Rethinking patient privacy: Information blocking

Jenna Bickford is a partner at MacDonald Illig Attorneys and is a member of the firm’s Business Transactions, Real Estate and Finance, and Healthcare Practice Groups.

Over the last two decades, the federal government has made several attempts, through regulations and financial incentives, to expand the use of electronic health records (EHRs) and make EHRs more compatible and interoperable. EHR compatibility and interoperability allows health-care providers, payors, and health information exchanges to share and access health information data across systems in order to better facilitate health-care delivery. In 2016, Congress continued these efforts by passing the 21st Century Cures Act, which included provisions aimed to promote electronic health information interoperability, promote patient access to records, and prohibit “information blocking.” Final rules took effect on April 5, 2021.

Information Blocking

Information blocking is any practice that is likely to interfere with, or discourage access, exchange, or use of, electronic health information. To constitute information blocking, a health-care provider must know that the practice is unreasonable and is likely to interfere with, or discourage access, exchange, or use of, electronic health information. Additionally, a health IT developer, exchange, or network engages in information blocking if it knew, or should have known, that a practice was unreasonable and was likely to interfere with, or discourage access, exchange, or use of, electronic health information. A study by the U.S. Department of Health and Human Services found anticompetitive uses of information blocking, such as an EHR developer who intentionally makes exportation of an EHR more difficult than necessary to discourage switching the EHR to a different developer. A health-care provider may engage in anti-competitive information blocking by refusing to interface its EHR technology with another provider who is a competitor. However, not all information blocking is anti-competitive. Conduct that has historically been considered not only legal, but good privacy practices, may now constitute information blocking. For example, a health-care provider’s privacy policies may be considered information blocking if the policies result in the provider declining to share electronic health information when other applicable law would permit the disclosure.

A Shift in Thinking About Patient Privacy

Information blocking requires healthcare providers to rethink patient privacy. Since the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was enacted, health-care providers have been rightfully cautious about disclosing patient information. HIPAA requires providers to disclose patient information only in limited circumstances. In many situations, HIPAA permits, but does not require, a provider to disclose patient information. Accordingly, many health-care providers disclose patient health information only when required. Now, health-care providers who decline to disclose electronic health information may run afoul of the information blocking rules if HIPAA would permit the disclosure. The question is no longer whether the provider is required to make the disclosure, but whether the provider is permitted to do so. If the provider is permitted to disclose, the information blocking rules may require the disclosure. Information blocking rules may also require proactive steps to facilitate a disclosure, such as working with a patient to obtain a valid HIPAA Authorization form in order to permit a requested disclosure.

Compliance Steps

To implement these changes, a health-care provider should consider the following compliance steps: • Reevaluate privacy practices and identify areas in which information blocking may exist. • Review EHR vendor and other data sharing agreements to ensure the contractual terms prohibit information blocking and promote interoperability between EHRs. • Review the Notice of Privacy Practices, and other HIPAA policies and procedures, to require appropriate access, exchange, and use of electronic health information in situations where

HIPAA permits such use or disclosure. • Review Business Associate Agreements for consistency with updated HIPAA policies and procedures. • Review fees charged in connection with

EHR interfaces or connections. • Communicate and train employees about these changes. For more information, contact Attorney Jenna Bickford at 814/870-7762 or jbickford@mijb.com.

