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Electronic Record Security and HIPAA Regulations
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Electronic Record Security and HIPAA Regulations
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Electronic Record Security and HIPAA Regulations
• Healthcare is an evolving field --
science, technology, and regulations are all changing&#=
13;
• Internet means easier/more efficient
access to information
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Electronic Record Security and HIPAA Regulations
• Communication
• Security
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Electronic Record Security and HIPAA Regulations
• Patients&=
#13;
• Physician=
s
• Hospitals=
and
Clinics
• Labs and
Pharmacies
• Public He=
alth
Professionals
• Health in=
surers
and administrators
• Educators=
and
Researchers
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Electronic Record Security and HIPAA Regulations
•Protect your Passwords
•Use encryption
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Electronic Record Security and HIPAA Regulations
• An application service which offers =
improved
delivery of health care and authorized access to electronic patie=
nt records
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‹date/time›
‹foot=
er›
‹#=
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Electronic Record Security
and HIPAA Regulations
Or, How to Keep your
Electrons Under Control
Anne
Linton, J.D.
Washington
Federal Strategies
Chicago, November 30, 2000, RSNA - IHE
Ov=
erview
•HIPAA
•Related Issues: Communication and Security
•Various Technical and Legal Issues =
3;
•Recap
HI=
PAA
Basics
•Health Insurance Portability and Accountability
Act of 1996; it was intended to protect consumers
•Administrative Simplification Act, a
subset
•Streamlining the movement of informati=
on, saving
time and money
HI=
PAA
Purpose
•To retain health insurance coverage fo=
r consumers
•To ensure that changing technology supports
effective provision of health care and the exchange of medi=
cal
information
•To reduce administrative and data transaction
costs
HI=
PAA
Implications
•HIPAA will affect all providers of med=
ical
care
•HIPAA also will affect everyone who =
delivers
information services to providers of medical care – such=
as
transcriptionists and the clerks who file insurance claims=
Ch=
anging
“Standards” of Care
<=
span
style=3D'mso-special-format:bullet;color:#FFCC66;mso-color-index:3;positio=
n:
absolute;left:-4.42%'>•More information means more research <=
/span>(and
vice versa)
<=
span
style=3D'mso-special-format:bullet;color:#FFCC66;mso-color-index:3;positio=
n:
absolute;left:-4.04%'>•Electronic information use can improve=
the
quality of care while constraining costs
Re=
lated
Issues
R=
elated
Issues - Communication
Re=
lated
Issues - Security
&#=
8226;What
issues do you need to keep in mind?
&=
#8211;Privacy
&=
#8211;Confidentiality
&=
#8211;Security
<=
/div>
R=
26;Some
definitions from Merriam Webster’s Dictionary
Pr=
ivacy
•The quality or state of being apart fr=
om company
or observation; freedom from unauthorized intrusion.
=
Co=
nfidentiality
•By nature, entrusted with private information
whose unauthorized disclosure could be prejudicial
Se=
curity
•Something that secures protection; measures
taken to guard against espionage or sabotage, crime, atta=
ck
or escape
Re=
commendations
•Implement electronic patient records
– the delivery of quality care should improve
<=
/span>
•Comply with HIPAA – these
regulations will apply to you and those with whom you work
Su=
ggestions
<=
span
style=3D'mso-special-format:bullet;color:#FFCC66;mso-color-index:3;positio=
n:
absolute;left:-4.12%'>•Be as cautious with electronic informa=
tion
as you would be with paper – ONLY MORE
SO
<=
span
style=3D'mso-special-format:bullet;color:#FFCC66;mso-color-index:3;positio=
n:
absolute;left:-4.32%'>•Use Virtual Private Network
technology
<=
span
style=3D'mso-special-format:bullet;color:#FFCC66;mso-color-index:3;positio=
n:
absolute;left:-4.19%'>•Check on your vendors –
transcriptionists and labs need to work with you on this<=
/div>
Re=
gional
Medical Archive
•Coming to your neighborhood soon;
=
•Brought to the Integrated Healthcare <=
/span>Enterprise by the Next Generation Internet;&=
#13;
We=
bsites
of interest
Re=
cap
•HIPAA
<=
/span>
̶=
6;Related
Issues – Communication and Security
•Various Leg=
al
and Technical Issues
•
•Anne Linton, J.D.
