Showing posts with label Patient ID. Show all posts
Showing posts with label Patient ID. Show all posts
Friday, June 13, 2014
Can't Miss NAHAM Webinar on Improvements to Patient Access Departments Through Automation, June 26th
NAHAM presents the "Building a More Efficient Patient Access Department Through Automation" webinar, free to NAHAM members on June 26, 2014, from 2:00-3:00 p.m. This webinar will be presented by Patrick Kelley, Dedicated Advisor at The Advisory Board Company, and Alexander Guambana, Senior Director at The Advisory Board Company.
In partnership with The Advisory Board Company and Lowell General Hospital, we will be walking through a health system’s response to new industry demands by leveraging automation and efficiency gains. The Advisory Board Company will present its research on new Patient Access trends across the industry, how patient estimation is becoming a major player in healthcare, and how hospital Revenue Cycle departments are responding to new legislation in the ACA. Join us as Lowell General Hospital and The Advisory Board present their experience of implementing a culture of point-of-service estimation and the utilization of technology.
Information
Building a More Efficient Patient Access Department Through Automation
Thursday, June 26, 2014
2:00 pm - 3:00 p.m. ET
This webinar is worth 1 contact hour.
Click here to register for the webinar. There is no cost for members!
Upon purchase, you will receive information via email about accessing the live webinar.
Thursday, February 27, 2014
Patient Identification and Matching Report Released by ONC
The Office of the National Coordinator for Health Information Technology (ONC) released the final version of the Patient Identification and Matching Report. The report evaluated best practices and current trends in using electronic health record systems to accurately identify patients and exchange information between providers, patients, and caregivers. Mistakes in properly identifying patient health records put patient safety at risk and has resulted in too many patient deaths.
The drafting process for the report included an industry environmental scan with input from stakeholders at meetings, on calls, and requests for submitted comments and recommendations. NAHAM was an active participant throughout the drafting process and provided recommendations focused on improving patient safety that are featured in the report. NAHAM's recommendations can be found on page 76 of the report.
The report resulted in 10 findings that ONC will use as they move forward with the process of improving electronic health record systems and patient matching to improve patient safety.The findings are below.
Findings
Findings
1. Standardized patient identifying attributes should be required in the relevant exchange transactions.
2. Any changes to patient data attributes in exchange transactions should be coordinated with organizations working on parallel efforts to standardize healthcare transactions.
3. Certification criteria should be introduced that require certified EHR technology (CEHRT) to capture the data attributes that would be required in the standardized patient identifying attributes.
4. The ability of additional, non-traditional data attributes to improve patient matching should be studied.
5. Certification criteria should not be created for patient matching algorithms or require organizations to utilize a specific type of algorithm.
6. Certification criteria that requires CEHRT that performs patient matching to demonstrate the ability to generate and provide to end users reports that detail potential duplicate patient records should be considered.
7. Build on the initial best practices that emerged during the environmental scan by convening industry stakeholders to consider a more formal structure for establishing best practices for the matching process and data governance.
8. Work with the industry to develop best practices and policies to encourage consumers to keep their information current and accurate.
9. Work with healthcare professional associations and the Safety Assurance Factors for EHR Resilience (SAFER) Guide initiative to develop and disseminate education and training materials detail best practices for accurately capturing and consistently verifying patient data attributes.
10. Continue collaborating with federal agencies and the industry on improving patient identification and matching processes.
Wednesday, February 5, 2014
Congressional Gridlock Stalls Hopes for National Patient Identifier and Meaningful Use Stage 2 Delay
Many in the health IT field
believe that implementing a national patient identifier and a deadline
extension for stage 2 meaningful use requirements would ensure a more cohesive
operation of patient access and identification systems and increase patient
safety. Both of these problems require
congressional action to solve, but with a Congress that fails to pass even the
most basic pieces of legislation and appropriations it is unlikely there will
be any legislation addressing these issues in the year to come.
National Patient Identifier
A national patient identifier
would go far to improve patient safety by improving the accuracy with which
patients are matched with their medical records. Ideally, a national patient identifier would
be a unique number for each patient with a two-digit checksum at the end of the
number. In practice this would allow a patient’s data to move completely
through multiple data systems without comingling with other patients’ records
that may contain similar names, addresses and other identifying factors.
