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Course "Tougher Import Rules for FDA Imports in 2016" has been pre-approved by RAPS as eligible for up to 12 credits towards a participant's RAC recertification upon full completion. Overview: FDA's and the Customs and Border Patrol Service (CBP) have become increasingly sophisticated and equally demanding in the submission of information and adherence to government procedures. Firm's that fail to understand and properly execute an import and export program find that their shipment is delayed, detained or refused. In 2016 entries must use the Automated Commercial Environment (ACE) entry filing system or face entry refusals and monetary penalties up to $10,000 per offense. A number of other factors can derail the expectation of a seamless import process. The course covers detailed information about the roles and responsibilities of the various parties with an import operation and how to correct the weakest link(s) in the commercial chain. The course will include tips on how to understand FDA's thinking and offer anecdotal examples of FDA's import program curiosities. Why should you attend: What happens when your product is detained? FDA will begin a legal process that can become an expensive business debacle. You must respond fully within short timeframes. This is not the time for you to be on a learning curve. You need to have a plan in place and know what you are doing. The FDA is steadily increasing the legal and prior notice information requirements. If you do not know what those requirements are and you initiate a shipment, your product is figuratively dead in the water. You must be accurate with the import coding information and understand the automated and human review process. If not, you can expect detained shipments. CBP is implemented a new "Automated Commercial Environment" computer program that changes import logistics and information reporting for FDA regulated products. Your shipment may be stopped before it is even loaded at the foreign port. What

Quality Management in Healthcare: Quality management in healthcare is a critical requirement for healthcare organizations. Making quality management patient-centric comes first. Adapting and implementing standards and tools is the next step towards this. Quality management in healthcare is of critical importance to the healthcare industry and the patient. Everyone in the loop -from physicians to practitioners to support staff -needs to be aware of the importance of quality management in healthcare. The most basic purpose of imparting high quality management in healthcare is to make sure that the patient is well taken care of. For this to happen, the healthcare setting has to implement systems and processes. Quality management centers on process management. If organizations have to ensure that meaningful quality management in healthcare is being implemented; they have to adhere to processes. Adapting standards and instilling processes into the healthcare system is how healthcare providers can assure quality in healthcare. Patient is at the center of quality management in healthcare Obviously, the first step in the direction of implementing quality management in healthcare is to make the healthcare setting's care and processes patient-oriented and patient-centric. Quality management in healthcare begins with the patient and should be fully tuned to her needs. As patients' requirements and expectations vary over time; quality management has to keep upgrading itself to keep up with the changing needs and demands. In line with this, the following means can go a long way in ensuring quality management in healthcare: The healthcare setting has to identify goals for ensuring quality management in healthcare. Each department has to be given measurable goals to reach. Implementing quality standards goes a long way in ensuring that quality management in healthcare is imparted in the organization. Six Sigma, ISO 9001 and ANOVA are some of the popular standards a

Quality Management in Healthcare: Quality management in healthcare is a critical requirement for healthcare organizations. Making quality management patient-centric comes first. Adapting and implementing standards and tools is the next step towards this. Quality management in healthcare is of critical importance to the healthcare industry and the patient. Everyone in the loop -from physicians to practitioners to support staff -needs to be aware of the importance of quality management in healthcare. The most basic purpose of imparting high quality management in healthcare is to make sure that the patient is well taken care of. For this to happen, the healthcare setting has to implement systems and processes. Quality management centers on process management. If organizations have to ensure that meaningful quality management in healthcare is being implemented; they have to adhere to processes. Adapting standards and instilling processes into the healthcare system is how healthcare providers can assure quality in healthcare. Patient is at the center of quality management in healthcare Obviously, the first step in the direction of implementing quality management in healthcare is to make the healthcare setting's care and processes patient-oriented and patient-centric. Quality management in healthcare begins with the patient and should be fully tuned to her needs. As patients' requirements and expectations vary over time; quality management has to keep upgrading itself to keep up with the changing needs and demands. In line with this, the following means can go a long way in ensuring quality management in healthcare: The healthcare setting has to identify goals for ensuring quality management in healthcare. Each department has to be given measurable goals to reach. Implementing quality standards goes a long way in ensuring that quality management in healthcare is imparted in the organization. Six Sigma, ISO 9001 and ANOVA are some of the popular standards a