HIGHMARK HEALTH TEAMS UP WITH BOSCH ON DEEP AUDIO AI TO DIAGNOSE PEDIATRIC PULMONARY CONDITIONS

Highmark Health and Bosch, a leading global supplier of technology and services, recently announced at the CES® 2022 convention in Las Vegas, NV, a research collaboration that will explore the use of innovative sensor technology to capture audio that is analyzed using artificial intelligence to detect pediatric pulmonary conditions, such as asthma. The Bosch SoundSee technology was launched to the International Space Station (ISS) in late 2019 and is currently being used aboard the station to assess system operations. The new research collaboration builds upon a longtime practice in doctor-patient care. When doctors put a stethoscope on a patient’s chest, they can hear audio patterns that help them detect an abnormality. Highmark Health and Bosch are applying the same principles of the stethoscope by using AI-enabled sensor technology to listen and detect audio cues that could help with patient diagnosis. Such AI capabilities have the potential to improve patient-centric, athome care where audio AI-based diagnostic results can be reported to a doctor for further analysis and recommended action. By using high-fidelity microphones coupled with AI and machine learning for sound analysis, the research team will investigate if pediatric pulmonary conditions such as asthma can be detected using the noise emitted through various breathing patterns from patients. Clinical studies will be conducted through the Pediatric Institute of Allegheny Health Network (AHN) and are scheduled to begin in the first quarter of 2022. Joseph Aracri, DO, AHN pediatrician and chair of its Pediatric Institute, will conduct the first feasibility study in a small cohort of pediatric patients. During the patient’s visit to the pediatric clinic, the high-resolution microphone will be used to capture the sounds as the children speak and breathe. The sounds will then be processed and added as a feature into the AI and machine learning techniques along with clinically relevant information and the child’s diagnosis. “This unique collaboration between two industry leaders fits squarely with our mission of exploring technological innovations that can improve the health and wellness of our patients and members,” said Kelly J. Shields, Ph.D., senior research data scientist for Highmark Health. “Bosch’s global leadership in the development of pioneering industrial and consumer technologies and Highmark Health’s R&D expertise, along with AHN’s leading pediatric expertise is an incredibly promising combination that we believe can help transform the diagnosis and treatment of asthma and other breathing disorders.” Dr. Aracri has practiced medicine as part of AHN Pediatrics since 1998 and served as its president from 2009 through 2014. Since 2014, Dr. Aracri has also served as the chair of the Department of Pediatrics for Allegheny Health Network, leading a Department of Pediatrics with more than 120 affiliated physicians, providing a broad range of inpatient and outpatient care, including general pediatrics, asthma, allergy and immunology, and neonatology services. For more information, visit highmarkhealth.org.

Highmark Health and Bosch are collaborating on research that may help pediatric patients with pulmonary conditions. Microphones collect audio data of breathing patterns that are analyzed using artificial intelligence.

WABTEC WINS EQUIPMENT CONTRACT TO MODERNIZE CHICAGO’S METRA COMMUTER RAIL SERVICE

Wabtec Corporation (NYSE: WAB) announced recently that has been awarded an order to improve passenger experience, reliability and safety for Metra, the commuter rail system in the Chicago metropolitan area serving the city of Chicago and its surrounding suburbs. The contract includes the latest brakes, passenger access doors, heating, ventilation, and air conditioning (HVAC), and event recorder solutions for 200 new rail cars.

“We are thrilled to begin work on this largescale contract supplying the most advanced technology for doors, brakes, and HVAC to one of the world’s busiest commuter rail systems,” said Lilian Leroux, Wabtec Transit President. “This new contract builds upon our position as a leading equipment manufacturer on both sides of the Atlantic and across the world, and will ensure safe, reliable, and timely passenger service to millions of riders over 1,200 miles of track and across more than 240 stations throughout the greater Chicagoland area.” Wabtec will provide 800 double doorways and 400 single doorways, which include the new DLC Next door control unit, one of the most modern door control systems in the world. This solution includes touchless buttons to protect passenger’s health and safety. It also enables acoustic sealing of cabin end-doors and allows for 80-percent commonality between all types of doors making maintenance easier. It is one of the most reliable and robust door systems available in the industry. The HVAC system will also provide another level of passenger comfort and safety. Wabtec will install 400 passenger HVAC systems, with an efficient energy management system. In addition, Wabtec will supply its proven FastBrake microprocessor controlled braking system along with the latest generation wheel slide protection to provide optimum stopping distances in adverse conditions. This system will allow interoperability with existing fleet cars. For more information, visit wabteccorp.com.

VIKING PLASTICS’ PARTNER OPENS INJECTION MOLDING COMPANY IN BRAZIL

Injequaly Industria LTDA, a Brazil-based injection molding company in São Paulo and partner of Viking Plastics in Pennsylvania has expanded, adding a plant in Joinville. The new 2,000-square-meter Joinville plant is the second location for Injequaly. The plant will produce plastic refrigerator components for Whirlpool, a multinational appliance company. “We worked alongside Whirlpool on this project, and we’re honored to be among their trusted partners. This plant produces parts that will be in refrigerators across the globe. The addition of this facility is projected to increase Injequaly’s business by 30 percent,” said Fernando Esteves, Injequaly’s director of Development. Injequaly’s last expansion came in 2019, when the plastic injection molding company added five injection molding machines to their São Paulo plant, bringing their total at the plant to 16 machines.

