is, of course, by having a social media policy.

But there’s no need to reinvent the wheel. The social media policy need not be different than your existing policy on patient privacy, Melnik explained. The hospital can have a social media-specific policy if it likes.

At the same time, you want to make sure you are allowing your employees to freely discuss working conditions in their personal lives.

“You want to make sure you’re not overstepping boundaries,” Melnik said.

She advised hospitals look to the National Labor Relations Board’s social media policy as an example, as well as other hospitals’ social media policies.

And even more importantly, once you have that social media policy in place, be absolutely sure to train employees.

“It’s really important to make sure employees are trained. It’s actually much worst to have a policy and not enforce it,” Melnik said, adding that hospitals could be held liable for having a policy and ignoring it.

Know and set the consequences

In some cases, a social media PHI breach might not call for an immediate employee termination. For instance, if the care coordinator let the patient take a photo of another patient’s medication, it’s up to the hospital’s discretion of how hard a line it wants to draw.

“It’s doesn’t have to be, ‘Well you violated it, and you’re automatically terminated.’ You can absolutely have flexibility and analyze what happened,” Melnik noted.

But some hospitals do automatically terminate employees because the risk is too great.

Check business agreements

Equally important to informing employees of the social media policy is letting business partners know. Business partners and contractors also are considered “covered entities”–from the electronic health record vendor to the company that services the photo copier and handles PHI.
______________________________

“It’s actually much worst to have a policy and not enforce it.”
______________________________

“Err on the side of having them sign a business associate agreement” for anyone that has access to patient information, Melnik said.

In the agreement, make sure to spell out notification requirements so the hospital has time to investigate and report. Covered entities are required to report a breach of more than 500 affected individuals within 60 days.

“That clock starts running as soon as someone in your organization knew or should have known by conducting reasonable diligence,” Melnik said.

Don’t be afraid of social media

And finally, the notorious cases of providers behaving badly on social media offer lessons, but HIPAA and HITECH shouldn’t deter hospitals from using social media, which can be a powerful tool.

“There are all kinds of services and educational things that hospitals can provide through using social media that could be very helpful to the community and increase their profile at the same time,” Melnik said.


Patients choose hospitals based on social media

With one-third of consumers using social media for seeking or sharing medical information, 41 percent say tools like Facebook, Twitter, YouTube and online forums influence their choice of a specific hospital, medical facility or doctor, according to Tuesday’s report from consulting firm PwC.

In a survey of more than a thousand consumers, more than two-fifths of individuals said social media did affect their choice of a provider or organization. Forty-five percent said it would affect their decision to get a second opinion; 34 percent said it would influence their decision about taking a certain medication and 32 percent said it would affect their choice of a health insurance plan.

The PwC report follows a study last summer by hospital market research firm YouGov Healthcare, which found that 57 percent of consumers said a hospital’s social media connections would strongly affect their decision to receive treatment at that facility.

Following the release of the study, YouGov Healthcare Managing Director Jane Donohue told FierceHealthcare, “We were surprised that consumers were going to review sites and blogs as often as they are going to the official hospital sites.” She added, “Clearly, any successful social media strategy is going to have to monitor and engage those [review site] conversations because you don’t control them. With your own content on Facebook and Twitter, you have a lot of control, but you certainly need to be engaged in those conversations.”

However, as one reader noted on the story, “This is the kind of research that ends up misleading healthcare managers to go down a strategic path to nowhere. … Social media is a valuable and growing tool for communication, but it is nowhere near the usage deciding factor.”

Even if the studies overestimate social media’s impact on consumer behavior, other experts say it goes beyond marketing.

“Savvy adopters are viewing social media as a business strategy, not just a marketing tool,” Kelly Barnes, US Health Industries leader of PwC, said in a company announcement.

Farris Timimi, medical director for the Mayo Clinic Center for Social Media, said social media in healthcare is a “moral obligation,” at the ninth annual World Health Care Congress in in National Harbor, Md., on Monday, FierceHealthIT reported.

“Our patients are there. Our moral obligation is to meet them where they’re at and give them the information they need so they can seek recovery,” Timimi said. “This is not marketing; this is the right thing to do.”


Who’s responsible for protecting patient privacy on social media?

Picture this: A patient videotapes another patient, who is drunk in the trauma center. The staff doesn’t notice. The hospital’s media relations department later stumbles across the footage on YouTube. Although the video portrays the staff members in a very good light, caring for the intoxicated man, the patient’s likely embarrassing event has gone public.

This scenario played out in real life at a Lifespan hospital in Rhode Island and was the topic of discussion on a thought-provoking Hospital Impact blog post last week by Nancy Cawley Jean, senior media relations officer of social media at Lifespan.

Jean explained that the hospital contacted Google to pull the video, although unsuccessfully, when YouTube’s parent company said it wouldn’t remove the video because it didn’t violate its user agreement. The hospital also called local police, who said they couldn’t help. The video still lives online.