•Washington Federal Strategies
•(301) 951-7062, alinton@alumni.princeton.edu
‹header›
‹date/time›=
Click to edit Master text styles
Second level
Third level
Fourth level
Fifth level
‹footer›
‹#›
It is an honor to be with you tod=
ay,
especially to be at the lectern following such distinguished speakers. I have been asked to address some
issues that will be pertinent to any implementation of an electronic patie=
nt
record throughout an integrated healthcare enterprise. Being aware of these issues, I be=
lieve,
will help you to make better decisions as you undertake the process. They include: HIPAA, Communication and security=
, and
assorted tech
HIPAA – legislation to ensu=
re that
health care consumers could move their health insurance information when t=
hey
changed employers – or moved into Medicare or Medicaid.
To facilitate the movement of health insurance information, the Department=
of Health
and Human services was directed by the statute to promulgate regulations
– Administrative Simplification – that would streamline the mo=
vement
of information in an electronic environment. Some of the regulations became fi=
nal
last month – those setting the standard for some of the insurance
forms. The privacy and secur=
ity
regulations have not reached final release yet. Even for those regulations which =
have
been released in final form, there is a two year window before healthcare
providers are required to be in compliance. The regulations will evolve over =
time,
and it becomes important to know what to watch.
Most recently, the regulations regarding the format for movement of insura=
nce information
became effective. These rule=
s,
issued in August, went into effect as of mid-October. However, the requirement of compl=
ying
with the regulations does not go into effect for another two years. There are many more regulations to
come, and each set is likely to have a window before industry participants=
are
required to comply.
Why did Congress pass this legisl=
ation
FOUR years ago? People move =
from job
to job. Insurance companies =
which
had stored insurance records electronically were raising barriers to consu=
mers
moving their insurance information from one carrier to another, and using =
the
incompatibility of electronic records as an excuse for denying coverage.
The Administrative Simplification portion of the statute was established t=
o streamline
the movement of information electronically, while the rest of the statute
covers insurance. The
Administrative Simplification provisions will have regulations that reach
health care providers, health care clearinghouses, health insurers, and the
allied health types – including labs, pharmacies, transcriptionists,=
and
more.
When the whole system is fully implemented, the costs of managing the volu=
mes
of information will be held to a lower rate than we would otherwise see - I cannot say that the costs wil=
l not
increase for a little while, but compared to remaining with a hardcopy sys=
tem,
operated in a labor-intensive fashion, the costs will be lower, and the sy=
stem
will function more effectively.
As broad as the scope of “c=
overed
entities” is expected to be in the ultimate regulations, it seems to me that the best plan=
is to
expect that HIPAA will affect you.
And, in some ways it seems that it may be better to accept the regu=
lations
than to struggle against them. The
reason: there will be certai=
nty, and
healthcare providers will then have a more certain idea of where to go with
their business decisions about implementation of technology.
And, with potential cost savings, and improved care, HIPAA could really he=
lp medicine. Further, the legislation prohibit=
s the
regulations from being amended more than once per year, so there will be a
fair amount of certainty. &#=
13;
I still recommend that each facility or provider appoint a HIPAA complianc=
e officer. This person will know how to read=
the
compliance matrices and the other guiding documents that HHS is issuing. Any healthcare enterprise that is=
looking
to integrate its operations more effectively will, perforce, need to have =
HIPAA
issues in mind as it integrates.
And, should the enterprise consider outsourcing the integration
function, the outside integrator will need to comply with HIPAA as well.
