Showing posts with label mobile health. Show all posts
Showing posts with label mobile health. Show all posts

Wednesday, September 11, 2013

Mobile Health, Meet Your Biggest Obstacle: HIPAA.

More and more, doctors are using smartphones, iPads, Dropbox and other mobile devices and cloud storage to share electronic patient health information ("ePHI") with colleagues and to diagnose. In fact, health care reform incentivises the increased use of patient data to improve patient outcomes as one avenue to decrease health care spending.

Technology can facilitate more expedient second opinions, generate better patient outcomes with fewer resources and, therefore, save money.  However it can also expose providers and their business associates with huge fines if usage of this technology violates HIPAA.

Recent reports by Manhattan Research found that a 9% increase in physician smartphone use in 2010 resulted in a 32% increase in data breaches.  Each data breach carries a $50,000 fine, that can be increase drastically if the breach is not remedied.

What Is HIPAA and Who Does it Affect? 

HIPAA is short for the Health Insurance Portability and Accountability Act.  Title I of HIPAA protects health insurance coverage for workers and their dependants when they change or lose their jobs. Title II establishes national standards for electronic health care transactions to protect the privacy of individually identifiable health information that is "created, received, used, or maintained" by a covered entity or its business associate.  The regulations associated with Title II of HIPAA govern the recent increased use of smart phones and cloud storage of ePHI.

A covered entity is a health care provider, health plan, or health care clearninghouse that transmits any information in an electronic form.  A business associate is an individual or business with whom the covered entity engages to help it carry out its health care activities and functions.  Entities that do not meet the definition of either covered entity or business associate do not have to comply with HIPAA.

Common Causes of HIPAA Violations:

CauseIn 2010In 2011
Lost or stolen computing device41%49%
Third-party problem34%46%
Unintentional employee action45%41%
Technical glitch31%33%
Criminal attack21%30%
Malicious insider15%14%
Intentional nonmalicious employee action10%9%

What Can Physicians Do?


  1. Safeguard Mobile Devices. 
    • Encrypt, encrypt, encrypt. Software is readily available that will encrypt smartphones and mobile devices.  Encryption means that information is sent in non-readable form, and must be unlocked by a key on the device of the person wishing to view it.
    • Conduct periodic risk assessments. Document which devices are being used to transmit ePHI, whether proper encryption exists, and what physical protections are in place to secure ePHI.
    • Password Protect All Devices. The lack of authentication on mobile devices presents a risk that any user of the device could access ePHI stored on the device 
  2. Set policies on mobile use in your practice or at your hospital.  Pay special attention to security measures, such as antivirus software and password protection.  Small physician practices who don't have technology professionals thinking through these issues for them, like hospitals do, should sit down and review their technology policies.  Consider quarterly training meetings for physicians and staff to reinforce these policies.
  3. Have a Secure Wi-Fi Connection.  Mobile devices that use public Wi-Fi or unsecure cellular networks to send and receive information risk exposing ePHI. Unless mobile device users connect to a secure website to transmit data or connect using a VPN ("virtual private networking"), which encrypts data to and from the mobile device, there is a risk ePHI could be compromised.

Friday, July 19, 2013

Friday Variety: The Uninsured Gap, Veterans' Mobile Health, & (of course) Abortion

The Uninsured Gap

In the 27 states that have not committed to expanding Medicaid, many individuals and families could fall into a health insurance "black hole" where coverage would continue to be unaffordable.  In those states, individuals or families whose income amounts to 99% of the federal poverty level would not be eligible for Medicaid or premium subsidies on their state health insurance exchange. However individuals or families making 101% of the federal poverty level would be eligible for those premium subsidies that would make purchasing health coverage more affordable. 
According to a new analysis by the Kaiser Commission on Medicaid and the Uninsured, about 6.4 million people will be uninsured next year, unless those 27 states change their minds and agree to expand Medicaid coverage.  Nearly 2/3 of the uninsured live in 21 of the states that are not expected to expand as of January 1, and the six states that are on the fence.  The Kaiser Commission analysis reported that 55 percent of the uninsured live in Texas, Florida and Georgia alone.

Veterans' Mobile Health

The Department of Veterans Affairs has begun "testing the viability and potential of mobile health technologies after launching several pilot projects," according to Healthcare IT News. One such pilot is a Veteran Appointment Request App.  The App offers approximately 600 veterans the ability to request primary care and mental health appointments from their computer or mobile device.
Additionally, the Family Caregiver pilot is offering iPads to 1,000 caregivers of serious injured veterans of the Iraq and Afghanistan wars enrolled in the program.

Abortion Rights Groups to Challenge Texas Bill

On Thursday, Texas Governor Rick Perry signed the controversial abortion bill into law.  The law includes some of the nation's toughest restrictions on abortion, effectively forcing the closure of all but 5 of the state's 42 abortion clinics, unless those clinics can can upgrade their facilities within a year after the law takes effect this October.

Opponents of the bill may file a lawsuit against the state of Texas to stop the implementation of the law.  Executive Director of the Texas ACLU, of of several organization considering a legal challenge to the bill, stated, "There are no decisions about litigation, but I think that maybe the course we have to follow."

According to Planned Parenthood v. Casey, the Supreme Court case that followed Roe v. Wade, state laws cannot erect substantial obstacles to women seeking abortions.  If the Texas law causes the widespread closure that many have projected, this "serious obstacle" standard may have a fighting chance in court.