Doctor's Life Magazine, Tampa Bay Vol.2 Issue 3, 2014

DOCTOR’SLife www.doctorslifetampabay.com

MAGAZINE

Business Lifestyles and Opportunities Vol. 2, Issue 3, 2014 Tampa Bay Edition

ARE YOU IN

COMPLIANCE WITH

HIPAA?

THE FUTURE OF THE PHYSICIAN WORKFLOW:

GOOGLE

GLASS Issue 3, 2014

Doctor’s Life Tampa Bay

What’s Inside From the Publisher Change is Constant

Page 4

Physician Spotlight Dr. Kathleen P. Soe

Google Glass Revolutionizing Page 10 Healthcare

Page 6

The Legal Corner

HIPAA: Are You in Compliance? Page 16

The Doctor Whisperer: The Importance of PR

Page 20

Advertisers American Heart Association

BioSpine Institute

Ciminelli Real Estate Services

Gunster 7 KB Healthcare Consultants The Meridian Club Moffitt Cancer Center

SAFER Guides for EHR

Page 14

10 Tips That May Bring More Patients

Page 22

Doctor’s Life Tampa Bay

Old Bahama Bay

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PNC Bank

Rita Shepard

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From the Publisher

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hange is a fact of life. Whether you embrace change or avoid it, it will never stop happening. If someone told me 20 years ago that in the near future there would be technology that would allow a pair glasses to act as a computer, I would have never believed them. Wearable devices like Google’s GLASS are the way of the future. This technology is a wearable computer with an optical head-mounted display (OHMD). It was developed by Google with the mission of producing a mass-market ubiquitous computer. The key will be how we interact with this technology when these features are available in our peripheral vision. How can this type of technology benefit your practice? Are there any risks? Doctors right now who participated in the Google Glass Explorer program are leading the way and demonstrating all the possibilities. In this issue we talk about how GLASS is being used in healthcare and its benefits. There are some privacy concerns, but they look to be easily managed. Kathleen Hargreaves, CPA with Kerkering, Barberio & Co. leads the firm’s Healthcare Advisory Services practice. Kathleen and her team provide best practice service solutions to healthcare industry organizations including all physician specialties, laboratories, hospitals and ambulatory surgery centers. In this issue she provided 10 easy expense-cutting strategies that can boost your profits. The Legal Corner lays out the information you need to know to be in compliance with HIPAA and The Doctor Whisperer explains the importance of good public relations. I sat down with Dr. Kathleen Soe and discussed electronic health records for the Physician Spotlight. Dr. Soe detailed how the technology benefits her practice. We welcome Dr. David B. Troxel, MD, Medical Director for The Doctors Company. Dr. Troxel’s article talks about a comprehensive suite of tools developed to assist healthcare institutions, medical groups, and physician offices with EHR implementation. Thank you to all our contributing writers and advertising partners. As always, I hope you enjoy this issue of DLM and look forward to your comments. I and the entire DLM team wish you a great summer. Be Well,

-Edd

MAGAZINE

Business Lifestyles and Opportunities Vol. 2, Issue 3, 2014 Tampa Bay Edition

ARE YOU IN

COMPLIANCE WITH

HIPAA?

THE FUTURE OF THE PHYSICIAN WORKFLOW:

GOOGLE

GL ASS Issue 3, 2014

Doctor’s Life Tampa Bay

TAMPA BAY

™

Tampa Headquarters 1208 East Kennedy Blvd. #1029 Tampa Fl, 33602 813-444-9204 Group Publisher Edd Suyak publisher@doctorslifetampabay.com Creative Director Bryan Clapper Editorial Director Edd Suyak Assistant Editorial Director Danielle Topper Advertising Account Executive CJ Cooper Contributing Writers Kathleen Hargreaves, CPA Sharon Fekete Paula Bentley David B. Troxel, MD Doctor’s Life Magazine, Tampa Bay is always seeking events, stories and remarkable physicians. Please email the publisher if you have an event, an editorial idea or you know of a doctor or dentist who may have done something extraordinary. We want your suggestions and feedback. publisher@doctorslifetampabay.com

Edd Suyak Group Publisher publisher@doctorslifetampabay.com

DOCTOR’SLife

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Doctor’s Life Magazine, Tampa Bay does not assume responsibility for the advertisements, nor any representation made therein, nor the quality or deliverability of the products themselves. Reproduction of articles and photographs, in whole or in part, contained herein is prohibited without expressed written consent of the publisher, with the exception of reprinting for news media use. Printed in the United States of America.

