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Supercharging the HVA Engineering and Maintenance Risk Assessment in the Healthcare Setting Webinar Registration Hospitals have been under close scrutiny for years to insure they evaluate and mitigate risks and exposures that could impact their ability to deliver healthcare services under all conditions. A staple of this activity is the "Hazard Vulnerability Assessment". A traditional HVA looks at specific threats within four categories (natural, technological, human and hazardous materials). While the HVA is useful for auditors looking to confirm minimum compliance, it does not properly arm the organization to assess how risk, mitigation strategies and limited capital can effectively be deployed for maximum benefit. Come hear from leaders of Deaconess Health Systems Engineering and Maintenance team on how they partnered with Virtual Corporation to execute an effective risk assessment methodology and toolkit across the DHS enterprise. Participants will see examples of innovative risk mapping and reporting methods that yield high information density in simple, understandable format. Presenters: Mark Merrill, Facility Engineer, Deaconess Health System Tom Barnett, Manager, Engineering and Maintenance, Deaconess Health System Scott Ream, President, Virtual Corporation Webinar Registration Hospitals have been under close scrutiny for years to insure they evaluate and mitigate risks and exposures that could impact their ability to deliver healthcare services under all conditions. A staple of this activity is the "Hazard Vulnerability Assessment". A traditional HVA looks at specific threats within four categories (natural, technological, human and hazardous materials). While the HVA is useful for auditors looking to confirm minimum compliance, it does not properly arm the organization to assess how risk, mitigation strategies and limited capital can effectively be deployed for maximum benefit. Come hear from leaders of Deaconess H

Industry Insiders Discuss HIT and HIPAA Issues March 30, 2009 by Astrid Fiano, Writer A significant part of President Obama's health care reform agenda is the push for implementing more health care technology. In the health care field privacy is always a major concern, and was the impetus of the Health Insurance Portability and Accountability Act of 1996--protecting the privacy of individually identifiable health information in all formats, and the confidentiality provisions of the Patient Safety Act--protecting identifiable information being used to analyze patient safety events. So those in the health care industry now wonder will the Administration's focus on health IT (HIT) present more challenges to privacy concerns? As part of a continuing focus on HIT issues, DOTmed interviewed industry expert Kirk J. Nahra, a partner in the Washington D.C. legal firm of Wiley Rein LLP, specializing in privacy and information security for the health care and insurance industries, and named an expert practitioner by the Guide to the Leading U.S. Healthcare Lawyers. DOTmed also interviewed Lise Rauzi, Vice President, Training Development, for Health Care Compliance Strategies (HCCS). HCCS provides online training compliance for employees. Nahra notes that regardless of the rising concern over privacy and the new HIT legislation, there have already been formal HIPAA security rules on electronic information in place for several years--the health care industry compliance has just been inconsistent. The problem -- to the extent there is one -- is that HIPAA rules are process-oriented, Nahra explained. The rules don't tell an entity what to do, but rather what to evaluate--a standard set of questions, but without a standard set of answers. For example, a covered entity has to have an internal audit, but the rules do not tell the entity how best to carry out that internal audit. Not surprisingly, different businesses have different ideas on how to implement their HIPAA evaluations

In all of 2008, 40 banking institutions failed - 25 banks and 15 credit unions. So far in 2009, 72 institutions have either been closed or taken over by regulators, including 7 banks just this past weekend. The Federal Deposit Insurance Corporation (FDIC)'s troubled bank list, now at 305, has more than doubled from last year's total, when 117 banks were listed. Which begs the questions: Where and why are all these institutions failing, and how many more closures will we see by year's end? Failures by the Numbers Analysis of this year's bank/credit union failures (see interactive map) reveals some interesting facts: * Total Failed Banks: 64 * Total Failed Credit Unions: 8 o Top States For Failures: o Georgia - 16 banks o Illinois - 12 banks o California - 8 banks, 3 credit unions o Florida - 3 banks * Largest Failure BankUnited, Coral Gables, FL., $12.8 billion in assets, * Total Cost to FDIC Insurance Fund: $13.553 billion