Are those communications handled =
in
ways that the information is transmitted in a standardized format –
HIPAA compliant? Are the
communications made securely, with encryption, limited access, using virtu=
al
private networks?
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obj=3DGetHrefObj(gCurSld)
if( obj.mOrigVis =3D=3D 1 )
return obj.mSldIdx
else =20
return gCurSld
}
function GetNumSlds()
{ =20
if( GetHrefObj(gCurSld).mOrigVis =3D=3D 1 )
return GetSldList().mNumVisSlds;
else
return GetSldList().mList.length
}
function GetSldNum( href )
{
for(ii=3D0; ii 1 )
PopSldList();
else if( !IsFramesMode() ) {
if( gLoopCont )
GoToFirst()
else
EndShow()
}
}
function GoToPrevSld()
{
ii=3DgCurSld-1
if( ii > 0 ) {
obj=3DGetHrefObj(ii)
while ( obj && ( obj.mVis =3D=3D 0 ) && ( ii>0 ) )
obj=3DGetHrefObj(--ii)
if( ii =3D=3D 0 ) ii=3D1
GoToSldNum(ii)
}
}
function GoToFirst(){ GoToSld( GetHrefObj(1).mSldHref ) }
function GoToLast()
{
ii=3DGetSldList().mList.length
if( ii !=3D gCurSld )
GoToSld( GetHrefObj(ii).mSldHref )
}
function GoToSldNum( num )
{
if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue
obj =3D GetHrefObj( num )
obj.mVis=3D1
gPrevSld=3DgCurSld
gCurSld =3D num;
PPTSld.location.replace(MHTMLPrefix+obj.mSldHref)
if( IsFramesMode() ) {
UpdNavPane(); UpdOtlPane(); UpdNtsPane()
}
}
function GoToSld( href )
{
if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue
GetHrefObj( GetSldNum(href) ).mVis=3D1
PPTSld.location.replace(MHTMLPrefix+href)
}
function SldUpdated( id )
{
if( id =3D=3D GetHrefObj(gCurSld).mSldHref ) return
gPrevSld=3DgCurSld
gCurSld=3DGetSldNum(id)
if( IsFramesMode() ) {
UpdNavPane(); UpdOtlPane(); UpdNtsPane()
}
}
function PrevSldViewed(){ GoToSld( GetHrefObj(gPrevSld).mSldHref ) }
function HasPrevSld() { return ( gIsEndShow || ( gCurSld !=3D 1 && GetHrefO=
bj( gCurSld-1 ).mVis =3D=3D 1 )||( GetCurSldNum() > 1 ) ) }
function HasNextSld() { return (GetCurSldNum() !=3D GetNumSlds()) }
function CloseWindow() {
if( HideMenu() ) return;
=09
var event =3D PPTSld.event;
if( !IsFramesMode() && event && (event.keyCode=3D=3D27 || event.keyCode=3D=
=3D32 || event.type=3D=3D"click" ) )
window.close( self );
CatchNumKeys( self, event );
}
function Unload() { gIsEndShow=3D0; }
function SetupEndShow() {
gIsEndShow=3D1;
PPTSld.document.body.scroll=3D"no";
PPTSld.document.onkeypress=3DCloseWindow;
PPTSld.document.onclick=3DCloseWindow;
PPTSld.document.oncontextmenu=3D_CM;
}
function EndShow()
{
if( IsFramesMode() ) return
if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue
doc=3DPPTSld.document
var dir =3D doc.body.dir
if( dir !=3D "rtl" ) dir =3D "ltr";
doc.open()
doc.writeln(' 0) {
PushSldList(sldList,fEnd);
gCurSld =3D 1;
}
else
if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue
}
function PushSldList(arr,fEnd) {
var ii =3D gSldStack.length;
gSldStack[ii] =3D new SldList(arr,gCurSld,fEnd);
GoToSld( gSldStack[ii].mList[0].mSldHref );
}
function PopSldList() {
if (gSldStack[gSldStack.length-1].fEndShow)
EndShow()
else {
gCurSld =3D gSldStack[gSldStack.length-1].mCurSld;
gSldStack[gSldStack.length-1] =3D null;
gSldStack.length--;
var sldList =3D gSldStack[gSldStack.length-1];
GoToSld( sldList.mList[gCurSld - 1].mSldHref );
}
}
var custShowList=3Dnew Array();
/*********************************************
Navigation button implementation
There are 2 types of buttons: ImgBtn, TxtBtn
implemented as function objects. They share
a similiar interface so the event handlers
can call SetActive, for example, on a button=20
object without needing to know exactly=20
what type of button it is.
