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Your new post is loading...!'s Good News and Bad News, by the Numbers's Good News and Bad News, by the Numbers | Healthcare and Technology news |

Nearly 260,000 Americans enrolled in private health insurance plans through the federal and state-run exchanges in November, according to the latest Obamacare numbers. That brings the total number of enrollments through November 30 up to  364,682. Whether that's good or bad depends on whether you're a glass half-full (that's so much better than October) or a glass half-empty (the Obama administration thought they'd have 500,000 enrollments in October) type of person. And of course, whether you want to repeal and/or defund Obamacare. By the numbers:

For the glass half-full people:
  • About 258,000 individuals enrolled in November — that's more than double October's 106,000.
  • The state-run exchanges more than doubled their enrollment numbers, for a total of 227,478 enrollments. That's more proof that, for the most part, the states that were dedicated to making the law work are having more success.
  • December is looking to be an even better month. New York recently reported that nearly 70,000 individuals bought healthcare. That's up from the 45,000 reported in the November numbers. The state expects to meet its enrollment goal
  • About 1.8 million applications were submitted and of those 2.6 million people were found eligible for the Marketplace. (An application can be submitted for a whole family.)
  • The real bright spot is that 803,000 people were deemed eligible for Medicaid.
  • Even before was deemed "fixed", the exchange had much better numbers — it went from about 27,000 enrollments to 137,000. Here's a chart that shows the dramatic improvement:

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  • Even Oregon enrolled some people!
For the glass half empty people:
  • Just kidding, the Oregon exchange still sucks. It enrolled a total of 44 people, which is impressive considering everyone was told to use paper applications. Covered Oregon isn't expected to be functional until next week and only 26,000 of 65,000 paper applications have been processed
  • The administration still counts plans selected but not paid for as enrollments. So if people never pay for their plans they won't actually be enrolled.
  • This isn't very close to 7 million, and the White House is backing away from that magic number. While Michael Hash of the Department of Health and Human Services said they expect to meet seven million, others are less convinced. Now, according to Politico, the administration is focusing on the "mix of healthy to unhealthy" as a measure of the "viability of the markets," as per David Simas, a White House Senior adviser. Basically, no death spiral, no problems. 
For the "defund Obamacare" movement:
  • There are now 364,682 people who'd be really upset to lose their Obamacare insurance.
  • There are only 364,682 who'd be really upset to lose their Obamacare insurance. 

This article was originally published at

Technical Dr. Inc.'s insight:

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-          The Technical Doctor Team

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Is there a cure for multiple sclerosis?

Is there a cure for multiple sclerosis? | Healthcare and Technology news |
Is there a cure for multiple sclerosis?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Asked by Kayla in North Carolina:

Hi, I got multiple sclerosis about a year ago, and I'm very young. I was curious if there has been any further information about a possible cure or not. I know that people have been searching for a cure, but I'm curious as to how close they really are.

Expert answer

Multiple sclerosis is a neurologic disease that affects women more often than men. Onset is most commonly in the 20s or 30s.

MS is an autoimmune disease in which there is initially focal inflammation and then permanent damage to nerves of the central nervous system. The damage is really removal of the insulating material surrounding nerves. The tissue that insulates nerves is called myelin, and the damage is referred to as demyelination.

As a nerve that controls sensation or movement of a part of the body loses some of its myelin covering, the nerve may become dysfunctional. This can manifest itself as loss of that nerves function which can be sensation, vision, movement or coordination of movement. Affected sensory nerves can also cause pain.

There have been tremendous advances in our ability to diagnose and assess MS with the development of magnetic resonance imaging. Unfortunately, our understanding of the cause of this disease remains limited, as does our ability to treat it. There is some limited success in stopping or decreasing the severity of an MS attack. We would also like to stimulate a regrowth of the damaged myelin over the nerve. Unfortunately, this is not possible at this time.

There are several types of MS. Some patients have disease that will have an acute exacerbation followed by a prolonged quiet period, which can last years or decades. This form of disease is referred to as relapsed remitting MS, or RRMS. Others have a disease that gets progressively worse over time. There are two types of progressive disease. In primary progressive MS, or PPMS, symptoms steadily worsen over time from the very beginning. Secondary progressive MS, known as SPMS, begins as relapsed remitting disease and becomes progressive over time.

For an acute exacerbation of multiple sclerosis that can result in neurologic symptoms and increased disability or impairments in vision, strength or coordination, the preferred initial treatment is usually a type of steroid called a glucocorticoid. Patients who do not have a good response to steroidal therapy are often treated with plasma exchange. Plasma exchange is an extreme therapy that removes antibodies to myelin from the blood.

Patients with RRMS are often treated with immune-modulating drugs such as interferon or glatiramer acetate. Glatiramer is an exciting drug. It is a series of small proteins that are similar to myelin protein. It is thought to prompt the immune system to avoid attacking myelin.

Available treatments of primary and secondary progressive MS are of limited efficacy and have significant side effects. An additional fact to consider is that most trials have not lasted longer than two or three years and give only hints about long-term results of treatment.

In brief, no clinical trial has shown convincing evidence of benefit in the treatment of primary progressive MS. All suggested treatments for PPMS are empiric. Several drugs that are more commonly used in the treatment of malignancy, cladribine and mitozantrone, appear to have some activity.

In contrast, there is definite modest benefit in some treatments for secondary progressive MS. These treatments include various regimens of steroid therapy and the use of some drugs that modulate the immune system. Many of these drugs are more commonly used in treatment of cancer and rheumatoid arthritis such as cyclophosphamide, methotrexate and interferon.

MS should be treated by a neurologist with experience in managing it. The American Academy of Neurology has published treatment guidelines for MS.

Got a question for our experts? Submit it here

Post by: Dr. Otis Brawley - CNNHealth Conditions Expert
Filed under: Expert Q&A • Multiple Sclerosis • Nervous system
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Kids' health care can vary widely by location, New England study shows

Kids' health care can vary widely by location, New England study shows | Healthcare and Technology news |

(CNN) -- A new study of pediatric care finds wide regional variations in the kinds of treatment and medication children receive, which is "raising troubling questions," according to its authors.

The Dartmouth Atlas report released Wednesday replicates and expands upon a groundbreaking study done in the 1970s.

Back then, scientists discovered a wide variety of care for children with throat problems. The 1970s study found 60% of the children who lived in Morrisville, Vermont, had their tonsils out by the age of 15. In other communities, fewer than 20% of kids in that same age group did.

The variety surprised researchers, and the previous study had a big impact on children's health care in the region. Doctors reexamined their practices and tried to establish exactly why there was such variation. The number of surgeries declined, and the rate of tonsillectomies in Morrisville fell to one of the lowest in the state.

Researchers wanted to revisit the same issue using current data to see if the regional variations in care continued. Again, they found a wide variety in the quantity and quality of children's care.