Rarely is the response to a new government initiative a unanimous round of "thumbs up," but so far that seems to be the case regarding yesterday's (April 9) announcement that The Defense Department and the Department of Veterans Affairs will collaborate on building an electronic database of administrative and medical information for U.S. servicemen and women. Since developing a broad electronic health records (EHRs) initiative is a prominent feature of the Obama Administration's economic stimulus plan, it makes sense to start (or at least focus) on a defined segment of the population -- current and past military personnel. But, apart from the specific technology, architecture and technical administration aspects of this program, there will be other challenges in pursuing the goal of EHRs for the military -- challenges that insurance technology executives know only too well. These include collaboration among different and sometimes competing interests (in this case, the Department of Defense (DOD) and the Department of Veterans Affairs (VA), which historically have not worked together as closely as one might imagine); and concerns about privacy and security. In fact, the ways in which the military EHRs initiative addresses the privacy issue could provide some interesting best practices (or actions to avoid) for private-sector players. "Currently, there is no comprehensive system in place that allows for a streamlined transition of health records between DOD and the VA," President Barack Obama said at yesterday's announcement, "and that results in extraordinary hardship for an awful lot of veterans who end up finding their records lost, unable to get their benefits processed in a timely fashion. And that's why I'm asking both departments to work together to define and build a seamless system of integration with a simple goal: When a member of the Armed Forces separates from the military, he or she will no longer have to walk paperwork from a DOD

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"If you live in Texas, your medical records are definitely up for sale by the state. If you live anywhere else in the United States, they probably are for sale there, too. Medical health records provide key information to researchers, who have lobbied hard to keep them accessible, despite government concerns about the privacy of patient data. The controversy dates back to 1996, when Congress passed the Health Insurance Portability and Accountability Act (HIPAA) to protect patients. "Researchers have very broad access rights to health care records under HIPAA," says Pam Dixon, director of a non-profit called the World Privacy Forum "The rules are pretty loose, and there are a lot of ways to get around them." That's especially true since the act wasn't designed to cover common scenarios today: records stored online in a vast, hackable cloud. In the rush to digitize all electronic health records, Dixon says not everyone is taking the proper steps to de-personalize the data and protect patients."

"Fomer UCLA Healthcare System researcher Huping Zhou has pleaded guilty to violating parts of the Health Insurance Portability and Accountability Act and could be one of the first people in the country convicted under the law, federal authorities announced Friday. After learning he was to be let go, the 48-year-old is alleged to have accessed the UCLA patient records system 323 times during the three-week period, mostly to check out the files of celebrities, according to the U.S. Attorney's Office. The names of the targeted stars have not been revealed. Federal authorities say Zhou admitted to accessing the records -- cruising files that were not necessary to view as part of his job -- under a plea agreement. He'll face a judge for sentencing March 22. It's not clear what kind of punishment the U.S. Attorney's Office will recommend in exchange for his cooperation."

For the third time in recent months, Tampa Bay citizens have found themselves the unwanted recipients of patients' private medical records. What's more, in two cases, the recipients' efforts to restore patients' privacy were rebuffed, suggesting the federal Health Insurance Portability and Accountability Act (HIPAA) is falling far short of its promise to protect and enforce patient privacy.

If the government won't enforce HIPAA, why bother having the law at all. Let patients know they are own their own.

"Whether a patient comes in for a gall-bladder operation or to have a baby, the routine remains the same for staff at Sharp HealthCare hospitals in San Diego. The front desk checks insurance records to make sure the bills get paid on time. Nurses take vitals and tag their charges with a bar-coded wristband. And behind the scenes, fund-raisers scan the assets of each patient -- to find out whether they're "megarich," "wealthy" or merely "comfortable.""

