Data Security and Backup Solutions in Health Care

Data security is like exercise: Everyone knows it's good. Few people care enough to do it…

Which is why it is important, to have the right strategy, and the right tools. 

Computers, Keyboards, Mice and Even Hard drives fail. It's a fact of computing life. It's not a question of whether your computer will stop working or even a matter of when. The question is how much it will disrupt your life, your processes, your practice and your patients - and it won't, if you have a backup copy. 

Backing up your data is most indispensable thing you do on your computer. The 2 important considerations one must have when deciding a backup strategy are the backup media and the backup tools.  

Local Backup Media: 

Using CD/DVD’s to store data backups 

Using CD/DVD’s to store data backups is popular. Blank CD/DVD’s are inexpensive, and copying data onto CD/DVD’s is easy. Unfortunately CD/DVD’s, like the floppy disks they've replaced, have a limited shelf life. We don’t recommend this method of data backup for any practice. 

Using tapes to store data backups 

Tape backups are a many times more reliable than DVDss, but tape drives and their associated media are many times more expensive than DVD writers and CD/DVDs. A good tape drive can cost over $1000, and individual tapes for the drive can cost up to $40 each. If one can afford the equipment, however, tape backup is far more reliable and recommended backup method. 

Using external hard drives to store data backups 

External hard disks are cheap compared to tape drive systems. They’re also easy to use as most of them support plug and play use with the computers USB port. And while hard drives do fail, their failure rate is much lower than that of other backup media such as DVD’s. A big factor to why we recommend External Hard Disks as the best Local backup medium is that a single hard disk drive or a maximum of 2 used for backups may well be enough to store your practice data. 

Online Backup in the Cloud: 

An online backup service offers the advantage of securely store your files at off-site server locations, so that your data stays intact and available even if your local disks, CD/DVD’s are corrupted or in a severe case stolen. 

With more and more emphasis on "cloud computing", it only makes sense that one should take advantage of this hot trend in technology for backups.

Factors to consider when choosing an online backup service: 

Does it upload new and changed files immediately? 

Does it allow syncing or sharing of data? 

Can it back up files while you have them open? 

Is there a Web client for restoring? 

Is there a mobile client? 

Does it offer a remote control feature via my mobile phone? 

Can I view my backed up files on an iPad? 

How much will it cost? 

Is it HIPAA Compliant? 

Limitations: 

The advantages of Online Backup solutions can be limited due to bandwidth problems. 

Secondly, the method is only as reliable as the company offering the online backup service. 

Thirdly, one should ensure that HIPAA requirements are met by the vendor who is offering the Online Backup Service 

 
If you'd like to know more about TechnicalDr's flexible and powerful HIPAA Compliant Backup Solution  please check the website http://www.technicaldr.com/tdr/hipaa-compliant-backup or Call 630 433 7453 for a Super Offer - Waiver on Setup and Training Costs

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Physicians and Blogging - II

This is a follow up post to "Physicians and Blogging". Here we look at Tips for Physicians to make their Blogging experience more useful, effective and mostly fun.

1. Clearly identify a theme for your blog.

A Blog is like any other project. If you don't have a path you won't know where you end up. Create a central theme for your blog and stick to it. Avoid making multifaceted and complicated blogs

2. Use Pictures as much as possible

A picture speaks a 1000 words. To make your blogging appeal more to your readers, it would be extremely nice if you will put some pictures in it.

N.B It does not necessarily mean you have to place a picture of yourself.

3. Make it interactive

As much as possible and if your capacity will allow it, make your blog interactive. You can do this by placing some video or audio clips in your blog.You can even place an area for comments. In this way, you can get the impressions and/or reactions of other people. Who knows, you might even gain some friends just by making them feel at home in your blog site.

4. Choose a good Blogging Engine

While there are many blogging platforms and applications, there are a few simple ones which are more popular than others. Blogger and Wordpress both offer multiple free and simple to customize themes. They are both easy to use and allow one to post text, images, audio as well as videos.

In future posts we will provide a tutorial to setup a blog using each

5. Network Online

The more you network online, the more your blog gets visibility. Share your posts on Social networks. Ask other readers to give you suggestions, respond to comments. The success this brings will push you to blog more and will help make your blog even more meaningful.

Feel free to post your suggestions as well as links to your blogs in the comments sections below.

If you'd need any help setting up blogs for yourself, please let us know. We'll be Happy to Help


Happy #hcsm via @TechnicalDr and @nrip

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What is ePrescribing?

ePrescribing(Electronic prescribing ) is the computer-based electronic generation, transmission and filling of a medical prescription,in effect automating the prescribing processes. E-prescribing allows a physician, nurse practitioner, or physician assistant to electronically transmit a new prescription or renewal authorization to a community or mail-order pharmacy.

Along the way, the system offers instant access to patient medication history, formulary coverage and decision support, helping you make the best possible medication choice for patients.

ePrescribing is a viable solution to counter shortcomings of the current paper-based prescribing processes that are in large part responsible for these errors

Benefits of ePrescribing:

1. Improved patient safety and overall quality of care
2. Reduces phone calls and call-backs to pharmacies.
3. Eliminates faxes to pharmacies.
4. Streamlines the refill's requests and authorization processes.
5. Offers true Provider Mobility
6. Improves reporting ability
7. Increases patient compliance.
8. By checking with healthcare formularies at point-of-care, generic substitutions and generic first-line therapy choices are encouraged thus reducing patient costs.
9. Increases patient convenience by reducing patient trips to the pharmacy and reducing wait times.

Useful Aids:

Find a System and Read Reviews:

Calculate Time Savings and Medicare Incentives

Implementing a System

Click to Learn About the ePrescribing Incentive Program

Contact Us at TechnicalDr Inc. and We'll be Happy to guide you further

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Survey Regarding Medical Websites for Doctors, Clinics and Small Hospitals

As a Doctor, what are your expectations from a Website. Apart from the basic features of a website, there are some simple tools which can go a long way to improve your website experience for your patients. Our aim is to recommend these tools , such as health calculators, video galleries, online patient history forms; customized ask the doctor queries; and Google maps which provide directions to the clinic. To understand you better we request you to help us out by filling in the following survey.

