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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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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.”

Want to publish your opinion?

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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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