ADVANCE Perspective: HIM : personal health information

Breach Notification: Technically Speaking

Cheryl McEvoy — Wed, 18 Nov 2009 14:50:00 GMT

While researching for my encryption article, " Are You Secured? " I was struck by what I would consider a loophole in the breach notification rules. According to the new regulations, when a security breach or theft occurs, the covered entity or business...(read more)

FTC Probes CVS

Cheryl McEvoy — Fri, 06 Nov 2009 14:51:00 GMT

Your friendly neighborhood drug store--OK, more like the corporate colossus that runs it--is under investigation again. CVS Caremark Corp. announced yesterday that the Federal Trade Commission (FTC) is investigating the company's business practices, according...(read more)

AHIMA 2009: The Health Information Bill of Rights

Cheryl McEvoy — Tue, 06 Oct 2009 12:41:00 GMT

At a news conference yesterday, the American Health Information Management Association (AHIMA) unveiled its Health Information Bill of Rights, a set of seven principles designed to protect and promote patient access to personal health information. Craig...(read more)

On the Record

Cheryl McEvoy — Wed, 30 Sep 2009 15:24:00 GMT

With all the prep for next week's American Health Information Management Association Convention and Exhibit and our HIM Team of the Year coverage (Yes, we have a winner!), I've been neglecting my Google Alerts. Well, I found some time this morning to...(read more)

HHS Releases Breach Notification Final Rule

Cheryl McEvoy — Thu, 20 Aug 2009 13:41:00 GMT

The Department of Health and Human Services (HHS) has released a final rule on breach notification requirements for covered entities (CEs) and business associates (BAs). Published in the Federal Register , the rule dictates proper procedure for responding...(read more)

HIPAA be damned?

Lynn Jusinski — Tue, 14 Jul 2009 12:05:00 GMT

[Editor's note: This is a guest blog by ADVANCE for Nurses editor Lyn A.E. McCafferty, who contributes to the "ADVANCE Perspective: Nurses " blog featured on the ADVANCE for Nurses Web site.] If you think the fictional Nurse Jackie and HawthoRNe are bad...(read more)

Retail Clinic Check-up

Lynn Jusinski — Thu, 25 Jun 2009 19:30:00 GMT

I'm what you might call "doctor phobic." I haven't had a check up since 2001, and that was required to get into college. After high school, I moved to the Philadelphia suburbs from quiet nook upstate in a rural area lovingly referred to as the "Polish...(read more)

Malicious Use of PHI Lands Woman in Jail

Lynn Jusinski — Thu, 11 Jun 2009 19:02:00 GMT

In a strange case of Internet harassment involving personal health information (PHI), a woman finds herself facing a year in prison for what a judge called "egregious" behavior, according to the Honolulu Advertiser. Rhonda Wong-Fernandez was sent immediately...(read more)

Suleman’s Records Accessed; 15 Employees Fired

Lynn Jusinski — Tue, 31 Mar 2009 15:18:00 GMT

I had a feeling when the Octomom story hit the wire and all the details spilled out that someone would be caught sneaking a peek at her medical records. Sure enough, 15 workers were fired for looking at the records of Nadya Suleman without permission....(read more)

Company Sells Health Info to Pharma Companies

Lynn Jusinski — Fri, 27 Mar 2009 13:36:00 GMT

Would you share your personal health information on the Internet, including intimate information like how sexually active you are or how heavy your menstrual cycles are? Well, more than 27 million people have, according to a New York Times article on...(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."

Surgery Goes Web 2.0

Lynn Jusinski — Tue, 17 Feb 2009 21:06:00 GMT

One of these things is not like the other: "Watching a good bootleg of The Wrestler." "Holy cannoli, unhappy baby. Early bedtime for you, kiddo." "Dr rogers (sic) has adequately sutured closed the urinary collecting system and any bleeding vessels."

The first two come directly from the people I'm following on Twitter. The last one is also from Twitter, the microblogging/short messaging service. While the first two are entertaining, or at least mildly informative, the last one is obviously a bit more serious.

On the morning of Feb. 9 at Henry Ford Hospital, the chief resident sat by on a computer tweeting about the live tumor removal being performed by lead surgeon Dr. Craig Rogers at the same time, in the same room. The resident managed to capture the surgery blow-by-blow in 140-character "tweets" as it happened. Here's the stream of the surgery on Twitter.

According to CNN, "Dr. Craig Rogers, the lead surgeon in the Henry Ford surgery, said the impetus for his Twittering was to let people know that a tumor can be removed without taking the entire kidney. ‘We're trying to use this as a way to get the word out,' Rogers said."