Founded in 2003, Injequaly Industria LTDA is a partner of Viking Plastics in Corry, Pennsylvania USA. Injequaly molds tight-tolerance products for automotive, consumer and industrial markets. The company is ISO 9002 certified and is working toward ISO 14001 certification in 2021.

For more information, visit injequaly.com.br or vikingplastics.com.

UNITED WAY OF ERIE COUNTY APPOINTS NEW VP OF FINANCE

United Way of Erie County has named Sally Opferbeck as vice president of finance and administration.

Opferbeck is responsible for all accounting, finance and treasury functions as well as for developing and maintaining the financial infrastructure of the United Way. Born in Baghdad, Iraq, Opferbeck lived for 17 years in Jordan before she moved to Erie in 2009. She is a graduate of Villa Maria Academy and earned her bachelor’s degree in accounting from Penn State Behrend. Opferbeck previously was the director of finance and administration at the United Way of Southern Chautauqua County.

ERIE INDEMNITY ANNOUNCES NEW EXECUTIVE OFFICER

The Board of Directors of Erie Indemnity Company (NASDAQ: ERIE) appointed a new executive vice president. The Board appointed Brian W. Bolash an executive vice president of the company. Bolash has been with the company for 21 years and served as senior vice president, secretary and general counsel, with responsibility for the Law Division and Internal Audit. Bolash continues to serve as the company’s general counsel and corporate secretary. Bolash is a graduate of Gannon University and The Dickinson School of Law of The Pennsylvania State University.

ERIE INSURANCE APPOINTS LEEMHUIS VP & CORPORATE RISK OFFICER

Erie Insurance (ERIE) recently named Dorothy Leemhuis as the company’s next vice president and corporate risk officer. In this role, Leemhuis will lead the company’s Enterprise Risk Management department in ERIE’s Actuarial division. In her previous role, Leemhuis led a team responsible for the actuarial modeling of ERIE’s auto, home and business insurance products. As an actuary in ERIE’s Corporate Actuarial department, Leemhuis also developed enterprise-level capital forecasts and recommended reinsurance and capital amounts to meet corporate risk tolerances and regulatory requirements. Leemhuis joined ERIE in 2010 as an actuarial analyst, after graduating from Case Western Reserve University with a bachelor’s degree in statistics. She is also a Fellow of the Casualty Actuarial Society (FCAS).

NATIONAL FUEL GAS COMPANY ANNOUNCES PROMOTION

National Fuel Gas Company, headquartered in Williamsville, New York, recently announced several promotions, including Michael Colpoys as senior vice president for National Fuel Gas Distribution Corporation with oversight for all utility field operations in New York and Pennsylvania. The promotion was effective October 1, 2021. In this role, Colpoys also will oversee the corporate Security Department and Pennsylvania-statewide Government Affairs Department. Colpoys started his career in 1987 as a management trainee and was promoted to junior engineer in 1988. In the following years, he was promoted numerous times, advancing to assistant vice oresident of Distribution Corporation in 2009 and then to vice president in 2015 of National Fuel Gas Midstream Company where he oversaw the development, construction, and operation of the company’s expanding gathering pipelines. In 2016, Colpoys was named vice president of Distribution Corporation. Colpoys received a Bachelor of Science degree from Clarkson University and a Master of Business Administration from Behrend College at Pennsylvania State University. National Fuel is a diversified energy company that operates an integrated collection of natural gas and oil assets across four business segments: Exploration and Production, Pipeline and Storage, Gathering, and Utility.

LARSON TEXTS CEO NAMED PENN STATE ALUMNI FELLOW

Larson Texts Chief Executive Officer Matthew Totzke has been named one of 22 Penn State Alumni Fellows for 2021. He is a 1996 graduate of Penn State Behrend. The lifelong title of Alumni Fellow is the highest award given by the Penn State ,Alumni Association.