Boy, did the article generate some heat! Readers were fired about up “freedom of the press,” just as much as patient privacy–some arguing the hospital had no right to try to censor the video, while others said it did the right thing. Here are some of the comments readers had:

“Unless the person taking the video was a hospital employee, he/she has no duty to protect the privacy of the patient.”

“How exactly do you expect [staff]–who are busy saving lives by the way–to notice some idiot with a cell phone, uploading this crap?”

“As a health worker, your first line of responsibility is the patient and protecting their safety and their privacy.”

The situation Jean described proved that patient privacy in the social media age is an evolving issue and hospitals need to get ahead of it. Was the patient’s privacy breached? Is the hospital responsible?

In short, it’s not likely a HIPAA or HITECH violation.

“While what happened is very disconcerting, it is not likely a HIPAA breach because the activity was carried out by an individual,” Tatiana Melnik, an associate at Dickinson Wright in Ann Arbor, Mich., told FierceHealthcare.

Because HIPAA and HITECH are directly aimed at healthcare providers (i.e., covered entities), as well their business associates and subcontractors, the regulations don’t cover patient-produced content. But–and it’s a big BUT–that doesn’t mean the hospital is off the hook. For situations like these (and it depends on the specific circumstances), the hospital and the person who took the video could still be held liable under state laws on emotional distress, invasion of privacy and negligence, Melnik explained.

The hospital already has a systemwide policy that says photographing and videotaping must go through media relations. The only exception is practitioners taking photos of patients for documentation purposes, in which the patient signs an agreement at admission time, Jean told FierceHealthcare.

“Our security department is vigilant in identifying anyone taking a photo or videotaping and has often notified the media relations team at all times of day or night to manage a situation involving photos or videos on campus [that are] not approved,” Jean said. But as this situation demonstrated, some photographers and social media-happy people slid by.

How should hospitals handle those situations?

“We deal with each on a case-by-case basis. Some situations have involved calling the police,” Jean said.

Readers of the blog post went as far as to recommend banning smartphones altogether.

“There used to be a time when we were asked to turn off mobile phones in hospitals. This was because of the interference it could cause to the equipment. While this may or may not be true, why not reintroduce this rule?”

“Perhaps the hospital should develop some new privacy policies, by which, no one is allowed to bring cell phones in or they will be confiscated, or people should be searched prior to enter the hospital, like in the airports.”

Well, as for Jean, she said the YouTube video holds some tough lessons.
______________________________

“We have learned that it’s vital to catch these things while they are happening, and not after they are posted.”
______________________________

In addition to the existing photography policy, Jean said the hospital is developing some new privacy policies, specific to patients and visitors using smartphones to take pictures and video, which will likely result in signage about the inappropriate use of personal devices for recording.

“We have learned that it’s vital to catch these things while they are happening, and not after they are posted because it is near impossible to have a video taken down if the one who posted it is not willing to do so,” Jean said. “I believe it’s an important message for staff to be more aware of what patients and visitors are doing, and they should feel empowered to ask people to turn off and put away phones and not take pictures or videos.”

Jean also said it’s important to constantly monitor what’s being said about the hospital, which she does through Google Alerts.

“Even if you aren’t talking about yourself in the social media world, you can be sure that others are,” she wrote.

Posted on

INcorporating DNA Sequencing Data in EMR Systems – Is this Dangerous?

[preamble]
I understand the idea of incorporating this important information in an EHR. Imagine if a doctor can review your genetic sequencing and have the ability to pick a medication that’s tailored to your specific needs.  Or the ability to provide preventive medicine before your genes do you in – this and more are wonderful benefits of DNA sequencing.

Now the bad part – will insurance companies have access to this data? Or can they get access to this data? What about he government having access to this data? I can see my insurance premiums going up because i MAY or have the propensity to have such and such a disease. Or my bones can be prone to fracture or my body will not respond well to generic drugs and i have to have “real” medicine which cost more.

Its not a stretch for this thinking – its going to happen and already happening – hospitals are already sharing your data no matter what you tell them and insurance companies are already collating your private data and using it against you. Are we really ready for this?
[backtopost]

A presidential commission studying privacy issues related to more readily available DNA sequencing recommends integrating whole genome sequence data into health records for research purposes.

In a report issued Thursday, the Presidential Commission for the Study of Bioethical Issues said that electronically exchanging DNA sequencing data through standardized EHRs and infrastructure would provide more data to researchers for genome-wide analysis that can advance clinical care.

The report, “Privacy and Progress in Whole Genome Sequencing,” recommends facilitating the exchange of information between genomic researchers and clinicians “while maintaining robust data protection safeguards,”  so DNA sequencing and health data can be combined in advancing genomic medicine.

“Current sequencing technologies and those in development are diverse and evolving, and standardization is a substantial challenge,” the panel said. “Ongoing efforts are critical to achieving standards for ensuring the reliability of whole genome sequencing results, and facilitating the exchange and use of these data.”

The panel makes clear that it wants to protect individuals’ privacy and the right to informed consent to having their DNA collected “while promoting data access and sharing.”