It is important to ensure food safety in hospitals Hospitals being what they are - where patients of almost all kinds visit or stay - are very potent sources of infection. Infection can arise from any part of the hospital. They can spread from patients to patients, from caregivers to patients, from patients to caregivers, from patients to support or administrative staff and vice versa, and so on. An often overlooked source of infection and contamination is the food that comes into hospitals. Food safety in hospitals is a very important element of hygiene First, an understanding of food safety in the context of hospitals is necessary. Food safety in hospitals is described as the scientific way by which food is prepared, handled and stored in hospital settings. Any food that is prepared in hospital kitchens are, like food prepared in other places such as canteens, hotels and restaurants and even homes, sourced from outside. This food comes from suppliers whose hygiene has to be ensured. Food hazards can come in many forms, including, but not limited to: Biological Chemical Physical Allergenic Hazards an Several other contributing factors It is in the process of procuring materials for food and preparing it in hospital kitchens that a major part of food safety in hospitals is compromised. There has to be a thorough mechanism to ensure that all these producers and suppliers follow regulatory requirements in ensuring that the food they produce and supply to hospitals is clean and safe. Literally thousands of patients get infected from over 250 kinds of bacteria, parasites and viruses when they consume food prepared in hospitals. Findings of a recent study It is pertinent to recall the findings of study done in May 2014 in Geneva, Switzerland. It carried out an examination of chicken supplied to and prepared in a hospital in this city. An astounding four fifths of these chickens were known to have been infected with E.coli, leading to its possible transmission to pati

A Basic Understanding of Shipyard Workplace Safety Shipyard Workplace Safety is a high importance, high criticality area for safety regulation. This is so because shipyards are among the most hazardous of places to work in. it is estimated that at any point of time, the number and incidences of injuries and fatalities in the shipyard industry is at least twice that of the next most hazardous industry, construction. This calls for urgent and important Shipyard Workplace Safety regulations. Present Shipyard Workplace Safety Regulations OSHA has a number of Shipyard Workplace Safety regulations for this industry. These need to be read with CFR Title 29 Code of Federal Regulations (CFR) Part 1915, which not only lay out regulations, but also prescribe codes and methods of implementation of these regulations. Why these two regulations need to be implemented together is that there may be a few hazards not covered by Shipyard Industry standards set out by OSHA. These gaps are covered by the regulations set out in CFR 1915, making these a well-rounded set of regulations for Shipyard Workplace Safety. The need for Shipyard Workplace Safety regulations The need for Shipyard Workplace Safety is acutely felt because of the sheer variety of hazards that present themselves in shipyards. Shipyards, which employ between a few dozen and a few thousand employees each, are a site of potentially serious accidents. Even if accidents do not occur, the very nature of work done at these shipyards can be dangerous and hazardous. Shipyard Workplace Safety is a core requirement that employers in this industry have to keep in mind and put in place. The nature of their work could range from and include any or many of these: Scrapping Demolition Electrical Fabrication Creating large and heavy steel or iron plates, sheets, beams, pipes and related items Soldering Drilling Dealing with propulsion systems Welding Shipyard Workplace Safety has to begin with an understanding of these issue