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Features in Practice Websites which increase Patient Satisfaction

An important part of managing a patient over a long period of time is communicating with the patient. Most follow up cases in medical practices have niche requirements and consequently patients have certain expectations from their physicians. Also a happy patient is a physician’s most powerful marketing asset. Practices should strive to provide for such patients by offering services which improve the quality of service they perceive, which in turn will increases their satisfaction.

A well planned and feature rich practice website allows physicians to assist patients in their day-to-day living by providing timely solutions for all their health queries even after a visit. For a patient, this continued access to expert medical advice via simple online tools is one of the most cherished features of any e-practice.

Despite best efforts, many patients make errors while following medical advice. Many times, follow-up patients have new queries they wish they could simply share with their physicians. A large number of patients also do not ask new questions just because they don’t want to look stupid in front of their physicians! These patients are often unsure of the importance of their queries and generally procrastinate visiting their physicians for answers. Sometimes new complaints crop up which may or may not affect the ongoing medical management. The internet, via a medical website, allows physicians to clarify many such small doubts these patients face while following medical advice. A timely word of advice can save these patients a whole lot of pain, literally and figuratively. Important issues which may arise during such advice can be solved by arranging for a new visit.

There are a number of ways medical websites and integrated web 2.0 tools can be used to help physicians improve patient-physician communications and thus decrease the morbidity among patients. Let’s look at five such applications:

Online Chats

Chatting on the internet is something most patients are comfortable with. Medical websites can have widgets which allow patients to directly chat with the physician or the physician’s representative. This is a common and simple to add functionality within any medical website. Patients can be given pre-decided timings (say, 9 p.m - 10 p.m on Mondays, Wednesdays and Fridays) when the physician shall be available for the chat. Such chat transcripts can then be appended to the electronic medical record of the concerned patient. More people can be added to chats so as to allow group discussions (e.g: Friday evening hour long chat session for all Pregnant women, in case of gynae practices).

Contact Forms and Feedback Forms

Medical websites allow all registered members (i.e. follow-up cases) to access some parts of the website which are meant only for them. A simple form is embedded within this secure area through which a follow-up patient can ask a question. These questions are then directed to the physician’s email address. The physician can answer such questions securely via email or even ask the patient to book an appointment if required. Ideally, physicians should create an email id purely for answering queries of follow up cases. This will help in segmenting all electronic medical communications between physicians and patients. All such queries are also automatically added to electronic medical record of that patient.

Facebook Groups

After email, Facebook is the most commonly used online platform for communications. physicians can easily use this platform (by forming closed groups) for answering some of the common queries by their patients. All follow up patients who share their primary email id can be added to specific closed groups on Facebook. These patients can post their queries on the group wall (which is not public and viewable only by group members) or send it as a direct message. Answers which have general significance for all patients can be posted on the group wall (e.g.: I am taking Metoprolol XL 50 mg once daily for my hypertension. I am scheduled for a tooth extraction next week. What precautions should I take? ). Personal queries can be answered via direct messaging. Urgent and important issues can be simply escalated to a telephonic conversation. Over time, such a Facebook group shall mature into a powerful resource for all new members. 

Video Chat

Questions which require visual inputs (like appearance of rashes or swelling on hands and feet) can be handled by using Video chat within Facebook. Important advice can be reinforced by typing it into the chat area so as to create a transcript document of the encounter. There are medical social media guidelines published by many international organizations which can be followed for all such patient-physician communications on Facebook.

eVisits using Skype

Physicians can also use Skype and payment gateways like PayPal to organize revenue generating e-visits by follow-up cases who find it difficult to physically visit the clinic premises at regular intervals. This is especially the case with geriatric and physically challenged patients.

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Medical Websites Help Small Practices Compete Against Large Hospitals

Practicing medicine in the private sector is a very tough proposition. It’s not enough simply to be a very good doctor; Its also imperative that one is known by most to be a very good doctor. It’s not enough to provide all the latest treatment options and services; Everyone must also know or be able to find out easily all the services provided at a practice/hospital.

Traditional Healthcare Communication Meant Word-Of-Mouth Publicity

Traditionally, physicians and medical practices have relied on word-of-mouth publicity to establish themselves. A patient who has undergone an event-free angiography at the local cardiac care center would then tell five others about his/her wonderful experience.And now five more people know about the latest angiography services at that cardiac center. Hopefully, this positive review would continue in a geometric progression and more and more people would visit the medical center. 

But is that enough? Also, what about the high tech cardiac catheterization and latest stenting services also available at that center? There would be hundreds of bits of positive details about your practice most patients would’nt even get to know of. Hoping that all visitors to a medical center realize all its plus points and then remember to pass these plus points to others is so optimistic, it’s foolish. Thus word-of-mouth publicity serves a very limited role in evangelizing any healthcare services.

Challenges In Healthcare Communication

Medical practices can no longer rely only on word-of-mouth to inform the world about their existence. But they also face a big handicap. They need to make themselves and their quality services known without resorting to overt advertising. Clinics and smaller hospitals face a specially forbidding challenge in breaking through this glass ceiling of ‘perceived quality’. Sheer size has allowed larger hospitals to carry an aura of quality, irrespective of the services they provide. In contrast, many clinics which provide top-of-the-line services are just not accorded due respect or simply remain unknown.

Medical Websites In Healthcare Communication

Despite providing the best services, many small practices are labeled ‘poor quality’ simply because of low visibility. Technology has broken down this artificial divide between small and larger medical practices. A high quality website has become the single most important way to establish your credibility, authority and niche online. Websites and social media channels provide an easy to access free platform for showcasing your expertise to any targeted/ segmented population.