Doctor’s Life Tampa Bay

Issue 3, 2014

Whatâ&#x20AC;&#x2122;s Next... The healthcare industry is continually responding to regulatory changes, technological advances and economic pressures. Our Healthcare Consultants can keep you ahead of the curve.

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Physician Spotlight

Dr. Kathleen P. Soe How long have you lived in the Tampa Bay area? I have lived in the Tampa Bay Area for the past 36 years, raised in Largo Florida. What is your favorite Tampa Bay restaurant? My favorite restaurant is Cafe Milano in downtown Clearwater. Where is your favorite place in Tampa Bay to relax? My favorite place to relax is riding my bike with my family on any part of the Pinellas Trail. What is your favorite event to attend to in Tampa Bay? My favorite event is the Dunedin Fine Art Show. How important is it today for physicians to be involved with their community and how important is it to you personally? I think a physician is missing the mark if they are not involved with their community. My practice spends a significant amount of time volunteering and participating in local events. This year we became the title sponsor for the Kiwanis Virginia Street Dermatology Midnight Run on July 4 here in Dunedin. What year did your practice implement Electronic Health Records (EHR)and what was the deciding factor of your choice? My practice implemented EHR at its inception in 2004. I knew this was the future of medicine and the world as we know it. I chose to work with a company called Misys because it was a seasoned EHR company with a good track record. Years later they were purchased by Allscripts and I have been with them ever since. Electronic Health Records has proven to be a huge asset. In your opinion how has EHR technology benefited your practice and have there been any setbacks? EHR ensures that patient charts are accessible both in the office, to the physician on call elsewhere and to the patient through a secured network. It also assists in consistent documentation and accuracy of patients records. With new technology comes new liability. Due to widespread implementation of EHR comes potential data breach violations, obligations to use EHR, and obligations to know the entirety of an exponentially increased volume of data included in the electronic chart. How has your practice protected such risk and managed new obligations? My practice elected to have Allscripts host our EHR. This essentially eliminates security issues from my end. Patients may access their records through a secure portal. A hosted system also simplifies updates. As we know, technology evolvesâ&#x20AC;Ś not just evolves, it rapidly changes. EHR has proven to be no different in regard to changes. Has it been a consistent learning curve for your staff and yourself to keep up with the changes and if so how have you overcome such challenges? As I said, it takes constant training to keep staff up to date and on the same page. This means hiring bright and computer literate staff from the start. We train and educate the staff daily, biweekly at staff meetings and typically hold weekend long sessions on a quarterly basis. During that time we overhaul our templates for better documentation, accuracy and to comply with government requirements. 6

Kathleen P. Soe, D.O., a dermatologic surgeon and board certified dermatologist, established Virginia Street Dermatology in 2004. Dr. Soe is a graduate of Nova Southeastern University College of Osteopathic Medicine. Her internship and residency were completed at Sun Coast Hospital. She received her undergraduate degree in Chemistry from the University of South Florida. She is affiliated with Mease Dunedin, Mease Countryside and Helen Ellis Hospital. With the usage of EHR and laptops in the examination room it raises the question of physician etiquette and how to maintain the personal attention during a patient visit. What measures do you use to implement technology while maintaining personal attention with your patients? Physician etiquette and maintaining personal attention with the patient is the MOST IMPORTANT practice to master. How do we combine technology in our practices without taking away from our patients? I elected to use computers in every exam room. My MA sits at the computer while I give my patient 100% of my attention. As I speak to my patient outlining their treatment plan, my MA acts as a scribe and prepares prescriptions, education materials and documents the visit. My eyes and ears never leave the patient which makes for very happy patients. Overall, how do view EHR and healthcare technology as a whole, more of an asset or burden and why? EHR and healthcare technology is for the most part neither an asset nor a burden. It simply is the way it is. The more people stop complaining about it and move forward with the world we live in, the better off we will all be. This will become an absolute non-issue as the next generation comes along. They donâ&#x20AC;&#x2122;t know it any other way. Realize I mean for the healthcare industry and the patients.

Doctorâ&#x20AC;&#x2122;s Life Tampa Bay

Issue 3, 2014

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Give Profitability a

Shot in the Arm

PHYSICIANS’ TOP 10 GUIDE TO STRATEGIC SPENDING

By Kathleen A. Hargreaves CPA Kerkering Barberio

eeling from painful efforts at legislative overhaul and still awaiting answers on Medicare reimbursements, many physicians are experiencing a healthcare-sized headache these days.