Is that a microscope following me around? Must get more tin foil to keep them from seeing my thoughts.

Much of the privacy debate has focused on cookies and icons and not what really matters: the misuse or abuse of consumer data by third parties in the real world. I don't care whether I see behaviorally targeted ads so much as I don't want my health care or auto insurance to be impacted by sites I've visited and stuff I post online.

The US government has now adopted a policy of fostering the adoption of electronic medical records (EMR). The policy is intended to increase the efficiency of the US healthcare system, thereby lowering costs and reducing the incidence of preventable errors. At the same time, through its The Health Insurance Portability and Accountability Act (HIPAA) privacy rules, the government has set minimum standards for the security of those records. These two goals-privacy and security of these records, along with their free interchange among medical providers-can easily wind up at odds with each other. A recent study that looked at the role of state privacy laws in EMR adoption suggests that the problem is very real, as state privacy laws seem to inhibit the use of EMR by hospitals located there. The authors, based at MIT and the University of Virginia, line up a variety of data that validate their suggestion that privacy and the use of EMR may require a careful balance. So, for example, they cite some highly publicized lapses when it comes to the maintenance of patient privacy: someone once offered the records of 200,000 patients for sale on Craigslist, while hospitals have seen their own employees attempt to get at the electronic files of famous patients. Perhaps more significantly, the authors suggest that the public, as represented by their legislators, has concerns about the privacy of EMR. They found that states that have passed their own privacy laws to supplement the HIPAA rules tend to have a higher percentage of their populace signed up for the Do Not Call Registry, indicating a corresponding individual-level interest in maintaining privacy. So, they looked at whether these laws had any impact on the adoption of EMR by hospitals located in each state.

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First quarter federal reports show Google lobbied on the electronic medical records provisions of the federal economic stimulus act, contradicting the Internet giant's earlier claims that Consumer Watchdog's report of its effort was "100 percent false." Google's report shows a total expenditure of $880,000 on lobbying during the period including on "online health-related initiatives; issues relating to online personal health records, including in connection with H.R. 1: American Recovery and Reinvestment Act of 2009." Google also contracted with an outside firm, the Podesta Group, which independently reported lobbying for Google on "health information technology" and "online privacy." King and Spalding LLP also independently reported lobbying for Google on "online health-related initiatives, including health information technology provisions in H.R. 1, The American Recovery and Reinvestment Act." After the nonprofit, nonpartisan Consumer Watchdog reported the "rumored" lobbying in January, Google contacted a charitable foundation about withdrawing Consumer Watchdog's funding. In a letter to Google CEO Eric Schmidt released today, Consumer Watchdog said the company owes the group an apology. Read Consumer Watchdog's letter here: http://www.consumerwatchdog.org/resources/LtrSchmidt042209.pdf. "It is now clear from public records that Google was lobbying Congress relating to online personal health records in connection with the economic stimulus act... What else could Google have been seeking except to be excluded from the Health Insurance Portability and Accountability Act (HIPAA) provisions on privacy and forbidding sale of records? Please tell us," wrote Jamie Court, Consumer Watchdog president and John M. Simpson, consumer advocate. "There is a simple way to resolve this," the letter said. "Publicly release all the substance of Google's lobbying efforts on H.R. 1. Google knows the drill: organize the information and make it universally accessible and useful."