A website becomes the way people remember and recall your clinic. A website creates a visual brand for your medical practice, allowing strong recall value even among people who may never have visited your clinic. With the help of a high quality medical website, a niche specialty clinic can achieve the same recognition as many large super-specialty hospitals.

Beyond branding, the practical utilities medical practices can provide the patients via their websites are plenty. Appointment scheduling and lab reports can easily be accessed via medical websites. Interactive patient communication widgets and electronic health records can add an entirely new dimension to the concept of medical websites.

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What is Meaningful Use?

The purpose of the Healthcare IT incentive program is not static adoption of EHRs. The program has been devised in a manner that incentivizes only the “meaningful use” of your EHR system. Simply put, your practice will be eligible for the $44,000 incentive payment ONLY if it is able to actively utilize the EHR for improving the quality of care by satisfying certain federally set criteria. These criteria are called “Meaningful Use Objectives”.

Meaningful Use objectives have been defined in order to allow the progress of Healthcare IT and its impact on the National Healthcare System to be measured in terms of quality and quantity. It encourages the active adoption and implementation of health information technology by rewarding practices that are able to successfully incorporate the EMR in their daily workflow, using it to their full potential for delivering higher standards of healthcare.  

Meaningful Use is a phased program. It consists of three stages and the successful implementation of each stage is linked to incentive payments to be received for meeting the requirements of that stage.   

Stage 1: Data Capture (2011-2012)

This stage focuses on electronically capturing patient health information in a structured digital format using your EHR and utilizing this information for clinical purposes as well as communicating it for care coordination to other providers. If your first year of payment is 2011, you must satisfy the requirements of this stage in your first and second years of payment, i.e, 2011 and 2012, to receive the incentive payment.

This stage divides the objectives into two groups:

   1. Core group of 15 mandatory objectives
   2. Menu Set of 10 objectives from which physicians can choose any 5

Stage 2:  Data Aggregation and Exchange (HIE) (2013-2014)

This stage builds on the objectives of Stage 1 to focus on using health information technology to improve the quality of healthcare at the point of care. It also involves electronic and digital exchange of structured medical information among providers. This includes computerized physician order entry or CPOE and electronic transmission of diagnostic test results and other data required for clinical and medical support services.

Stage 3: Data Use to Improve Outcomes (2015)

Stage 3 focuses on utilizing the structured medical data made available in the earlier stages to improve healthcare quality and outcomes. This stage lays emphasis on the macro aspect of the healthcare system by encouraging support for national high priority conditions, emergency medical crises, self management tools for patients, access to patient medical databases and improvement in overall standards of healthcare delivery and population health.

Given below is a list of the Core and Menu Set Criteria required to be satisfied in Stage 1.

15 Core Criteria

[1] Objective: Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines.
Measure: CPOE is used for more than 30% of all unique patients with at least one medication in their medication list seen by the Eligible Professional (EP) have at least one medication order entered using CPOE. (Exclusion: Any EP who writes fewer than 100 prescriptions during the EHR reporting period)

[2] Objective: Implement drug-drug and drug-allergy interaction checks.
Measure: The EP has enabled this functionality for the entire EHR reporting period.

[3] Objective: Maintain an up-to-date problem list of current and active diagnoses.
Measure: More than 80% of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data.

[4] Objective: Generate and transmit permissible prescriptions electronically (eRx).
Measure: More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

[5] Objective: Maintain active medication list.
Measure: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data.

[6] Objective: Maintain active medication allergy list.
Measure: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data.

[7] Objective:  Record the following demographics: preferred language, gender, race, ethnicity, date of birth. 
Measure: More than 50% of all unique patients seen by the EP have demographics recorded as structured data.

[8] Objective: Record and chart changes in vital signs: height, weight, blood pressure, calculate and display body mass, plot and display growth charts for children 2-20 years, including BMI.
Measure: For more than 50% of all unique patients age 2 and over seen by the EP, height, weight, blood pressure are recorded as structured data. (Exclusion: Any EP who either see no patients 2 years or older, or who believes that all three vital signs of height, weight and blood pressure have not relevance to their scope of practice.)

[9] Objective: Record smoking status for patients 13 years old or older.
Measure: More than 50% all unique patients 13 years old or older seen by the EP have “smoking status” recorded as structured data. (Exclusion: Any EP who sees no patients 13 years or older)

[10] Objective: Report ambulatory quality measures to CMS or the states.
Measure: Successfully report to CMS (or States) ambulatory clinical quality measures selected by CMS in the manner specified by CMS (or States).

[11] Objective: Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule.
Measure: Implement one clinical decision support rule.

[12] Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request.
Measure: More than 50% of all patients who request an electronic copy of their health information are provided it within three business days. (Exclusion: Any EP that has no requests from patients or their agents for an electronic copy of the patient health information during the EHR reporting period.)

[13] Objective: Provide clinical summaries to patients for each office visit.
Measure: Clinical summaries provided to patients for more than 50% of all office visits within three business days. (Exclusion: Any EP who has no office visits during the EHR reporting period)

[14] Objective: Capability to exchange key clinical information (for example, problem list, medication list, allergies and diagnostic test results), among providers of care and patient authorized entities electronically.
Measure: Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information.

[15] Objective: Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
Measure: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

Menu Set Criteria
Given below is the Menu Set of 10 objectives from which physicians can choose any 5. One of the 5 must be either Objective 9 or 10.

[1] Objective: Implement drug formulary checks.
 Measure: The EP has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period.

[2] Objective: Incorporate clinical lab-test results into EHR as structured data. Measure:  More than 40 percent of all clinical lab tests results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified E HR technology as structured data. (Exclusion: An EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period.

[3] Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.
Measure: Generate at least one report listing patients of the EP with a specific condition.

[4] Objective: Send reminders to patients per patient preference for preventive/follow-up care.
Measure: More than 20 percent of all patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period.  (Exclusion: An EP who has no patients 65 years old or older or 5 years old or younger with records maintained using certified EHR technology.