As these matters play out on the national stage, doctors are also worried about the health of their own practices. It’s a justifiable concern, and, unlike healthcare policy, it’s an area where you can actually make a difference. I’ve developed a top 10 list of expense-cutting strategies that can help boost the profitability of your practice regardless of decisions (or the lack of them) in Washington. 1. Don’t leave Medicare money on the table. A good example is Medicare’s Physician Quality Reporting System (PQRS), which offers financial incentives for reporting quality measures under the Physician Fee Schedule. 2014 is the last year that there will be a bonus for participating in this government program. 2014 is also the last year to initiate participation in the EHR Meaningful User bonus program. Providers can still qualify for $24,000.00 for successfully participating as an EHR Meaningful User. Make sure that you are proactive in reviewing your EHR documentation. “Cloned or Templated” EHR documentation is on the 2014 OIG Work Plan. Audits can be quite costly financially as well as consuming valuable staff time. Consider hiring a consultant to review your documentation and coding practices. 2. Understand your expenses. A good manager is intimate with overhead and understands each component as a percentage of collections or revenue. Make sure your financial statements are structured in order to readily reveal your non-physician overhead or other practice expenses. 3. Get a grip on salaries. Staff salaries make up the largest single expense category in any service business. Consider these steps to boost productivity and prevent waste. • Make sure your staff is properly using technology you’ve acquired, and make sure they’re leveraging the features and benefits of your practice management system. Invest in training and cross-training to ensure more capable, productive employees. • Seek out efficiencies and new ways of working. Don’t get trapped in the potentially costly “we’ve-always-done-it-this-way” mentality. 8

• Find the right person for the job and offer competitive pay and benefits. Sure, the dollars are important, but for many employees, intangibles like a family-friendly workplace matter just as much. • Implement seasonal hiring if appropriate to cut down on overtime and prevent burnout during your busiest periods. Also consider asking staff to take non-paid/voluntary leave during your slow period. You may be surprised at the response; many working parents and older employees are eager for time off. 4. Survey your space. After personnel, occupancy is likely your biggest expense. Take the time to closely review your lease. In many parts of the country commercial rents are at their lowest point in years. Consider re-negotiating your lease with more favorable terms and updating your current office. A professional space planner can help determine if it’s being used to maximum benefit in terms of productivity and patient appeal. For example, some practices are eliminating individual physician offices to create more comfortable exam and waiting space. 5. Pull out those equipment leases. Do you know the buy-out date for your leased equipment? The vendor may not inform you, which means you may continue to be charged the monthly lease rate until you exercise the buy-out option. Also be cautious about pouring money into costly durable devices unless you are relatively certain of the return-on-investment. Track referrals, survey patients and learn all you can before you buy. 6. Review warranties and maintenance agreements. Trimming expenses in this area is a function of committing the time to review existing agreements with an eye to cost vs. value. 7. Audit your insurance policies. When’s the last time you or your business manager comprehensively reviewed your insurance polices? At Kerkering Barberio we brought

Doctor’s Life Tampa Bay

Issue 3, 2014

in a consultant to review our health insurance approach and expenditures. It was a valuable step that saved us thousands of dollars. 8. Review bank fees and services. Here, too, a few hours with a consultant could potentially save you quite a bit. Many services that were once fee-based are now free, and you may not be taking advantage of these. Our firm has saved considerably with on-line bill paying for clients and direct-deposit of paychecks. Ask your banker about services like remote capture and get a second opinion about credit card and swipe fees. 9. Pay with plastic. I recommend establishing a dedicated business (not personal) credit card for practice-related expenses in order to take advantage of cash back and air miles. 10. Tackle taxes. Talk with your accountant to be sure youâ&#x20AC;&#x2122;re benefiting from new tax law changes and make sure that you are not inadvertently doing things incorrectly. This year employers may want to focus on incentives like the Small Business Health Care Tax Credit as well as penalties arising from the Affordable Care Act.

IT ALL ADDS UP

For the average medical practice, every dollar of additional revenues yields about 50 cents, a margin not possible by cutting expenses. But I believe you will be pleasantly surprised at the increased profitability that is possible by strategically reviewing and reducing expenses.

For the average medical pracitce, every dollar of additional revenues yields about 50 cents, a margin not possible by cutting expenses. But I believe you will be pleasantly surprised at the increased profitability that is possible by strategically reviewing and reducing expenses.

