Category: SOS Blog

What happens to your digital life after your life?

Posted on | by SOS Blog | 2 Comments on What happens to your digital life after your life?

We have recently had a number of customers retire or sell their practices. While many other companies do not, we allow our customers to transfer their software to another individual or organization with our approval. In our last newsletter, we set out some requirements and procedures for folks to follow. We also reminded them that they are likely governed by state licensing laws about record keeping and record maintenance specific to behavioral health professionals. Those records belong to your patients, not to you as the provider, so some mechanism must be established for them to obtain the record if they want it.

But what about all your personal accounts and data? What should you do to make sure that the appropriate people have access to your information when you die or are no longer competent to or interested in dealing with everything you have done online? How will you assure that your family can access the hundreds of photos you have stored in the cloud? Do you know if you have a right to pass on your library of ebooks or your digital music collection?

A couple of weeks ago, I read some comments made by a colleague, Bruce G. Borkosky, Psy.D., about passing on digital account information when you die. He talked about the password management program that he uses (LastPass) and the way they are handling transfer of your passwords to a designated individual.

One of the best things you can do for your loved ones, after you pass, is to given them access to your accounts. With a password manager, this can be done pretty easily (doesn’t take care of things where the person needs legal access, of course, such as financial or health).
You could give them the master ps, of course. Better, though, I just discovered a feature in lastpass.com. It works like this:
1. loved one signs up for free lastpass.
2. you send them a one-time invite to be your emergency-handler
3. they accept.
4. you specify a waiting period (so you can decline a wrongful request)
then, in case of your illness or untimely death:
5.  they request access to your account
6. they wait the waiting period
7. your passwords show up on their account
Bruce G. Borkosky, Psy.D., P.A.
Sebring, FL

Blog author Angela Alcorn shares Dr. Borkosky’s enthusiasm about using LastPass for this purpose. There are other password management products (Roboform, Keepass, DashLane*) that are free or inexpensive. You could always just leave the master password to that manager you have chosen in your safe deposit box.

A quick Google search of ‘access to password accounts after death’ had over 42 million hits, so I guess some other people are thinking about this, too.

Recently, Apple refused to reset the device password for a widow who shared her iPad with her husband. She had the password to the app she used, but not the one to login to the device. They told her to get a court order. Estate planning attorney Jim Lamm (Minnesota, North Dakota and South Dakota) has created a digital audit that can be maintained on paper or in a document to provide your heirs with this important information. Lamm’s blog (Digitalpassing.com) focuses on this issue.

One of the biggest challenges is keeping the information current. Most of us are not privileged with the information about when we are going to die and there is a real tendency to put off attending to matters such as these. A password management program keeps itself updated.

This article on computerhope.com suggests a sealed envelope with all the necessary information…and an online password manager. But a company called PasswordBox.com and Legacy Locker have developed specific tools for this purpose. Google and the other services have their own mechanisms for handling the accounts of deceased users. Do you have any idea what those mechanisms are for the banks and other companies with whom you do business or for the email services you utilize?

I know that many people will look at this and think that it is just too morbid to consider. Others are planners and have their wills and personal instructions all in place. Where do you fit on the continuum from ‘have it all in place’ to ‘I won’t even think about this’? What do you want to happen to your digital life after your life?

Please share your thoughts and comments below.

*Neither SOS nor I have any proprietary or financial interest in any of these companies or products.

 

Stress in America: APA’s 2015 survey on the effects of discrimination

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Each year since 2007, the American Psychological Association (APA) has conducted a survey on stress in the U.S. The results of the 2015 survey were released in early 2016. In addition to results of the annual surveys, the association provides publicly available information and resources on stress as a general factor in our lives. This most recent survey focused on the impact of discrimination on stress in our lives. The press release gives a very good quick overview.