[5] Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within 4 business days of the information being available to the EP.
Measure: At least 10 percent of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP’s discretion to withhold certain information.  (Exclusion: Any EP that neither orders nor creates any of the information listed during the EHR reporting period.)

[6] Objective: Use certified E HR technology to identify patient-specific education resources and provide those resources to the patient if appropriate.
Measure: More than 10 percent of all unique patients seen by the EP are provided patient specific education resources.

[7] Objective: The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.
Measure: The EP performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP.  (Exclusion: An EP who was not the recipient of any transitions of care during the E HR reporting period.)

[8] Objective: The EP who transitions his/her patient to another setting of care or provider of care or refers his/her patient to another provider of care should provide summary care record for each transition of care or referral.
Measure:  The EP who transitions or refers his/her patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals.  (Exclusion: An EP who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period.)

[9] Objective: Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice.
Measure: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP submits such information has the capacity to receive the information electronically). (Exclusion: An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically.)

[10] Objective: Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice.
Measure: Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP submits such information has the capacity to receive the information electronically). (Exclusion: An EP who does not collect any reportable syndromic information on their patients during the EHR reporting period or does not submit such information to any public health agency that has the capacity to receive the information electronically.

(Source: http://www.osteopathic.org/inside-aoa/advocacy/regulatory-issues/Documents/meaningful-use-objectives.pdf)

References:

http://missourihealthconnect.org/FAQRetrieve.aspx?ID=45267

http://www.osteopathic.org/inside-aoa/advocacy/regulatory-issues/Documents/meaningful-use-objectives.pdf

http://www.emrandehr.com/2010/08/30/meaningful-use-resource/

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How are Physicians taking to Social Media?

Social Media is no more just an in-thing. It has quickly become an integral part of our days and provided an excellent online extension to our lives. And it is now being used to keep track of sport scores, understanding stock market trends, ordering dinner etc. Social Media has also started making its in presence felt in various aspects of healthcare.

In an online survey carried out over apprx. 4,000 doctors with regards their involvement and interest in different types of social media, 87 % of the physicians claimed to be active on at least one social media site for personal use, while 67 % had used social media sites professionally too.

This is remarkable, given that a year back, predicting such numbers would have been preposterous. What is even more remarkable is that 66 % of the respondents described themselves as either “positive” or “very positive” with regard to the impact online patient communities are having on patients.

While Physicians were found to favor the social biggies, Facebook and LinkedIn over Twitter, 28 % said they were also using Physician Specific Online Communities. This is an interesting result and shows the scope for targeted and richer social networks directed at physicians. Sermo, DoctorsHangout, DocGlobal are 3 popular networks, and we’re sure that in 2012, a number of smaller more focused networks will also emerge.

While all seems to point to increased usage of Social media amongst Physicians, there are some aspects which will need addressing. Most surveyed physicians expressed concerns about privacy and legal ramifications. There is a great post by Dave Ekrem, on “7 tips to avoid HIPAA violations in social media” at kevinmd.com for the interested. 

Besides these, it seems to be a concern to Physicians that there was no way to get paid for interacting with patients online. As more physicians jump on the Social media bandwagon, more concerns are bound to be raised. But each problem offers a potential business case. Some innovative EMR providers like have already demonstrated smart integrations with Social Services like Twitter and Facebook to help create a more robust patient record.

Also, social networks will start emerging which let patients discuss their problems and offer doctors the chance to help them. From a marketing perspective, this will help physicians create more trust amongst patients leading to more referrals.

13 % have participated in public online discussion forums with other physicians, while 2% have participated in public online discussions with patients; and 5 % have engaged in online chat with other physicians, while 2 % have engaged in online chat with their patients.

Another common concern amongst social media savvy physicians was that the technology was too new for them. This will get addressed over time as physicians get more acquainted with latest in technology. The more they use technology, the faster they will be able to adapt to newer technologies.

Use of Social Media is sure to grow amongst physicians. Since it involves both involvement as well as content, Social Media used effectively can help both in promotions as well as a medium for education.

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How Can Computer Viruses Affect Your Medical Practice?

As healthcare becomes increasingly dependent on information technology, system breakdowns due to viruses, worms and other malware can potentially stall the entire working of your practice. This article aims to discuss how practitioners can protect their computers against viruses to ensure the safety and confidentiality of their data systems.

What are Computer Viruses?

A virus is simply a software program or a piece of code that is developed to spread and break into computer systems to consume available memory, corrupt or erase data and eventually cause the system to stop working. 

There are many types of malware and computer viruses and they vary in characteristics, disguises and potency to breach security and spread across networks. 

Computer viruses are nowadays commonly spread by attachments in emails or IM messages. They can also be disguised as attractive images, lucrative discount deals, lottery announcements and other audio-visual files that are likely to arouse user-curiosity and consequent click or download response. Computer viruses and malware are easily spread using free Internet downloads and pirated or illegal programs and files. 

A computer virus infection can be detected from typical symptoms like lowered system speed, frequent hanging or freezing, unprecedented restarts, improper or sluggish functioning of applications, inaccessibility of disk or drives, unusual error messages, missing programs etc.

Even though these indicators may hint at other hardware or software problems, the safest option in such a situation is to run an anti-virus check and contact your data security provider.

How Can Computer Viruses Affect Your Practice?

EMRs and other electronic healthcare data systems hold confidential patient information and practitioners are responsible for their privacy, safety and security. Data theft, loss and system breakdowns due to virus attacks can be very detrimental to a practice and can even put people’s lives in danger.

While effective backup systems and regularly updated anti-virus software can help you avert these debacles, medical professionals must be informed about the repercussions and penalties that HIPAA mandates in case they fail to protect medical information. The federal law treats medical data security as a legal requirement and any compromise on this front is a punishable offense. HIPAA has also released guidelines to assist practitioners and data security professionals in building unbreachable data systems that protect electronic medical data in EMR and other software.

What Can You Do To Prevent Virus Attacks?

A comprehensive data security plan involves regularly updated system security, frequent data backups, employee education and effective administrative policies that regulate the use and accessibility of medical IT systems.