Kathleen Hargreaves joined Kerkering Barberio in 1992 and was admitted as shareholder in 1997. She leads the firmâ&#x20AC;&#x2122;s Healthcare Advisory Services practice and specializes in individual and business tax consulting. Kathleen and her team provide best practice service solutions to healthcare industry organizations, including all physician specialties, laboratories, hospitals and ambulatory surgery centers.

Medical Office Space Available - June 2014.pdf 1 6/10/2014 2:38:56 PM

R EA L ES TAT E SERVI C ES

GOOGLE GLASS

Revolutionizing Healthcare G

oogle Glass: is it a new concept or is it just an improved concept of technology? The majority of the technology incorporated into Google Glass (Wi-Fi, Bluetooth, cameras, voice activation, etc.) is already currently available on our smartphones. Google Glass is a wearable computer with an optical head-mounted display (OHMD). It was developed by Google with the mission of producing a mass-market ubiquitous computer. The key difference will be how we interact with this technology when these features are available in our peripheral vision. It has proven great for entertainment, but where it shows the most promise is in the select few medical professionals that have been part of the Google Glass Explorer program. Doctors from all over participated to research the benefits the product may hold for medical professionals and patients. With each day that passes, we are reading about more benefits and uses where this technology will have or is having an impact within the medical field. Even though it has shown to be an asset for the medical community, there are some obvious concerns when it comes to security and possibly being viewed as a distraction. However, here are a few of the areas Google Glass is demonstrating to be a helpful tool with healthcare. 10

Doctorâ&#x20AC;&#x2122;s Life Tampa Bay

Issue 3, 2014

Physicians participating with the Google Glass Explorer edition agree it is a huge benefit when it comes to data access. Google Glass provides doctors the ability to walk in an exam room to see your patient and have instant access with up-to-date data about that patient automatically displayed in the corner of your eye. Some of the most highly publicized use of Google Glass in healthcare so far has involved surgical procedures. Phillips and Accenture Technology Lab have teamed up to help surgeons view patients’ vital statistics, such as heart rate, oxygen levels and blood pressure on the Google Glass display. The hands-free voice activated system eliminates the need during surgical procedures to turn around to check a computer monitor. Pristine is one of the tech companies at the forefront of developing Glass apps for surgeons, nurses and anesthesiologists. They are designing apps for the before use, during and after surgery. Kyle Samani, CEO of Pristine has been quoted saying, “If you’re running around all day, using your hands, and you need to access and share information, Glass is going to change how you do your job.” The ability to access patient data from an EHR (electronic health record) is useful for any healthcare professional, not just surgeons. Google Glass could also take care of the issue that some doctors have with laptops and tablets in the exam room. Instead of turning to a computer to look up information, the information will be available instantly with never having to look away from your patient. Most say that this alone will help strengthen patient-physician relationships. Dr. Pierre Theodore, a cardiothoracic surgeon at the University of California, San Francisco, calls wearable computers “a game changer.” “In surgery, Google Glass is incredibly illuminating,” said Dr. Theodore, who uses Glass to float X-rays and CT scans in his field of view at the operating table. “It helps you pinpoint what you’re looking for, so you don’t have to shift your attention away from the operation to look at a monitor somewhere else.” Issue 3, 2014

HANDS FREE TECHNOLOGY MEANS HANDS CLEAN TECHNOLOGY

Wearable technology such as Google Glass reduces the need for healthcare professionals to touch devices before, during or after being with a patient. Studies have shown that keyboards, smart phones and other electronic devices used on a regular basis are usually breeding grounds for harmful bacteria. Google Glass may even be able to work with Microsoft Kinect technology, which will allow surgeons and other healthcare professionals to select and modify data on a screen with movement sensors, i.e. by the waving of a hand in front of the monitor.

EMERGENCY SITUATIONS

Dr. Steve Horng, a dual-certified doctor in emergency medicine and clinical informatics from Beth Israel Deaconess Medical Center in Boston, was recently interviewed about an emergency situation that he believes the wearable technology saved a man’s life. A patient came in the ER with severe brain bleeding. Dr. Horng had little time to react and needed to make life-saving decisions. Google Glass provided him instant access to the patient’s data, he was able to scan through the patient’s file, see his history and realize that he needed to change the patient’s course of treatment. This allowed for Dr. Horng

Doctor’s Life Tampa Bay

to make a critical decision without having to leave the patient, which resulted in a life saved. When it comes to time in an emergency situation, saving time can become the difference in saving a life or not. Google Glass gives the ability to have access to a patient’s record and history instantly. Google Glass can be an important tool in emergency situations with first responders. The glass could be sending real time information to the hospital as it happens. This type of real time data could assist the hospital in being prepared for incoming emergency patients. It could also help the first responder in critical decision making or possible instructions for emergency lifesaving procedures that can’t wait until they reach the hospital.

