The Impact of Medical Identity Theft on Health Care

Posted on March 15, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

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Health Plan Related Breaches Since 2009

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Health Data Breaches Multiplying

Posted on March 2, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

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YET – Fines Remain Rare

By Charles Ornstein @charlesornstein

[ProPublica]

Federal health watchdogs say they are cracking down on organizations that don’t protect the privacy and security of patient records, but data suggests otherwise.

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Fines Remain Rare Even As Health Data Breaches Multiply

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data

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New-Age Physician Risks Courtesy of Health Information Technology

Posted on May 4, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

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Issues You May Not Have Considered

By David K. Luke MIM, Certified Medical Planner™

www.CertifiedMedicalPlanner.org

The entire nation continues to experience a medical malpractice liability crisis.

Facing physicians is the concern of frequency and severity of claims that either continues to rise or remains steady. And, much has been written about the impact of the liability crisis on physicians, the medical community, patients and access to care.

But, with health 2.0 connectivity, there are even more risks for doctors, and most all medical professionals, to consider.

So, here are a few fresh liability risks to your medical practice, to you, and to your patients courtesy of the health information age:

  1. Data breech risk. While not a new risk, the higher prevalence is new. The risks of a being fined by OCR due to the privacy rules of HIPAA because a practice had a data-breech with their EHR is becoming more common and very expensive
  2. Risks of telemedicine. As physicians become more technologically enabled in their practice of medicine, some are turning to real-time videoconferencing and other technologies. Some specialties such as psychiatry have been early adopters, but have to make sure they are still employing the same standards of care required by an in office visit (Cash 26). Also, the telephone can facilitate medical care but also result in adverse outcomes leading to telephone-related malpractice suits (Mondor, et al 517).
  3. Risks of new age medicine practices and their regulation. Case in point: Dry needling, which is like acupuncture, is a growing practice in places like Australia but is unregulated. Physicians should understand all regulatory and other risks when implementing new unregulated practices pushed by our new age society (Janz). Home births are on the rise in North America (even in Canada with government provided hospital delivery) but physicians end up dealing with the disasters and associated risks when they occur (Bochove 68).
  4. Reputation Risk. Reputation is a doctor’s most valuable asset. With the new age of internet and instant information, physicians must take great care in managing their reputation on such media sources as they are under increasing public and press scrutiny (Boyd 221).
  5. Communication risks to immigrants with limited non-native language proficiency. With today’s higher immigrant population in the United States, more medical practices are treating patients with limited English language proficiency. Clinicians now run the risk of not properly communicating medical risk information to these populations. A recent study shows that materials that include visual aids are being used by medical practices to effectively communicate with the patient (Garcia-Retamero, Rocio, and Mandeep, K. Dhami 47).
  6. The rise of the informed distrusting patient and related risks. With the ubiquity of medical information on the internet, the risks incurred by a medical practice in properly dealing with the newly informed patients with medical degrees from the University of Google Medical School are on the rise. Physicians must refine their “bed side manner” and improve their communication skills in order to deal with a more questioning patient population. Clinicians should actively discuss what patients have read on the internet when patients refer to their internet diagnoses (Lam-Po-Tang, John, and Diana McKay 130).

Works Cited

  • Bochove, Danielle. “Don’t Try This At Home.” Maclean’s 124.33/34 (2011): 68. MasterFILE Premier. Web. 27 Apr. 2012.
  • Boyd, M. “Managing Risk To Reputation.” Clinical Risk 15.6 (2009): 221-223. CINAHL Plus with Full Text. Web. 27 Apr. 2012.
  • Cash, Charles, D. “Telepsychiatry And Risk Management.” Innovations In Clinical Neuroscience 8.9 (2011): 26-30. CINAHL Plus with Full Text. Web. 27 Apr. 2012.
  • Garcia-Retamero, Rocio, and Mandeep, K. Dhami. “Pictures Speak Louder Than Numbers: On Communicating Medical Risks To Immigrants With Limited Non-Native Language Proficiency.” Health Expectations 14.(2011): 46-57. CINAHL Plus with Full Text. Web. 27 Apr. 2012.
  • Janz, StephenAdams “Acupuncture by Another Name: Dry Needling in Australia.” Australian Journal Of Acupuncture & Chinese Medicine 6, no. 2: 3-11. Alt HealthWatch, EBSCOhost. Web. 27 Apr. 2012
    • Lam-Po-Tang, John, and Diana McKay. “Dr Google, MD: A Survey Of Mental Health-Related Internet Use In A Private Practice Sample.” Australasian Psychiatry 18.2 (2010): 130-133. Academic Search Complete. Web. 27 Apr. 2012.
    • Maureen Mondor, et al. “Patient Safety And Telephone Medicine.” JGIM: Journal Of General Internal Medicine 23.5 (2008): 517-522. Academic Search Complete. Web. 27 Apr. 2012

