What Uses of Health Data Does HIPAA Allow?

The Office of the National Coordinator (ONC) has begun a new weekly blog on permitted and appropriate uses of healthcare patient information. You might find it useful.

The first blog article is entitled The Real HIPAA Supports Interoperability. The series emphasizes that HIPAA not only protects personal health information from misuse, it also enables personal health information to be accessed, used or disclosed interoperably, when and where it is needed for patient care. A new blog will be posted every Thursday, with the final blog in the series released on February 25, 2016.

The fact sheets and blog posts detail specific common circumstances where health care providers or payers are permitted to share PHI without prior patient authorization, such as an inpatient facility to prospective long-term care facilities, or between unaffiliated hospitals in the same community who treat the same patient.

Download the fact sheets

Permitted Uses and Disclosures: Exchange for Health Care Operation [PDF – 1.3 MB]

Permitted Uses and Disclosures: Exchange for Treatment [PDF – 1.1 MB]

I hope you find this information useful. Thanks for reading.

February is Heart Health Month

This morning I opened the monthly newsletter from our long-time customers at Behavioral Health Institute in Coral Springs, FL. I was very impressed with Dr. Ellie Nelson-Wernick’s take on the importance of psychological factors in heart health. I asked if I could re-post her article so you too could benefit from her insights. She graciously acquiesced. Her article is below. I hope you will be motivated to assess your own efforts to care for your heart.

Why a Psychologist is Writing about 
Heart Health
By Ellie Nelson-Wernick, Ph. D.
 

Heart disease can cause serious illness and disability — And it is the No. 1 cause of death in the US for both men and women.

Psychology is the study of human behavior, and psychologists are trained to help individuals identify when change in behavior could be beneficial, and how to go about making changes for a healthier life.

Health Behavior matters. Most of us are aware that healthy lifestyle choices reduce the risk of developing illness, and that practicing positive health behaviors  such as these are vital to those with a diagnosis of heart disease:

  • Exercise for 30 minutes most days of the week.
  • Don’t smoke or use tobacco products and avoid second hand smoke.
  • Eat a diet low in fat, cholesterol and salt.
  • Maintain a healthy weight.
  • Get regular health screenings to detect early signs of hypertension, high cholesterol or diabetes, which are all risk factors for heart disease.
If you are not making conscious efforts to achieve these goals, I challenge you to ask yourself WHY NOT? And more importantly, if you want to have good health, what behaviors are you willing to start changing?
 

Here’s something you may not know — A growing body of research demonstrates that our THOUGHTS and EMOTIONS have as great an impact on our heart health as smoking, obesity and hypertension.

  • While some stress in our lives is inevitable, and can even serve as a motivator, chronic stress produces hormone levels that disrupt the body’s healthy functioning.
  • Prolonged pressure from work, financial problems, marital conflict, caretaking of a family member as well as other sources of stress have been correlated with the development of heart disease. 
  • Particularly at risk are those of us who respond to stress with anger and hostility. 
  • Depression, anxiety and lack of social support are additional factors contributing toward heart disease.

And are you aware — there is also strong evidence of a link between heart disease, open heart surgery and depression?

Over half of patients with a history of heart attack experience depression, and only 10% of these patients are identified.  Not only do these individuals suffer the effects of depression, but if it is left untreated there is increased risk for subsequent heart attack or stroke.

Estimates of patients who develop depression following coronary bypass surgery range from 30 – 50%. That’s a lot of people — and again, the diagnosis is often missed, along with the opportunity for treatment.

Here’s something else we need to change —
Cardiac rehabilitation programs are known to help patients live longer and have a better overall quality of life — physically, psychologically, and socially — and yet they are grossly underutilized. Only about half of patients who leave the hospital after heart attack or surgery are referred, and fewer than 20% of patients who are referred participate.

Health professionals need to educate themselves and their patients about the importance of Physical AND Behavioral health.

  • Simple screening measures can be used to identify individuals at risk.
  • Patients and their families need to be informed of the potential for depression following cardiac events and how to address it.
  • Referral to cardiac rehabilitation programs is the standard of care and patients should be strongly encouraged to participate. 
It can be difficult making healthy behavior changes and managing our emotions adaptively. Meeting with a psychologist, who can work in collaboration with you and your physician, will help you learn ways to live a healthier life.
 
References:

Depression After A Cardiac Event or Diagnosis
http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Depression-and-Heart-Health_UCM_440444_Article.jsp#.VqpnovkrLIU

Depression, anxiety, and cardiac morbidity outcomes after coronary artery bypass surgery: a contemporary and practical review
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418911/

Cardiac rehabilitation past, present and future: an overview

Starting the new year

This is not the way I planned to start the new year.  On Christmas Eve, I fell off my bike. For the first few days, I behaved as if I had sprained my wrist.  On December 30, I decided I should have it x-rayed.

Needless to say, I was not pleased to learn that the wrist is broken. While it is a hairline fracture of the radius just above the wrist, it still must be immobilized and protected from further injury.

Until I get the hang of dictating to the computer, things are taking me three times as long as previously. Because of that, I will not be writing a blog post for a while. I hope to have my skill as a one-handed left-hander increase rapidly so that I can get back to regular posting!

Thanks for reading.  Happy 2016!

Incorporating Behavioral Health Data into Primary Care Records

Have you as a behavioral health provider begun to wonder how behavioral healthcare data is going to be incorporated into general health records?

Well, the Office of the National Coordinator (ONC) is working on that issue and would like you and anyone else who is interested to attend a webinar on the subject.

Webinar: Integrating Behavioral Health Data into HIEs

Join ONC and the Substance Abuse and Mental Health Services Administration for a free webinar about the benefits of integrating behavioral health data into Health Information Exchanges (HIEs). The webinar begins Wednesday, Dec. 16 and focuses on how these data are being integrated into primary care systems in a way that ensures the privacy and confidentiality of this sensitive information. You can sign up for the webinar, which will run from 1:00 p.m. – 2:00 p.m. (EST), here: http://bit.ly/1ReJpoh

This is certainly a sensitive issue that requires careful thought and the right technology before it can work well. I will look forward to some discussion on this topic after the webinar. Let me know if you attend.

Please share your comments below.

ICD-10 Use Moves Smoothly

In spite of all the hoopla and angst about implementation of the ICD-10 among providers of every stripe during the past year, things among our customers and most behavioral health providers appear to have gone pretty smoothly. The Centers for Medicare and Medicaid Services (CMS) say the same thing. According a report by HIMSS Electronic Health Record Association (EHRA), there have been isolated problems processing ICD-10 codes for certain National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), but so far, most of the process has been smooth. CMS made some clarifications about these NCDs and LCDs and the actions they are taking to correct matters.

The CMS/ICD-10 site continues to have significant resources to assist providers in coding and filing accurately. A CMS infographic walks one through the process of dealing with ICD-10. Make sure you have resources handy in case you need them. You can get to the general ICD-10 page with many links by clicking here. You will find Frequently Asked Questions (FAQs) and the ICD-10 Ombudsman just a click away.

Getting this job done has been a major learning process for all. In the next few years, as more detailed data about diagnoses and treatments becomes available, we will all likely be glad that we went through the effort!

Please comment below about your experience with the ICD-10 transition.