Antivirus Software

When implementing your EMR, ensure that your server and workstations are adequately protected against malware. There are many effective virus protection software programs that help shield your system from viruses, malware and spyware. Ideally, these virus protection programs must be installed and regularly updated as soon as you get your IT infrastructure in place, with or without the EMR. Some antivirus programs are freely available for download online (with paid premium versions) while others can be purchased for a fee. 

We list some of the most effective virus protection software programs that are popular for medical IT security.

1. ESET NOD32

Information: http://www.eset.com/

2. KASPERSKY

Information: http://www.kaspersky.com/

3. BIT DEFENDER

Information: http://www.bitdefender.com/

4. QUICK HEAL

Information: http://www.quickheal.com/

5. NORTON INTERNET SECURITY

Information: http://us.norton.com/

In the free to download segment, the most popular antivirus software programs are,

1. AVG

Information: http://www.freeavg.com/?lng=in-en&cmpid=corp

2. AVAST

Information: http://www.avast.com/index

3. AVIRA

Information: http://www.avira.com/

You may also ask your local computer vendor or EMR provider to guide you on the most appropriate protection program for your practice. Many reputable EMR vendors include antivirus and security programs in their services at no additional fee or cost of resources.

Data Backup Systems

Regular backups are an absolute must in order to prevent the loss of crucial medical information to disruptive computer viruses. All data must be backed up on remote servers that are professionally managed by data security experts. With a backup system in place, even if your local server were to get infected and your data were to get erased or corrupted, you would still have all your information secure and intact on this remote server.

Along with antivirus and data backup systems, practitioners and healthcare staff must adopt the following practices in order to build the practice’s defense against unprecedented virus attacks. 

1. Routers and wireless internet connections must be protected with strong, unbreachable password keys.

2. Install firewalls and always keep them on.

3. Do not download attachments or click links from unknown email messages, IMs and social media sites unless you are expecting them. 

4. Do not respond to unusual virus attack warnings from unrecognized sources or download rogue programs that offer to heal the virus. More often than not, they are viruses disguised a antivirus software. 

5. Do not be lured into downloading malware hidden in funny images and unknown audio/video files. Only download from trusted sources and websites.

6. Regularly install updates for all your software. Subscribe to automatic updates if available. 

7. Passwords should be strong and kept confidential. They should ideally include a combination of letters, numbers and symbols and be at least 14 characters long. Staff should be advised to memorize them instead of noting them down somewhere. Also, each application should have a unique password that is not repeated elsewhere in another application, website or program. 

8. Be cautious while using flash drives. Ensure that they are virus-free before running them on your system.

References:

1. http://www.articlesbase.com/alternative-medicine-articles/emr-software-from-the-cloud-5060639.html

2. http://www.ondd.org/the-top-100-open-source-software-tools-for-medical-professionals/

3. http://www.mdbase.com/Newpages/emrpdf/Guide_Part1_Chapter5.pdf

4. http://support.microsoft.com/kb/129972

5. http://www.microsoft.com/security/pc-security/protect-pc.aspx

6. http://hcpfcu.coop/protect.html

7. http://www.articlesnatch.com/Article/How-Secure-Is-Emr-Software-/671247

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Difference Between Medical Billing Software and EMR

Medical billing and EMR software systems are often designed to have overlapping features that improve the functionality and usability of the systems in order to make them a “one-stop-solution” for a practice’s medical IT needs. As a result, medical billing software and EMRs end up being interchangeably used discounting the primary objectives of each of the systems.

Medical Billing Software vs. EMR

Many EMR companies are going the whole way to provide doctors with a single, comprehensive solution that will help them achieve Meaningful Use by incorporating crucial features like clinical notes, patient information and history, medication/prescription/drug allergies, diagnosis/treatments/procedures, patient scheduling, appointment reminders, e-prescribing, electronically available results, scans and reports, patient education resources, clinical decision support as well as full-fledged medical billing programs.

Specialized medical billing software on the other hand, is particularly programmed to maintain and keep detailed records of tests, procedures, examinations, diagnoses and treatments conducted on patients. It combines this medical information with the patient’s policy details to formulate a complete medical record that is used to generate bills. 

The software electronically submits these bills to the patient as well as the health insurance company for payment. Before a bill can be submitted to the policy provider, it has to be coded based on Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9/ICD-10) protocols. Medical billing software systems are programmed to automatically assign these codes based on the patient’s medical record. After reviewing the bill, the insurance company sends the appropriate payment (or notice of denial) notifying the patient and practitioner via an Explanation of Benefits (EOB) letter which is added to the patient’s medical billing record by the software. In case of a dispute, rectification of bills with errors or missing information and follow up on claims, the software will update the patient’s medical record and billing details with the revised information. 

Medical billing and coding software is thus equipped to seamlessly and accurately handle all complex processes and correspondence involved in medical billing.

A typical base package of medical billing software would contain features that are restricted to medical billing and accounting functions like patient recordkeeping, claims processing, electronic claims submission, receivables management, patient billing and accounting integration. However, many software providers extend their scope to include features like practice management, scheduling and other administrative and clinical functions that are generally a part of EMR software systems.

Therefore, the difference between medical billing software and an EMR is that of core functionality. While medical billing software focuses on a practice’s medical billing procedures and billing-related administrative and financial processes, features of an EMR are primarily concentrated on clinical functions, records and outcomes. 

Medical billing software may serve clinical EMR functions in addition to electronic billing and coding for greater versatility. The same is true for EMR systems that incorporate specialized medical billing and coding program features to supplement their clinical applications.

References:

1. http://www.wisegeek.com/topics/medical-billing-software.htm

2. http://www.wisegeek.com/what-is-medical-billing.htm

3. http://www.medical-billing.com/blog/medicalbilling/pid-303/list-of-best-medical-billing-software/

4. http://pn.psychiatryonline.org/content/43/8/6.3.full

5. http://technology4doctors.blogspot.com/2011/02/emrs-providing-indian-doctors-with-edge.html

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Cloud Computing in Healthcare

This article aims to discuss aspects of cloud computing that are relevant to the healthcare industry and can be applied by doctors to improve their practice.

