How to Use HIPAA to Obtain Timely Medical Records

Are you hip to HIPAA?

August 27, 2018 by 

Members of the claims management team obtain medical records on a frequent basis when investigating workers’ compensation claims. It is important they do this promptly given the many constraints of workers’ compensation laws. Given the nature of these requests, state and federal privacy laws come into play. Failure to understand these laws and their requirements can lead to delay and problems down the road. Now is the time to better understand these laws and how to incorporate them into your team’s best practices.

It All Starts with HIPAA

HIPAA logo for article, How to Use HIPAA to Obtain Timely Medical RecordsThe Health Insurance Portability and Accountability Act of 1996 (HIPAA) serves as the basis for healthcare privacy and the dissemination of medical records in the United States. The law was enacted in 1996 to address the many issues medical providers were facing and to protect the privacy of all individuals. In essence, it serves as the baseline for standards enacted at the state level for all covered entities.

Understanding the Basics of HIPAA

To understand the law, it is important to understand when it applies and whom it protects. HIPAA applies to all “covered entities,” which are defined under 45 C.F.R. §160.103, as:

Health care providers who transmit “protected health information;”

Entities that process personal health information (healthcare clearinghouses);

Health plans such as Group Health Plans; and

Any business partner of a “covered entity.”

It is also important to note that the federal law applies to “protected health information,” otherwise known as PHI. This is information defined under 45 C.F.R. §164.501, which is individually identifiable health information maintained or transmitted in any form, whether electronically, on paper or orally.

Exceptions to HIPAA in Work Comp

Employees at healthcare providers are required to know and understand HIPAA and have a duty to protect a patient’s PHI. Continue reading How to Use HIPAA to Obtain Timely Medical Records

8 ways hospitals are cutting readmissions

Written by Megan Knowles | August 15, 2018 | Print  | Email

As hospitals work to reduce readmissions, healthcare experts are looking at why patients return to the hospital and strategizing ways to keep discharged patients from becoming inpatients again, according to U.S. News & World Report.

1. Rapid follow-up. Congestive heart failure patients are some of the patients who have the highest risk of early hospital readmission, and patients who see a physician soon after their hospital stay or receive a follow up from a nurse or pharmacist are less likely to be readmitted, a study published in Medical Care found.

graph of top causes for hospital readmissionAfter researchers looked at about 11,000 heart failure patients discharged over a 10-year period, they found the timing of follow-up is closely tied to readmission rates, said study co-author Keane Lee, MD. “Specifically, it should be done within seven days of hospital discharge to be effective at reducing readmissions within 30 days,” Dr. Lee said.

2. Empathy training. When clinicians are trained in empathy skills, they may better communicate with patients preparing for discharge, and encouraging two-way conversations may help patients reveal their care expectations and concerns. Providers at Cleveland Clinic, for example, receive empathy training to better engage with patients and their families.

3. Treating the whole patient. When a patient suffers from multiple medical conditions, catching and treating symptoms of either condition early may prevent an emergency room visit. Integrated care models make it easier to give patients all-encompassing, continuous care, said Alan Go, MD, director of comprehensive clinical research at the Kaiser Permanente Division of Research in Oakland, Calif.

4. Navigator teams. A patient navigator team of a nurse and pharmacist can help cut heart failure patient readmissions. Patients who are discharged may be overwhelmed by long medication lists and multiple outpatient appointments. A patient navigator team of a nurse and pharmacist can help cut heart failure patient readmissions.

One study examined results of these teams at New York City-based Montefiore Medical Center. The navigator team helped reduce 30-day readmission rates by providing patient education, scheduling follow-up appointments and emphasizing patient frailty or struggle to comprehend discharge instructions.

5. Diabetes home monitoring. For high-risk patients with diabetes and coronary artery disease, home monitoring can help avoid readmissions. In a study examining a Medicare Advantage program of telephonic diabetes disease management, nurses conducted regular phone assessments of patients’ diabetes symptoms, medication-taking and self-monitoring of glucose levels. The study found hospital admissions for any cause were reduced for the program’s patients.

6. Empowered patients. It is critical for patients to understand their care plan at discharge, including medications, physical therapy and follow-up appointments, said Andrew Ryan, PhD, professor of healthcare management at the University of Michigan School of Public Health in Ann Arbor. “Patients don’t want to be readmitted, either,” Dr. Ryan said. “They can take an active role in coordinating their care. Ideally, they wouldn’t have to be the only ones to do that.”

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How Facebook — yes, Facebook — might make MRIs faster

Facebook’s artificial intelligence lab is working with New York University’s medical school to make MRI exams 10 times faster, which, if successful, would allow radiologists to complete a test in minutes.

