ADVANCE Perspective: HIM : lawsuits

Registry: Child's Play?

Cheryl McEvoy — Thu, 06 Aug 2009 14:43:00 GMT

Call me a bandwagoner, but I just started reading Julie and Julia (Quite frankly, I'm just a wannabe foodie who wanted something to breeze through after being semi-forced into reading a 500-page sci-fi book). I was poring through Julie Powell's witticisms...(read more)

Abortion Records Go on Long, Strange Trip

Lynn Jusinski — Tue, 24 Feb 2009 21:05:00 GMT

When patient records of women receiving abortions made their way from the Sedgwick County, KS, court to the Johnson County, KS, district attorney's office and then probably on to somewhere in Virginia and then back to Johnson County, KS, that's an issue worth considering, according to a lawyer for Wichita abortion provider George Tiller.

Tiller faces 19 misdemeanor charges for violating the state's late-term abortion law. Phill Kline, former attorney general and anti-abortion Republican, started scrutinizing abortion clinics during his 2003-07 tenure as Kansas attorney general. After losing a re-election bid, Kline became Johnson County's district attorney, according to the Associated Press. After losing the Republican primary for that spot, he took a position as a visiting law professor in Lynchburg, VA.

Here's where the medical records come in (whew!). A box was sent from Sedgwick County to the Johnson County DA. It was then forwarded on without being opened to Kline's new address in Virginia, The Wichita Eagle reported.

But the address was insufficient. Kline never received the box, which included copies of the medical records of women who received abortions as well as state reports of abortions, notes about the investigation and prosecution of Tiller and an activist group document, according to the AP.

Instead, the box headed back to the Johnson County DA's office, where the records were locked away. Tiller's attorney used the traveling records as part of a plea to dismiss the charges against Tiller, who heads to trial in March. "Tiller's lawyers have argued that Kline's conduct in investigating the doctor was so outrageous that the resulting charges against him should be dismissed," The Wichita Eagle wrote.

In the end, the box of records mailed halfway across the United States shouldn't affect the case, the Kansas attorney general's office said Friday. The prosecutor said the mailing wouldn't harm the case against Tiller. "The mailing of this package is at its best an innocent act that means nothing," Prosecutor Barry Disney said in a pleading. "At its worst, it is the act of a private citizen whose conduct is not binding upon the office of the attorney general."

HIT Help on the Way?

Cheryl McEvoy — Wed, 18 Feb 2009 13:30:00 GMT

Breaking through red tape at seemingly record speed, the $787 billion economic stimulus package--officially dubbed the American Recovery and Reinvestment Act of 2009--was signed into law yesterday. President Obama expressed confidence in the plan before issuing his signature.

The final plan directs $19 billion toward HIT, including $17 billion in incentives for hospitals and physicians practices that adopt and use EHRs, starting in 2011. Providers who do not implement such HIT initiatives by 2014 or 2015 will be penalized through reduced Medicare and Medicaid reimbursements. The stimulus package also lays aside funds to aid floundering state Medicaid programs and help recently unemployed workers extend their health coverage through COBRA.

To help achieve HIT goals, the new law formalizes the Office of the National Coordinator for HIT, a position established during the last administration to guide and encourage EHR implementation and standardization. The government will also establish an HIT Research Center to identify best practices, which regional centers will then communicate to providers.

Debate has ensued over privacy provisions in the law, particularly about who will have access to patients' EHRs. While the law strengthens HIPAA regulations and cites penalties for security breaches, privacy proponents argue that certain loopholes may permit the sale of protected health information for research and marketing purposes. Others claim the new regulations are too stringent and will limit the public health benefits of digitized records.

ICD-10 Final Rule Issued; Implementation Slated for 2013

Lynn Jusinski — Thu, 15 Jan 2009 17:22:00 GMT

The eagerly awaited Final Rules for adoption of ICD-10 will be published in the next few days, and the implementation date has been bumped from 2011 to 2013.

The American Health Information Management Association (AHIMA) released a brief statement today applauding the Department of Health and Human Services (HHS) on approving the Final Rules for adoption of ICD-10.

AHIMA did express unhappiness about the compliance deadline being extended to Oct. 1, 2013, as opposed to Oct. 1, 2011. "This further extension means more years without the data needed to make intelligent data-driven decisions related to all aspects of health care," AHIMA CEO Linda Kloss, MA, RHIA, CAE, FAHIMA said in the statement. "Nonetheless, this extra time gives the industry no excuse for an adequate implementation and compliance. This extra time should be used wisely and the industry needs to start now and not wait."

Kloss also noted that the transition process won't be an easy one, but noted all of the improvements that will come in health information with the adoption of the new code sets. The organization's CEO also said it's working with HHS to help make the transition smooth. Kloss also called on HIT vendors to begin working on the development of new software for the switch to ICD-10.

You can read the final rules here. The final rule will be effective 60 days after its publication in the Federal Register. According to AHIMA's Web site, "Actual posting of the final rules is expected in the Federal Register in the next few days. The 60-day delay in the effective dates come as a requirement of the original HIPAA regulations and were set, to allow Congress a chance to review the rules. AHIMA will publish an in-depth analysis of the final rules in the coming weeks."

ADVANCE just published an in-depth article on ICD-10 implementation, looking at the myths and realities and offering up tips on how to best prepare. You can also view the article in our digital edition.

A Twist on Patient Privacy

Cheryl McEvoy — Thu, 04 Dec 2008 14:26:00 GMT

Still recovering from Thanksgiving (and 2 nights of reenacting the feast, thanks to Tupperware and a microwave), I spent last Sunday morning lounging on the couch and watching the news. I usually zone out during the sports segment, but a story about Giants wide receiver Plaxico Burress caught my attention. No game-saving play, no philanthropic Thanksgiving deed; instead, the man shot himself in the thigh-at a nightclub-on accident.

I shook my head and chalked the incident up as a (highly illegal) social faux pax that will likely be recounted on SportsNight and E!'s stupid celebrity moments. Why Burress had a gun and why the safety was off, I'll leave for the police to untangle.

But scan the news sites today and viola! The plot thickens. Investigators are looking into some questionable practices at the hospital where Burress was treated; namely, why the incident wasn't reported. Hospitals are required by law to report gun shot wounds to authorities, but this time, no notification was issued.

With UCLA Medical Center still embroiled in controversy surrounding patient privacy breaches-most recently, an employee pleaded guilty to selling Britney Spears' medical information to the National Enquirer-it's not surprising that a facility would want to tip-toe around Burress' celeb status. But by keeping tight-lipped, doctors violated their legal obligation to report a gunshot wound. Countless hospitals have kept their mouths shut to protect celebrities in their care, but a hospital that actually breaks a law when doing so? That's newsworthy.

Perhaps it was a no-win situation; alert the police (and, inevitably, every media outlet in the metro area) or keep Burress' treatment under wraps and hope authorities don't catch wind. No matter the facility's intentions, you have to give employees some credit for not blabbing as soon as Burress hopped on the examination table. But by failing to alert police, the facility still broke the law-and to protect someone who allegedly had a loaded gun in a public place, nonetheless.

Burress may be nursing his thigh for a while, but his doctors just shot themselves in the foot.