Researchers focused on the northern New England area, since state legislatures in Maine, Vermont, and New Hampshire require medical claims reporting. In many other parts of the country, there is no such requirement for reporting data, which has created a data gap for researchers.

"The regional differences are striking here," said Dr. David Goodman, professor of pediatrics at the Dartmouth Institute and an author of the report. "What makes this particularly striking is the data we now have is so vivid detail, we can identify the very hospitals" at the heart of the variations.

See the map

Looking at tonsillectomies again, researchers found that there is still a wide regional variety in how many are performed.

Tonsillectomies are mostly done in children with problems with sleep apnea or for kids who suffer from chronic sore throats.

Randomized trials show these surgeries have limited effectiveness. Consequently, fewer tonsillectomies had been performed since the 1960s when the rate peaked, but researchers have noticed a small upward trend between 1996 and 2006. The rate rose from 4.97 to 8.7 per 1,000 children (that's 243,000 procedures per year).

Rates in the region did vary significantly. They were lowest in Bangor, Maine, at 2.7 per 1,000, compared with Berlin, New Hampshire, where the rate was nearly four times higher.

"These surgeries are fairly common in younger children, where there are absolutely no studies showing that this is beneficial, and even with older children, the beneficial effects are quite small," Goodman said. "What this shows is that whether a child has this surgery depends more on where they get their care as opposed to who they are."

The report looked beyond tonsillectomies. The authors also looked at the number of well-care visits children had, what kind of tests they were given, and what kind of prescriptions they received.

Again, researchers continued to find a wide variety of treatments across the region. For instance, when it came to adolescents' annual doctor visits, 55% of teens in Lebanon, New Hampshire, annually saw a doctor, versus only 29% of teens in Colebrook, New Hampshire.

Children were screened for lead exposure in varying numbers as well. While 86% of children under the age of 2 were screened in Berlin, New Hampshire, between 2008 and 2010, only 8% were tested in Dover-Foxcroft, Maine.

ADHD care also seemed to have wide differences. Medication rates varied more than twofold, with more than 75 per 100 children in Caribou, Maine, compared with less than 35 per 100 children receiving it in Greenville, Maine. (Nationally, only 8.4% of children ages 3-17 were ever diagnosed with ADHD through 2009, the latest year available in a 2011 survey by the Centers for Disease Control and Prevention).

What this suggests, according to the Dartmouth study authors, is that children are being under-treated in some areas and over-treated in others.

Goodman said there is intense interest from doctors and hospitals in the region in the findings of this report.

"They want to understand what is occurring and to use this information to improve care," he said.

He also hopes that other state legislatures will now make this kind of data collection on care mandatory. "We'd like for other states to realize the value of this data and know that its collection is important for the well-being of their population."

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Will your children buy candy, gum or little cigars?

Will your children buy candy, gum or little cigars? | Healthcare and Technology news |

Editor's note: Dr. Tom Frieden is director of the Centers for Disease Control and Prevention.

(CNN) -- They're on display at cash registers all across America: Candy bars, packs of gum -- and little cigars.

In some cases, those cigars aren't tucked away behind the counter where only the attendant can get to them but right in front for anyone to pick up.

Traditional fat cigars are a small part of today's cigar industry. Newer types of cancer sticks include cigarette-sized cigars, or little cigars, designed to look like a typical cigarette but which evade cigarette taxes and regulations.

Flavored little cigars can be sold virtually anywhere, and kids are a prime target of these new products.

CDC Director Dr. Tom Frieden

Unlike cigarettes, many are sold singly or in small, low-priced packs, at a fraction of the cost of a cigarette in most states.

These little cigars have names like "Da Bomb Blueberry" and "Swagberry." The flavors themselves -- chocolate mint, watermelon, wild cherry and more -- can mask the harsh taste of tobacco and are clearly attractive to children.

The Food and Drug Administration banned candy and fruit flavors in cigarettes so young people would not be enticed. But cigars weren't covered.

The tobacco industry claims that its marketing efforts are solely aimed at adults. It has long argued that its marketing doesn't increase demand or cause young people to smoke but instead is intended to increase brand appeal and market share among existing adult smokers.

How many grown-ups do you know who smoke grape-flavored cigars?

CDC: More teens smoking flavored tobacco

Little cigars have become more popular in recent years. Flavored brands have almost 80% of the market share.

In 2011, among middle school and high school students who currently smoke cigars, more than one in three reported using flavored little cigars.

Six states -- Florida, Georgia, Maryland, Massachusetts, Rhode Island and Wisconsin -- have youth cigar smoking rates the same as or higher than those of youth cigarette smoking.

Despite industry statements to the contrary, the link between marketing and youth tobacco use is clear.

Some legislative and regulatory actions that tackle elements of tax discrepancies, youth appeal and marketing are in place or under consideration.

New York and Providence, Rhode Island, have enacted city-wide ordinances prohibiting the sale of flavored tobacco products, including flavored little cigars. Both ordinances have been challenged and upheld in U.S. District Court.

In April, the Tobacco Tax and Enforcement Reform Act was introduced in the Senate. This bill aims to eliminate tax disparities between different tobacco products, reduce illegal tobacco trade and increase the federal excise tax on tobacco products.

Based on decades of evidence, the 2012 surgeon general's report on tobacco use among youth and young adults concluded that tobacco industry marketing causes youths to smoke, and nicotine addiction keeps them smoking.

This sobering fact holds true in spite of bans on advertising and promotions that target children and youths, and restrictions on certain other marketing activities.

Nearly 90% of smokers started before they were 18 years old, and almost no one starts smoking after age 25.

To prevent the needless death, disability and illness caused by smoking, we must stop young people from even starting to smoke.

A key part of prevention efforts must be action that will eliminate loopholes in restrictions on tobacco marketing, pricing and products that encourage children and youth to smoke.

I don't think it's too much to expect of our society that we protect our kids so they can reach adulthood without an addiction that can harm or kill them.

'Emerging' tobacco products gaining traction among young, CDC survey finds

The opinions expressed are solely those of Dr. Tom Frieden.

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Unlock Patient Data With Natural Language Understanding

Unlock Patient Data With Natural Language Understanding
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Compiled by Susan Kreimer, contributing editor

Natural language understanding (NLU) technology is helping Lancaster General Health improve physician documentation, prepare for ICD-10, and translate patient notes into discrete data measurable by analytics.

Voice recognition technology has evolved to become much more than a speech-to-text dictation tool. Today’s voice-driven solutions can understand context, prompt physicians for clarification, and analyze unstructured data contained in a patient note. These capabilities are a powerful clinical resource for physicians, contributing to a more complete patient record and, ultimately, improving care.