Totzke, who joined Erie-based Larson Texts in 1993 while still a student at Penn State Behrend, has held positions in software development, information technology, process improvement, project management, and project development with the company. In 2008, he managed the launch of the first product line of Big Ideas Learning. During his tenure, the companies have grown from creating educational materials for third-party publishers to becoming one of the country’s leading K-12 mathematics publishers.

MENTAL HEALTH, DIGITAL SOLUTIONS TOP LIST OF EMPLOYEE WELLNESS TRENDS

Over the past two years, the COVID-19 pandemic accelerated existing workplace trends and highlighted essential benefits that have been ignored for too long. Two such areas include mental well-being and digitally offered solutions. To better understand the future of employee well-being in a post-COVID-19 world, particularly the renewed focus on a holistic approach, Wellable Labs conducted its annual Employee Wellness Industry Trends Report. Here are a few findings that company decision makers should plan for in 2022:

• Employers are prioritizing mental health programs for employees.

Mental health programs are seeing a rapid increase HR Q&A in adoption and investment in the workplace as the COVID-19 pandemic triggers mental health conditions. The majority of employers surveyed are increasing their investment in mental health programs (90 percent), followed closely by stress management and resilience programs (76 percent), and mindfulness and meditation programs (71 percent).

• Virtual employee benefits are now the preference as employers expand their offerings.

According to their brokers, 72 percent of employers who expect to be investing more in health and well-being will do so completely or mostly virtually.

Examples of such benefits include on-demand fitness classes, health education and literacy, health coaching, and health fairs.

• Telemedicine adoption and utilization are soaring.

In recent years, telemedicine has been an employee benefit to watch. Due to the sharp rise in remote work and safety concerns at heath offices, the adoption of telemedicine accelerated rapidly since the pandemic began and continues to climb. Employees and employers alike have come to appreciate telemedicine’s ability to offer flexible, on-demand, and cost-effective solutions. As a result, 80 percent of employers plan to invest more in this benefit this year.

SURVEY: CLEANING PROTOCOLS STILL A TOP PRIORITY IN AMERICAN WORKPLACES

A new survey of 1,600 Americans reveals a clean workplace is still a top priority for those returning to work amid the ongoing COVID-19 pandemic. The survey conducted by the Cleaning Coalition of America finds that U.S. workers increasingly value enhanced cleaning of the workplace and feel safer seeing professional cleaners onsite — a sentiment shared by both vaccinated and unvaccinated Americans. Fielded in late October, the survey examined the perceptions of 1,099 vaccinated and 501 unvaccinated workers to understand expectations surrounding returnto-work as businesses continue to reopen. An overwhelming majority — 93.4 percent — of vaccinated respondents and 82.2 percent of unvaccinated respondents cited workplace cleaning protocols as important as employees return to the office, with 77.2 percent of workers wanting the workplace cleaned daily. Take the Lead in Reducing Stress for Your Team Who hasn’t talked about their own stress levels and listened to co-workers talk about their increased stress levels in the past months? We spend so much of our time in our work environments that work plays a big role in our stress and can also be a source of support and healing. Direct supervisors play a huge role in an employee’s attitude in the workplace and need to be cognizant of this effect on their stress, attitude and performance. Just a few simple supervisory skills can help reduce stress levels immensely when we are all working in a supportive team environment.

What leadership skills should you focus on?

• First, try a bit more of the old standard — employee praise and appreciation. The best recognition comes from the heart of a manager they respect and know they can trust. Use the individual’s name, be specific and timely regarding the great work they performed, and there’s no problem if co-workers overhear your positive words and see your attention to details with your team. • Take time to listen to employees whether it is about an event that took place outside of work, or if it’s about an idea they have on a work process. Employees want to be heard and genuinely showing your listening skills is a clear way to show you care about your employees as the people they are, not just about the job they do. • Communicate clear expectations and do so using two-way communication. “Where do I stand? Can I ask for help with this? Do I have autonomy on this?” These are a few of many things to talk openly about with your people. • Finally, along with clear expectations, communicate your positive expectations in your words, actions and support to help produce those positive outcomes. Knowing we are doing well at our jobs and have a supportive team environment in the workplace goes a long way toward overall health and well-being. The skills listed above — and many more — can be learned in the MBA’s Supervisory Skills Series, Leadership for Team Leaders Series and other training classes. To learn more, visit mbausa.org or contact the Association’s Professional Development Training Department at 814/833-3200 or 800/815-2660. Lisa DeFilippo is the senior professional development trainer at the Manufacturer & Businesss Association. Contact her at 814/833-3200, 800/815-2660 or ldefilippo@mbausa.org.