**********************************************/
//----------------------------------
function ImgBtn( oId,bId,w,action )
//----------------------------------
{
var t=3Dthis
t.Perform =3D _IBP
t.SetActive =3D _IBSetA
t.SetInactive=3D _IBSetI
t.SetPressed =3D _IBSetP
t.SetDisabled=3D _IBSetD
t.Enabled =3D _IBSetE
t.ChangeIcon =3D null
t.UserAction =3D action
t.ChgState =3D _IBUI
t.mObjId =3D oId
t.mBorderId=3D bId
t.mWidth =3D w
t.mIsOn =3D t.mCurState =3D 0
}
function _IBSetA()
{
if( this.mIsOn ) {
obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 )
obj.style.posTop=3D0
}
}
function _IBSetI()
{
if( this.mIsOn ) {
obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 )
obj.style.posTop=3D0=20
}
}
function _IBSetP()
{
if( this.mIsOn ) {
obj=3Dthis.ChgState( gShadowClr,gHiliteClr,2 )
obj.style.posLeft+=3D1; obj.style.posTop+=3D1
}
}
function _IBSetD()
{ =20
obj=3Dthis.ChgState( gFaceClr,gFaceClr,0 )
obj.style.posTop=3D0=20
}
function _IBSetE( state )
{
var t=3Dthis
GetObj( t.mBorderId ).style.visibility=3D"visible"
if( state !=3D t.mIsOn ) {
t.mIsOn=3Dstate
if( state )
t.SetInactive()
else
t.SetDisabled()
}
}
function _IBP()
{
var t=3Dthis
if( t.mIsOn ) {
if( t.UserAction !=3D null )
t.UserAction()
if( t.ChangeIcon ) {
obj=3DGetObj(t.mObjId)
if( t.ChangeIcon() )
obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-4)*t.mWidth
else
obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-0)*t.mWidth
}
t.SetActive()
} =20
}
function _IBUI( clr1,clr2,nextState )
{
var t=3Dthis
SetBorder( GetObj( t.mBorderId ),clr1,clr2 )
obj=3DGetObj( t.mObjId )
obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-nextState)*t.mWidth-obj=
.style.posTop
t.mCurState=3DnextState
return obj
}
//-----------------------------------------
function TxtBtn( oId,oeId,action,chkState )
//-----------------------------------------
{
var t=3Dthis
t.Perform =3D _TBP
t.SetActive =3D _TBSetA
t.SetInactive=3D _TBSetI
t.SetPressed =3D _TBSetP
t.SetDisabled=3D _TBSetD
t.SetEnabled =3D _TBSetE
t.GetState =3D chkState
t.UserAction =3D action
t.ChgState =3D _TBUI
t.mObjId =3D oId
t.m_elementsId=3D oeId
t.mIsOn =3D 1
}
function _TBSetA()
{
var t=3Dthis
if( t.mIsOn && !t.GetState() )
t.ChgState( gHiliteClr,gShadowClr,0,0 )
}
function _TBSetI()
{
var t=3Dthis
if( t.mIsOn && !t.GetState() )
t.ChgState( gFaceClr,gFaceClr,0,0 )
}
function _TBSetP()
{
if( this.mIsOn )
this.ChgState( gShadowClr,gHiliteClr,1,1 )
}
function _TBSetD()
{ =20
this.ChgState( gFaceClr,gFaceClr,0,0 )
this.mIsOn =3D 0
}
function _TBSetE()
{
var t=3Dthis
if( !t.GetState() )
t.ChgState( gFaceClr,gFaceClr,0,0 )
else
t.ChgState( gShadowClr,gHiliteClr,1,1 )
t.mIsOn =3D 1
}
function _TBP()
{
var t=3Dthis
if( t.mIsOn ) {=20
if( t.UserAction !=3D null )
t.UserAction()
if( !t.GetState )
return
if( t.GetState() )
t.SetPressed()
else
t.SetActive()
} =20
}
function _TBUI( clr1,clr2,lOffset,tOffset )
{