What Should Doctors Know About Cloud Computing?

There is a sea of information available on the internet about cloud computing and how it works. As a doctor with limited interest in information technology, understanding all that jargon (most of which may not even be directly related to your work and computing requirements) can be quite intimidating and time consuming.

Simply put, the cloud is a set of hardware, networks, storage, services and interfaces that are equipped to provide computing power, infrastructure, applications, software, business processes and storage – in short, all your computing needs, as a service wherever and whenever you need it.

Migrating to the cloud 'can' help you reduce cost, space, time and power that would otherwise be utilized for traditional IT services performing the same functions. This is possible because the cloud puts together a large pool of computing resources available to be used as an assured service by anyone who wishes to use it, anywhere in the world. Traditional IT environments on the other hand, have a limited set of resources that are independently managed and delivered to a limited number of people confined to a certain geographic location, thus pushing cost, time, space and power factors.

Using Cloud Computing To Improve Your Practice

Cloud computing can transform the way healthcare is practiced by empowering professionals to deliver better care at lower costs. Cloud computing allows doctors, researchers and scientists across the globe to collaborate and form a centralized, integrated and regularly updated medical database that can be seamlessly accessed by healthcare professionals without having to invest in over-the-top infrastructure or software. Doctors can use the cloud for viewing reports, scans, EMRs, prescriptions and information required to solve complex medical problems anywhere in the world.

Patients’ health data and EMRs can be combined to form a single, comprehensive health record that can be instantly accessed from one single source. The cloud also brings together patient information like insurance claims, prescription and drug details, lab reports, patient history and progress in cases of chronic illnesses and other details and consolidates them to be available at the point of care whenever required.

This not only helps improve the level of accuracy with which care is delivered but also reduces the time and cost of treatment for physicians and patients alike. As all data is sourced from a single, homogenous center, it also brings down the possibility of conflicting treatments, prescriptions and medical data miscommunication in cases where multiple physicians and providers are involved.

Cloud computing is typically subscription based. In many cases, it works on a metered billing model of payment where you pay only for what you use. It also allows for flexible self-service by which you can enable and disable the provision of required services depending on your usage and needs.

Cloud computing users need not invest in heavy capital expenditure on hardware, software, and services. As resources can be unsubscribed whenever required, the risk of investment is considerably reduced. The cloud also addresses increased data storage needs of physicians without having them spend on expensive personal storage devices. Software updates and innovation are centrally managed by cloud service providers, helping doctors focus the best part of their day on patient care.

Cloud computing can thus help physicians meet meaningful use criteria as it demonstrates better quality of care, lower costs and higher insurance/government reimbursements.

Popular Cloud Services

Most of us have “been on the cloud” without even knowing about it (eg: Facebook is an example of a public cloud). Depending on the visibility of data there are three types of cloud platforms: Public, private and hybrid (a combination of public and private).

A more popular classification is based on the services offered:

1. Infrastructure as a service (IaaS) offers hardware related services like disk storage, database or virtual servers. Amazon Web Services (AWS),Rackspace Cloud Servers and Flexiscale are popular IaaS providers.

2. Platform as a Service (PaaS) offers development platforms. Google’s Application Engine, Microsofts Azure, Salesforce.com’s force.com are well-knows in this category.

3. Software as service (SaaS) involves software services on the cloud like web based software applications, email services and so on. Popular examples of SaaS services are Salesforce.com (CRM), Google’s Gmail, Google Apps, Dropbox, Zoho, QuickBooks, Piwik, Microsoft Hotmail and their online version of office called BPOS (Business Productivity Online Standard Suite).

A good read on top cloud platforms at http://www.liventerprise.com/news/3608/.

Cloud Security

Cloud security and data ownership is a major concern for users and new adopters of cloud computing. As there is very little regulation currently pertaining to cloud computing, there are many data privacy and security issues to be dealt with. New users must be informed about details on who owns the data, third parties that may gain access to the data and the jurisdiction of the contract. We will look at Cloud Security in detail via a separate article.

References:

1. http://ehealth.johnwsharp.com/2008/09/19/the-intelligent-cloud-implications-for-health-and-medicine/

2. http://thecloudtutorial.com/cloudtypes.html

3. http://lawandmedicine.wordpress.com/2010/07/03/cloud-computing-the-future/

4. http://www.wikinvest.com/concept/Cloud_Computing

5. http://www.goomedic.com/applying-cloud-computing-on-medicine-part-2.html

6. http://searchcloudcomputing.techtarget.com/definition/cloud-computing

7. http://www.infoworld.com/d/cloud-computing/what-cloud-computing-really-means-031

8. https://www.technologyreview.com/business/38473/page2/

9. http://www.ama-assn.org/amednews/2010/10/18/bisa1018.htm

10. http://www-03.ibm.com/press/us/en/pressrelease/32267.wss

11. http://socialmediatoday.com/garylevin/296483/why-cloud-computing-may-be-dead-healthcare-and-medicine

12. http://healthtrain.blogspot.com/2011/05/why-cloud-computing-may-be-dead-for.html

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How Does Email Help You As A Doctor?

Email or electronic mailing has revolutionized business communication. The incentivization of technology in the healthcare industry coupled with its growing inclination towards consumerism and strong patient-doctor relationships has made it necessary for doctors and healthcare professionals to utilize this channel of communication to improve the quality and reach of their practice. However, even though a majority of doctors do own personal email accounts, not many are comfortable using the email for regular, professional correspondence.

Why Should Doctors Use Email?

Doctors are busy people. Email is fast, easy to manage and allows for instant response. As emails can be read on PCs, tablets, smartphones and practically any device with web access in your clinic, home or while commuting, incorporating email communication in your daily practice will help you stay connected with patients and other healthcare professionals wherever you are. 