With locations throughout southeastern PA, Lancaster General Health is one provider that understands the benefits this new breed of voice recognition can offer. The health system currently leverages the M*Modal Fluency Natural Language Understanding solutions suite. In this Q&A, Gary Davidson, senior vice president and CIO at Lancaster General Health, discusses the health system’s experiences with the technology to date.

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Lab Costs In EHRs Influence Providers Decisions

Lab Costs In EHRs Influence Providers Decisions | Healthcare and Technology news |
Lab Costs In EHRs Influence Providers Decisions

By Katie Wike, contributing writer

Study reveals showing lab costs as part of EHRs helps physicians make better decisions when ordering tests

A study published in the Journal of General Internal Medicine found, “Including real-time cost of lab tests in electronic health system could make physicians think twice before ordering them. The research project was led by Daniel Horn of the Massachusetts General Hospital’s Division of General Medicine in the US, and is among the first to focus on the impact that the passive display of real-time laboratory costs can have within a primary care, non-academic setting.”

Thomas D. Sequist, MD, MPH, of Atrius Health, the senior author on the study and his research team separated the participants into two groups; one that received real time lab costs through their EHRs and one that did not. Researchers compared ordering rates for a one year period, both before, during, and after the prices were provided to one group of physicians.

Doctors who were shown the prices of labs upfront were less likely to order unnecessary tests. According to the study’s publisher, Springer, “The researchers found a significant decrease in the ordering rates of both high and low cost range tests by physicians to whom the costs of the tests were displayed electronically in real-time. This included a significant relative decrease in ordering rates for 4 of the 21 lower cost laboratory tests, and 1 of 6 higher cost laboratory tests.

Sequist adds, “Our study demonstrates that electronic health records can serve as a tool to promote cost transparency, educate physicians, and reduce the use of potentially unnecessary laboratory tests by integrating the relative cost of care into providers’ decision-making processes.”

EHR Intelligence reports 81 percent of study participants said the cost information helped them make better decisions and showed them exactly what their services were really going to cost. “It’s like putting price labels on goods you buy in the supermarket,” says Sequist. “When you know the prices, you tend to buy more strategically.”

“In the past, the way to make money was to do more,” says Dr. Brent C. James, Chief Quality Officer of Intermountain.  “If you know the true cost of providing care, you can ask yourself whether doing one thing is really more important than doing something else.  Once I get those costs, I can manage them the way I would if I were building an automobile or a washing machine.  Maybe we’ll be able to move health care out of the dark ages.”

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A Guide to Patient Portals for Medical Practices | Medical Practice Insider

A Guide to Patient Portals for Medical Practices | Medical Practice Insider | Healthcare and Technology news |
Technical Dr. Inc.'s insight:
A Guide to Patient Portals for Medical Practices

Patient portal technology enables patients to use a web-based connection to communicate with their healthcare provider. Forty percent of U.S. office-based physicians currently have a portal through their electronic health record or practice management system, according to research released by Frost and Sullivan in September 2013.

Although the technology can be utilized in a variety of ways, practices generally set up a portal to give patients the following capabilities:

  • Schedule appointments
  • Complete registration forms
  • Send secure email to providers
  • Access lab results
  • Request prescription refills
  • Create and maintain a personal health record (PHR)
  • View educational materials

A potent driver of portal growth is that Stage 2 of meaningful use under the federal EHR Incentive Program requires "patients to electronically view, download and transmit electronic copies of their own medical records." Physicians must engage at least 5 percent of their patients via an online portal under Stage 2.

Medical Practice Insider identified patient portal products listed on the Office of the National Coordinator for Health IT (ONC)'s Certified Health IT Product List (CHPL) that have been certified to 2014 Edition criteria under the EHR Incentive Program. We further filtered to obtain products categorized by ONC in the CHPL as being applicable to ambulatory practices and modular in nature (as opposed to complete EHR systems with an integrated portal component).

Details on those products appear in the comparison table below and on hyperlinked individual pages compiled by Medical Practice Insider. Use the available hyperlinks to navigate among the products you wish to analyze.

VendorProduct NameProduct VersionCertification BodyNotable FeatureeClinicalWorksHealow Enterprise Patient Portal1.0CCHITPHR and patient profile can be securely transported and shared. [More]InteliChartInteliChart Patient Portal2.5ICSA LabsDelivers connectivity for patients through one mobile app. [More]MedfusionMedfusion Patient Portal13.5CCHITAnytime, anywhere access to health information [More]Medical Office TechnologiesezAccess Patient Portal3.0CCHITPractice can do more than 100 workflow processes in the software. [More]Medical Web ExpertsBridge Patient Portal1.1ICSA LabsIncreases patient engagement. [More]NoMoreClipboardNoMoreClipBoard Patient Portal2.8Drummond GroupPortal is branded to the practice, but also provides a PHR to the patient. [More]Sophrona SolutionsSophrona MU2 Portal Technology5.0Drummond GroupPatients view a calendar on the practice website and choose their appointment. [More]

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Bridging EHR-Created Gaps At Michigan HIE

Bridging EHR-Created Gaps At Michigan HIE | Healthcare and Technology news |
Bridging EHR-Created Gaps At Michigan HIE

By Wendy Grafius, contributing writer

Exchange of medical records now automated with implementation of platform, significant benefits expected for providers, payers, and patients

The Michigan Health Information Network (MiHIN), a collaboration of public and private organizations, is deploying IOD Incorporated’s eDetermine platform to automate social security determinations between the Social Security Association (SSA) and providers. Utilizing the MiHIN’s CONNECT 4.2 uplink via the national eHealth Exchange operated by HealtheWay, Michigan’s HIE will electronically receive requests and submit medical records to the SSA, bridging the gap created by healthcare’s move to EHRs and reducing paperwork.

The SSA facilitates one of the world’s largest disability programs, with 15 million medical records requests from 500,000 providers for 3 million initial disability claims. “Social Security handles a large volume of paperwork received from providers responding to requests of medical records for SSA disability claims determinations,” said George Abatjoglou, CEO of IOD. “Working closely with MiHIN, IOD is proactively solving the growing labor and paper intensive problem. MiHIN’s advanced approach has already been integrated and tested with IOD’s eDetermine platform and we have hospital systems ready to start testing as soon as possible. Each successful exchange of medical records is a fully automated process leveraging the same industry standards behind the Meaningful Use Stage 2 requirements, providing significant benefits for providers, payers, but most importantly, for patients.”

IOD is a leading health information management company, with solutions implementations in over 1800 hospitals and clinics in over 40 states. Currently, eDetermine installations provide close to 500,000 SSA medical records requests per year nationwide, accelerating the disability claim process and resulting in expedited access to public health benefits. Additionally, the automated process frees up precious labor resources. “IOD’s extensive existing national network of hospitals represents an excellent opportunity to improve service quality and efficiency for hospitals and clinical providers in Michigan and in other states,” said Tim Pletcher, executive director of MiHIN. “IOD already successfully powers some of the most successful electronic disability determination deployments in the nation.”