However, the likelihood of
legislation requiring a national patient identifier is very slim after Congress
voted to overturn a HIPAA provision that would have required a patient
identifier in 1998. Congressional opposition focused on privacy concerns and
the capability providers have to identify patients with several different
identifying factors. Former national health IT coordinator Farzad Mostashari,
M.D., explained that he believed the odds were very low for a national patient
identifier and that it would require the industry proving they are unable to keep
patients straight by cross-checking a patient’s identity with other identifying
factors available to the provider.
Meaningful Use Incentive Program
The electronic health records
meaningful use incentive program was created to advance the adoption of health
information technology nationwide. Beginning in 2014 eligible hospitals and
professionals will have to comply with stage 2 of the regulatory standards in
order to receive corresponding incentive payments.
Senator Alexander and Senator
Thune, along with 15 other Senators, wrote a letter to HHS Secretary Kathleen
Sebelius requesting more time for implementation of stage 2 standards. Their letter stated, “If the goal is to
improve care by achieving broad and meaningful utilization of EHRs, providing
sufficient time to ensure a safe, orderly transition through Stage 2 is
critical to having stakeholder buy-in, a necessary component of long-term
success.
However, former national health IT
coordinator Farzad Mostashari, M.D., does not think that this extension will be
granted. Without speaking to the merit
of the request, Mostashari recently told a group gathered at the CHIME Fall
Forum that the extension would take up to a year to approve, and the extension
requested is a year. The overlap would through U.S. health IT into “total chaos”
due to the uncertainty during the rulemaking process to amend the schedule.
Don
Fluckinger’s article, “Shut down thoughts of a national patient identifier,stage 2 extension,”
A podcast discussing the benefits
of a national patient identifier can be found here.
Alexander-Thune Letter from 17
Senators to Secretary Kathleen Sebelius requesting a meaningful use stage 2
delay can be found here.
Friday, January 17, 2014
Hidden Costs of Duplicate Patient Records
A recent article by Patricia Consolver, Minimizing Duplicate Patient Records to Maximize Cash Flow, highlighted the relationship between a reduction in duplicate patient records and increases in revenue cycle efficiency. A 2008 RAND Corporation study found that the average duplicate patient record is 8 percent. In addition to the inherent risks to patient safety, duplicate and incorrect patient identifications have the potential to impair downstream financial activities such as delayed payments, appeals, and denials.
The costs associated with duplicate records also include instances of repetitious lab and diagnostic tests that were performed, but documented in a duplicate record. Insurance companies often deny claims for repetitive tests. This results in care that the hospital will not be reimbursed for and cannot collect.
Texas Health Resources, a 13-hospital system that serves over 1 million patients per year, implemented a four-step process during the transition to EHRs that resulted in a duplicate patient record rate of 0.36 percent.
The Four-Step Process
1. Scrubbing the existing MPI
2. Identifying and selecting the correct patient records
3. Educating key stakeholders on avoiding duplicate creation
4. Monitoring performance
Education was necessary to ensure the EHR did not devolve to the state of MPI's duplicate records. Texas Health Resources education efforts were focused on both registration and medical record department employees. These courses emphasized the importance of using a full, legal name and the ways that duplicate records affect downstream activities in several areas of the hospital's operations. Data integrity teams were created to monitor the records and focus new education efforts on common mistakes that needed to be corrected.
The implementation of similar systems is being evaluated at hospitals across the country as Meaningful Use requirements become effective.
The costs associated with duplicate records also include instances of repetitious lab and diagnostic tests that were performed, but documented in a duplicate record. Insurance companies often deny claims for repetitive tests. This results in care that the hospital will not be reimbursed for and cannot collect.
Texas Health Resources, a 13-hospital system that serves over 1 million patients per year, implemented a four-step process during the transition to EHRs that resulted in a duplicate patient record rate of 0.36 percent.
The Four-Step Process
1. Scrubbing the existing MPI
2. Identifying and selecting the correct patient records
3. Educating key stakeholders on avoiding duplicate creation
4. Monitoring performance
Education was necessary to ensure the EHR did not devolve to the state of MPI's duplicate records. Texas Health Resources education efforts were focused on both registration and medical record department employees. These courses emphasized the importance of using a full, legal name and the ways that duplicate records affect downstream activities in several areas of the hospital's operations. Data integrity teams were created to monitor the records and focus new education efforts on common mistakes that needed to be corrected.
The implementation of similar systems is being evaluated at hospitals across the country as Meaningful Use requirements become effective.