Overview: The primary goal of this session is to demonstrate why the health care organization needs to perform a risk assessment and how to perform the risk assessment. This includes a description of the types of breaches of protected health information that have already occurred and the reasons those breaches happened. The presentation then provides that reasons that a risk assessment is required in a health care organization and who needs to perform the assessment. There are a number of approaches available both for purchase on the web and performed by professionals on site. This discussion helps the participant determine which approach is best for their health care organization and what portions of the assessment are most important to the organization. The topic addresses the key components of a risk assessment and how to perform the risk assessment. This includes how to define the specific risks, how to know, how to assess the likelihood and impact of the risk and the final determination on the level of severity of the risk for the organization. Finally, the session explains how to interpret the results of the risk assessment, how to use the results of the risk assessment for preparing the health care organization's policies and procedures and how to conduct the HIPAA training for its staff. Why should you attend: In addition to the negative publicity and potential fines, a breach of a patient's health information often leads to litigation which is also time consuming and costly. The way to avoid these situations is to perform a Risk Assessment to understand where the health care organization is risk of an unauthorized breach and provide a basis for becoming HIPAA compliant. There are three reasons why a Risk Assessment is necessary: First, both the HIPAA Privacy and Security Regulations require a Risk Assessment for the organization to be HIPAA compliant Second, as a result of the Risk Assessment the organization knows where it needs to address its effo

What is HIPAA ? Compliance with the Health Insurance Portability and Accountability Act (HIPAA) is a core requirement of the stakeholders involved in health information. HIPAA has prescribed standards with which to protect critical data relating to patients. Electronic Health Records (EHRs) are important documents that contain sensitive patient data, and are thus considered Protected Health Information (PHI). Since this data is accessible to a number of players involved in the field of healthcare; it extremely important to set regulatory guidelines aimed at ensuring that patient information remains protected. HIPAA compliance is essentially about staying in compliance with these guidelines. Measures needed to show compliance with HIPAA HIPAA requires a healthcare organization dealing with PHI to implement all of the following measures and comply with them: Physical measures Network measures, and Process security measures The role of HIPAA Privacy Rule and HIPAA Security Rule HIPAA has set out two important rules that pertain to compliance. These are the HIPAA Privacy Rule and the HIPAA Security Rule. While the Privacy Rule relates to how the medical information of a patient is saved, accessed and shared; the Security Rule is about how to implement national security safeguards for protecting electronic PHI, or ePHI. Who all need to be HIPAA compliant? Since the aim of HIPAA compliance is to ensure complete safety of patient data, it has requirements for every stakeholder in the EHR process. These stakeholders comprise: Covered Entities (CE): Anyone involved in the treatment, payment and operations in healthcare Business Associates (BA): Any person who has access to patient information and is involved in supporting treatment, payment or operations. These include third-party administrators and private sector vendors Those with whom BA's work, or those that are called subcontractors Hosting providers. These typically include healthcare software pro

Quality Management in Healthcare: Quality management in healthcare is a critical requirement for healthcare organizations. Making quality management patient-centric comes first. Adapting and implementing standards and tools is the next step towards this. Quality management in healthcare is of critical importance to the healthcare industry and the patient. Everyone in the loop -from physicians to practitioners to support staff -needs to be aware of the importance of quality management in healthcare. The most basic purpose of imparting high quality management in healthcare is to make sure that the patient is well taken care of. For this to happen, the healthcare setting has to implement systems and processes. Quality management centers on process management. If organizations have to ensure that meaningful quality management in healthcare is being implemented; they have to adhere to processes. Adapting standards and instilling processes into the healthcare system is how healthcare providers can assure quality in healthcare. Patient is at the center of quality management in healthcare: Obviously, the first step in the direction of implementing quality management in healthcare is to make the healthcare setting's care and processes patient-oriented and patient-centric. Quality management in healthcare begins with the patient and should be fully tuned to her needs. As patients' requirements and expectations vary over time; quality management has to keep upgrading itself to keep up with the changing needs and demands. In line with this, the following means can go a long way in ensuring quality management in healthcare: The healthcare setting has to identify goals for ensuring quality management in healthcare. Each department has to be given measurable goals to reach. Implementing quality standards goes a long way in ensuring that quality management in healthcare is imparted in the organization. Six Sigma, ISO 9001 and ANOVA are some of the popular standards and tools t

Eye exams are important for patients of all ages to get regular eye exams whether they are having problems or not. Eye exams can detect a problem before you even know you have one. This is particularly important if you have a family history of eye problems.