With social networking sites abounding, there's likely to be more of this happening. Are there limits to what should be shared on the Internet? Just this morning, I was contemplating updating my Facebook friends on the status of a broken sewer pipe in my apartment. No, that's not pretty information at all, and yes, I just told the Internet via this blog. Is "tweeting" the surgery as it happens progress, or just pushing the limits of privacy?

I personally think the idea is pretty cool, as long as the patient consents to being tweeted about. If the information is helpful to others performing or curious about the surgery, then it might be worth it for more than just a novel Internet trick.

I look at it from two angles. If I was getting ready to go through a robotic partial nephrectomy, as the patient did in the Tweetstream above, I would probably be scouring the Web for information beforehand, and coming across the tweets would either calm my fears or seriously wig me out. And if I was getting ready to go under the knife and was asked if I would mind being tweeted about during surgery, well, I might hesitate a bit on that one. What are your thoughts?

A Smoking Idea...and One Not-So-Hot

Cheryl McEvoy — Thu, 20 Nov 2008 17:36:00 GMT

I’ve heard complaints about doctors who don’t take their own advice. You know, the ones who pause in the middle of explaining the benefits of exercise to hack up a lung or hike their pants up over their guts? Well, HIM professionals are just as immersed in health care, whether a tumor registrar tracking a lung cancer patient’s treatment or an MT transcribing an emphysema diagnosis. The risks are out there, but it’s up to you to take action.

While it’s a personal preference and right whether or not you light up, the American Cancer Society is helping those looking to quit. Today marks the 33rd annual Great American Smokeout, a day that invites all smokers to give their lighters a rest. According to the American Cancer Society, 44.2 percent of smokers tried to quit for at least one day last year. For those looking to take a permanent break, the society is offering a number of supportive resources, including the Quitline, a free, confidential counseling hotline.

If you’d like to find out more about the Great American Smokeout, check out the American Cancer Society’s Web site at www.cancer.org.

In other news, I found out about a new product on the market called My Medical Memory, which allows consumers to carry around medical information on a flash drive. For a fee, the company can transfer your medical records onto the flash drive, which you can then tote about town--or straight to a hospital--on a keychain or around your neck. When seeking medical care, simply fork over the device and the doctor can load your personal health information using any USB port. Allergies? OK. Prescriptions? Got ‘em.

The product sounds convenient, and perhaps even lifesaving in an emergency. But at the same time, I have to question the security risk that comes with such easy access to medical data. Privacy breaches abound, even when data is encrypted, so what will come of our medical information if the flash drive winds up in the wrong hands?

The company claims mobile data means providers no longer need to worry about treating patients who can’t remember their medical histories; the device does all the talking for them. But couldn’t these forgetful patients also misplace their flash drives during a bout of absent-mindedness? Let’s be honest--those things are tiny.

While writing my college thesis, I had my fair share of panic digging through my laptop case to find the coveted flash drive, so putting my medical records on a similar storage device seems like a big no-no, especially without password protection or data encryption. But what’s the consensus among HIM professionals? A convenient tool or a security nightmare? Feel free to weigh in!

What's On the West Coast

Cheryl McEvoy — Fri, 10 Oct 2008 15:36:00 GMT

Before I wind my watch to Pacific Time, I thought I'd scan health care headlines from the West Coast. In California, the Governator just vetoed a legislative bill 2 years in the making that would have required medical facilities to inform patients of their medical retention policies.

Alan Boinus, a Laguna Beach resident, has been driving the bill through government ever since his wife was diagnosed with breast cancer for a second time and found out that medical records from her previous diagnosis had been destroyed. According to the Laguna Beach Coastline Pilot, details from those records may have been helpful in determining a treatment course for her second diagnosis.

Following an unprecedented delay in passing the state budget, Gov. Schwarzenegger has only passed bills deemed to be of "highest priority." According to the article, while Boinus' bill did not make the cut, a staffer informed him that it would likely be supported in the future.

As someone who hates deleting old e-mails (hey, you never know when that book someone happened to mention might come in handy for research), I couldn't fathom destroying medical documents--especially ones containing information relating to a life-threatening disease. But then again, I'm not exactly an example of responsible record-keeping; as a recent grad, my medical history is dispersed between my hometown doctor, the university's student health center and, as recently as yesterday, a new physician near the ADVANCE office. So while my records are in safe hands and probably have a good 10 years of non-activity before they're in danger of hitting the shredder, I'm a long way from the complete documentation that would ensure the best patient care.

It seems like this would be another case for EHR: just upload the information from any facility and--presto!--complete and permanent documentation at your fingertips. But even computer systems have their storage limits, so it's likely that electronic records won't last forever. As documentation continues its transition into cyberspace and patients assume greater responsibility for personal health information, keeping the average citizen up-to-date on issues--including retention policies--just might become a "top priority."