Report Questions How HIPAA Affects Health-Related Text Messages

The HIPAA Security Rule could affect how health agenices structure text messaging campaigns, according to a report published in the American Journal of Public Health, FierceMobileHealthcare reports.

The researchers — from the Seattle & King County Department of Public Health — wrote that they are not aware of case law or HHS guidance addressing whether text messages are subject to the HIPAA Security Rule. However, they wrote that a text message “arguably is within the [HIPAA] definition of electronic media because it involves data that exist in electronic form prior to transmission” (Slabodkin, FierceMobileHealthcare, 2/25).

Details of Report

In a case study, the researchers examined two approaches for using text messages to send reminders to lower-income parents whose children needed a follow-up influenza shot.

They determined that planned messages that included the child’s name and a reference to a “second flu shot” contained patient health data as defined by HIPAA, specifically the patient’s name and the implication that the child already had received a flu shot.

The first text messaging approach developed for the case study eliminated the patient’s name and made the language more generic.

The second approach sought to meet HIPAA standards while still including the information by requiring recipients to sign a security waiver at the time they signed up for the text message reminders (Comstock, MobiHealthNews, 2/20).

However, the researchers determined that “no communication method is 100% secure, and text messaging is no different.” They concluded that sending messages containing personal health data is a policy decision that must be made by decisionmakers at each health system.

Recommendations

The researchers wrote, “We recommend that the federal government take steps now to clarify how health departments can reasonably use text messaging to send protected health information.”

They added, “Until guidance is available and regulations are better defined, many health departments will lose the opportunity to use the technology in the most effective way” (FierceMobileHealthcare, 2/25).

Health IT Could Help Reduce Disparities in Care, Report Says

Health IT could help reduce disparities in care among ethnic and racial minorities, according to a report released Thursday at a White House Summit hosted by the Office of the National Coordinator for Health IT, HHS’ Office of Minority Health and the not-for-profit organization ZeroDivide, Healthcare IT News reports.

About the Report

Several groups collaborated to produce the report:

The Asian & Pacific Islander American Health Forum;The California Pan-Ethnic Health Network;Consumers Union, the policy arm of Consumer Reports; andThe National Council of La Raza.

The report provides policy recommendations for how health IT can best improve health care in all communities.

Data Collection

The report stated that health IT systems could facilitate the collection and analysis of demographic data. Such data could help health care providers identify disparities and ensure that they have culturally and linguistically appropriate clinical staff and services.

Kathy Ko Chin — president and CEO of APIAHF — in a statement said, “Gathering data on race/ethnicity and language needs at enrollment, combined with a robust system of electronic health records, has the potential to change the health care experience in our communities” (Monegain, Healthcare IT News, 2/21).  

However, Mark Savage — senior attorney for Consumers Union — warned, “We must be careful that new technologies preserve the privacy and security of patients’ health information and avoid any misuse of data collected” (Consumers Union release, 2/21).

Electronic Enrollment Portals

According to the report, electronic enrollment portals could help improve participation in public health programs (Healthcare IT News, 2/21). However, the report recommended that such portals be constructed in a way that avoids creating additional barriers for certain populations.

Jennifer Ng’andu — director of health and civil rights policy projects from NCLR — said, “Technologies must account for the needs of those most vulnerable to enrollment challenges and barriers, including mixed status families” (Consumers Union release, 2/21).

Social Media Tools Can Help HIV-Prevention Efforts, Study Finds

Facebook and other social networking tools could help prevent HIV infection among at-risk groups, according to a study published in the journal Sexually Transmitted Diseases, Medical News Today reports.

Study Details

For the study, researchers recruited 112 men who have sex with men, 90% of whom were African-American or Latino.

Participants were recruited through:

Banner advertisements on social networking websites, such as Facebook and MySpace; Banner ads and posts on Craigslist; A Facebook fan page with study information; and Venues such as bars, schools, gyms and community organizations.

