HIPAA Omnibus Final Rule

bbbWhat physician practices must comply before deadline?

HIPAA Omnibus Final Rule has made several modifications to the privacy, security and enforcement rule which is ensuring confidentiality and security of the health data of patients across the United States since its enactment almost fifteen years ago. Since then, a number of changes and amendments have been made to the rule and the modifications made earlier this year have been termed ‘omnibus’ which is an indication of combining all the amendments and finalizing the rule. The rule obligates physicians and healthcare providers to vehemently safeguard the privacy of their patients health information and has recently extended this obligation to ‘Business Associates’ as well.

The United States Department of Health and Human Services (HHS) summarizes the 500 pages that encompass the Omnibus rule and highlights the modifications that physician practices are obligated to,

  1. Make Business Associates of Covered Entities directly liable for compliance with certain HIPAA Privacy and Security Rules’ requirements.
  2. Strengthen the limitations on the use and disclosure of protected health information for marketing and fundraising purposes, and prohibit the sale of protected health information without individual authorization.
  3. Expand individuals’ rights to receive electronic copies of their health information and to restrict disclosures to a health plan concerning treatment for which the individual has paid out of pocket in full.
  4. Require modifications to, and redistribution of, a covered entity’s notice of privacy practices.
  5. Modify the individual authorization and other requirements to facilitate research and disclosure of child immunization proof to schools, and to enable access to decedent information by family members or others.
  6. Adopt the additional HITECH Act enhancements to the Enforcement Rule not previously adopted in the October 30, 2009, interim final rule, such as the provisions addressing enforcement of noncompliance with the HIPAA Rules due to willful neglect.

Physician practices need to implement and comply with the HIPAA Omnibus Final Rule requirements before the September 23, 2013 deadline and according to The American Medical Association (AMA), there are three areas that they need to focus on:

1. Privacy, Security, and Breach Notification policies and procedures

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If there is a breach of Protected Health Information (PHI), physicians first have to perform a risk analysis that denotes how sensitive the health data was and the extent of damage incurred from a financial or clinical perspective. Then, they must notify the patients that the security of their PHIs have been compromised.

Moreover, physicians cannot disclose details of their patients health plan to third parties containing details about the services that the patient paid out-of-pocket.

Although physicians can give their patients gifts of nominal value, they may not promote a specific brand or product as if marketing it.

Physicians are not permitted to sell PHIs to a third party for any type of financial gains in the absence of the patient’s written authorization.

If a patient requests a copy of their health records, physicians have to respond to the request within 30 days and must provide it in mutually agreeable formats.

2. Notice of Privacy Practices (NPP)

Physicians are required to revise Notice of Privacy Practices (NPP) and provide them to patients through their website or distribute in print form, making necessary changes in the light of the Omnibus rule (breach notification, disclosures of PHI or health plans etc.)

3. Business Associate (BA) Agreements

If physician practices are utilizing services performed by third parties for the handling of PHIs, such as for health information exchange, data storage or e-Prescribing, they are termed as ‘Business Associates’ in the Omnibus rule. Physicians are responsible for the actions of their Business Associates as well as Subcontractors and require them to meet the HIPAA security standards.  Physicians should review and renew their agreements with BAs, in the light of the HIPAA Omnibus final rule.

A copy of HIPAA Omnibus Final Rule is available here.

ONC Offers EHR Interoperability Training

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The Office of the National Coordinator (ONC) has developed online training courses to teach the interoperability of electronic health record (EHR) with practical examples and stories. The training modules have been developed to educate Eligible Professional (EPs) and Critical Access Hospitals (CAHs) about how to achieve transitions of care, lab exchange, patient engagement and public health measures which are required by the stage 2 of the Meaningful Use program.