By supporting a statewide electronic exchange of health information, MiHIN intends to improve the healthcare experience and reduce costs for the citizens of Michigan and the nation. “MiHIN is emerging as a national leader in HIE connectivity and the implementation of federal use cases for sustainability,” said Abatjoglou. “We’re using a thoroughly vetted solution with an innovative company responsible for Michigan’s Statewide HIE that is also highly responsive to sharing its innovative solutions nationally.”

MiHIN is a public and private nonprofit collaboration created for the coordination of a statewide capability to securely exchange EHRs throughout Michigan, so that valuable data is available at the point of care. Organizations that are sharing its services include the State of Michigan, the Office of the National Coordinator, sub-state HIEs, insurers, payers, providers, and patients. The MiHIN works to overcome data sharing barriers and reduce costs for the improved health of Michigan’s population.

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Surgical Assistance Virtually

Surgical Assistance Virtually | Healthcare and Technology news |
Surgical Assistance Virtually

By Katie Wike, contributing writer

Google Glass and a virtual reality program were recently used by a team from University of Alabama at Birmingham to perform surgery

“Imagine a world where a surgeon can keep their eye on the insides of the patient, but with a quick glance up get all vitals and any research needed to make things run smoother,” said Rob Patey in an article on Healthcare Technology Online. With Google Glass, it seems we can let our imaginations run wild. The device has been used as a teaching tool, a way to record operating room procedures, a hands-free avenue for viewing patient data, and now as a way to conduct surgery virtually.

According to Science Daily, the University of Alabama at Birmingham (UAB) has performed the first virtual surgery using Google Glass paired with virtual reality technology. UAB combined Glass with VIPAAR, which stands for Virtual Interactive Presence in Augmented Reality, a UAB-developed technology that provides real time, two-way, interactive video conferencing. On September 12, team leader Brent Ponce, M.D., UAB orthopedic surgeon, performed a shoulder replacement surgery in Birmingham while Phani Dantuluri, M.D., watched and interacted from his office in Atlanta.

"It's not unlike the line marking a first down that a television broadcast adds to the screen while televising a football game," said Ponce. "You see the line, although it's not really on the field. Using VIPAAR, a remote surgeon is able to put his or her hands into the surgical field and provide collaboration and assistance.

“It's real time, real life, right there, as opposed to a Skype or video conference call which allows for dialogue back and forth, but is not really interactive," said Ponce. According to UAB News, “Dantuluri could watch Ponce perform the surgery and simultaneously introduce his hands or instruments into Ponce’s view as if they were standing next to each other during the case.”

Essential to this of course was the virtual reality technology. “VIPAAR uses video on mobile devices to allow experts or collaborators to connect in real time and not only see what might need to be fixed, corrected or solved, but also be able to reach in, using tools or just their hands, and demonstrate. It’s like being there, side by side with someone when you might be a thousand miles, or 10 thousand miles away,” said Drew Deaton, CEO of VIPAAR.

“Today, we can’t imagine having a smartphone without the capability to take picture or record a video,” he said. “Five years from now, I can’t imagine anyone trying to solve a visual problem without having a knowledgeable, live expert reach in and help just as if he or she were there in person.”

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Is Gmail HIPAA Compliant? UPDATED - Adelia Risk

Is Gmail HIPAA Compliant? UPDATED

Posted by Carissa Broadbent on Oct 8, 2013 in hipaa | 0 comments

Many health care providers are required to adhere to the Health Insurance Portability and Accountability Act (HIPAA). This act was designed to protect a patient’s personally-identifying information from being accessible to the general public. As more clinicians are electronically transmitting patient records and other personal information to specialists and medical facilities, it is imperative that we ensure that information is secure.

Isn’t Email Secure? No way!

Email in general is not secure. Most people don’t realize there really is no way to know that the person receiving the email you sent is who you intended. This is especially so in companies whose messaging system is controlled through an IT department. Oftentimes companies have an email policy in place informing employees that they should expect no privacy as it relates to using the company’s email or Internet systems. So, those people handling sensitive information, including discussing diagnoses and treatments for patients, need to be aware that general email has no guarantee of privacy.

What does HIPAA Say about Email?

I’m summarizing here, but generally HIPAA requires three things when it comes to email:

  • Strong security: According to Section 164.314(a) of HIPAA, it is the responsibility of the health care provider to ensure that everyone involved in handling such confidential and personally-identifying information complies with the safeguards established by the HIPAA laws. Most providers meet this requirement by adding extra security around email like secure email, scanning outbound emails for sensitive data, and having a good handle on who is allowed to access email.
  • Consent:The HIPAA Omnibus Final Rule released March 18, 2013 states that clients are allowed to authorize communications via email, but to do so the client must be informed of the risks relating to sending protected health information via email before they sign the authorization. Most firms have a consent form that clients must fill out before email can be used.
  • Business Associate Agreement: Many health care providers use a third party (like Gmail, Microsoft, or their IT company) for email. These firms are referred to by HIPAA as “Business Associates.” These Business Associates are required to sign an agreement that states they will protect a patient’s confidential information with the same high standards required of the health care provider.
How does Gmail measure up?

In case you don’t know, Gmail is a service used for email by hundreds of millions of people people worldwide. Many small businesses use it for email because it’s inexpensive, convenient, and offers some very nice security features. While most people feel secure sending and receiving personal and confidential information via their Gmail accounts, let’s see how Gmail does against our three criteria:

  • Strong Security: Google arguably has some of the best security available in a hosted web service. Companies that take advantage of Google’s free two factor authentication have strong assurance that their email accounts aren’t hacked, plus Google offers some nice user logging and other security features that are much stronger than many competitors. Also, third party services (reviewed in another article) are available to add secure email and outbound email scanning which really make Gmail’s security top notch.
  • Consent: Since this is something that you’ll need to manage in your own office, this has no bearing on which email provider you choose.
  • Business Associate Agreement: As of September 2013, Google has stepped up and will agree to sign a Business Associates Agreement stating that they will “implement physical, technical and administrative safeguards” to hold the information secure. The company states publicly that Gmail is already HIPAA compliant in its security and privacy practices.

So is Gmail HIPAA Compliant?

As of September 2013, the answer is that, yes, Gmail can be used as part of a HIPAA-compliant organization!