Quality Assurance in Nursing Healthcare: Quality assurance in nursing is about assuring quality in nursing by ensuring that practices are compliant with quality standards. This is a full-fledged profession with its own educational and experience requirements. Quality assurance in nursing has to be understood from the standpoint of quality assurance and compliance. Quality assurance in nursing is about ensuring adherence to quality standards as mandated by nursing regulatory bodies. Quality assurance in nursing assesses what healthcare processes are in place and what else needs to be implemented to better the system. Where do quality assurance nurses work? Professionals who make a career out of quality assurance in nursing are employed in various healthcare settings. They could work in clinics or small or large hospitals. Professionals who make a career in quality assurance in nursing are licensed registered nurses. Since they are registered nurses, they should also obtain a licentiate. To get this, they should complete a prerequisite approved nursing program. The exam for getting licensure is the National Council Licensure Examination for Registered Nurses (NCLEX-RN), a computer-based examination. A higher level of education for those in quality assurance in nursing is a master's degrees inhealth care quality or a near degree. In some healthcare organizations, this is required at entry level. Some of the works they do in maintaining quality assurance in nursing include: Reviewing reports or files to make sure that activities contained in them are following regulatory clinical standards Collaborating with colleagues from other departments to which nursing is related either directly or indirectly Interacting with other hospitals or organizations, if the need arises For professionals pursuing a career in quality assurance in nursing, the ability to analyze data and manage cases is a must, as a major part of their work involves these. They should also be prompt abou

What is Corporate Governance? In a broad sense, corporate governance can be defined as a set of processes by which corporations are run and administered. These are a collective function of the critical, core decision makers in the organization, such as Directors, CEO, managers, investors, stakeholders, shareholders, creditors, auditors and others. Corporate Governance sets out the methods and rules for making rules that govern corporate entities. Although business is the main concern and task of an organization, Corporate Governance occupies as important a position, because while the financial aspect of a business is all about profits, the Corporate Governance aspect is primarily about its integrity, values and reputation. Corporate Governance takes into consideration all aspects of the governance of the organization from critical standpoints such as ethics, regulatory aspects, policies and mission, etc. History of the growth of Corporate Governance Although Corporate Governance has been around for a number of decades in some or another form, it came to acquire proper shape and direction of late, following the collapse of very big multinationals such as Enron, WorldCom and others. It was felt that their shady dealings, which led to huge losses for their stakeholders and eventually to the businesses collapse, could have been averted if a proper regulatory framework of Corporate Governance were in place. This is the feeling that led to the passing of the Sarbanes Oxley Act, or SOX in the early 2000's. One of the core principles enunciated in SOX related to Corporate Governance. Elements of Corporate Governance As a result of the SOX Act and other legislations in other developed countries, such as the Cadbury Report of the UK and other legislations in the OECD nations; Corporate Governance is now administered through a well-defined set of principles. As a result of these legislations, Corporate Governance is now concerned with the following: Problems areas of Co

Patient Safety in Medical Education A very important aspect of medical education that had been overlooked for a long time is patient safety. When patient safety in medical education gets relegated to the backseat; the result is there for everyone to see: something like close to a 100,000 deaths at the turn of the previous century, according to the alarming results of a comprehensive study carried out by the Institute of Medicine. The tragedy of these deaths is that these were preventable. This reinforces the belief that patient safety in medical education is the core factor, which if handled properly, can save thousands of lives. How does patient safety in medical education come about? It goes without saying that physicians and other caregivers practice in their professions what they learn in schools. So, patient safety in medical education has to be incorporated into the curriculum at the earliest stages. Hospitals, medical colleges and other institutes that impart medical education have now started taking more than mere baby steps in inculcating patient safety in medical education as a core part of teaching, the already heavily burdened curriculum in medical education notwithstanding. Efforts by medical education bodies Following the publication of the IOM report, the American Association of Medical Colleges (AAMC) and the Curriculum Management and Information Tool (CurrMit) in the US and Medical Schools Council and the General Medical Council (GMC) in the UK sprang into action, announcing a slew of measures aimed at bringing about and reinforcing patient safety in medical education. Entire lessons and chapters are devoted to patient safety in medical education. Keywords and technical jargon relating to patient safety are now a highly visible aspect of patient safety in medical education. These are spread across all disciples and subjects of medical education, be it gynecology or anesthetics. What should curricula teach about patient safety in medical edu