Tuesday, March 13, 2012
HHS settles HIPAA case with BCBST for $1.5 million
Blue Cross Blue Shield of Tennessee (BCBST) has agreed to pay the U.S. Department of Health and Human Services (HHS) $1,500,000 to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules, Leon Rodriguez, Director of the HHS Office for Civil Rights (OCR), announced today. BCBST has also agreed to a corrective action plan to address gaps in its HIPAA compliance program. The enforcement action is the first resulting from a breach report required by the Health Information Technology for Economic and Clinical Health (HITECH) Act Breach Notification Rule.
The investigation followed a notice submitted by BCBST to HHS reporting that 57 unencrypted computer hard drives were stolen from a leased facility in Tennessee. The drives contained the protected health information (PHI) of over 1 million individuals, including member names, social security numbers, diagnosis codes, dates of birth, and health plan identification numbers. OCR’s investigation indicated BCBST failed to implement appropriate administrative safeguards to adequately protect information remaining at the leased facility by not performing the required security evaluation in response to operational changes. In addition, the investigation showed a failure to implement appropriate physical safeguards by not having adequate facility access controls; both of these safeguards are required by the HIPAA Security Rule.
“This settlement sends an important message that OCR expects health plans and health care providers to have in place a carefully designed, delivered, and monitored HIPAA compliance program,” said OCR Director Leon Rodriguez. “The HITECH Breach Notification Rule is an important enforcement tool and OCR will continue to vigorously protect patients’ right to private and secure health information.”
In addition to the $1,500,000 settlement, the agreement requires BCBST to review, revise, and maintain its Privacy and Security policies and procedures, to conduct regular and robust trainings for all BCBST employees covering employee responsibilities under HIPAA, and to perform monitor reviews to ensure BCBST compliance with the corrective action plan.
HHS Office for Civil Rights enforces the HIPAA Privacy and Security Rules. The HIPAA Privacy Rule gives individuals rights over their protected health information and sets rules and limits on who can look at and receive that health information. The HIPAA Security Rule protects health information in electronic form by requiring entities covered by HIPAA to use physical, technical, and administrative safeguards to ensure that electronic protected health information remains private and secure.
The HITECH Breach Notification Rule requires covered entities to report an impermissible use or disclosure of protected health information, or a “breach,” of 500 individuals or more to HHS and the media. Smaller breaches affecting less than 500 individuals must be reported to the secretary on an annual basis.
Individuals who believe that a covered entity has violated their (or someone else’s) health information privacy rights or committed another violation of the HIPAA Privacy or Security
Rule may file a complaint with OCR at: http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html.
The HHS Resolution Agreement can be found at http://www.hhs.gov/ocr/civilrights/activities/agreements/index.html
Additional information about OCR’s enforcement activities can be found at http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/index.html.
Source: HHS News Release
The investigation followed a notice submitted by BCBST to HHS reporting that 57 unencrypted computer hard drives were stolen from a leased facility in Tennessee. The drives contained the protected health information (PHI) of over 1 million individuals, including member names, social security numbers, diagnosis codes, dates of birth, and health plan identification numbers. OCR’s investigation indicated BCBST failed to implement appropriate administrative safeguards to adequately protect information remaining at the leased facility by not performing the required security evaluation in response to operational changes. In addition, the investigation showed a failure to implement appropriate physical safeguards by not having adequate facility access controls; both of these safeguards are required by the HIPAA Security Rule.
“This settlement sends an important message that OCR expects health plans and health care providers to have in place a carefully designed, delivered, and monitored HIPAA compliance program,” said OCR Director Leon Rodriguez. “The HITECH Breach Notification Rule is an important enforcement tool and OCR will continue to vigorously protect patients’ right to private and secure health information.”
In addition to the $1,500,000 settlement, the agreement requires BCBST to review, revise, and maintain its Privacy and Security policies and procedures, to conduct regular and robust trainings for all BCBST employees covering employee responsibilities under HIPAA, and to perform monitor reviews to ensure BCBST compliance with the corrective action plan.
HHS Office for Civil Rights enforces the HIPAA Privacy and Security Rules. The HIPAA Privacy Rule gives individuals rights over their protected health information and sets rules and limits on who can look at and receive that health information. The HIPAA Security Rule protects health information in electronic form by requiring entities covered by HIPAA to use physical, technical, and administrative safeguards to ensure that electronic protected health information remains private and secure.
The HITECH Breach Notification Rule requires covered entities to report an impermissible use or disclosure of protected health information, or a “breach,” of 500 individuals or more to HHS and the media. Smaller breaches affecting less than 500 individuals must be reported to the secretary on an annual basis.