Participants randomly were assigned to either a general health group on Facebook or a confidential HIV-prevention group on the social networking site.

Study Findings

The study found that participants assigned to the private HIV-prevention group discussed HIV-related topics, including:

Advocacy; Knowledge; Prevention; Stigma; and Testing.

According to the study, participants in the HIV-prevention group who were over the age of 31 were more likely to discuss prevention, testing, stigma and advocacy, while participants younger than age 31 were more likely to discuss general HIV information.

The study also found that participants in the HIV-prevention group who posted about prevention and testing were 11 times more likely to request an HIV testing kit than participants who did not discuss those topics.

Comments on Study

Sean Young — principal investigator and assistant professor at the University of California-Los Angeles’ David Geffen School of Medicine — said the study demonstrates that “participants will use social media to learn about HIV prevention and that those who talk about HIV prevention over social networking groups are not just talking about it — they are acting on their words by getting an HIV test.”

However, researchers said that because all participants were from the Los Angeles area, the findings might not be applicable to men from other areas (Medical News Today, 2/11).

Microsoft Kinect Could Help Cut U.S. Health Costs, New Study Finds

A new system from Microsoft Kinect — a motion-sensing video game controller — could help save up to $30 billion in U.S. health care costs by allowing physicians to interact with patients remotely, according to a study published in the International Journal of Electronic Finance, FierceHealthIT reports.

Benefits of Kinect System

The study found that the Kinect system — called the Collaboration and Annotation of Medical Images — can help prevent the risk of hospital-acquired infections and cut costs for individuals who live far from hospitals.

In a study announcement, the authors wrote, “The Kinect allows doctors to control the system without breaking the sterile field via hand gestures and voice commands with a goal of reducing the direct cost of health care-associated infections to hospitals and patients” (Gold, FierceHealthIT, 2/14).

The study also found that the system functions in areas where only low-bandwidth and unreliable connectivity is available (Medical News Today, 2/15).

While professional telehealth technology can cost thousands of dollars, the system — which requires a Kinect, a PC and the correct Windows software — can function well enough for a physician consultation at a cost of a few hundred dollars, according to the study (Lecher, PopSci, 2/14).

Implications

The authors said that the system will not single-handedly improve telehealth.

However, they said that it still is “a powerful tool that can be affordable in virtually any community that has existing technology and communication infrastructure” (FierceHealthIT, 2/14).

Standards Panel Offers Recommendations for Meaningful Use Stage 3

For Stage 3 of the meaningful use program, the Health IT Standards Committee is urging the Office of the National Coordinator for Health IT to focus on menu options and certification for use cases instead of core requirements, Government Health IT reports (Brino, Government Health IT, 2/7).

Background

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.

The final rules for Stage 3 of the meaningful use program are expected to take effect in 2016 (iHealthBeat, 1/15).

Input From Standards Panel

John Halamka — vice chair of the Standards Committee and CIO of Beth Israel Deaconess Medical Center — said that the Standards Committee generally agrees with the Health IT Policy Committee’s goals for Stage 3 of the meaningful use program, adding that Stage 2 requirements “should be extended with higher thresholds.”

However, Halamka said that the Standards Committee is concerned about whether the Stage 3 goals are realistically achievable, considering that standards and interoperability for certain EHR functions and clinical procedures still are evolving. For example, Halamka noted that there is a lack of:

EHR vocabulary for describing adverse events and contraindications; andMethods for broadcasting rules that would create patient medication reconciliation and problem lists.

Halamka recommended that ONC focus on “interoperability where standards are mature” for Stage 3 of the meaningful use program (Government Health IT, 2/7).

Groups Offer Input on ONC’s Draft Plan on Health IT, Safety

Several health care industry organizations have commented on the Office of the National Coordinator for Health IT’s draft plan on how the health IT industry could improve the safety of health IT systems.