Overview: Today's health care delivery occurs in a diverse, fast-changing, multidisciplinary health care environment. This often presents challenges to the health care professional that are not easy to navigate. Medical records and their confidentiality have long been the exclusive province of state law, but has now been recognized for some time in the federal HIPAA statutes and federal regulations. Differing and even conflicting sources of requirements at the state level still exist for the retention and disposition of medical records. These sources may vary based upon the specific health care practitioner - whether physicians, dentists, psychologists, or other health care providers, including mental health practitioners. As to the specific, individual health care practitioner, state laws mandate their confidentiality, retention, and even their specific content with regards to patient, clinical records. In addition to these clinical requirements, additional state laws set forth the content and retention of other types of records kept by the professional, such as supervisory agreements with other professionals subordinate to them as well as their own unique record content requirements. With the majority of medical records moving to an electronic format, special rules now exist with regard to the confidentiality, security, retention, and disposition of electronic medical records. This is particularly important as state laws continue to allow for and regulate the provision of telemedicine by various health care practitioners. For example, while psychotherapy and mental health services are ideal treatments to offer over the internet, that is, by simultaneous audio-visual transmission between the doctor and the patient, the risks of breaches of confidentiality also vastly increase. And when the successful doctor-patient relationship is over, how does the health care practitioner providing a mental health service dispose of these electronic records? In addition to

Rationale for Clinical Trial Regulations Clinical trials, as we all know, are carried out to test the efficacy of a new drug or device being developed for a specific condition or disease. Clinical trials are experiments that have a high degree of risk if they are not properly implemented. For this reason, it is necessary for regulatory bodies to regulate clinical trials. The core rationale for regulating the various stages of clinical trials is that human subjects, who are part of the research, have to be protected. These clinical trial regulations are legislated at all stages: local, State, national and international. Clinical trial regulations are in force in different countries of the world. Common clinical trial regulations are also made globally by the International Conference on Harmonization (ICH), which has the mandate of setting out good practices for clinical trial regulations for trials done in global cooperation. These regulations cover the administrative, procedural and ethical aspects of clinical trials. Briefly, these are the areas in which there are clinical trial regulations for each of these aspects of clinical trials: Administrative: The administrative aspects of clinical trial regulations pertain to the way the clinical trials are run, and the way they are tracked and monitored throughout their lifecycle. A clinical trial is usually monitored by a sponsoring company or a Contract Research Organization (CRO), which the former hires at times for reasons of convenience and cost cutting. Clinical trial regulations in this area is obviously of importance because if something goes wrong at any administrative stage; these can be rectified. Procedural: Procedural aspects of clinical trial regulations relate to ways by which subjects are chosen for a clinical trial. Proper care has to be taken to ensure that the subjects are appropriate for the clinical study, are from the prescribed age, geographical, demographic, racial and gender-related cl

Overview: Drug and device research is confusing and difficult on its own but when you start combining drugs with devices the regulatory landscape changes as there are more nuances to deal with. Knowing how drug and device studies are each regulated is important in navigating the challenges posed by studies that wish to use both. It is also important to be aware of current guidance affecting the use of both drugs and devices in a study as well current guidance affecting the classification of devices. Why should you attend: Information on drugs and devices is plentiful. But, it can also be daunting .The webinar will give attendees a foundation and a starting point on which they can build. Learning objectives: Define drug research Define device research Explore the differences between the two Describe requirements when drugs and devices are combined in one study Areas Covered in the Session: Defining Drug Research FDA approved drugs Investigational drugs Compassionate use Defining Device Research FDA approved devices 510 K devices Humanitarian Device Exemptions Invitro Diagnostic Devices Investigational Devices Federal regulations governing drugs and devices Guidance governing drugs and devices Combining devices and drugs into one study What are the requirements? What are the regulations and guidance? How these studies are reviewed Who Will Benefit: Investigators Researchers Research Staff Study Coordinators Auditors Research Administrators Speaker Profile Sarah Fowler-Dixon is Education Specialist and instructor with Washington University School of Medicine. She has developed a comprehensive education program for human subject research which has served as a model for other institutions. She crafted budgets, policies, procedures, reporting, and training for the new program. She has initiated the planning, development, authorship and implementation of many human subjects research policies, practices, guidelines, submission and reviewer forms often working with st