SetBorder( GetObj( this.mObjId ),clr1,clr2 )
Offset( GetObj( this.m_elementsId ),lOffset,tOffset )
}
function Offset( obj, top, left ){ obj.style.top=3Dtop; obj.style.left=3Dle=
ft }
function SetBorder( obj, upperLeft, lowerRight )
{
s=3Dobj.style;
s.borderStyle =3D "solid"
s.borderWidth =3D 1=20
s.borderLeftColor =3D s.borderTopColor =3D upperLeft
s.borderBottomColor=3D s.borderRightColor =3D lowerRight
}
function GetBtnObj(){ return gBtnArr[window.event.srcElement.id] }
function BtnOnOver(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetActive() }
function BtnOnDown(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetPressed() }
function BtnOnOut(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetInactive() }
function BtnOnUp()
{
b=3DGetBtnObj()
if( b !=3D null )
b.Perform()
else
Upd()
}
function GetNtsState(){ return parent.gNtsOpen }
function GetOtlState(){ return parent.gOtlOpen }
function GetOtlTxtState(){ return parent.gOtlTxtExp }
function NtsBtnSetFlag( fVal )
{
s=3Ddocument.all.item( this.m_flagId ).style
s.display=3D"none"
if( fVal )
s.display=3D""
else
s.display=3D"none"
}
function _BSetA_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S=
etActive() }
function _BSetI_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S=
etInactive() }
function _BSetP_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S=
etPressed() }
function _BSetA_BorderImg()
{=20
b =3D gBtnArr[this.mBorderId]=20
if( b !=3D null && this.mIsOn && !b.GetState() ) {
obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 )
obj.style.posTop=3D0
}
}
function _BSetI_BorderImg()
{=20
b =3D gBtnArr[this.mBorderId]
if( b !=3D null && this.mIsOn && !b.GetState() ) {
obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 )
obj.style.posTop=3D0
}
}
var gHiliteClr=3D"THREEDHIGHLIGHT",gShadowClr=3D"THREEDSHADOW",gFaceClr=3D"=
THREEDFACE"
var gBtnArr =3D new Array()
gBtnArr["nb_otl"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOtlPan=
e,GetOtlState )
gBtnArr["nb_otlElem"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOt=
lPane,GetOtlState )
gBtnArr["nb_nts"] =3D new ImgBtn( "nb_nts","nb_ntsBorder",10,parent.ToggleN=
tsPane )
gBtnArr["nb_nts"].SetActive =3D _BSetA_BorderImg;
gBtnArr["nb_nts"].SetInactive =3D _BSetI_BorderImg;
gBtnArr["nb_ntsBorder"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.=
ToggleNtsPane,GetNtsState )
gBtnArr["nb_ntsElem"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.To=
ggleNtsPane,GetNtsState )
gBtnArr["nb_prevBorder"] =3D gBtnArr["nb_prev"]=3D new ImgBtn( "nb_prev","n=
b_prevBorder",30,parent.GoToPrevSld )
gBtnArr["nb_nextBorder"] =3D gBtnArr["nb_next"]=3D new ImgBtn( "nb_next","n=
b_nextBorder",30,parent.GoToNextSld )
gBtnArr["nb_sldshw"]=3D new ImgBtn( "nb_sldshw","nb_sldshwBorder",18,parent=
.FullScreen )
gBtnArr["nb_sldshwBorder"] =3D new TxtBtn( "nb_sldshw","nb_sldshwBorder",pa=
rent.FullScreen,null )