Are there alternatives?
  • Office 365: Google’s competitor, Microsoft, has also stated that they would be willing to sign a Business Associates Agreement stating that their Office365 program will maintain the standards of HIPAA compliance. We’ve experimented with their service and find it comparable to Google in many respects.
  • Other Secure Email Providers: lots of lesser known companies offer email services that they claim are HIPAA compliant. A simple Google search for “hipaa email provider” will pull up lots of ads. A note of caution here — simply using an email provider that claims to be “HIPAA compliant” does not suddenly make your practice HIPAA compliant. HIPAA compliance comes from holistic protection of sensitive data, not just secure email.
  • Use two email services: some companies still use Gmail for their main email service, but then use a secondary, secure email service for communicating about lab results, diagnoses, or treatments. While we wouldn’t recommend that as a long term solution (it’s much easier to accidentally email PHI/PII when bouncing back and forth), this is something that could be implemented quickly as a short-term fix.
What About Mobile?

iPhones, Android devices, and tablets use various programs such as Google Apps to download their email messages while they are out of the office. Gmail is pre-programmed into most of those devices for the convenience of users. However, this convenience can create a breach of security according to HIPAA, and such breaches are required to be reported, causing further liability issues and potential fines for violation. Be especially careful about giving employees access to email via mobile, especially if it may contain PHI/PII.

Protecting the client’s personal information is very important in this technological age. Breaches of HIPAA laws can result in severe penalties for health care providers.

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It’s an exciting time of healthcare reform for the United States and a lot of that excitement revolves around the transition from ICD-9 to ICD-10. If you’re asking yourself what is ICD-10, then you've come to the right place.

ICD-10 or a clinical modification of ICD-10 is the classification system currently being used by the majority of the world. The US is the only industrialized nation not using an ICD-10-based classification system.

There are two main reasons that the transition to ICD-10-CM/PCS is necessary:

Payors cannot pay claims fairly using ICD-9-CM since the classification system does not accurately reflect current technology and medical treatment. Significantly different procedures are assigned to a single ICD-9-CM procedure code. Limitations in the coding system translate directly into limitations in the diagnosis-related groups (DRG).

The healthcare industry cannot accurately measure quality of care using ICD-9-CM. It is difficult to evaluate the outcome of new procedures and emerging health care conditions when there are not precise codes. Most importantly, we have a mission to improve our ability to measure health care services provided to our patients, enhance clinical decision-making, track public health issues, conduct medical research, identify fraud and abuse and design our payment systems to ensure services are appropriately paid.


ICD-10-CM is a clinical modification of the World Health Organization’s ICD-10, which consist of a diagnostics classification system. ICD-10-CM includes the level of detail needed for morbidity classification and diagnostics specificity in the United States. It also provides code titles and language that compliment accepted clinical practice in the US. The system consist of more than 68,000 diagnosis codes


ICD-10-PCS was developed to capture procedure codes. This procedure coding system is much more detailed and specific than the short volume of procedure code included in ICD-9-CM. The system consists of 87,000 procedure codes. 

Together ICD-10-CM and ICD-10-PSC have the potential to reveal more about quality of care, so that data can be used in a more meaningful way to better track the outcomes of care. ICD-10-CM/PCS incorporate greater specificity and clinical detail to provide information for clinical decision making and outcomes research.

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Sebelius: Back end of will be ready in mid-January - CBS News

Sebelius: Back end of will be ready in mid-January - CBS News | Healthcare and Technology news |

Some back-end portions of won't be fully functional until mid-January, Health and Human Services Secretary Kathleen Sebelius told Congress Wednesday, but she assured them that customers enrolled on the federal website will get full coverage -- and their promised subsidies -- starting on January 1.

"The financial management system, which is getting the insurance companies their money for accelerated tax credits and cost-sharing, is due to go into effect in mid-January," Sebelius told a subpanel of the House Energy and Commerce Committee. She explained, "This is reimbursing insurance companies -- it has nothing to do with enrollment."

If a customer enrolled in Obamacare is eligible for subsidies, those government payments go directly to the insurer, and then the insurer passes on the savings to the customer in the form of lower premiums. HHS is still working to fully automate that payment system to insurers, Sebelius explained. Until then, insurers participating in the Obamacare marketplaces have signed off on a system to ensure they're paid in a "timely fashion."

"There's a manual workaround for virtually everything that isn't fully automated yet," Sebelius said.

Nevertheless, Rep. Joe Barton, R-Texas, said he predicted Sebelius would be back before the committee in mid-January to explain more problems with The secretary took a number of tough and at times angry questions from Republicans on the committee -- Rep. John Shimkus, R-Ill., declared at one point that questioning her was "like talking to the Republic of Korea or something."

Sebelius acknowledged that the Oct. 1 launch of, which serves as a portal to the new Obamacare marketplaces in 36 states was "flawed and failed and frustrating."

Had she known the rollout would be so flawed, she would've done things differently, she said. "I would have probably done a slower launch with fewer people and done some additional beta testing."


 In addition to continuing work on's payment systems, Sebelius said that HHS is attempting to ensure that individuals who enrolled in Obamacare weeks earlier -- when the site was more dysfunctional -- are, in fact, signed up for coverage. Because of a glitch on the site, insurers complained they were receiving incorrect information -- or in some cases, no information at all -- from users who thought they had successfully enrolled in private plans. Administration officials said that one specific bug, which is now fixed, accounted for 80 percent of those problems.

Sebelius said HHS is now in the process of "hand matching" individuals with insurers. "We are seeing a vastly improved system, but we want to go back and make sure everyone who thinks they are enrolled is matched with a company," she said.

The secretary noted that HHS has dedicated $677 million for's total IT costs through the end of October. Of that amount, $319 million has been spent so far, she said. Rep. Marsha Blackburn, R-Tenn., asked whether HHS will request the contractors who initially built the flawed site to pay back the taxpayers who footed the bill, Sebelius noted that she's asked the HHS inspector general to investigate the contracting process.

"I will act based on his recommendations," she said.

In the meantime, Sebelius noted that has made "great progress" since its botched launch. Pages that once took 8 seconds to load are now responding in under a second, and the site's error rate is now under 1 percent.

Users, she said, are "finding the experience is night and day compared to where we were in October... It's now easier than ever."

HHS reported Tuesday evening that nearly 365,000 individuals nationwide are now signed up for private Obamacare plans, while an additional 1.9 million people have applied and been deemed eligible, but they have yet to select a plan. Sebelius noted Wednesday that the open enrollment period lasts through March.

© 2013 CBS Interactive Inc. All Rights Reserved.
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Video chat may help language learning

Video chat may help language learning | Healthcare and Technology news |
Video chat may help language learning

As a graduate student studying how children develop language, Sarah Roseberry made an interesting observation.  Parents would come into her lab at Temple University and talk about how they Skyped with grandparents in places like the Dominican Republic.

"The parents would swear their children were learning Spanish," recalls Roseberry, now a postdoctoral fellow at the University of Washington. "The more we thought about it, the more we realized this made sense."

Roseberry decided to take her theory into the research lab.  What she found was intriguing: Language can be learned via video chat, as long as the conversation allows for meaningful back-and-forth exchanges.

For the study, Roseberry and her colleagues gathered a group of 36 children between the ages of 2 and 2-and a-half, the time when children are still just learning language from others and not from videos.