Individuals who believe that a covered entity has violated their (or someone else’s) health information privacy rights or committed another violation of the HIPAA Privacy or Security
Rule may file a complaint with OCR at: http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html.
The HHS Resolution Agreement can be found at http://www.hhs.gov/ocr/civilrights/activities/agreements/index.html
Additional information about OCR’s enforcement activities can be found at http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/index.html.
Source: HHS News Release
New Report Calls for Enhanced Security to Safeguard Protected Health Information
A new report, The Financial Impact of Breached Protected Health Information: A Business Case for Enhanced PHI Security, provides health care organizations with a new method to evaluate the “at risk” value of protected health information (PHI) that will enable them to make a business case for appropriate investments to better protect PHI.
This report was created through the “PHI Project” – a collaboration of the American National Standards Institute (ANSI), via its Identity Theft Prevention and Identity Management Standards Panel (IDSP), in partnership with The Santa Fe Group/Shared Assessments Program Healthcare Working Group, and the Internet Security Alliance (ISA) – that involved a cross-section of more than 100 health care industry leaders from over 70 organizations.
Representatives from Utica College and the Center for Identity Management and Information Protection (CIMIP) traveled to Washington to take part in a congressional briefing to unveil the Protected Health Information (PHI) Project report.
The survey responses revealed that the majority of participants want to comply and secure PHI, but they believe that budgetary constraints and the lack of executive commitment, leadership, and accountability, as well as the evolving nature of threats and the technologies available to protect PHI, combine to make real protection of health information extremely challenging.
Seventy-five percent believed their organization possesses effective policies to protect PHI and takes effective steps to protect PHI. But almost 40% did not believe that their organizational management views privacy and security as a priority, and 54% did not feel that their organization possesses sufficient resources to ensure protection requirements are currently being effectively protected. When asked about the complexity of the laws and the ease of compliance, only 12% felt the laws were “easy to understand” and only 14% thought the laws were “not difficult at all” to comply with. When asked to identify the most significant impediments their organization faces to achieving a strong privacy and data security posture with respect to how PHI is collected, used, and retained the most common impediment was seen as “lack of funding”(59%) and followed by insufficient time, lack of senior executive support,” and lack of accountability and leadership.”
Responses showed that more than 85.3 % of participants stated that the accidental or inadvertent exposure from an insider was the “most likely” or “very likely” threat to protected data. More than 50 % believed that some type of security threat was likely adversely affecting their organizations now.
The report is available for free download at webstore.ansi.org/phi.
Source: ANSI News Release
This report was created through the “PHI Project” – a collaboration of the American National Standards Institute (ANSI), via its Identity Theft Prevention and Identity Management Standards Panel (IDSP), in partnership with The Santa Fe Group/Shared Assessments Program Healthcare Working Group, and the Internet Security Alliance (ISA) – that involved a cross-section of more than 100 health care industry leaders from over 70 organizations.
Representatives from Utica College and the Center for Identity Management and Information Protection (CIMIP) traveled to Washington to take part in a congressional briefing to unveil the Protected Health Information (PHI) Project report.
The survey responses revealed that the majority of participants want to comply and secure PHI, but they believe that budgetary constraints and the lack of executive commitment, leadership, and accountability, as well as the evolving nature of threats and the technologies available to protect PHI, combine to make real protection of health information extremely challenging.
Seventy-five percent believed their organization possesses effective policies to protect PHI and takes effective steps to protect PHI. But almost 40% did not believe that their organizational management views privacy and security as a priority, and 54% did not feel that their organization possesses sufficient resources to ensure protection requirements are currently being effectively protected. When asked about the complexity of the laws and the ease of compliance, only 12% felt the laws were “easy to understand” and only 14% thought the laws were “not difficult at all” to comply with. When asked to identify the most significant impediments their organization faces to achieving a strong privacy and data security posture with respect to how PHI is collected, used, and retained the most common impediment was seen as “lack of funding”(59%) and followed by insufficient time, lack of senior executive support,” and lack of accountability and leadership.”
Responses showed that more than 85.3 % of participants stated that the accidental or inadvertent exposure from an insider was the “most likely” or “very likely” threat to protected data. More than 50 % believed that some type of security threat was likely adversely affecting their organizations now.
The report is available for free download at webstore.ansi.org/phi.
Source: ANSI News Release
Tuesday, February 21, 2012
HIE Set to Expand
Electronic Health Information Exchanges that allow the secure sharing of patient health information between providers is set to grow considerably in coming years because of new service and payment models that are being adopted said panelists at a recent Brookings Institution presentation.