gBtnArr["nb_sldshwBorder"].SetActive =3D _BSetA_Border;
gBtnArr["nb_sldshwBorder"].SetInactive =3D _BSetI_Border;
gBtnArr["nb_sldshwText"] =3D new TxtBtn( "nb_sldshw","nb_sldshwText",parent=
.FullScreen,null )
gBtnArr["nb_sldshwText"].SetActive =3D _BSetA_Border;
gBtnArr["nb_sldshwText"].SetInactive =3D _BSetI_Border;
gBtnArr["nb_voice"] =3D gBtnArr["nb_voiceBorder"] =3D new ImgBtn( "nb_voice=
","nb_voiceBorder",18,parent.ToggleVNarration )
gBtnArr["nb_otlTxtBorder"] =3D gBtnArr["nb_otlTxt"]=3D new ImgBtn( "nb_otlT=
xt","nb_otlTxtBorder",23,parent.ToggleOtlText )
gBtnArr["nb_ntsBorder"].m_flagId=3D "nb_nts"
gBtnArr["nb_ntsBorder"].SetFlag =3D NtsBtnSetFlag
gBtnArr["nb_otlTxt"].ChangeIcon=3D GetOtlTxtState
/*********************************************
Context menu implementation
_CM() is the function that's hooked up to
the oncontextmenu event. Once we're asked to
show the menu, we first build it by creating
DIVs on-the-fly. Then we position it=20
within the screen area so it doesn't get
clipped.
Creating the DIVs using createElement() means
we don't have to write out any extra HTML
into the slide HTML files.
**********************************************/
var sNext=3D"Next",sPrev=3D"Previous",sEnd=3D"End Show",sFont=3D"Arial",sAr=
row=3D"Arrow",sFreeform=3D"Freeform",sRect=3D"Rectangle",sOval=3D"Oval"
function ShowMenu()
{
BuildMenu();
var doc=3DPPTSld.document.body,x=3DPPTSld.event.clientX+doc.scrollLeft,y=
=3DPPTSld.event.clientY+doc.scrollTop
m =3D PPTSld.document.all.item("ctxtmenu")
m.style.pixelLeft=3Dx
if( (x+m.scrollWidth > doc.clientWidth)&&(x-m.scrollWidth > 0) )
m.style.pixelLeft=3Dx-m.scrollWidth
m.style.pixelTop=3Dy
if( (y+m.scrollHeight > doc.clientHeight)&&(y-m.scrollHeight > 0) )
m.style.pixelTop=3Dy-m.scrollHeight
m.style.display=3D""
}
function _CM()
{
if( !parent.IsFullScrMode() ) return;
if(!PPTSld.event.ctrlKey) {
ShowMenu()
return false
} else
HideMenu()
}
function BuildMenu()
{
if( PPTSld.document.all.item("ctxtmenu") ) return
var mObj=3DCreateItem( PPTSld.document.body )
mObj.id=3D"ctxtmenu"
mObj.style.visibility=3D"hidden"
var s=3DmObj.style
s.position=3D"absolute"
s.cursor=3D"default"
s.width=3D"120px"
SetCMBorder(mObj,"menu","black")
var iObj=3DCreateItem( mObj )
SetCMBorder( iObj, "threedhighlight","threedshadow" )
iObj.style.padding=3D2
CreateMenuItem( iObj,sNext,M_GoNextSld,M_True )
CreateMenuItem( iObj,sPrev,M_GoPrevSld,M_HasPrevSld )
=09
CreateSeparator( iObj )
CreateMenuItem( iObj,sEnd,M_End,M_True )
mObj.style.visibility=3D"visible"
}
function Cancel() { window.event.cancelBubble=3Dtrue; window.event.returnVa=
lue=3Dfalse }
function Highlight() { ChangeClr("activecaption","threedhighlight") }
function Deselect() { ChangeClr("threedface","menutext") }
function Perform()
{
e=3DPPTSld.event.srcElement
if( e.type=3D=3D"menuitem" && e.IsActive() )
e.Action()
else
PPTSld.event.cancelBubble=3Dtrue
}
function ChangeClr( bg,clr )
{