EDUCATION AND THE REAL-TIME APPLICATION

Trauma surgeon and early-adopter of Google Glass, Dr. Rafael Grossmann, has stated in interviews that he believes Google Glass could revolutionize the healthcare industry in a number of ways relating to teaching and consultation. “This device and its platform are certainly intuitive tools that have great potential in healthcare, and specifically for surgery, could allow better intra-operative consultations, surgical mentoring and potentiate remote medical education, in a very simple way.” By live-streaming an operation to Google Hangout as Grossman has done, students can have a much better insight into the challenges involved during each procedure and may feel more prepared for the next stage of development in the medical profession. On the issue of privacy, Dr. Grossman was able to work around the issue by obtaining proper consent before the operation, and ensuring that no personal information was revealed during the recording.

THE REDUCTION OF ERRORS

Alerts and reminders could be displayed in Google Glass for health workers with hectic schedules and an overwhelming number of patients to care for. When administering prescriptions, a pharmacist or nurse could use Google Glass to automatically scan the barcode 12

for the medication and compare it with the patient’s health record and display proper dosage amounts. A Google Glass app could instantly alert the health worker if any mistakes have been made or changes to the patient’s record. There are medical Glass app companies developing safety checklists that can be used in wide variety of situations across the medical field. Google Glass app makers are developing similar health and fitness apps that we have on our smart phones but smarter. Glass wearers can display a Yoga class video for example; helpful when performing stretches that requires the user to take their eyes off a screen. Glass wearers may also want to scan barcodes in supermarkets to display nutritional value and make better food buying decisions. The health and fitness self-tracking apps are already some of the most popular on the market today, it’s likely that Glassware will change the way we approach our health and fitness once again. Getting fit with Glass has an augmented reality app in development, called Race Yourself. This app lets users run against themselves and beat personal fitness goals. This is just one of the many on the horizon. The one thing for sure about wearable technology, it is here to stay and is only going to become bigger and better with time. There are concerns and there should be. The same concerns when computers were first introduced. Doctor’s Like Dr. Matthew Katz, medical director of radiation oncology at Lowell General Hospital in Massachusetts, is not alone, where he feels that the security and distractions are a primary concern. A doctor wearing Glass could accidentally stream confidential medical information online or it might make patient feel uncomfortable with their doctors wearing cameras in their faces. Many doctors think the technology shows huge potential for the future but still believe until it has been better studied in health care and equipped with proven safeguards against potential data breaches, it should remain as a research tool. Whether you’re a fan of Google Glass technology or not it looks to be the way of the future. As a society in modern day, we seem to not only embrace technology that creates easy accessibility, we can’t live without it.

Doctor’s Life Tampa Bay

Issue 3, 2014

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SAFER Guides for

Electronic Health Record

Implementation and Use P

By David B. Troxel, MD Medical Director The Doctors Company

roblems with electronic health record (EHR) implementation and use are common. Examples include the following: • Unwillingness by vendors to modify their systems to meet the complex workflows of the real-world practice setting. • Failure to use a team approach involving physicians and other healthcare professionals in leadership positions to ensure that their clinical concerns are met. • Not adequately addressing known problems with EHR use, e.g., “alert fatigue” as a result of too many alerts, problems locating where lab and x-ray results are filed (or misfiled), difficulty correcting progress note entry errors, and unnecessary operational complexity. The Office of the National Coordinator for Health Information Technology recently released the Safety Assurance Factors for EHR Resilience (SAFER) Guides. They are a practical, useful, and comprehensive suite of tools developed to assist healthcare institutions, medical groups, and physician offices with EHR implementation. I recommend that all physicians, medical groups, and healthcare institutions that are considering implementation or replacement of an EHR visit the SAFER Guides website and spend an hour becoming familiar with those guides that address the areas of greatest interest or concern. The free guides—which can be downloaded as PDF files or used online—provide a well-organized work plan for tackling the organizational complexities of EHR implementation and use. In order to ensure that clinically important considerations are addressed, the guides apply a structured team approach involving everyone whose professional life will be permanently affected by the EHR. The SAFER Guides are designed to help healthcare organizations conduct self-assessments to optimize the safe use of electronic health records in nine areas. The last three in the following list are of particular importance to physicians: • High Priority Practices • Organizational Responsibilities 14