Conclusion

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Don’t Co-operate with eDR Vendors, Doc!

Posted on February 5, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

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My Opinion of eDRs and eDR  Vendors

By D. Kellus Pruitt DDS

Don’t cooperate with those you don’t trust, Doc.

eDR Stakeholders

If you allow Dentrix, the W. K. Kellogg Foundation, the ADA and other ambitious EDR stakeholders talk you into switching from paper dental records to digital before 2014, it will be the most regrettable business decision you have ever made.

PHI Breaches

Regardless if a data breach of your patients’ Protected Health Information (PHI) is your fault or not, it can easily cause bankruptcy, and the odds aren’t in your favor. According to a recent Redspin study, the number of breaches doubled between 2010 and 2011. (See “Health data breaches up 97% in 2011” by Diana Manos in Healthcare IT News, February 1, 2012).

http://www.healthcareitnews.com/news/health-data-breaches-97-percent-2011

Procrastination and Late Adopters

So even if unlike Americans who enjoy freedom, professionalism keeps you from publicly expressing an opinion, there’s never been a better time to drag your feet in our usual way. Besides, what have you got to lose by waiting? If consumers prefer EDRs, don’t you think we would see dentists touting their safety in their ads?

RedSpin

Daniel W. Berger, President and CEO of Redspin, is quoted in Diana Manos’ article: “Information security breach is the Achilles’ heel of PHI. Without further protective measures, data breaches will continue to increase and could derail the implementation, adoption and usage of electronic health records.” So why allow selfish EDR stakeholders who cannot be held accountable for harming your patients rush you into buying their favorite technology?

Note that the ineffective “further protective measures” will make EDRs even more expensive compared to paper dental records – allowing paper dentists to charge less than paperless practices, while still making more profit. Indeed, Doc. What have you got to lose by waiting?

Over the last 6 years, virtually all of my predictions about HIPAA have been right, and following the recent Redspin report, I feel even stronger about this one: The national failure of HIPAA will become noticeable in dentistry first.

OCR Culture

Not only is the Rule ineffective at protecting dental patients’ identities, but the tedious, mostly worthless compliancy requirements are so unreasonably time consuming and costly that no dentist can ever be 100% compliant. What’s more, eager HIPAA auditors working on commission to enforce the Office of Civil Rights’ “culture of compliance,” can find a dentist “willfully negligent.” Is that not subjective? The fines for such an auditor’s opinion are obscene. If you unfortunately experience a data breach, you don’t want to lose even more sleep over an audit that you cannot win, do you? Dentists don’t have to take this.

Dentistry Is Billing Simple

Unlike the complex administrative tasks in physicians’ offices, the business of dentistry is simple: Billing involves ten times fewer patients and CDT codes cover fees for procedures only involving the lower third of patients’ faces. Ledger cards, pegboards and lots of carbon paper have functioned adequately and safely for busy dental practices for decades. Besides, computers still haven’t shortened the time it takes to do a technique-sensitive filling in a squirmy kid’s mouth. If the front desk is the bottleneck rather than the speed of the dentist’s hands, someone needs to brush up on their alphabet skills.

If you think you might miss your computer, now is a perfect time to encourage dentistry’s leaders to consider de-identifying EDRs… Or if like me, you aren’t a HIPAA covered entity, we could wait a little longer if you’d like. Within a year, Americans will be noticeably seeking dentists who don’t put their PHI on computers.

Assessment

The hope for miracle discoveries derived from safely data-mining interoperable dental data doesn’t have to end like this, but I certainly don’t mind the windfall profits that expensive HIPAA regulations and patients’ fear of identity theft will bring to my practice.

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