  @mattmcfarlandAugust 20, 2018: 11:14 AM ET

Doctors use MRI — shorthand for magnetic resonance imaging — to get a closer look at organs, tissues and bones without exposing patients to harmful radiation. The image quality makes them especially helpful in spotting soft tissue damage, too. The problem is, tests can take as long as an hour. Anyone with even a hint of claustrophobia can struggle to remain perfectly still in the tube-like machine that long. Tying up a machine for that long also drives up costs by limiting the number of exams a hospital can perform each day.

photo of high speed MRI machine for article, How Facebook -- yes, Facebook -- might make MRIs fasterComputer scientists at Facebook (FB) think they can use machine learning to make things a lot faster. To that end, NYU is providing an anonymous dataset of 10,000 MRI exams, a trove that will include as many as three million images of knees, brains and livers.

Researchers will use the data to train an algorithm, using a method called deep learning, to recognize the arrangement of bones, muscles, ligaments, and other things that make up the human body. Building this knowledge into the software that powers an MRI machine will allow the AI to create a portion of the image, saving time.

“You could be in and out in five minutes. It would be a real game-changer.” Daniel Sodickson, vice chair for research in radiology at NYU School of Medicine, told CNNMoney.

{SEE FULL ARTICLE HERE}

To Fix That Pain In Your Back, You Might Have To Change The Way You Sit

My back hurts when I sit down.

It’s been going on for 10 years. It really doesn’t matter where I am — at work, at a restaurant, even on our couch at home. My lower back screams, “Stop sitting!”

To try to reduce the pain, I bought a kneeling chair at work. Then I got a standing desk. Then I went back to a regular chair because standing became painful.

spinal gif animation for article, To Fix That Pain In Your Back, You Might Have To Change The Way You SitI’ve seen physical therapists, orthopedic surgeons and pain specialists. I’ve mastered Pilates, increased flexibility and strengthened muscles. At one point, my abs were so strong my husband nicknamed them “the plate.”

All these treatments helped a bit, at first. But the pain never really went away. So a few years ago, I decided to accept reality: Sitting down is — and will always be — painful for me.

Then back in November, I walked into the studio of Jenn Sherer in Palo Alto, Calif. She is part of a growing movement on the West Coast to teach people to move and sit and stand as they did in the past — and as they still do in other parts of the world. For the past 8 years, Sherer has been helping people reduce their back pain.

I was interviewing Sherer for a story about bending. But she could tell I was in pain. So I told her my story.

Her response left me speechless: “Sitting is a place where you can find heaven in your joints and in your back,” she says. “It’s not sitting that’s causing the pain, it’s how you’re sitting.

“Do you want me to show you how?”

[SEE FULL STORY HERE]

How wildfires can threaten your health

By the time Thomas Dailey woke up on Tuesday, smoke from the Mendocino Complex Fire had drifted 150 miles south to his pulmonary practice in Santa Clara, staining the sunrise blood red.

For many Californians, the crimson sky was another reminder of the 19 wildfires burning across the state, a larger and more destructive threat than in recent years. It could become the worst fire season in state history.

info graphic for article, How wildfires can threaten your healthFor Dailey, a pulmonologist who has treated asthma patients for 29 years, it also signaled a growing health risk for his patients and the public. As wildfires burn through forests, vegetation and homes, they expel smoke and toxic pollutants, sending fine particulate matter into the air.

“It’s pretty sobering as soon as you see that,” said Dailey, whose asthma patients at his Santa Clara office recently began complaining about tightness of breath when they go outside. “You know there’s a lot of particulates in the air.”

[SEE FULL ARTICLE HERE]

SmokerStop App Review: A Motivational Tool for Your Patients

Douglas Maurer, DO/MPH/FAAFP | August 2, 2018

Tobacco use remains the #1 preventable cause of morbidity and mortality in the United States and worldwide. Overall, cigarette smoking among U.S. adults (aged ≥18 years) declined from 20.9 percent in 2005 to 15.5 percent in 2016. Still nearly 38 million

smoking cessation info graphic for article, SmokerStop App Review: A Motivational Tool for Your PatientsAmerican adults smoked cigarettes in 2016, according to the Centers for Disease Control and Prevention (CDC). Smoking remains the leading cause of cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD). National efforts have included tobacco taxes and smoking bans which have both proven effective.

More recently, the prescribing of apps for cessation has been utilized and shown to be effective. We recently reviewed and praised the outstanding QuitMedKit from the University of Texas MD Anderson Cancer Center. The app includes nearly everything the primary provider would want to have to aid patients in tobacco cessation: the 5A’s approach, information on medications for cessation, tips on motivational interviewing, graphics to assist in cessation, and links to online resources.

The QuitMedKit app does not include much information tailored to patients regarding personal health and financial goals. The SmokerStop app by Dr Titus Brinker in Germany uses personal motivation as its primary smoking cessation technique. The app uses data input by the patient to calculate health information such as reduction in blood pressure, lung cancer risk, as well as financial goals such as when an ex-smoker will have enough cash for movie tickets, an iPhone, etc. The app also allows patients to put in their own goals. All of this information is tracked by the app and reminders are periodically sent to to the patient to help keep them motivated.

[SEE FULL STORY HERE]

Off Your Mental Game? You Could Be Mildly Dehydrated