Overview: The idea of providing health care treatments and insurance coverage according to "medical necessity" determinations seems eminently reasonable. Its obvious ethical thrust is to discourage unnecessary, wasteful or fraudulent practices. As practically implemented, however, "medical necessity" regulations and determinations have proven remarkably controversial and elusive. First of all, the language connected with medical necessity is inherently vague. Language to the effect that a treatment is medically necessary if it is "likely to achieve a significant practical improvement," is "realistic," or "reasonable" will predictably cause disputes between payors and providers of care. Second, the persistence of these disputes calls into question whether evidence based practices have evolved to a point where they are all that reliable and useful. Third, medical necessity determinations incur problems as to who should ultimately make them: payors, health providers or the courts. Obviously, whoever controls the definition of medical necessity controls the flow of health care dollars. While ethical theory can offer important insights about our moral obligations, it remains unable to reliably translate its theoretical principles and rules bearing on harms, benefits and justice into informing medical necessity determinations. Thus, resolving disputes over medical necessity have taken a procedural approach that looks to the interpretation of contractual language in insurance policies, often at the bench of an administrative law judge. This presentation will advance a reasonable set of strategies whereby a convincing case can be made for certain care interventions qualifying as "reasonable and necessary." Why should you Attend: Despite their central importance as a locus for determining reimbursement, "medical necessity" regulations and determinations have proven remarkably controversial and vexing for at least the last 20 years. Yet, whoever controls the definition

Practical steps to compliance with HIPAA Computer Policy: That the HIPAA has a clear and stringent policy on computers is absolutely understandable, because computers constitute the very soul of HIPAA. Ensuring security of patient data is one of the core causes for which HIPAA was enacted; so, it is only natural that Computer Policy should be at the center of HIPAA compliance. A HIPAA Computer Policy rule came into effect in 2005. The nub of this enactment is to ensure that there are technical, physical and administrative security procedures that must be adhered with. These are meant for Covered Entities to ensure that the data they have of patients, namely electronic Protected Health Information (PHI) is safe and secure. Understand the reason for HIPAA Computer Policy Any implementation has to start with an understanding of the rationale for the action, right? The same goes for something as important and big as implementation of HIPAA compliance into systems. HIPAA Computer Policy is in place for a specific and critical reason ���protection of patient data, loss of which can lead to hefty penalties that can affect the business very adversely. So, installing the necessary protections is the first step to protecting vital data and with it, one's own business or practice, as well. Implement a sound access policy A strong access policy is at the heart of HIPAA Computer Policy. It is in the computer systems that all the data relating to the patient are stored. So, making sure who in the organization has access to these and how and when, is very important. Not only should access be restricted to only designated and permitted personnel in the organization; there should be a system by which tracking of access is easily determined. This is to find out who accessed which record, when, what action followed, what happened as a result of this access, and so on. Keep a record of all system components This is another step to ensuring compliance with HIPAA Computer Po