Policy Megachange and Health Information Exchanges featured panelists Janet Marchibroda, Chair of the Health Information Technology Initiative of The Health Project at the Bipartisan Policy Center; John Piescik of the Strategy and Engagement Center Center for Transforming Health at The MITRE Corporation; P. Jon White, Director Health IT and Acting Director, Center for Primary Care, Prevention and Clinical Partnerships Agency for Healthcare Research Quality (AHRQ); and Claudia Williams, Director of the State Health Information Exchange Office of the National Coordinator (ONC) U.S. Department of Health and Human Services (HHS).
Panelists agreed that HIEs would expand. “[O]ur goal is to get information moving to
support patient care in a secure way," said Claudia Williams of ONC. "Our goal is not necessarily to support a particular model or particular approach, but to see the percentage of transitions that are supported by the information that's needed, of lab results going to doctors electronically and of patients able to get their own information. We need to see these measures really take
off.”
"We've got a business case on the horizon with payment reform and delivery system
reform and for the first time talking with a whole host of folks that maybe weren't there 2 years ago," agreed Janet Marchiboda. "...whether it's providers, physician practices, hospitals, labs or vendors, I see an appetite for coming to agreement around a set of policies and standards. We'd have to talk about how far down you go, but principles and policies for getting to exchange even
on a voluntary basis that could be something that could inform what the federal government adopts over the long-term."
The Brookings Institution released a paper called Health Information Exchanges and Megachange in conjuction with the presentation.
Additional information about the presentation, including an audio webcast of the presentation may be accessed here.
Source: CQ HealthBeat (subscription required)
Policy Megachange and Health Information Exchanges featured panelists Janet Marchibroda, Chair of the Health Information Technology Initiative of The Health Project at the Bipartisan Policy Center; John Piescik of the Strategy and Engagement Center Center for Transforming Health at The MITRE Corporation; P. Jon White, Director Health IT and Acting Director, Center for Primary Care, Prevention and Clinical Partnerships Agency for Healthcare Research Quality (AHRQ); and Claudia Williams, Director of the State Health Information Exchange Office of the National Coordinator (ONC) U.S. Department of Health and Human Services (HHS).
Panelists agreed that HIEs would expand. “[O]ur goal is to get information moving to
support patient care in a secure way," said Claudia Williams of ONC. "Our goal is not necessarily to support a particular model or particular approach, but to see the percentage of transitions that are supported by the information that's needed, of lab results going to doctors electronically and of patients able to get their own information. We need to see these measures really take
off.”
"We've got a business case on the horizon with payment reform and delivery system
reform and for the first time talking with a whole host of folks that maybe weren't there 2 years ago," agreed Janet Marchiboda. "...whether it's providers, physician practices, hospitals, labs or vendors, I see an appetite for coming to agreement around a set of policies and standards. We'd have to talk about how far down you go, but principles and policies for getting to exchange even
on a voluntary basis that could be something that could inform what the federal government adopts over the long-term."
The Brookings Institution released a paper called Health Information Exchanges and Megachange in conjuction with the presentation.
Additional information about the presentation, including an audio webcast of the presentation may be accessed here.
Source: CQ HealthBeat (subscription required)
Tuesday, January 24, 2012
Weigh In: WSJ Discussion on Patient Unique IDs
A robust debate has begun in the Wall Street Journal regarding Should Every Patient Have a Unique ID Number for All Medical Records?
NAHAM members are encouraged to weigh in.
Source: WSJ Article
NAHAM members are encouraged to weigh in.
Source: WSJ Article
Thursday, January 5, 2012
Study: U.S. Needs to Strengthen Privacy Safeguards for EHRs
Electronic health records can potentially save billions of dollars in health care costs and increase patient safety, but have considerable risks to individual privacy in the United States, more so than the European Union, says a new study co-authored by Pamplin College of Business professor Janine Hiller.
“EU countries have adopted electronic health records and systems, or EHRs, and legally protected privacy at the same time,” Hiller says. EHRs include a wide range of patient medical information collected in digital format and accessible via computer, most often over a network.
Strengthening the legal and technical safeguards, she says, would significantly minimize the privacy and security risks and address public concerns in the U.S. about EHRs. Her study examines their benefits and drawbacks, the adequacy of U.S. laws to meet the challenges posed by the privacy risks and concerns, and compares the EU’s legal approach to EHRs.