This online self-paced training series consists of five courses:

1. Interoperability Basics Training

This training course is approximately 75 minutes long and introduces basics of interoperability and highlights the benefits of enhanced Stage 2 Meaningful Use interoperability requirements which enable improved patient care and outcomes. The main topics covered by the course are:

  • Interoperability Basics Introduction
  • Defining Interoperability
  • Interoperability Path to Meaningful Use Stage 2
  • Building Blocks of Interoperability
  • The Effect of Interoperability on Categories of Care

2. Transitions of Care

The training course provides implementation guidance and practical examples to aid those who assist providers and hospitals, exchanging key information in support of care transitions. This course contains three lessons:

  • Introduction to Interoperability and Transitions of Care
  • Interoperability Standards for Transitions of Care
  • Implementing Standards-Based Exchange for Transitions of Care

3. Lab Exchange

The lab exchange course demonstrates the benefits of integrating labs and EHR systems in clinical settings where providers can send and receive lab orders and share lab results more efficiently and securely. This course contains five lessons.

  • Introduction to Interoperability and Lab Exchange
  • Incorporating Structured Lab Data
  • Lab Results Interface Guide
  • LOINC Codes
  • Sending Lab Results

4. Patient and Family Engagement

The course points out the tools and practices which the physicians should employ to engage patients in the care process. It exemplifies the ways physicians should use patient portals and online services to communicate with the patients, sending health education material and a summary of the clinical visit. Similarly, educating patients on how to keep track of medication, view lab results, and schedule appointments. This course contains four lessons.

  • Introduction to Patient and Family Engagement
  • Viewing, Downloading, and Transmitting Health Information
  • Providing Clinical Summaries to Patients
  • Using Secure Electronic Messaging

5. Public Health

The course covers the basics of population health management. How to form, educate and empower people about health hazards in the community. The responsibilities of care providers to diagnose, investigate and spread awareness about health issues present in a specific community and its recommended cure. This course contains six lessons.

  • Introduction to Interoperability and Public Health
  • Ongoing Submission to Public Health Agencies
  • Submission of Electronic Data to Immunization Registries
  • Submission of Electronic Syndromic Surveillance Data to Public Health Agencies
  • Submission of Electronic Reportable Lab Results to Public Health Agencies
  • Submission of Electronic Cancer Data to Public Health Agencies

These online training courses are available at HealthIT.gov website and they are really helpful to achieve Meaningful Use of EHR.

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Connected EHRs and MU2 transition of care measures

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The Meaningful Use program has emphasized the need for exchanging health information by using certified EHRs. Especially, the Meaningful Use stage 2 Transition of Care (TOC) measures which require 10% of referrals by eligible providers/hospitals to be sent electronically and providing a summary of care record for more than 50% of transitions of care and referrals.

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In the current scenario, EHRs must be capable of communicating with other services and devices, not only to fulfill Meaningful Use criteria but to realize real benefits of this health care technology. To make it possible, SequelMed offers an EHR system which is capable of extending the reach and efficacy of health care providers and the system successfully integrates with a multitude of health care services.

Here are a few advantages of using a connected EHR system.

  • EHR integration with an online patient portal, bridges the communication gaps between providers and the patients and facilitates sharing of PHRs.
  • A virtual connection with the lab helps in sending lab orders and receiving lab reports and medical images, without any delay.
  • An online connection with pharmacies enables users of SequelMed EHR to send electronically the prescriptions or renew/refill orders to the preferred pharmacy of the patients.
  • Patient referrals and sharing health records to another physician is only possible if the EHR system is capable of exporting health data in a CCDA standard format and can transmit it to other networks.
  • EHR connected mHealth apps improve patient care and increase patient loyalty
  • The EHR system which can connect across networks and can integrate data from all sites are beneficial for the medical practices who have a presence in multiple locations and facilities.
  • During emergencies and for the patients in critical condition, connected EHRs are highly beneficial because they can fetch in advance the patients’ health records and vital signs connecting with the ambulatory CPOE.
  • The EHR systems connecting with web-based services bring to work the advanced communication protocols, such as, instant messaging, email and online fax services.

The EHR applications are spreading their wings and are ready to bring in advantages of a connected health care system, population health management and the benefits of health information exchange. It is moving towards m-Health where interoperability of health information would reach to mobile devices and patients and providers would have flexible access to health data round the clock.

Switching EHR vendor for all the right reasons


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Switching EHR vendor is not just a fad now; Black Book Rankings tags 2013 as the year of “the great EHR vendor switch” and they were right in saying it. Most of the physician practices and healthcare providers are switching their EHR vendor because they are not satisfied and EHR product has failed to meet their requirements or facing difficulty to meet the criteria set by the Meaningful Use incentive program.