They were divided into three groups: the first group worked one-on-one with adults in the room, the second group worked one-on-one with an adult via video chat and the third group of toddlers were shown a video of an adult communicating in a video chat with another child.

The researchers then introduced the children to nonsense words which required an action.  So for example "meeping" was used to refer to turning and "blicking" referred to bouncing.  After learning the words, the researchers showed the children a split screen on a computer.  On one side Sesame Street characters were performing the action and on the other side, they were doing something else.  Researchers then asked the children to point out which characters were performing the nonsense words.

They found the children who learned the words through live interactions and video chat, were the only ones who could do it.  The kids only watching the video and not engaging with the adult, didn't pick up the concepts.  "It's the difference between the child being an active learner versus a passive learner," says Roseberry.

So what's the take away for parents? Roseberry thinks the message is nuanced.

"Screen time isn't all good or all bad," says Roseberry.

For those of us with children who love their iPads and tablets, she suggests looking for games that encourage learning versus entertainment.  "All screens are not created equal," says Roseberry.

The study appears in the most recent edition of the journal Child Development.

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Eyes are better at mental snapshots than cameras, study suggests

Eyes are better at mental snapshots than cameras, study suggests | Healthcare and Technology news |

(CNN) -- I've got hundreds of photos from my recent Europe trip, split between a smartphone and a big camera. A lot are shots of the same thing -- my attempt to get the perfect lighting on a fountain or a cathedral, for example -- so that I'll have these scenes to remember always.

So I was interested to read a new study in the journal Psychological Science suggesting that the act of taking photos may actually diminish what we remember about objects being photographed.

"People just pull out their cameras," says study author Linda Henkel, researcher in the department of psychology at Fairfield University in Connecticut. "They just don't pay attention to what they're even looking at, like just capturing the photo is more important than actually being there."

At the same time, she found that zooming in on objects helps preserve people's memory of them, beyond just the detail on which they zoomed.

Henkel's father is a photographer, so she has been hanging around photos and taking photos all her life. She wanted to see if snapping photos of objects would impact people's memories of what they saw at a museum.

This study had a small sample size: 27 undergraduates participated in the first part, and 46 in the second. Both groups were mostly women. In order to strengthen the conclusions, this research would need to be replicated with a lot more people and a more balanced sex ratio, not to mention a wider range of demographic characteristics such as age.

But this is an interesting start. It underscores the point that there are different ways that the brain processes information: At an automatic level, by taking pictures, and at a more meaningful level, by focusing on a specific object or something with a personal association, said Paul D. Nussbaum, clinical neuropsychologist at the University of Pittsburgh School of Medicine.

It's that deeper level that enables memories to form, Nussbaum said in an e-mail.

"The more we engage our brain into processing a stimuli and the more personal that processing is, the more solid the memory formation and recall," he said.

Photos impairing memory?

For the first experiment, participants went to the Bellarmine Museum of Art. One-third of them had never been to the museum before. They visited 30 objects, spanning such media as painting, sculpture, jewelry and pottery.

One group of students was instructed to read the name of each object out loud, look at the object for 20 seconds and then take a photo of it. The other participants looked at an object for 30 seconds without taking a picture.

The following day, participants were asked to write down the names of all objects they remembered from the museum, and to indicate which they photographed. They could describe any objects whose names they could not recall.

Then, they were given a list of 30 objects and were asked to indicate which they had seen, which they had photographed and which were not on the tour. They also answered questions about details of objects, and completed a photo-recognition test of objects they may or may not have seen.

Henkel found that people performed worse on memory recognition tasks in reference objects they had photographed, compared to objects they had observed with their eyes only. Similarly, they appeared to remember fewer details about what they photographed, compared to the ones they had only seen.

"When we distract ourselves and count on the camera to remember for us, then we don't remember as many objects," she said. "We don't remember as many details about the objects."

Zooming protecting memory

The second experiment gave participants 25 seconds to view each object, in addition to extra time for photographing when that was asked of them. That meant they had extra time with objects that they had to photograph. Some were also asked to zoom in on specific parts of the objects.

The next day, it was time to test their memory: Participants had to indicate, from a list of names of art objects, which were part of the tour they had been on.

For objects they remembered, participants were asked to say whether they had photographed the object or just seen it, and answer two questions about visual aspects of the object.

Henkel found a similar effect as in the first experiment: Photographed objects tended to be associated with a decline in memory about them.

But here is the twist: Zooming in on one part of the object preserved participants' memory about that entire object, not just the part on which the camera zoomed. Accuracy was about the same, regardless of whether participants just observed objects or zoomed in on individual parts.

Henkel explains that when you zoom in on part of an object, it's drawing your visual attention there, but you're also thinking about the object as a whole.

"So what your eyes are doing, what the camera is doing, is not the same thing as what your brain is doing," Henkel said.

In other words, when you spend the extra time and attention to zoom in on something, you're likely to remember aspects of it as well as if you had just observed it without a camera.

The bigger picture

OK, so maybe it's a little more complicated than just "taking photos is bad for your memory." That's good news, since people took more than 3 billion photos in 2012, according to an estimate cited in the study, and 300 million photos are uploaded to Facebook daily.

Still, says Nussbaum, "I wonder sometimes how much we may be missing when we rely so much on technological gadgets rather than using our brains."

Henkel points out that the advent of digital photography has overstepped the age-old traditions of printing photos out, putting them in scrapbooks and sitting around with your family and looking at them. That sounds a little like using a paper map.

But maybe those photo-related activities that make us take time to reminisce do enhance our memory of the experiences we have tried to photograph so diligently.

"If we're going to going to rely on that external memory device of the camera to remember for us, we've got to take that extra step and look at it," Henkel says.

Keep that in mind this holiday season when you take hundreds of photos with with friends and family.

They're worth a second look.

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How IT Can Produce Better Patient Care

How IT Can Produce Better Patient Care | Healthcare and Technology news |

How is technology changing the healthcare industry?

Let me respond with a story: On the first day of my internal medicine rotation at the University of Pennsylvania, a distinguished professor held up Harrison's Principles of Internal Medicine. He told us to memorize the book, because it contained everything we needed to know.

Memorization has been expected of physicians since the Middle Ages. Today, that same textbook is on my smartphone in my pocket. I don't need to memorize it. I can just look up the information I need. As physicians, we no longer need all that knowledge in our minds; we are free to focus more on our patients and on new ways of delivering healthcare. This alone is revolutionary.

As you point out, the medical profession is thousands of years old. How do you create a culture where healthcare professionals embrace technology change?

We have a favorite phrase at Christiana Care: "Better and easier." The phrase was originally used for IT, but now we apply it to everything from process change to organizational redesign.

If you want to convince people at Christiana Care to do something differently, explain how it will be better and easier for the healthcare professionals and their patients. That's a compelling argument.