• • • • • • •

Contingency Planning System Configuration System Interfaces Patient Identification Computerized Provider Order Entry with Decision Support Test Results Reporting and Follow-Up Clinician Communication

Each of the nine SAFER Guides begins with a Checklist of recommended practices that indicates the extent to which each recommended practice has or has not been implemented. Links embedded in each Checklist open the corresponding practice Worksheet that gives the rationale for each recommended practice, examples of how to implement each practice, likely sources of input into the assessment of each practice, and fields to record team members and follow-up actions. You can download the content of each guide (with all of its interactive references and supporting materials) as individual PDFs or download all of the guides in a single zip file by going to http:// www.healthit.gov/safer/. The guides are based on a literature review,

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expert opinion, and field testing at a wide range of healthcare organizations—from small ambulatory practices to large health systems. The recommended practices are intended to be useful for all EHR users. However, every organization is unique and will implement a particular practice differently. As a result, some of the recommended practices may not be applicable to every organization. The SAFER Guides are designed to help deal with safety concerns created by the continuously changing land-scape that healthcare organizations face. When using the guides, changes in technology, clinical practice standards, Meaningful Use, and/or HIPAA Security Rule requirements should be taken into account. Because the guides are designed to help organizations prioritize EHR-related safety concerns, clinician leadership in the organization should be engaged to assess whether and how any recommended practice affects the organization’s ability to deliver safe, high-quality care. To optimize EHR-related safety and quality, collaboration between clinicians and staff should lead to a consensus about the organization’s future path. The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. Reprinted with permission. ©2014 The Doctors Company (www. thedoctors.com). Issue 3, 2014

The SAFER Self-Assessment Guides were developed by the following team of health IT safety researchers and informatics experts: Joan Ash, PhD MLS, MS, MBA, Professor and Vice Chair, Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University. Hardeep Singh, MD, MPH, Associate Professor of Medicine at the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine and Chief of the Health Policy, Quality and Informatics Program at the Houston VA HSR&D Center of Excellence, and Director of the Houston VA Patient Safety Center of Inquiry. Dean Sittig, PhD, University of Texas School of Biomedical Informatics at Houston, UT-Memorial Hermann Center for Healthcare Quality & Safety.

Doctor’s Life Tampa Bay

The Legal Corner

The Security Risk Assessment Requirement of HIPAA:

Are You in Compliance? By Paula Bentley Attorney and Licensed Health Care Risk Manager Gunster

n an effort to protect the privacy and security of individualsâ&#x20AC;&#x2122; health information in the face of increased availability and use of electronic health care information systems, the U.S. Department of Health and Human Services (HHS) has published what are commonly known as the HIPAA Privacy Rule and the HIPAA Security Rule. The Security Standards for the Protection of Electronic Protected Health Information, or the Security Rule, establishes a set of national security standards for protecting individually identifiable health information that is created, received, maintained, or transmitted in electronic form (e-PHI). The Security Rule applies to health plans, health care clearinghouses, and any health care providers who transmit e-PHI in connection with the provision of or payment for health care (covered organizations). to:

Specifically, the Security Rule requires covered organizations

1. Ensure the confidentiality, integrity, and availability of all e-PHI they create, receive, maintain, or transmit; 2. Identify and protect against reasonably anticipated threats to 16

the security or integrity of the information; 3. Protect against reasonably anticipated, impermissible uses or disclosures; and 4. Ensure compliance by their employees.