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Ironically, Meaningful Use program is cited as well for the rapid adoption of EHRs and now it has emerged as one of the main causes of disrupting the EHR implementation process. We reviewed this issue of ‘switching EHR vendors’ and pointed out factors causing it. For instance:

  • Providers are not satisfied with the current EHR system
  • Lack of vendor support
  • Practice incompatibility with the EHR in use
  • Meaningful Use is raising the bar day by day, adding new requirements which the EHR vendor is not able to incorporate
  • There are conflicts in the integration or synchronization of the EHR software with other applications

The physician practices who switched their EHR vendor had one question in common. How an eligible professional (EP) would attest if switched to another certified EHR vendor in the middle of the Meaningful Use program year?

Apprehending the situation CMS came up with the answer:

If an EP, eligible hospital or CAH switches from one certified EHR vendor to another during the program year, the data collected for the selected menu objectives and quality measures should be combined from both of the EHR systems for attestation. The count of unique patients does not need to be reconciled when combining from the two EHR systems.

If the menu objectives and/or clinical quality measures used are also being changed when switching vendors, the menu objectives and/or quality measures collected from the EHR system that was used for the majority of the program year should be reported.
(CMS FAQ8227)

Why switching to SequelMed is a win-win deal?

SequelMed is a viable health IT vendor, trusted by physician practices since 1995. Over the years, the company has developed and offered a range of health care IT products which integrate with each other and provide a complete solution to all the needs of the providers.

  • SequelMed suite of health IT products include EMR, EHR, Practice Management, Patient Portal, e-Prescribe and e-Link.
  • For years now, SequelMed has been providing medical billing and coding services to billing companies and providers; a value adding expertise which plays an important role in optimizing ROI.
  • The company extends its support through assistance in the implementation phase and follows with comprehensive training sessions.
  • SequelMed EHR is an ONC-ATCB certified solution that meets all the requirements of Meaningful Use criteria.
  • SequelMed EHR meets HL7 protocols for health information exchange and is HIPAA 5010 compliant.
  • Switching to SequelMed is ideal for health care providers who want complete automation of clinical workflows, ranging from scheduling to billing and want the easiest path to Meaningful Use incentives.

EHRs for solo and small physician practices

Solo physicians and small practice groups are increasingly adopting Electronic Health Record (EHR) systems and the adoption rate has never been this steep. EHR systems improve the efficacy of a practice which can manage a variety of clinical tasks with fewer resources. Such as, maintaining the health records in paper form requires someone dedicated to the task, whereas, electronic version of health records can be solely managed by the physician. Similarly, a certified EHR system is capable of virtually connecting labs, pharmacies and the patients with the physician practice, resulting in a reduced spending on communication and also a decrease in the running expense of an office. The Meaningful Use incentive program has also attracted small physician practices and solo physicians to adopt the EHR systems, who were initially reluctant due to the difficulties in managing the costs of the system.

Although Meaningful Use program has incentivized the EHR adoption and is one of the major contributing factors for the rapid acceptance of the EHR systems in a few years, however, the realization of its benefits is also an important factor in pivoting the way for adoption. Small physician practices have reported improved productivity starting from the first thirty days of the EHR implementation and startling improvements in the workflow and soaring profits. Some of the benefits realized after the EHR system implementation are:

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Workflow optimization

  • Better communication within the practice and with the patients
  • Integrated workflow
  • Quick access to health records
  • Efficient time scheduling
  • Low claim denials
  • Better control over bills and payments

Clinical outcomes

  • Reduced medication errors
  • Enhanced patient care
  • Better assessments through decision support system
  • Improved patient satisfaction and loyalty

Over the years, SequelMed has earned the trust of physician practices and has always been a step ahead in offering state-of-the-art health IT solutions to its clients. It has been a couple of decades now that our integrated line of practice management tools, healthcare IT solutions, business services, and technical support is catering to the needs of physician practices, health organizations, hospitals, and billing companies. Due to our extensive support and professional relationship building, our customers have become lifetime partners.

Our solutions have been rated high and have been recommended as the best choice for small practices who need better control of clinical workflow with easy to use health IT solutions.

Read the buzz and testimonials from physician practices about SequelMed products.