I recently saw a cartoon that had a physician looking at a computer with his back to the patient. That's not the fault of technology; that's poor design. Technology should make it easier for doctors to focus on patients and make the patient's experience a better one.

Can you give an example?

Last year, we developed Insight, a tablet-based self-evaluation tool that allows patients to communicate their medical concerns to their doctors prior to their actual appointments. Insight was initially developed for cancer patients, who tend to have so many concerns that their questions vanish from their mind during their time with their doctors.

Now, patients sit down in private, when they are calm and able to reflect, and use the Insight tool to provide information, ask questions and express their concerns. The tool also helps patients overcome discomfort about discussing sensitive emotional and physical health issues when meeting face-to-face.

This way, the physician and patient can spend all their time together addressing the most critical and troubling issues, not gathering data.

In the world of healthcare, what is the next big technology innovation on the horizon?

We tend to focus on the information that surrounds a patient, but there is a tremendous amount of information that is actually in a patient, and that's where I see great opportunities for technology innovation. The prospect of making a person's DNA relevant to her healthcare presents a computing challenge of astronomical proportions and profound significance.

Equally as exciting is the way technology will continue to empower individuals to manage their own health. As medical and patient information becomes more accurate, accessible and easily distributed, we will see patients becoming more knowledgeable and more in control of their health. This kind of patient self-actualization has the potential to be revolutionary.

Technical Dr. Inc.'s insight:

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Telehealth Bill Introduced To Congress

Telehealth Bill Introduced To Congress | Healthcare and Technology news |
Telehealth Bill Introduced To Congress

By Katie Wike, contributing writer

New bill would expand remote care access for military personnel, allow veterans and their families to participate as well

On November 15, U.S. Representatives Mike Thompson and Scott Peters introduced H.R. 3507, the 21st Century Care for Military & Veterans Act. According to Thompson’s website, “This bipartisan legislation would expand coverage of telehealth services to active-duty servicemembers, their dependents, retirees, and veterans.

“Because of provider shortages at local practices, many servicemembers and veterans lack access to a primary care physician, and in rural and underserved communities patients often must travel extended distances to see a healthcare provider. The bill would establish and expand reimbursement policies covering the use of telehealth services, including essential mental health monitoring, under TRICARE and the VA,” he continues.

EHR Intelligence reports that a letter sent to congress from groups such as American Telemedicine Association and The Telecommunications Industry Association is also urging representatives to pass the bill. “Patients want – and need – to transmit information they perceive as important near real-time,” the letter argues. “The use of standards for interoperability between remote patient monitoring devices and EHRs would leverage the broader information and communications technology industry that has flourished globally through ubiquitous interoperable mobile devices, systems and networks. It would also enable systemic engagement between patients, health care providers, and other stakeholders reduce long-term health care costs.”

The legislation introduced would utilize video and web conferencing, remote patient monitoring and smart devices. Thompson’s website says the VA has already seen a 40 percent reduction in bed days and an 87 percent reduction in annual per-patient costs through telemedicine technology. Telemedicine is so productive for the VA, that EHR Intelligence reports their plans to add more than 25 million dollars in funding to their telehealth program.

“As we look for ways to provide the best-quality care for our servicemembers and veterans, telehealth technologies are increasingly important to the full range of options we should be offering,” Peters said. “We’ve already seen that these technologies create a more responsive and more efficient health care system that provide for better care and lower costs.”

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5 EHR workflow flaws to watch out for | Medical Practice Insider

Technical Dr. Inc.'s insight:
5 EHR workflow flaws to watch out for

While the frustrating state of EHR usability gets so much attention, the real reason they are so hard to use is not as well understood. Yet.

“Healthcare has been slow to absorb workflow technology, so most EHRs aren't built on true workflow platforms,” Charles Webster, composer of three successful applications for the ambulatory EHR HIMSS Davies Award, told Medical Practice Insider. “And the reason many EHRs have lousy usability is that they have lousy workflow.”

According to Webster, the EHR environment needn’t be this way, and providers can play a pivotal role in getting the industry to solid ground by being privy to ways in which EHR workflow designs are:

  1. Unnatural. Many EHRs do not match healthcare task structure. The very definition of workflow is a series of tasks consuming resources and achieving goals. If EHR workflow does not match the everyday workflows required to perform patient encounters effectively and efficiently, those tasks will be performed, if at all, in the only alternative way: ineffectively and inefficiently.
  2. Inconsistent. Similar information within an EHR may require completely different workflows to access, depending on which vendor or even which programmer wrote a particular module.
  3. Irrelevant. At each step in a workflow, only a small subset of the possible data or entry options is relevant, yet users face high-resolution screens thick with tiny checkboxes. Users can easily be overwhelmed with irrelevant data and data/order entry options.
  4. Unsupportive. Many EHRs fail to support user-shared mental models of workflow. One of the very few benefits of paper-based workflow is that documents and forms can explicitly and visually represent workflow state. Whomever has the documents has the responsibility. Whatever remains to be filled out signals what remains to be done. Instead, workflow state is hidden in database tables and obscure screens.
  5. Inflexible. Most important of all, much EHR workflow is inflexible. The workflows are hardcoded. If the software is unnatural, inconsistent, irrelevant, and unsupportive when installed, it cannot easily be changed to become natural, consistent, relevant, and supportive.

Of course, there was no great scheme that landed the healthcare industry in such an unusable state — it was more incidental of natural blockades — but that doesn’t mean it’s wrong to reconsider the current status.

By implementing stronger workflow initiatives through the recognition of weak design, doctors can hasten proper EHR development by voting with their dollars on an EHR that focuses on the usability elements that count.

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Building The Perfect EHR For Community Hospitals

Building The Perfect EHR For Community Hospitals
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Compiled by Susan Kreimer, contributing editor

Four community hospital leaders share their EHR wish lists — outlining the performance strengths of their existing solutions and identifying areas for improvement.

As explored in the previous story, Are Community Hospitals Behind The Health IT Curve?, EHR adoption and implementation is currently the top IT initiative at most community hospitals despite significant financial and resource limitations. With this in mind, community hospitals need to make wise decisions when it comes to their EHR technology purchases. The clinical, workflow, and reporting needs of a community hospital are very different from those of a larger health system, and the EHR solution in use at a community hospital should address these unique needs effectively. Healthcare Technology Online interviewed leaders from four community hospitals — St. Claire Regional Medical Center, Grande Ronde Hospital, Forrest General Hospital, and Ellenville Regional Hospital (all of which have successfully attested for Stage 1 Meaningful Use [MU]) — to gain a better understanding of the EHR features they find most valuable, where EHRs fall short in satisfying their demands, and how EHR use is impacting their organizations to date.