In a report summary, the commission notes it is urging federal and state governments to ensure a “consistent floor of protections” for DNA data “regardless of how they were obtained, the idea being to protect individual privacy by prohibiting sequencing without the patient’s consent.

The commission noted that in about half the states, it is legal to surreptitiously collect a DNA sample from something as simple as a discarded coffee cup without getting a person’s permission for testing.

Earlier this year, the UnitedHealth Group Center for Health Reform & Modernization issued a report noting that interoperable EHRs could alert clinicians when genomic testing might be called for when treating patients. Cincinnati Children’s Hospital, for example, has a digital patient entry system alerting doctors to available genomic tests to help guide treatments.

“E-prescribing systems also could serve as platforms to alert providers that genetic test exist to determine the efficacy of particular treatment options,” they added.

Posted on

Statewide health information exchange efforts hit a snag in Michigan

[preamble]
For years hospitals had the means to share data. For years they have ignored it because they do not want to lose money to their fellow hospitals aka rivals. So why does the government think this will be different?

Having multiple HIE’s is a duplication of resources hence a wast of time and money. In realty, there can be ONLY ONE HIE that has all data and is available to all. The more duplications, the higher the costs the more difficult the standards to keep and the more waste and non compliance you will have.

But its government at its best – expensively – meaninglessly ineffective.
[backtopost]
The electronic exchange of healthcare information on a statewide level has proved a difficult task in Michigan, Crain’s Detroit Business reports. Instead of cooperating to achieve interoperability, the state’s two largest health information exchanges–Great Lakes HIE in Okemos and Michigan Health Connect in Grand Rapids–have, thus far, been using separate technology systems that aren’t interoperable with one another.

While talks have been taking place to spur data sharing between the two systems, Doug Dietzman, executive director of Michigan Health Connect, told Crain’s that an agreement could be within a year, but there’s no rush.

“I don’t have any providers coming to me and saying that this is something I need you to do,” Dietzman said. “When they start saying that, then maybe we will move faster.”

What’s more, while an HIE task force convened in June by the Michigan Health and Hospital Association determined that a single, statewide HIE would be the best route for the state, according to Crain’s, some stakeholders–like Great Lakes HIE Executive Director Carol Parker–remain at odds with that sentiment.

“Last year we decided to expand statewide to be [financially] sustainable,” she told Crain’s. “We don’t want to overwhelm participants with costs because it is expensive to develop the infrastructure for an HIE.”

In an interview with InformationWeek Healthcare, Jennifer Covich Bordenick, CEO of the Washington, D.C.-based eHealth Initiative, agreed with Parker.

“You don’t resolve the issue [of competition] by picking one HIE,” Bordenick said. “You resolve the issue by having standards and systems that talk to each other. If you don’t do that, you’re going to have the same problem in another six months when another HIE pops up.”

That’s exactly the approach Massachusetts is taking with its statewide health information exchange, which is set to go live next week.

Posted on

CMS violated data breach notification requirements

[preamble]
Your personal medical data is not secure – just like your credit card information can be hacked from the largest credit card companies, so too can your personal medical data be compromised.  Interesting, Physicians are penalized i believe $1000 for every medical chart compromised. Is CMS holding themselves to the same penalization or is this ONLY for doctors and does not apply to the government?
[backtopost]

The Centers for Medicare & Medicaid Services failed to meet federal notification requirements when its Medicare patient database was breached, or offer much help to beneficiaries whose protected health information was compromised, an audit by the Department of Health & Human Services’ Inspector General found.

CMS had 14 breaches of protected health information (PHI) between Sept. 23, 2009, and Dec. 31, 2011, affecting 13,775 Medicare beneficiaries, according to the HHS Office of the Inspector General (OIG). The beneficiaries were notified, but CMS failed to meet several notification requirements detailed in the American Recovery and Reinvestment Act, OIG found.

CMS has since developed a database for contractors detailing compromised numbers, but OIG said in a summary of its report that the “usefulness could be improved,” noting that “contractors do not consistently develop edits to stop payments on compromised [Medicare] numbers.” And while CMS offers some remedies to providers, OIG says, fewer remedies are available to beneficiaries victimized by medical identity theft because of the breaches.

The OIG recommended that CMS:

  • Ensure that breach notifications meet Recovery Act requirements.
  • Improve the compromised number database
  • Provide guidance to contractors about using database information and implementing edits
  • Find a way to ensure that beneficiaries whose PHI is stolen have access to needed services
  • Develop a way to reissue identification numbers to beneficiaries whose medical identification is stolen

CMS last year took steps to help healthcare providers victimized by medical ID theft, launching its Provider Victim Validation / Remediation Initiative to help them exonerate themselves. Providers also can ask for help from the OIG or Medicare Administrative Contractors if they are victims of Medicare identity theft but have not sustained financial liability.

Data breaches are a major problem nationwide, with HHS’s Office for Civil Rights (OCR) listing nearly 500 breaches since September 2009 affecting more than 500 people each. The number affected totaled nearly 21 million as of the end of July.