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Continued from Page 16

HHS designed the Security Rule to be flexible so that an organization can implement policies, procedures, and technologies that are appropriate for their specific environments. The Rule does not dictate what security measures must be implemented, but it does establish numerous security “standards” that must be achieved by a covered organization. One such standard is the Security Management Process, which requires an organization to “[i]mplement policies and procedures to prevent, detect, contain, and correct security violations.” A security risk assessment (SRA) is the first of four required specifications that must be addressed as part of the Security Management Process. Not only is an SRA a key requirement of the Security Rule, it is also a core requirement for providers seeking payment through the Medicare and Medicaid EHR Incentive Program, commonly known as the Meaningful Use Program. The SRA requirement directs covered organizations to: “Conduct an accurate and thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of [e-PHI] held by the covered entity.” Regardless of the methodology used, the organization must document the following information as part of its SRA: 1. Identification of where the organization’s e-PHI is stored, received, maintained or transmitted. All forms of electronic media must be included, such as hard drives, floppy discs, CDs, DVDs, smart cards or other storage devices, transmission media, or portable electronic media. 2. Identification of reasonably anticipated threats to an organization’s e-PHI. This information would include identified vulnerabilities in the organization’s systems which, if triggered or exploited by a threat, would create a risk of inappropriate access or disclosure of e-PHI. 3. Assessment of the security measures the organization uses to safeguard e-PHI, whether security measures required by the Security Rule are already in place, and if current security measures are configured and used properly. Small organizations such as private physician practices will likely have more control within their environment and fewer variables to consider when making decisions regarding how to protect e-PHI. 4. Identification of all threat and vulnerability combinations with associated estimates regarding the likelihood of occurrence. The results of this assessment, combined with the organization’s initial list of threats, will influence the determination of which threats are required under the Security Rule to be protected against because they are “reasonably anticipated.” 5. Assessment of the magnitude of all potential impacts resulting from the occurrence of identified risks that threaten the confidentiality, integrity, and availability of e-PHI. The organization may use either a qualitative or quantitative method, or a combination of the two, to measure the impact on the organization. 6. Assignment of risk levels for all threat and vulnerability combinations identified by the organization. The risk level determination could be performed by assigning a risk level based on the average of the assigned likelihood and impact levels. This step should document the assigned risk level as well as a list of corrective actions to be performed to mitigate each risk level. The SRA should be an ongoing process, as the Security 18

Rule requires an organization to update its documented security measures “as needed, in response to environmental or operational changes affecting the security of the [e-PHI].” The Rule does not specify how frequently an organization should perform a risk assessment, as the appropriate frequency will necessarily vary based on the characteristics of an organization’s environment. Organizations are required to keep documentation related to their SRA for six years from the date of its creation or the date it was last in effect, whichever is later. Although performance of an SRA has been a long-standing requirement of HIPAA, many organizations remain non-compliant. The U.S. Office for Civil Rights (OCR), which is charged with enforcing the Security Rule through investigation of complaints and performance of organizational audits, recently reported that private physician practices have been the most common entities to require corrective action to achieve compliance with the Security Rule.

The SRA should be an ongoing process, as the Security Rule requires an organization to update its documented security measures “as needed, in response to environmental or operational changes affecting the security of the [e-PHI].” The Rule does not specify how frequently an organization should perform a risk assessment, as the appropriate frequency will necessarily vary based on the characteristics of an organization’s environment. Performing a risk assessment can be an intimidating undertaking, but there is a wealth of resources available to guide an organization in its efforts to meet the requirements of the Security Rule. The HHS recently released a free security risk assessment tool to help health care providers in small to medium sized offices conduct and document a risk assessment in a thorough and organized fashion. The tool includes helpful features such as context sections to help users understand potential threats, vulnerabilities and impacts; examples of safeguards that could be instituted; glossary of terms; and color report charts showing your organization’s risk levels based on the questions answered. The SRA tool also produces a report that can be provided to auditors. This user-friendly application, which includes a user guide and video tutorial, can be down-loaded at www.HealthIT.gov/securityrisk-assessment.

Doctor’s Life Tampa Bay

Issue 3, 2014

THE IMPORTA PR FOR PHYSI By Sharon Fekete The Doctor Whisperer www.thedoctorwhisperer.com

completely understand how busy you are doctor and I certainly empathize with your schedule. It is never easy to suggest adding more to your already full plate. That said, have you ever wondered why you see Dr. ____ on the news so much? Maybe you think he/she has other physicians in the practice to cover the patient schedule while they are out there in the media talking about the latest technology in medicine. Well, that might be true, but there is ALWAYS time to get your name out in the community if you want your practice to grow. Anything can be carved out of your schedule if it brings value & volume to your business. It never ceases to amaze me how many of the physicians I consult for have these endless talents but nobody knows about it but them. I have been in physician offices where their picture has been taken with Dr. Oz or a famous athlete & it is sitting all by it’s lonesome in THEIR office! I’m thinking the waiting room might be a better home for a picture that screams conversation piece! There are simple ways of enhancing your opportunity to enhance your credibility and eventually land on the evening news. It starts with getting involved in the community! As a previous administrator, I can tell you that I was constantly approached for the physician’s expertise on a topic of current interest. There were pharmaceutical companies, parks and recreation directors, community outreach programs, and media outlets, calling to utilize my physicians to speak or lead as the expert in a variety of platforms. I always said yes and took the initial tongue lashing for adding more to their plates. In the end, I was always thanked for pushing them to give back to the community because the rewards were endless. They began to be called upon by others who started to see them as experts in the community. There are two significant events I can share with you that have brought much notoriety to a practice. The first event is called ‘Playing Unplugged, Just What the Doctor Ordered.’ One of the physicians in the practice was called upon to host this annual event to fight childhood obesity. A day to get the children to unplug from their electronic devices and PLAY! An obvious worthy cause but there was an enormous commitment to host this event. There were monthly meetings, sponsorship encouragement to fellow practitioners, and time away from seeing patients. At the end of the 1st two events the physician and I would always say “I don’t know if we can do this again” & inevitably we would laugh and realize the work put in had always paid off. More of a ‘feel good’ kind of way, 20