URAC, the leading health care accreditation and education organization, announced today the recent Healthcare Information and Management Systems Society (HIMSS) annual conference raised important questions about consumer privacy and security around electronic health records (EHR). (Logo: http://www.newscom.com/cgi-bin/prnh/20030501/URACLOGO ) "There is no doubt that electronic health records are coming. The question is whether or not consumers' privacy is a key issue or an afterthought," said Alan P. Spielman, President and CEO of URAC. "A lot of forces are driving the push for EHR. However, it is important that standards go hand-in-hand with policy so that it doesn't become the Wild West with every vendor and health care provider using different terms." The rules set by the Health Insurance Portability and Accountability Act (HIPAA) are integral to the widespread adoption of EHR. However, the rules can be confusing for consumers and providers. URAC was the first organization to offer HIPAA Privacy Accreditation. The organization now offers comprehensive standards for both HIPAA Privacy and HIPAA Security accreditation. These standards are applicable to all personal health information storage formats and exchanges claims transactions and are designed for many different types of health care organizations including both Covered Entities (CE) and Business Associates (BA). They also require an ongoing compliance program that identifies, tracks and makes the necessary changes in response to a federal or state regulatory change.

Plans by Internet service providers to deliver targeted adverts to consumers based on their Web searches threaten online privacy and should be opposed, the founder of the Web said Wednesday. "I just want to know that when I click on a link it is between me and the Web, and the Internet service provider is not going to immediately characterise me in different categories for advertising or insurance of for government use," Tim Berners-Lee told a Web conference in Madrid. "The postman does not open my mail, the telephone company does not listen to my telephone conversations. Internet use is often more intimate than those things," he added. New software called Webwise allows Internet service providers to show adverts to their clients based on their Web browsing habits instead of based on the content of a single Web page as currently happens. Several British Internet service providers, including BT and Virgin Media, have said they are considering using the software, which is aimed at making the Web more financially profitable for advertisers. With the help of other scientists at the European Organisation for Nuclear Research (CERN), Berners-Lee set up the Web in 1989 to allow thousands of scientists around the world to stay in touch. The WWW technology -- which simplifies the process of searching for information on the Internet -- was first made more widely available from 1991 after CERN was unable to ensure its development, and the organisation made a landmark decision two years later not to levy royalties.

Last week, the government took another step toward closing a legal loophole in federal privacy and security rules for emerging Health 2.0 information technology applications by issuing proposed rules aimed at covering an estimated 900 companies and organizations offering personal health records and electronic systems connected to them. The Federal Trade Commission was careful to point out its new interim proposed rule on federal breach notification requirements for the developers of electronic PHR systems did not apply to covered organizations or their business associates as defined by the Health Insurance Portability and Accountability Act of 1996, heretofore the key federal privacy and security regulation. The FTC, operating under new authority given it by the American Recovery and Reinvestment Act of 2009, noted that its new rule seeks to cover previously unregulated entities that are part of a Health 2.0 product mix. FTC staff estimates that about 200 PHR vendors, another 500 related entities and 200 third-party service providers will be subject to the new breach notification rule. The staffers estimate that the 900 affected companies and organizations, on average, will experience 11 breaches each per year at a total cost of about $1 million per group, per year. Costs include investigating the breach, notifying consumers and establishing toll-free numbers for explaining the breaches and providing additional information to consumers. Pam Dixon, founder and executive director of the World Privacy Forum, said that this isn't the first involvement of the FTC in healthcare-related regulation, noting the consumer protection agency joined with the Food and Drug Administration in a joint statement on the marketing of direct-to-consumer genetic tests. The FTC also has worked in the field of healthcare competition. She noted the compliance deadline with the FTC's "red flag rules" on provider organizations that provide consumer credit to patients for installment payment

The Senate and House appear headed for a clash over competing visions of how to protect the privacy of patients' electronic medical records, with the House favoring strict protections advocated by consumer groups while the Senate is poised to endorse more limited safeguards urged by business interests. President Obama has called creation of a nationwide system of electronic medical records fundamental to health-care reform, and both chambers of Congress have included about $20 billion to jump-start the initiative as part of their stimulus bills. But as with much in the stimulus package, it is not just the money but the accompanying provisions that groups are trying to influence. The effort to speed adoption of health information technology has become the focus of an intense lobbying battle fueled by health-care and drug-industry interests that have spent hundreds of millions of dollars on lobbying and tens of millions more on campaign contributions over the past two years, much of it shifting to the Democrats since they took control of Congress. At the heart of the debate is how to strike a balance between protecting patient privacy and expanding the health industry's access to vast and growing databases of information on the health status and medical care of every American. Insurers and providers say the House's proposed protections would hobble efforts to improve the quality and efficiency of health care, but privacy advocates fear that the industry would use the personal data to discriminate against patients in employment and health care as well as to market the information, often through third parties, to generate profits.

