November 24th, 2011 by DavidHarlow in Health Policy, News
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The Wall of Shame welcomes Sutter Health. Another computer with unencrypted protected health information on over 4 million patients – gone. Now, those guys are pretty smart, so why don’t they encrypt all computers with PHI? One of life’s persistent questions. I mean, I can accept the fact that a health plan operator like Cignet Health might have issues with getting a grip on HIPAA compliance, but Sutter Health? What were they thinking? Can’t happen here? Encryption is a drag? It’s an easy way to avoid major egg-on-face and to avoid spending significant coin on PR, credit reporting services, and potentially on court judgments — all in addition to significant administrative fines payable to HHS and state regulators.
So the federales are piloting the HIPAA audit program. I know it’s required by the HITECH Act, but who believes that it will motivate behavior change? Anyone? Sutter Health was clearly not motivated to seek a safe harbor that would have made the loss of 4 million patient records a non-event. I know encryption can be a drag, but I’m not a techie. If you are, I invite you to educate me (and the other non-techies out there) on the question of how miserable it really is to have to deal with encrypted data; if you’re really a techie, write a program to enable light-touch encryption that doesn’t interfere with use of data.
Whether or not encryption is miserable, we should be asking: Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
October 11th, 2011 by RyanDuBosar in News, Research
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Hospitalists in adult medicine reported an increase in median compensation from $215,000 to $220,619 in 2010, while pediatric hospitalists median compensation rose from $160,038 in 2009 to $171,617 in 2010. Though hospitalists earned more in 2010, they also reported higher productivity. The annual median adult hospitalist physician work relative value unit (wRVU) rate was 4,166, a 1.4% increase over last year.
According to the Medical Group Management Association (MGMA) and Society of Hospital Medicine’s (SHM’s) State of Hospital Medicine: 2011 Report Based on 2010 Data, compensation varied by how it was structured. Adult hospitalists with 50% base salary or less reported median compensation of $288,154, while adult hospitalists with 51-70% base salary reported median compensation of $249,250. Adult hospitalists who reported 71-90% base salary earned Read more »
*This blog post was originally published at ACP Hospitalist*
October 10th, 2011 by DavidHarlow in Health Policy, News
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On September 14, HHS released for comment draft lab results regulations that will, if finalized, effectively bathe the Achilles’ heel of health data in the River Styx of ¡data liberación! All lab results will be made available to patients, just like all other health data. (See the HHS presser and YouTube video from the recent consumer health summit. Todd Park, HHS CTO, is also the chief activist for what he calls ¡data liberación!)
Forgive me for mixing my metaphors (or whatever it is I just did), but even though there are just a couple dozen words of regulations at issue here, this is a big deal.
When HIPAA established a federal right for each individual to obtain a copy of his or her health records, in paper or electronic format, there were a couple of types of records called out as specifically exempt from this general rule of data liberation, in the HIPAA Privacy Rule, 45 CFR § 164.524(a)(1): psychotherapy notes, information compiled for use in an administrative or court proceeding, and lab results from what is known as a CLIA lab or a CLIA-exempt lab (including “reference labs,” as in your specimens get referred there by the lab that collects them, or freestanding labs that a patient may be referred to for a test; these are not the labs that are in-house at many doctors’ offices, hospitals and other health care facilities — the in-house labs are part of the “parent” provider organization and their results are part of the parents’ health records already subject to HIPAA).
(“CLIA” stands for the Clinical Laboratory Improvement Amendments of 1988, which established quality standards for certain laboratory testing.)
This carveout of lab results from patient-accessible records has long been a thorn in the side of the e-patient. This month, Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
May 9th, 2011 by DrWes in Health Policy, Research
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Quality measures. Patient satisfaction surveys. With our new health care reform law, these “performance measures” are the new black in health care.
Hospitals are currently spending, conservatively, tens of millions of dollars to bolster these “performance measures” in hopes of securing a refund of a mere 1% of payments that CMS will soon withhold from them in the name of “assuring” quality improvement.
But what if, nationwide, there wasn’t a big difference in these measures between hospitals? What happens then? Might payments then be made on political grounds?
Performance measures have been collected for some time now in anticipation of this new payment initiative by the government, so data exist to evaluate. In fact, Kaiser Health News was nice enough to aggregate the findings from our government’s Hospital Compare website for my review.
So I calculated the mean, median and standard deviation of the results of all of this data collected across 50 states and 2 territories and found very little difference in measures collected between states: Read more »
*This blog post was originally published at Dr. Wes*
December 28th, 2009 by Edwin Leap, M.D. in Better Health Network, Health Policy, True Stories
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We have a new EMR system. I like it because I type well. I’m facile at using a keyboard and touch-screen. Not everyone in my group is so blessed, and we’ve had some difficulties using the voice-transcription software. Nevertheless, my gut tells me that in a month or two more, we’ll be getting along with our new system swimmingly. It’s the sort of thing I have wanted for a while, since I truly hate to dictate; and especially hated dictating the information the nurses had already entered into the computer!
However, I have an issue. Not so much with our EMR, but with all EMRs. I have an issue with the deeply-held delusion that computerization will automatically improve charting and patient care.
Some time ago, the inimitable, world famous blogger Dr. Wes (who can be found at http://drwes.blogspot.com/ ) told me that his facility’s conversion to EMR caused him to spend far more time at the computer than with the patient. And true to his great wisdom and insight, that’s where I find myself. It isn’t the location of the computers. We have portable ‘tough-books’ that can go to the bedside. Read more »
*This blog post was originally published at edwinleap.com*