Background

The draft plan — called the Health IT Patient Safety Action & Surveillance Plan — recommends several strategies for the health IT industry to follow through 2015. Some of the strategies call for:

Establishing a code of conduct for health IT developers; Supporting health care providers in their efforts to report adverse events; Creating a forum for health IT users to compare their experiences; Leveraging surveillance and testing opportunities available through ONC’s authorized accrediting bodies; Incorporating health IT-related patient safety requirements into CMS’ health care facility safety standards; Creating an ONC program to analyze data on health IT safety issues; and Establishing a multi-agency HHS health IT safety panel.

The draft plan also calls for incorporating safety requirements into the meaningful use program’s criteria for the certification of electronic health record systems. Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.

ONC is accepting comments on the draft plan through Feb. 4 (iHealthBeat, 1/3).

AHA’s Comments

In its comment letter on the draft plan, the American Hospital Association commended ONC for recognizing that industry stakeholders and federal agencies share responsibility for the safety of health IT systems (AHA News, 2/4). AHA also praised provisions of the plan that:

Outline specific steps that health IT vendors can take to ensure safety; and Call for the creation of a code of conduct for health vendors (Goedert, Health Data Management, 2/5).

In addition, the association recommended that ONC:

Establish a single, national approach to matching patients to their EHRs; and Advance the infrastructure necessary to support health data exchange (Rodak, Becker’s Hospital Review, 2/5).CHIME’s Comments

The College of Healthcare Information Management Executives also offered comments on ONC’s draft plan, saying that it supports the idea of using existing patient safety efforts led by the government and private sector as a foundation for strengthening health IT and patient safety.

CHIME suggested that ONC:

Rely on a stakeholder-driven organization that includes federal partners — but is not controlled by the federal government — to implement the patient safety plan; Use “voluntary consensus bodies” to facilitate agreement among health care stakeholders on a recognized set of standards and guidelines on patient safety in health IT; and Monitor the amount of time and resources needed to report on patient safety events to ensure that health care providers are not overburdened (Clinical Innovation & Technology, 2/5).HIMSS’ Comments

The Healthcare Information and Management Systems Society also sent a letter expressing support for many aspects of ONC’s draft plan.

The letter noted that the aggregation of adverse event reports often occurs too late to allow for adequate response time to immediate issues. To address such challenges, HIMSS stated that ONC’s final plan on health IT and patient safety should:

Recognize the importance of having health care providers work with their EHR vendor when investigating the root causes of patient safety events; and Include health IT vendors in the work processes of patient safety organizations (HIMSS letter, 2/4).

Report Predicts Rise in U.S. Residents Using Telehealth Technology

The number of U.S. residents using telehealth services is expected to reach nearly 1.3 million by 2017, a nearly sixfold increase over 2012 rates, according to a report by IMS Research, The Hill’s “Healthwatch” reports (Viebeck, “Healthwatch,” The Hill, 2/8).

Current State of Telehealth Use

Currently, about 75% of all patients using telehealth services — or about 227,400 individuals — are located in the U.S. Most telehealth users are post-acute care patients who recently were discharged from the hospital for conditions such as:

Congestive heart failure; Chronic obstructive pulmonary disease; Diabetes; Hypertension; and Mental health issues.IMS Research’s Projections

According to IMS Research, U.S. health care costs accounted for nearly 18% of gross domestic product in 2012, and that figure is expected to rise to 18.4% of GDP by 2017.

Shane Walker — senior manager for consumer and digital health research at IHS, IMS Research’s parent company — said that telehealth technology could help curb U.S. health care costs by reducing:

Hospital readmission rates; and Home care visits (Irving, PhysBizTech, 2/8).

The report predicted that revenue from U.S. telehealth services would increase from $174.5 million in 2012 to $707.9 million in 2017 (“Healthwatch,” The Hill, 2/8).

In a separate report released in December 2012, IMS Research predicted that the worldwide market for telehealth services would grow by 55% in 2013, partly as a result of changes stemming from the Affordable Care Act (Parmar, MedCity News, 2/8).