One of the more interesting panel discussions at the IDC Cloud Computing Forum on Feb 18th in San Francisco was about managing the complexities of security, privacy and compliance in the Cloud. The simple answer according to panelists Carolyn Lawson, CIO of California Public Utilities Commission, and Michael Mucha, CISO of Stanford Hospital and Clinics is "it ain't easy!" "Both of us, in government and in health, are on the front-lines," Lawson proclaimed. "Article 1 of the California Constitution guarantees an individual's right to privacy and if I violate that I've violated a public trust. That's a level of responsibility that most computer security people don't have to face. If I violate that trust I can end up in jail or hauled before the legislature," she said. "Of course, these days with the turmoil in the legislature, she joked, "the former may be preferable to the later." Stanford's Mucha said that his security infrastructure was built on a two-tiered approach using identity management and enterprise access control. Mucha said that the movement to computerize heath records nationwide was moving along in fits and starts, as shown by proposed systems likeMicrosoft (NSDQ: MSFT)'s Health Vault and Google (NSDQ: GOOG)'s Personal Health Record. "The key problem is who is going to pay for the computerized of health records. It's not as much of a problem at Stanford as it is at a lot of smaller hospitals, but it's still a huge problem." Mucha said that from his perspective security service providers in the cloud and elsewhere are dealing with a shrinking security parameter or fence, which is progressing from filing cabinets, to devices, to files, and finally to the individual, who under the latest Health Insurance Portability and Accountability Act (HIPAA) privacy rules has certain rights, including rights to access and amend their health information and to obtain a record of when and why their Protected Health Information (PHI) record has bee

The recent U.S. stimulus bill includes $18 billion to catapult the health industry toward the world of electronic health records. This is sure to light a fire under every hungry security vendor to position itself as the essential product or service necessary to achieve HIPAA compliance. It should also motivate healthcare IT professionals to learn where their sensitive data is located and how it flows. To be sure, with federal money allocated through 2014 for the task of modernizing the healthcare industry there will be many consultant and vendor businesses that will thrive on stimulus money. Healthcare is unique in that storage of electronic health records is highly distributed between primary care physicians, specialist doctors, hospitals, and insurance/HMO organizations. Information has to be efficiently shared among these entities with great sensitivity towards patient privacy and legitimate claims processing. Patients want to prevent over zealous employers from performing unauthorized background checks on medical history; claim processors want to prevent paying fraudulent claims arising from targeted patient identity theft. The bill has two provisions which turn this into a tremendously challenging plan, and a daunting task for securing patient data: * Citizens will have the right to monitor and control use of their own health data. This implies a large centralized identity and access control service, or perhaps a federated network of patient registration directories. Authenticated users will be able to reach into the network of health databases audit use of their data and payment history. * Health organizations suffering loss of more than 500 patient records must publicly disclose the breach, starting with postings on the government's Health and Human Services website. This allows related organizations to trace the impact of the breach throughout the healthcare network, but care must be taken not to disclose vulnerabilities in the system to intruders