The U.S. legal framework for health care privacy, she says, is “a hodgepodge of constitutional, statutory, and regulatory law at the federal and state levels.” Hiller and her co-authors believe that though federal efforts to protect privacy seem to be a step up from inconsistent state laws, Americans currently still “have no real control over the collection of sensitive medical information if they want to be treated,” in contrast to the choice accorded to EU residents.
Their study, Hiller says, makes it clear that the privacy issue should be central to any discussion of EHR implementation in the U.S. and the technical and policy framework that guides it. Her recent research in Sweden, she says, showed her “that the legal and technical frameworks cannot stand alone; that they should be developed hand in hand in order to design systems that will effectively protect patient privacy.”
Until then, she says, “public confidence and trust in EHRs is unlikely.”
The study, titled Privacy and Security in the Implementation of Health Information Technology (Electronic Health Records): U.S. and E.U. Compared, appears in the winter 2011 issue of the Journal of and may be viewed here. An article about the study, Privacy or Savings? published in the Virginia Tech Pamplin College of Business Magazine, may be viewed here.
Source: VA Tech News Release
“EU countries have adopted electronic health records and systems, or EHRs, and legally protected privacy at the same time,” Hiller says. EHRs include a wide range of patient medical information collected in digital format and accessible via computer, most often over a network.
Strengthening the legal and technical safeguards, she says, would significantly minimize the privacy and security risks and address public concerns in the U.S. about EHRs. Her study examines their benefits and drawbacks, the adequacy of U.S. laws to meet the challenges posed by the privacy risks and concerns, and compares the EU’s legal approach to EHRs.
The U.S. legal framework for health care privacy, she says, is “a hodgepodge of constitutional, statutory, and regulatory law at the federal and state levels.” Hiller and her co-authors believe that though federal efforts to protect privacy seem to be a step up from inconsistent state laws, Americans currently still “have no real control over the collection of sensitive medical information if they want to be treated,” in contrast to the choice accorded to EU residents.
Their study, Hiller says, makes it clear that the privacy issue should be central to any discussion of EHR implementation in the U.S. and the technical and policy framework that guides it. Her recent research in Sweden, she says, showed her “that the legal and technical frameworks cannot stand alone; that they should be developed hand in hand in order to design systems that will effectively protect patient privacy.”
Until then, she says, “public confidence and trust in EHRs is unlikely.”
The study, titled Privacy and Security in the Implementation of Health Information Technology (Electronic Health Records): U.S. and E.U. Compared, appears in the winter 2011 issue of the Journal of and may be viewed here. An article about the study, Privacy or Savings? published in the Virginia Tech Pamplin College of Business Magazine, may be viewed here.
Source: VA Tech News Release
New HHS Regs Streamline Health Electronic Funds Transfer; Cut Red Tape
New standards for electronic funds transfers in health care, required by the Affordable Care Act, will reduce up to $4.5 billion off administrative costs for doctors and hospitals, private health plans, states, and other government health plans, over the next ten years, according to estimates included in new rules published by the U.S. Department of Health and Human Services (HHS).
The standards build upon regulations published in 2011 that set industry-wide standards for how health providers use electronic systems to quickly and easily determine a patient’s eligibility for health coverage and check on the status of a health claim.
Together, the two regulations implementing the Administrative Simplification provisions of the Affordable Care Act and the Health Insurance Portability and Accountability Act (HIPAA) are projected to save the health care industry more than $16 billion over the next 10 years. These savings come from the adoption of electronic standards that will help eliminate inefficient manual processes and reduce costs.
“Thanks to the Affordable Care Act, health care professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients,” said HHS Secretary Kathleen Sebelius.
A May 2010 study in the journal Health Affairs found that physicians spend nearly 12 percent of every dollar they receive from patients to cover the costs of filling out forms and performing other excessively complex administrative tasks. The study found that simplifying these systems could save four hours per week of professional time per physician and five hours of support staff time every week – time that could be better spent on patient care.
“As a nurse, I know the importance of giving health care professionals time to focus on patient care,” said CMS Acting Administrator Marilyn Tavenner. “The less time a physician has to spend on paperwork is that much more time that can be devoted to patient care. Having standardized procedures across the health care industry can only lead to lower costs and greater efficiencies all around.”
The rule—the Adoption of Standards for Health Care Electronic Funds Transfers and Remittance Advice — adopts streamlined standards for the format and data content of the transmission a health plan sends to its bank when it wants to pay a claim to a provider electronically (through an electronic funds transfer) and to issue a Remittance Advice notice. Remittance Advice is a notice of payment sent to providers that may or may not accompany the payment the provider receives.