e=3DPPTSld.event.srcElement
if( e.type=3D=3D"menuitem" && e.IsActive() ) {
e.style.backgroundColor=3Dbg
e.style.color=3Dclr
}
}
function M_HasPrevSld() { return( parent.HasPrevSld() ) }
function M_GoNextSld() { if( gIsEndShow ) M_End(); else GoToNextSld() }
function M_GoPrevSld() { if( gIsEndShow ) { gIsEndShow=3D0; history.back();=
PPTSld.event.cancelBubble=3Dtrue; } else GoToPrevSld() }
function M_True() { return true }
function M_End() { window.close( self ) }
function CreateMenuItem( node,text,action,eval )
{
var e=3DCreateItem( node )
e.type=3D"menuitem"
e.Action=3Daction
e.IsActive=3Deval
e.innerHTML=3Dtext
if( !e.IsActive() )
e.style.color=3D"threedshadow"
e.onclick=3DPerform
e.onmouseover=3DHighlight
e.onmouseout=3DDeselect
s=3De.style;
s.fontFamily=3DsFont
s.fontSize=3D"9pt"
s.paddingLeft=3D2
}
function CreateSeparator( node )
{
var sObj=3DCreateItem( node )
SetCMBorder(sObj,"menu","menu")
var s=3DsObj.style
s.borderTopColor=3D"threedshadow"
s.borderBottomColor=3D"threedhighlight"
s.height=3D1
s.fontSize=3D"0px"
}
function CreateItem( node )
{
var elem=3DPPTSld.document.createElement("DIV")
node.insertBefore( elem )
return elem
}
function SetCMBorder( o,ltClr,rbClr )
{
var s=3Do.style
s.backgroundColor=3D"menu"
s.borderStyle=3D"solid"
s.borderWidth=3D1
s.borderColor=3DltClr+" "+rbClr+" "+rbClr+" "+ltClr
}
------=_NextPart_01C4C816.92B4BA90
Content-Location: file:///C:/C9764A33/annelintonElectronicRecordSecurityandHIPAARegulations_files/fullscreen.htm
Content-Transfer-Encoding: quoted-printable
Content-Type: text/html; charset="us-ascii"
Electronic Record Security and HIPAA Regulations
------=_NextPart_01C4C816.92B4BA90--
HIPAA, and some of the applicatio=
ns of
technology to be addressed, will cause these “standards” to
change, incorporating into “best practices” the use of all the
information that new technology can make available.
Physicians who will be able to review past medical records, including prev=
ious
medical images, now that the information is available in real-time electro=
nically
will have an ability to make better informed decisions about on-going care=
for
patients. And, multiple user=
s will
be able to view information simultaneously from diverse locations. This will allow professionals a b=
etter ability
to consult, providing higher quality care. It is far easier to share and MRI
on-line with a colleague than it is to print a new copy and send it to ano=
ther
office. And, ultimately, the
marginal cost will be so much lower in an electronic environment that the =
old
way will look too expensive to imagine.
One recent example of the changes taking place was the announcement two we=
eks
ago of the formation of the Leapfrog Group. This collection of large companies
– including AT&T, GE, GM, Boeing, and IBM – is encouraging=
all
of the employees of the companies to select hospitals that use technology =
to improve
patient safety.