Overview: Upon completing this course participants will leave with a preliminary preventive control implementation plan and will: * Understand US FDA final rules for the Preventive Controls for Human and Animal Foods * Define and review your current system to identify gaps in your preventive controls planning. * Be able to develop and implement a valid preventive control company food safety plan to close any gaps * Write and implement appropriate procedures. * Know your requirements for control over your supply chain * Be able to plan and implement HARPC * Be able to perform environmental monitoring * Know how cross contamination can impact your preventive control plan * Know the difference between validation and verification * Understand and be able to use statistical process controls basics * Be able to plan and implement a team approach to preventive controls * Be able to help your food importers to jump through FDA hoops * Develop a system to risk rank your suppliers * Have a plan in hand that will pass any validation check for preventive controls * Understand some of the technology and costs that can help you establish preventive controls * Prove that your system actually prevents food safety problems * Be able to document and report results to upper management, external food safety auditors and FDA auditors * Save your company money Establish simple, low cost complete data collection and reporting systems. * Establish teambuilding between food safety and quality personnel to develop and implement changes to your current system * Understand food safety, security and recall responsibilities in light of cargo theft, adulteration and temperature failures * Learn how to use your system to get some ROI and improve your marketing position * Review current and future technologies designed to improve and simplify data collection * Establish a completely documented system Why should you attend: Validation of preventive co

Wheelchairs are easy to push, they fold to make them easier to store and simple for a friend or relative to load into a car. A wide selection of accessories too. So customise chair to give the performance, portability, comfort and style. Lightweight portable wheelchair are designed for ease of use and are made from durable material. These wheelchair are often foldable and are easier to store than conventional or custom. They are perfect for both manual and electric wheelchairs, as well as many walking aids such as a 4 wheel scooter. Lightweight portable wheelchair are extremely lightweight and for this reason they are easier to transport and store than many other types of wheelchair. Lightweight portable are made to be ultra lightweight, compact, and user friendly. They fold up in interesting ways to collapse to the size of a suitcase when not in use and are usually large enough to cover one or two stairs when extended. It is important to consider their weight and the person who would most often be carrying the ramp and setting it up. Karma KM 2500 Small Wheel Wheelchair: Karma KM 2500 Small Wheel Wheelchair Specifications: Width 18" Front/Rear Wheels 6" to 14" Seat Width 47cm Seat Depth 40cm Overall Width 66cm Overall Collapsed Width 36cm Armrest Height 21cm Overall Length 90cm Seat Height 47cm Backrest Height 38cm Overall Height 86cm Weight 9.2 k.g. Karma KM 2500 Small Wheel Wheelchair Seat and Back: AEGIS Microbe Shield Approved by the FDA, EPA, EU, etc., bonded anti-microbial barrier upholstery protects from odor, staining and deterioration from bacteria, fungus and other microorganisms. It is a shield for your health. Karma KM 2500 Small Wheel Wheelchair Extended Armrest: By simulating the natural position of arms, the extended armrest design is ergonomic and creates bigger seating space. An Ultra lightweight wheelchair (9.2 kg) with a compact design for either attendant assisted or self propelling users. The use

Overview: Today's health care delivery occurs in a diverse, fast-changing, multidisciplinary health care environment. This often presents challenges to the health care professional that are not easy to navigate. Medical records and their confidentiality have long been the exclusive province of state law, but has now been recognized for some time in the federal HIPAA statutes and federal regulations. Differing and even conflicting sources of requirements at the state level still exist for the retention and disposition of medical records. These sources may vary based upon the specific health care practitioner - whether physicians, dentists, psychologists, or other health care providers, including mental health practitioners. As to the specific, individual health care practitioner, state laws mandate their confidentiality, retention, and even their specific content with regards to patient, clinical records. In addition to these clinical requirements, additional state laws set forth the content and retention of other types of records kept by the professional, such as supervisory agreements with other professionals subordinate to them as well as their own unique record content requirements. With the majority of medical records moving to an electronic format, special rules now exist with regard to the confidentiality, security, retention, and disposition of electronic medical records. This is particularly important as state laws continue to allow for and regulate the provision of telemedicine by various health care practitioners. For example, while psychotherapy and mental health services are ideal treatments to offer over the internet, that is, by simultaneous audio-visual transmission between the doctor and the patient, the risks of breaches of confidentiality also vastly increase. And when the successful doctor-patient relationship is over, how does the health care practitioner providing a mental health service dispose of these electronic records? In addit