The amazing fact for me is that 7 in 10 adults report having experienced some form of discrimination, while 6 in 10 report experiencing discrimination on a day-to-day basis. 47% report experiencing serious discrimination, like unfair stops by police, negative behavior from new neighbors when relocating, being discouraged from continuing one’s education, or unfair treatment when receiving healthcare.
     American Psychological Association (2016). Stress in America: The impact of discrimination. Stress in America™ Survey

Modern life is challenging for most of us. Adding discrimination to the mix can make life extremely stressful and downright unhealthy. Please take a look at the highlights of the report when you get a chance. Behavioral health providers should certainly be well-informed about this important subject.

Feel free to share your comments below.

International Women’s Day 2016: #PledgeForParity

Posted on | by SOS Blog | 4 Comments on International Women’s Day 2016: #PledgeForParity

I do not usually celebrate or publicly mark obscure holidays observed in the U.S. and other countries. This one feels different.

As a lifelong feminist who has always been proud to use that word and to actively support the rights and development of women, I would share three links with you:

Google’s Doodle for the day; InternationalWomensDay.com theme for the year; and InternationalWomensDay.com action page.

Look at all of them and determine what you will do today to improve parity for women and girls.

Steps may be large or small, simple or complex, public or private. Please feel free to share this post as your action to take a step toward parity for women. Your wife, your sister, your daughter, your mother, your friend… will thank you.

And do enter your comments below.

ICD-10: What now?

Posted on | by SOS Blog | 3 Comments on ICD-10: What now?

Is it possible that we have actually been using ICD-10 for five (5) months? If you started using it on October 1, 2015, as required by the Centers for Medicaid and Medicare Services (CMS), then, yes, you have!

So what is the next step? What are the supposed benefits we were all going to get out of ICD-10? Are their places you are not yet using it most effectively? What should you do about them?

CMS has addressed some of these issues in its new Next Steps Toolkit.

  • Assess your ICD-10 progress using key performance indicators (kpi’s)
  • Address opportunities for improvement
  • Maintain your progress and keep up to date on ICD-10.

Let us know what you think of the Toolkit. Please share your comments below.

A Patient’s Right to Access Their Health Data

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The Office for Civil Rights (OCR) appears to be on an educational path, providing information to assure that Covered Entities (CEs) understand their responsibilities under HIPAA. One of their recent posts relates to the rights of individuals to access their health data.

We in the mental health world have been notoriously protective of patient/client records. There has sometimes been the belief that an individual directly accessing the record of their therapy or other treatment might be harmful.

I never really subscribed to that notion. Many years ago, I remember having an adolescent sit down at my computer to enter their own statement about what had happened in our treatment session that day.

General Right

The Privacy Rule generally requires HIPAA covered entities (health plans and most health care providers) to provide individuals, upon request, with access to the protected health information (PHI) about them in one or more “designated record sets” maintained by or for the covered entity.  This includes the right to inspect or obtain a copy, or both, of the PHI, as well as to direct the covered entity to transmit a copy to a designated person or entity of the individual’s choice.  Individuals have a right to access this PHI for as long as the information is maintained by a covered entity, or by a business associate on behalf of a covered entity, regardless of the date the information was created; whether the information is maintained in paper or electronic systems onsite, remotely, or is archived; or where the PHI originated (e.g., whether the covered entity, another provider, the patient, etc.).

There are two categories of data that are excluded from this general right.

  • Psychotherapy notes, which are the personal notes of a mental health care provider documenting or analyzing the contents of a counseling session, that are maintained separate from the rest of the patient’s medical record.  See 45 CFR 164.524(a)(1)(i) and 164.501.
  • Information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.  See 45 CFR 164.524(a)(1)(ii).

However, the underlying PHI from the individual’s medical or payment records or other records used to generate the above types of excluded records or information remains part of the designated record set and subject to access by the individual.

If you would like that your detailed psychotherapy notes . . . your personal notes about a session . . . are not releasable to the client, then you must maintain them separately from the rest of the patient’s record.

Some organizations prohibit maintaining separate notes considering them litigation waiting to happen. What is your organization’s stance on psychotherapy notes, whether and how to keep them?

Please enter your comments below.