knowing we were doing something important in the community to raise awareness. As a direct result of participating, our physician was called upon to many media outlets to promote the event. He was seen weekly by thousands of viewers watching the news and the practice information was always highlighted during the interview. We didn’t have to ASK to be on the news, it came as a direct result of doing good in the community! This led to an opportunity for me to ask Randi Zuckerberg (yes, FACEBOOK Zuckerberg), sister to Mark Zuckerberg, to speak at our event. She had just written a children’s book called DOT. about the importance of kids putting down their electronic devices and playing outside! The irony was incredible so I took a shot in the dark and asked her to join us and she said YES! I dove into fundraising and the medical community came out in full swing to support this great event that grows every year! Having a celebrity speaker this year presents a great opportunity to book another one next year!

Doctor’s Life Tampa Bay

Issue 3, 2014

ANCE OF ICIANS

From left to right... Edd Suyak, Sharon Fekete, Randi Zuckerberg, Dr.Greg Savel

The second community effort was to join PITCH, Pinellas Immunization Team for Community Health. This was a big task force started to encourage families to get educated about the importance of vaccinations. An incredible documentary called Invisible Threat was done by an amazing group of high school students to shine a light on this growing epidemic of families not vaccinating their children. I was offered an opportunity to watch this film and I ran back to the office shouting their praise. I was greeted by the inevitable “we are so busy” speech but again, the physicians looked at the record of success in getting out in the community and I can proudly report as vice-chair of this incredible task force, we are making a difference. The Issue 3, 2014

physicians have spoken to crowds of 700 plus and have been on the news countless times. They have been on a number of panel boards to answer questions from families of concern about something they are so very passionate about today! It has brought a great sense of pride to be involved in something we are all passionate about and as a result, public relations is at a level 10. I encourage you to get out there and do something you believe in, the universe will pay you back again and again. We need you to bring your expertise to the families who may not be able to afford health care but deserve a piece of your great knowledge. It is understood that your time is taken advantage of at times, and we thank you for committing yourself to helping others. Get out there and speak on a platform that commands a large audience and your good deeds will not go unnoticed.

Doctor’s Life Tampa Bay

10 Tips That May Bring More Patients to Your Medical Practice A

re you looking for ways to get more patients? Of course you are! Here are a few initiatives that can help create an effective marketing budget and plan for your medical practice.

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1. Check out your competitor sites to see what works for them. Are they using promotions? Facebook? Twitter contests? Discounts? Study the most successful competitors. Research what has been working for them and determine how it could be implemented as a benefit to your practice.

2. Think long range. Rome was not built in a day. The marketing and advertising you implement today is setting you up for the tomorrow business. It takes time to create a brand.

3. Content is king. (Blogs, website news feed, Facebook, newsletter) Keep your patients informed. Create content that answers questions and displays you as an expert.

4. Allocate 10 percent of your budget to marketing. Establish how much revenue comes in on an average per patient visit. Know exactly how many patients you will need to see to breakeven with your marketing expense.

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6. The use of Facebook and WordPress as a website has become a growing trend in business today because it is cheaper and faster to make changes and updates.

7. Interns from local colleges are a great source to help market your practice.

8. Use Constant Contact to promote your business’ monthly specials, events or any updates.

9. Market and advertise your practice to physicians that are not direct competition. Physician referrals are one of the best ways to gain a new patient.

10. Get involved with your community. Sponsor wellness events. Volunteer with community outreach programs and wellness events.

5. Remember your practice is a business— start thinking about it as one— some doctors have a hard time doing that. If this is you, bring an office manager on board to handle the business side.

Doctor’s Life Tampa Bay

Issue 3, 2014

Doctorâ&#x20AC;&#x2122;s Life Tampa Bay

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