Get Moving! Time to Engage Employees in Workplace Wellness

Workplace wellness refers to the education and activities that a worksite may sponsor in order to promote healthy lifestyles for their employees and their families. Examples of wellness initiatives include health education classes, subsidized use of fitness facilities and internal policies or programs that promote healthy behavior. When sponsoring a wellness program, the main hurdle to success is employee engagement. The benefits of wellness programs can only be realized if a significant number of your employees take part in your efforts. In order to gain buy-in, some businesses offer employees an incentive for participating or reaching certain health goals.

Why Workplace Wellness?

Wellness affects your company’s bottom line in many ways — in particular, it can lower health-care costs, increase productivity, decrease absenteeism and raise employee morale. Because employees spend many of their waking hours at work, the workplace is an ideal setting to address health and wellness issues. The U.S. Centers for Disease Control and Prevention (CDC) promotes the formation of workplace wellness programs because, according to one of its studies, employees in companies with “a strong culture of health” are three times more likely to actively strive to improve their health.

Control Health Insurance Costs

A wellness program can help employees with high risk factors make the lifestyle changes to improve their quality of life and reduce their health-care costs, while also helping employees with fewer risk factors stay healthy.

Reduce Workers’ Compensation and Disability Costs

Employees who make healthy changes and lower their health risk factors often have a reduced chance of a workplace injury, illness or disability. This, in turn, can save employers money, not just on insurance premiums and benefits paid out, but also on the costs of recruiting and training a new worker to replace an employee who is out of work for health reasons.

Increase Employee Productivity and Fewer Missed Days

Healthier employees mean fewer sick days, which is another benefit companies can achieve through wellness programs. Plus, employees’ healthier behaviors may translate into better family choices, so employees may also miss less work caring for ill family members. Increased productivity and reduced absenteeism can yield significant cost savings.

Higher Morale and Improved Recruiting

A company that cares about its employees’ health is often seen as a better place to work, and wellness programs can attract top talent in a competitive market. In addition, demonstrating a commitment to your employees’ health can improve employee morale and strengthen retention.

WE CAN’T DO A COMPREHENSIVE WELLNESS PROGRAM RIGHT NOW, BUT IS IT STILL WORTH DOING SOMETHING?

Absolutely — even a small activity can plant the seeds of success for your wellness program to grow. Engage in some low-cost activities, like providing a health and wellness bulletin board or newsletter. You can also coordinate walking groups or encourage managers to hold walking meetings when it is nice outside. These small steps can promote a healthier workplace.

WE HAVE TRIED HEALTH AND LIFESTYLE PROGRAMS, BUT PARTICIPATION IS SMALL. WHAT CAN WE DO?

Keep trying, and be patient. It will take some time for your program to get going. Remember that, ultimately, you are trying to change workplace culture, and change is a process that happens slowly over time. One approach that has proven successful for employers, though, is to offer incentives for participation or attendance. For instance, you could offer free healthy snacks if employees attend a wellness meeting. Another approach is to invite people in the organization who are well-liked and respected to participate in your program in the hopes that it will encourage other employees to join as well.

HAVE AN HR QUESTION? THE MBA CAN HELP!

The Manufacturer & Business Association (MBA) knows that urgent HR and employment law issues can arise at a moment’s notice. As a member, you can call our certified HR consultants and labor and employment law attorney any time, at no charge for counsel on a broad range of workplace-related issues including: • Hiring and firing practices • Company policies • Compensation and benefits • Employment law • Employment agreements • Workers’ compensation • Affirmative Action Plans • Unemployment compensation claims • Employee handbook policies • OSHA compliance • Sexual harassment • Family Medical Leave Act • COBRA • Americans with Disabilities Act Contact the MBA HR & Legal Hotline at 814/833-3200, 800/815-2660 or hrservices@mbausa.org.

Rose Bruno, PHR, SHRM-CP,

is an HR consultant at the Manufacturer & Business Association. Contact her at 814/8333200, 800/815-2660 or rbruno@mbausa.org

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