For example, currently when a provider submits a claim electronically for payment, a health plan often sends a Remittance Advice separately from the Electronic Funds Transfers payment. The disconnect between the two makes it difficult or sometimes impossible for the provider to match up the bill and the corresponding payment. The rule addresses this by requiring the use of a trace number that automatically matches the two. The new tracking system will allow health care providers to eliminate costly manual reconciliation that must currently be done.
Future administrative simplification rules will address adoption of:
- A standard unique identifier for health plans;
- A standard for claims attachments; and
- Requirements that health plans certify compliance with all HIPAA standards and operating rules.
The regulation is effective January 1, 2012. All health plans covered under HIPAA must comply by January 1, 2014.
To view the Interim Final Regulation with comment period, go to: http://www.regulations.gov
For more information on the June 2011 HIPAA Administrative regulation: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status, visit: http://www.hhs.gov/news/press/2011pres/06/20110630a.html
Source: HHS News Release
The standards build upon regulations published in 2011 that set industry-wide standards for how health providers use electronic systems to quickly and easily determine a patient’s eligibility for health coverage and check on the status of a health claim.
Together, the two regulations implementing the Administrative Simplification provisions of the Affordable Care Act and the Health Insurance Portability and Accountability Act (HIPAA) are projected to save the health care industry more than $16 billion over the next 10 years. These savings come from the adoption of electronic standards that will help eliminate inefficient manual processes and reduce costs.
“Thanks to the Affordable Care Act, health care professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients,” said HHS Secretary Kathleen Sebelius.
A May 2010 study in the journal Health Affairs found that physicians spend nearly 12 percent of every dollar they receive from patients to cover the costs of filling out forms and performing other excessively complex administrative tasks. The study found that simplifying these systems could save four hours per week of professional time per physician and five hours of support staff time every week – time that could be better spent on patient care.
“As a nurse, I know the importance of giving health care professionals time to focus on patient care,” said CMS Acting Administrator Marilyn Tavenner. “The less time a physician has to spend on paperwork is that much more time that can be devoted to patient care. Having standardized procedures across the health care industry can only lead to lower costs and greater efficiencies all around.”
The rule—the Adoption of Standards for Health Care Electronic Funds Transfers and Remittance Advice — adopts streamlined standards for the format and data content of the transmission a health plan sends to its bank when it wants to pay a claim to a provider electronically (through an electronic funds transfer) and to issue a Remittance Advice notice. Remittance Advice is a notice of payment sent to providers that may or may not accompany the payment the provider receives.
For example, currently when a provider submits a claim electronically for payment, a health plan often sends a Remittance Advice separately from the Electronic Funds Transfers payment. The disconnect between the two makes it difficult or sometimes impossible for the provider to match up the bill and the corresponding payment. The rule addresses this by requiring the use of a trace number that automatically matches the two. The new tracking system will allow health care providers to eliminate costly manual reconciliation that must currently be done.
Future administrative simplification rules will address adoption of:
- A standard unique identifier for health plans;
- A standard for claims attachments; and
- Requirements that health plans certify compliance with all HIPAA standards and operating rules.
The regulation is effective January 1, 2012. All health plans covered under HIPAA must comply by January 1, 2014.
To view the Interim Final Regulation with comment period, go to: http://www.regulations.gov
For more information on the June 2011 HIPAA Administrative regulation: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status, visit: http://www.hhs.gov/news/press/2011pres/06/20110630a.html
Source: HHS News Release
Friday, October 14, 2011
ONC/FHA Call For Participants in HIMSS 2012 Interoperability Showcase
Is your organization successfully using nationally recognized standards to securely share patient data with other organizations? Demonstrate your successes within the Office of the National Coordinator for Health IT (ONC) and Federal Health Architecture (FHA) area in the HIMSS 2012 Interoperability Showcase!
ONC and FHA are looking to highlight cutting-edge interoperable health information exchange at HIMSS 2012, with a focus on ONC-related initiatives, including:
Nationwide Health Information Network
CONNECT
Direct Project
State HIE Programs
S&I Framework
SHARP Program
Regional Extension Centers
Beacon Communities
All nominated demonstrations must include interoperable health information exchange among at least three end user organizations. End users include healthcare organizations (hospitals, clinics, state or federal agencies, etc.) and health information exchanges, not health IT vendors or IT service providers. All demonstrations must be live. No canned demonstrations or static presentations will be considered.