Data breaches are running at record levels, according to the San Diego-based Identity Theft Resource Center, a non-profit that tracks cybercrime. ITRC says it recorded 342 data breaches from Jan. 1 through June 24, up 69% from the same period in 2007. But, like the origins and perpetrators of so many individual data breaches, mystery also lies behind the aggregated numbers. "I'm not sure that this says breaches are increasing," ITRC founder Linda Foley tells Digital Transactions News. "What we know is the reporting of breaches is increasing." A handful of states now require some disclosure of data breaches to authorities, Alaska being the most recent. And some companies that have been hacked are starting to report breaches voluntarily, Foley says. While data breaches can compromise all manner of personal and business records, they often involve credit and debit card data and bank-account information. ITRC lists five major categories of breached entities, with the so-called banking/credit/financial sector accounting for 10% of 2008's breaches. Businesses, which include physical and Internet retailers, insurance companies and other private enterprises, accounted for 36.8%. Schools accounted for 21.3%; government and military facilities, 17%; and health-care facilities, 14.9%. IRTC also categorizes breaches by how they happened, such as through hackings-break-ins into computers and related systems, insider thefts, data lost in physical transit, and by other methods. The number of 2008 hackings through late June in the banking/credit/financial category was 10-double the five for all of 2007. The estimated number of records compromised as a result was 227,864. In 2007, the reported number of compromised records at financial institutions through hackings was 83,500. But Foley says not to put too much stock in the records numbers because so many breached organizations don't know or fail to report the number of compromised records when they report a bre

Current government rules do too little to protect the privacy of people's personal health information and also hinder the use of health data in medical research, a panel of experts reported on Wednesday. A committee of the Institute of Medicine, which provides advice to U.S. policymakers, urged Congress to take an entirely new approach to protecting personal health data in research. Federal standards for protecting privacy of personal health data under the Health Insurance Portability and Accountability Act of 1996, or HIPAA, are not doing the job, the panel said. Congress and the Obama administration are planning major changes this year to the U.S. health care system. Regarding the privacy rules, Congress should either start from scratch or thoroughly overall HIPAA's privacy provisions, the panel said. Better data security is needed, with greater use of encryption and other security techniques, the panel said. Encryption should be required for laptops, flash drives and other devices containing such data, it said. "Both privacy and health research are important. And we feel that we can strengthen privacy protections for people who participate in research while also allowing important research to proceed without unnecessary impediments," Dr. Bernard Lo of the University of California San Francisco, a member of the panel, told reporters. HIPAA governs how personally identifiable health information can be used and disclosed by health plans, health care providers and others. The intention is to protect personal health information while permitting the flow of information for health-related research and medical care. Lo said HIPAA has burdensome and confusing procedures for people to consent to have their health data used in medical research, dissuading people from taking part in such research.

A group of U.S. companies, led by technology giants Microsoft, Hewlett-Packard and eBay, is set to outline recommendations for new federal data-privacy legislation that could make life easier for consumers and lead to a standard federal breach-notification law. The recommendations, which were developed by a group of industry players called the Consumer Privacy Legislative Forum, are set to be released at an upcoming privacy conference six weeks from now, according to Peter Cullen, Microsoft's chief privacy officer. The companies have been working for the past three years to encourage the adoption of federal consumer data-privacy laws and to answer the question of what federal legislation should look like, Cullen said in an interview. Other forum members include Google, Oracle, Procter & Gamble and Eli Lilly. One idea is that laws should make it easier for consumers to understand what they're getting into when they share their personal data with Web sites, Cullen said. "The whole focus on consent really puts an unfair burden on the consumer," he said. "My mom doesn't know what an IP address is." The recommendations will cover rules around data use and the ability of consumers to correct inaccurate data. And they will cover data breach notification, which is now covered by a patchwork of state laws. Simplifying breach-notification laws by creating a single federal standard is important, Cullen said Wednesday while speaking at a discussion of privacy policy in San Francisco. "It's not that there is no privacy law. There's actually too much privacy law," he said. "If you think about data-breach notification laws just as an example, there are 38 state laws, many of them very different." "We need to think about much more of a framework approach." Congress has passed some laws covering consumer data privacy, such as the 1996 Health Insurance Portability and Accountability Act (HIPAA), but existing laws do not comprehensively cover consumer privacy in general.