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Security Options In The Cloud

Security Options In The Cloud | Healthcare and Technology news |
Security Options In The Cloud

By Katie Wike, contributing writer

Mobility is an advantage for healthcare professionals, but having personal data on many mobile devices also means needing more protection

Doctors and nurses are on the move now more than ever, taking with them electronic health records (EHRs) on tablets and smartphones, and interacting with those EHRs on these devices regularly. A Vitera Healthcare survey found 93 percent of physicians want the ability to review a patient’s EHR, and 87 percent want to be able to update a patient’s chart and order prescriptions.

With that many healthcare professionals using mobile solutions, a new concern arises: how secure is the data contained in the EHR? When patient information is being bounced around the cloud from an iPad to a smartphone to a nurses’ station all in a matter of seconds, there are many opportunities for security breaches.

HealthIT Security author Bill Kleyman, an expert in network infrastructure management, writes, “What does your healthcare organization really want to control? Does it make sense to manage the physical device or simply the workload that’s being delivered to it? How can the healthcare organization securely deliver data and applications to user devices that don’t really belong to them?

“These types of questions have come from one simple evolution within the healthcare security and IT world: The management of physical devices has progressed much further with more data, users, and many more devices. In creating a secure solution, there needs to be an understanding of the security and management layers within the mobility and device control environment.”

The first layer Kleyman details is device layer security, “Where mobile device management (MDM) solutions fall into place.” The next level is application layer security, or mobile application management (MAM). MDM “for organizations looking to purchase, control and distribute their own mobility devices” and MAM is “to logically segment the physical device and the applications that are being delivered.”

Third is data layer security, through data and file sharing solutions in the cloud. Kleyman says, “Healthcare organizations are able to recreate Dropbox-like environments within their own data center walls. This means full control over the data, where it’s being delivered, who is accessing it, and how it’s being shared. Furthermore, these technologies directly integrate with both MDM and MAM solutions.”

Last is user layer security, or where organizations can now secure their end users by using a personalized profile and settings. “This means that settings, personalization elements, and other user-related data can be delivered to any device on any operating system (OS). Administrators are able to place the user’s settings into a container and allow it to carry over to various platforms. This means that working with different version of software or even OSes no longer becomes an issue.”

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Google Helpouts Connect Patients To You Instantly

Google Helpouts Connect Patients To You Instantly | Healthcare and Technology news |
Google Helpouts Connect Patients To You Instantly

By Katie Wike, contributing writer

The new Google app pairs the chat feature of Hangouts with other Google services to provide expert advice in an instant

Instantaneous telemedicine is here, in the form of Google Helpouts, a “service (that) marries the video chat features of Hangouts with the payment processing of Google Wallet, the identity management of Google+, and a slew of other Google service features. The end result is a gorgeous Frankenstein monster that lets you find expert help instantly via video,” according to VentureBeat.

According to MedCity News, “While Helpouts can be used for anything from getting a lawn care consultation to rock guitar lessons, the implications for telemedicine and healthcare are probably most significant. Prices can range from per minute to per session and are set by providers. Google takes a 20 percent cut via Google Wallet and voila. Customers are asked to write a review, moving one step closer to the future of healthcare, more toward consumers selecting doctors like they select restaurants – which surgeon has the most stars?”

HealthIT Security notes Google maintains they are a HIPAA compliant and secure product for healthcare professionals. “Ensuring that our users’ data is safe, secure, and always available to them is one of our top priorities. For providers who are subject to the requirements of the Health Insurance Portability and Accountability Act (HIPAA), Helpouts can also support HIPAA compliance.”

Here’s an example of a physician offering his services on the Helpout board:

“I am here for patients and healthcare providers. If you are a patient, I can help you work with your primary care team.  We can discuss medical conditions, medication use, and communication tips.  I do not want to replace your primary care provider’s advice — that relationship is important.  This is not a professional consult.  I will not order any tests or write any prescriptions for you.”

According to HealthIT Security, “The physician makes it clear that he is not assuming responsibility as a patient’s provider, but merely offering general medical advice and best approaches.”

CNN writes of Helpouts, “The category with the most intriguing potential is health services. People can have a counseling session, consult with a dietitian or get advice from a registered lactation support consultant over the video chats” and “Google is checking credentials for any providers in the medical field.” CNN also notes, “There is no framework for getting a Helpout session covered by insurance, but Google thinks the category has potential to become a regular part of modern health care.

“Telemedicine is not a new idea. Companies already offer therapy sessions and one-on-one physician appointments over video. It's great for people who are far from proper medical facilities or who are homebound because of illness.”

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ICD-10 - Centers for Medicare & Medicaid Services

ICD-10 - Centers for Medicare & Medicaid Services | Healthcare and Technology news |

About ICD-10

On October 1, 2014, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets.

The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). Please note, the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services.

Stay up to date on ICD-10!

Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.

CMS Resources


This official CMS ICD-10 logo (displayed on the top of this page) signifies that these materials were developed by CMS, and are intended for general industry use.

CMS materials intended solely for providers in the Medicare Fee-for-Service program feature the Medicare Learning Network logo.

  • Page last Modified: 09/09/2013 3:20 PM
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5 ways to help your medical staff survive ICD-10 | Healthcare Finance News

5 ways to help your medical staff survive ICD-10 | Healthcare Finance News | Healthcare and Technology news |

If hospitals and health systems do not get buy-in from their physicians, the ICD-10 transition may be hazardous to the health of the organization. Physicians need to accept the changes required to make ICD-10 implementation work.

If physicians don't document patient encounters properly, medical coding productivity and accuracy will suffer. That leads to financial problems, as medical claim rejections and denials increase.

Hospital administrators need to engage physicians in a way that ensures they learn what they need to know and apply the knowledge after Oct. 1. The following five tactics will help.

Find value in ICD-10 coding

Blaming the federal bureaucracy and health insurance industry is not going to motivate physicians to accept ICD-10. They need to see the value in improving clinical documentation and using ICD-10 codes.

Simply telling physicians that ICD-10 codes will provide more data that can improve population health won't be enough. Organizations need to have a plan that uses clinical data and shares it with physicians. They need to know their work makes a difference and see the results.

Train physicians to be teachers

Physicians aren't going to want to hear from medical coders or documentation specialists. They will be more receptive to physicians who speak their language, work in the same specialty and won't tell them they're doing their jobs wrong.

Physicians need to learn about the importance of ICD-10 from someone who respects their knowledge and time. Physician trainers will be able to help customize training for each specialty.

Customize sessions to fit learning styles

The first impulse of an ICD-10 educator may be to gather physicians in a room and fire up a projector. Perhaps this works for some physicians. But maybe there are more physicians who will learn better at their own pace and don't need a classroom session.

Make videos and workbooks available that let physicians learn at their pace, on their schedules. But be sure to follow and reinforce the sessions, and be available to answer questions. Making a variety of training options available to physicians will help them accept change.

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