Email not only improves your accessibility (especially in situations where instant responses are needed for critical correspondence) but also helps you shorten your workday by eliminating those piled up stacks of paper mail that welcome you to your clinic every morning! 

Managing your email is very easy and most free email services are built on simple, user-friendly models. You can send, receive and store all your correspondence instantly, without having to use paper, fax machines or courier services. You can prioritize your mails and respond to them based on the immediacy required. You can use the email to schedule visits, send appointment reminders, prescription refills, lab reports, scans, pre and post surgery care instructions, medication advice and billing details to patients. You can network with media, other doctors and medical professionals in the industry. You can also use it to educate patients by sending useful links and important online study material that could help them understand and work on their condition better.

One of the biggest advantages of using the email is quick and organized storage of all your communication which may include records and other documentation. Your files, scanned paper work, pictures, reports, graphs, numbers and other medical data which have been sent or received via email can be saved and stored online. These files can be neatly organized under appropriate tags for quick and easy retrieval whenever you wish to view them. Adding to that, convenient email search options save you hours of otherwise looking through paper files to find that one elusive paper that just won’t show up!

Using the email to communicate with your patients has a number of advantages. However, you cannot aim to completely replace telephone calls, personal visits and other forms of patient communication with it. One cannot communicate critical medical data requiring the doctor’s personal presence and support using this rather impersonal communication device. Doctors must identify the correspondence that will show positively on productivity and patient satisfaction if exchanged over email and only model those functions and areas under its purview on a regular basis.

Popular Email Services

There are many popular free email services that will help you send, receive, store and manage your correspondence. Gmail, Yahoo, Windows Live and AOL are widely used web email services. MS Outlook or Zimbra can be used to configure your email on your computer and is also a popular choice. Another email service that specifically complies with HIPAA rules is MD email.net (Medical Email). It is a medical industry secure HIPAA email for medical professionals and has over 395,000 doctor-users spanning over 65 medical specialties.

How To Set Up An Email Account?

To set up an email account, key in the URL address of the provider of your choice, click on the usually prominent “Sign up” button, fill a form and you’re ready to get started.

For example, if you wish to set up an account with Gmail, 

1. Goto the URL http://www.gmail.com (You can click this link and it will take you there)

2. Click on “Create an account”

3. Fill in the registration form. 

Here is a video which shows you how.

What’s Keeping the Doctors Away?

The medical industry is historically known to be a conservative one characterized by sluggish and rather cynical adoption of technology. Studies indicate that while 90% patients would like their doctors to be accessible over email, doctors continue to elude this space.

One reason for doctors shying away from using the email could be that email correspondence is not reimbursed by insurance providers. Also, most doctors still prefer to operate under traditional models of communication simply because they have been using them for all these years and are too comfortable to venture out and try newer, faster and more productive ways of reaching out to their patients. 

Security and compliance issues are also responsible for doctors being weary about using email communication in their practice. Medical data is always sensitive and like any other form of communication, email too has its medical-legal implications. The AMA lays down guidelines for doctor-patient electronic communication that can be read at http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/advocacy-resources/guidelines-physician-patient-electronic-communications.page

Along with following these guidelines, doctors must ensure that they operate on a secure and reliable internet connection. Computers must be well-protected against spam, virus and other bugs. As a rule of thumb, unknown emails should not be opened. Your password must be unbreachable, kept confidential and regularly changed. Keeping these security guidelines in mind, doctors can safely utilize the benefits of email to improve the productivity and accessibility of their practice.

References:

1. http://www.msnbc.msn.com/id/24260074/ns/health-health_care/t/only-doctors-use-e-mail-patients/

2. http://digital-medicine.blogspot.com/2011/05/doctors-use-of-email-and-social-media.html

3. http://www.in-depthresearch.com/healthcare-it-market-research/why-doctors-dont-use-email/

4. http://mdemail.net/hipaa-medical-email-security/the-news/76-doctors-and-hospitals-use-md-email.html

5. http://www.jmir.org/2006/1/e2/

6. http://office.microsoft.com/en-gb/outlook-help/patients-doctors-and-e-mail-HA001046773.aspx

7. http://www.telegraph.co.uk/health/healthnews/8277674/Patients-could-contact-doctors-by-email.html

8. http://www.advantagesofemail.com/

9. http://www.in-depthresearch.com/healthcare-it-market-research/why-doctors-dont-use-email/

10. http://mdemail.net/hipaa-medical-email-security/the-news/76-doctors-and-hospitals-use-md-email.html

11. http://office.microsoft.com/en-gb/outlook-help/patients-doctors-and-e-mail-HA001046773.aspx

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Using Skype To Help Your Practice

What is Skype?

Skype is a software program that allows its users to make voice and video calls between computers (including tablets, smartphones with web access) and voice calls from computers to regular telephones that are not connected to the internet, anywhere in the world. Some of their services are free to use while some are available for a fee. 

What makes Skype such a valuable asset to medical practice is its videoconferencing tool. Gaining widespread adoption in the healthcare industry, this tool has the potential to transform the process and practice of medicine for physicians as well as patients.

Skype in Healthcare

 Practitioners have identified a number of functional areas where Skype can help improve the quality of care by raising the level of accessibility, reach and convenience for both patients and doctors.

While Skype calls and videoconferencing may not serve to replace personal visits and interactions, many physicians are turning to it for pre-appointment screening and post-appointment follow-ups and monitoring. Some doctors use Skype to effectively educate new patients prior to their first consultation to get them familiar and comfortable with typically intimidating medical environments. In remote areas with inadequate medical care facilities, Skype video calling allows patients to connect with their doctors and other medical providers for virtual consultations and evaluations, saving on a good amount of travel and other medical expenses. 

Skype is also gaining popularity in helping patients keep in touch with their loved ones in medical facilities like children’s hospitals (Skype works with UCSF Children’s Hospital and UCSF Medical Center), birthing suites and skilled nursing units.