A panel of ONC staff will evaluate all nominations and determine which nominated demonstrations will be included within the ONC/FHA area of the Interoperability Showcase. Only nominations directly related to ONC programs will be considered. Nominations are due October 26th at 5:00 p.m. ET, and the determination of who will be included will be made by November 2nd.
Complete information is here:
http://www.connectopensource.org/forms/himss12-call-for-participants
Source: ONC/FHA News Release
ONC and FHA are looking to highlight cutting-edge interoperable health information exchange at HIMSS 2012, with a focus on ONC-related initiatives, including:
Nationwide Health Information Network
CONNECT
Direct Project
State HIE Programs
S&I Framework
SHARP Program
Regional Extension Centers
Beacon Communities
All nominated demonstrations must include interoperable health information exchange among at least three end user organizations. End users include healthcare organizations (hospitals, clinics, state or federal agencies, etc.) and health information exchanges, not health IT vendors or IT service providers. All demonstrations must be live. No canned demonstrations or static presentations will be considered.
A panel of ONC staff will evaluate all nominations and determine which nominated demonstrations will be included within the ONC/FHA area of the Interoperability Showcase. Only nominations directly related to ONC programs will be considered. Nominations are due October 26th at 5:00 p.m. ET, and the determination of who will be included will be made by November 2nd.
Complete information is here:
http://www.connectopensource.org/forms/himss12-call-for-participants
Source: ONC/FHA News Release
Monday, September 12, 2011
HHS Proposes to Increase Security of Patient Lab Info; Releases Model Privacy Notice
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius proposed new rules designed to expand the rights of patients to access their health information through the use of health information technology (IT). Specifically, the new rules would empower patients and allow them to gain access to test results reports directly from labs. They would ensure that labs covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) provide such information, upon request, directly to patients or their personal representatives.
The announcement came at the kick-off of the first-ever HHS Consumer Health IT Summit, which brought consumers, providers, and the public and private sectors together to discuss how best to empower consumers to be partners in their health and care through health IT.
The Notice of Proposed Rulemaking (NPRM), jointly drafted by the Centers for Medicare & Medicaid Services, the HHS Office for Civil Rights (OCR), and the Centers for Disease Control and Prevention, proposes to amend the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations and HIPAA privacy regulations to strengthen patients’ rights to access their own laboratory test result reports. The NPRM will be published in the Federal Register on September 14, 2011; public comments on the proposal will be accepted for 60 days after publication in the Federal Register.
Secretary Sebelius also unveiled an innovative voluntary Personal Health Record (PHR) Model Privacy Notice, which creates an easy-to-read, standardized template allowing consumers to compare and make informed decisions based on their privacy and security policies and data practices about PHR products. The new template is similar to the Nutrition Facts Labels in that it presents certain complex information in a simple way to improve transparency and consumer understanding about data practices. By making this Model Privacy Notice available, PHR companies can help build greater trust in PHRs.
For more information about the proposed amendments to the CLIA and HIPAA Privacy regulations, please visit https://www.cms.gov/apps/media/fact_sheets.asp.
Source: HHS News Release
The announcement came at the kick-off of the first-ever HHS Consumer Health IT Summit, which brought consumers, providers, and the public and private sectors together to discuss how best to empower consumers to be partners in their health and care through health IT.
The Notice of Proposed Rulemaking (NPRM), jointly drafted by the Centers for Medicare & Medicaid Services, the HHS Office for Civil Rights (OCR), and the Centers for Disease Control and Prevention, proposes to amend the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations and HIPAA privacy regulations to strengthen patients’ rights to access their own laboratory test result reports. The NPRM will be published in the Federal Register on September 14, 2011; public comments on the proposal will be accepted for 60 days after publication in the Federal Register.
Secretary Sebelius also unveiled an innovative voluntary Personal Health Record (PHR) Model Privacy Notice, which creates an easy-to-read, standardized template allowing consumers to compare and make informed decisions based on their privacy and security policies and data practices about PHR products. The new template is similar to the Nutrition Facts Labels in that it presents certain complex information in a simple way to improve transparency and consumer understanding about data practices. By making this Model Privacy Notice available, PHR companies can help build greater trust in PHRs.
For more information about the proposed amendments to the CLIA and HIPAA Privacy regulations, please visit https://www.cms.gov/apps/media/fact_sheets.asp.
Source: HHS News Release
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