One subspecialty that has greatly benefited from Skype’s video communication is Psychiatry. As America’s baby boomers age (over 50% of the 85+ age group deals with dementia), healthcare costs are positioned to rise. In such a situation, Skype offers an affordable and effective alternative for patients to interact with their doctors and be regularly monitored without having to spend time and money on travelling and office visits. It also enables doctors to access higher healthcare education via Skype-enabled virtual classrooms taught by global healthcare experts.

As Skype strengthens its focus on mobile users, medical professionals are presented with newer opportunities to leverage this trend for improving their practice as well as the relationship they share with their patients.

Getting Skype for your Practice

To make a Skype call, you will need the following:

- Desktop/Laptop/Tablet/Smartphone/Skype-enabled TV

- Internet access

- A microphone and headset

- Optional Web camera (even though most laptops have a built-in web cam, it is advisable that patients purchase a separate, detachable web cam that can be adjusted to focus on specific body parts that need virtual examination)

- Optional Skype Accessories like USB Phones, Bluetooth Headsets, Skype VoIP Adapters can also be used to enhance your Skype experience

Once, you have all the hardware and equipment in place, the next step is to download the program from their website. You can do so here: www.skype.com

After downloading Skype (ensure that you download the version that’s compatible with your particular device), you have to install it on your system. 

Both these steps are as easy as signing up for an email and are very well explained on their website. 

When you have finished the download and installation, you will log in with your Skype name and Password from your system.

On logging in, you will be able to add your patients to your list of Skype contacts (in case they have added you already, you may accept their request). You can make or receive voice and video calls to/from anyone in your contact list. 

If you still have doubts concerning the download and installation, this Slide Share presentation http://www.slideshare.net/hmartyn/skype-4069998 offers a simple Step-by-Step guide through the entire process.

Video Calling On Skype

You can use Skype to offer high quality virtual consultations, pre-appointment screenings, follow-ups and monitoring to your patients. However, for a clear, uninterrupted video call, you will need a fast internet connection, or in the case of smartphones, a mobile data plan or Wi-Fi. 

Watch this online tutorial to know exactly how you can make video calls using Skype: http://www.skype.com/intl/en/features/allfeatures/video-call/

Skype Features For Your Practice

- Platforms Supported by Skype

Skype is available on Windows, Mac, Linux, Android, iPhone, Symbian platforms. You can also make high quality video calls from Skype-enabled Panasonic, Samsung and Sony TVs as well as Blu-ray™ players from Panasonic and Sony.

- Free to Use Skype Services

Skype offers a number of services that you can use free of charge to connect with patients and other medical providers across the globe. Skype-to-Skype calls, One-to-one video calls, instant messaging and screen sharing are features that you can use for free. For practitioners using Skype for the first time, these features will more than serve your purpose, at least to begin with. Once you get comfortable using the software and are able to identify the features that will fulfill your specific communication needs, you can always upgrade to the paid and premium versions.

- Paid Features

Skype’s paid features include voice calls to regular phones and cell phones anywhere in the world at very low calling rates, SMS, call forwarding, voicemail, group video calling with three or more people in a single video call and live chat support. You can also get your own online Skype number for your patients to call and reach you wherever you are or you can sign up for a Skype To Go number to make low-cost international calls from your mobile or regular landline. These features are competitively priced, depending on the subscription package you opt for.

Skype Security for Healthcare – HIPAA Compliance

Despite Skype’s potential to combat rising healthcare costs, busy patient and physician schedules and healthcare accessibility issues, practitioners seem to be reluctant to adopt Skype in their practice due to the controversy surrounding its security and compliance protocols. 

However, Skype’s 256-bit-point-to-point encryption is in agreement with HIPAA’s privacy requirements. It is a secure videophone and any HIPAA requirements that apply to a regular telephone are applicable to Skype. Practitioners, however, must ensure that their systems are well-protected against spammers, bugs and malware as a precautionary and safety measure that holds not just for Skype but for any other web-related activity as well.

References:

1. http://thehealthcaremarketer.wordpress.com/2010/09/23/hospital-allow-skype-in-the-birthing-suite/

2. http://telementalhealth.com/blog/microsoft-buys-skype-what-does-mean-health-care-practitioners

3. https://www.aarpglobalnetwork.org/netzine/Industry%20News/SeniorLivingNews/Health%20and%20Beauty%20for%20seniors/Pages/Skypeprovidescommunicationandhealthservicesforelderly19897475.aspx

4. http://www.futuregov.asia/articles/2011/apr/01/skype-classroom/

5. http://theunquietlibrary.wordpress.com/2011/02/15/7th-period-healthcare-science-students-skype-with-er-physician-dr-jeff-weintraub/

6. http://www.fiercemobilehealthcare.com/story/work-needed-microsoft-skype-deal-fulfill-its-healthcare-potential/2011-05-17

7. http://www.guardian.co.uk/healthcare-network/2011/jul/26/berkshire-nhs-trust-skype

8. http://www.telecareaware.com/index.php/skypes-tiptoeing-around-healthcare-part-2.html

9. http://telehealth.net/blog/skype-security-hacking-into-voip/

10. http://imedexchange.com/2011/05/skype-for-healthcare

11. http://thehealthcaremarketer.wordpress.com/2010/10/04/skype-connects-new-parents-to-family-world-wide/

12. http://blogs.skype.com/enterprise/2009/05/doctors_using_skype_to_transform_medical_practice.html

13. http://www.slideshare.net/hmartyn/skype-4069998

14. http://mobihealthnews.com/8377/interview-skypes-mobile-health-interest/

15. http://www.slideshare.net/gkrahn/conference-calling

16. http://blog.soliant.com/healthcare-it/9-killer-apps-that-will-revolutionize-healthcare/

17. http://voiceontheweb.biz/2009/05/stealthing-skype-into-healthcare-consumer-experience-drives-practitioner-adoption/

18. http://www.ubuntudoctorsguild.org/public/index.php/Skype_for_Telemedicine

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