With whom do you communicate????&nbs=
p;
What sort of communications are these?&nb=
sp;
What sort of frequency is there to these types of communications?In this context - Keeping personal
information about patients or doctors including their identities and relat=
ed
information private. &=
#13;
The general principles of on-line privacy, as determined at the Federal Tr=
ade Commission,
include notice of use of information, consent to the use, provision of acc=
ess
to the information, security from unauthorized access, and enforcement =
211;
usually applied to those who have opted in to the safeharbors allowing the=
m to
use on-line tools to share private information. This field is evolving, with medi=
cine a
specific subset of on-line privacy principles.
In context - medical records are,=
by
their very nature, confidential, because the information contained in them=
is
private. Further, that information could be used against patients or
providers, or against their will, if the confidential information were to =
be
released to unauthorized persons.
In the medical context - working =
to keep
private information and confidential records private and confidential. As with the communication of medi=
cal record
information, the storage and on-site use needs also to be secure, with pas=
sword
protection, timing out of logged in access to a system, and the use of Vir=
tual
Private Networks in moving information outside of a local area network. This will help prevent access to
private and confidential information by unauthorized persons.
Recent development in the security arena:=
Rijndael – an encryption algorithm which was selected as the =
new
standard by the National Institute of Standards and Technology. The announcement came in early
October. There will be a com=
ment
period, but this is expected to become the new commercially available
standard.
You can take steps to secure the
electronic patient record information.&nb=
sp;
Electronic patient information may be vulnerable in some ways that =
we
are not as familiar with yet – but people walk into medical records
offices and take files and access private information everyday, when they
should not have that access. These
suggestions may be useful in looking at implementing electronic patient re=
cord
systems in ways that protect the privacy and confidentiality of the
information, while allowing better access to valuable information needed to
provide quality care by authorized persons.
Don’t give your password to your nurse – make it possible for =
her
to get her own!
Have your transcription company put into its contract with you that it wil=
l comply
– this goes back to privacy enforcement we mentioned before.
As you choose folks with whom to work on implementing technology solutions,
try to find advisors who look at both the technical and legal issues toget=
her. This will simplify the process an=
d make
implementation easier. Furth=
er, it
will cause less strain on your staff, because you will not have to make as
many adjustments to address technical issues the lawyers did not consider =
or
legal issues that the technologists were unaware of.
One option that you have is to implement the regional medic=
al
archive.
All the preceding information is relevant if you consider
implementing a regional medical archive as a solution to the need for secu=
re
electronic patient records. =
The ultimate application service
Outsource your records maintenance to a secure records
database
Access those records securely
Share the information in confidence with other medical
professionals, offering better care, improved costs and secure info mgmt.&=
#13;
Mention that there is a one-page =
hand out
with the website information which may be of interest. And, it will have the addresses of
glossaries as well. Thanks to
everyone for attending. Offe=
r to
answer any questions for which there may be time, thank Dr. Dreyer. Thanks to everyone who helped put=
the presentation
together.
------=_NextPart_01C4C816.92B4BA90
Content-Location: file:///C:/C9764A33/annelintonElectronicRecordSecurityandHIPAARegulations_files/master04_stylesheet.css
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Content-Transfer-Encoding: quoted-printable
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SlideObj.style.visibility=3D"visible"
if( fTrans )
SlideObj.filters.revealtrans.Play()
}
function MakeNotesVis()=20
{
if( !IsNts() ) return false=20
SlideObj.style.display=3D"none"
nObj =3D document.all.item("NotesObj")
parent.SetHasNts(0)
if( nObj ) {=20
nObj.style.display=3D""
parent.SetHasNts(1)
}
return 1
}
function ChkAutoAdv()
{
if(SldHasTrans())
SlideObj.onfilterchange=3DAutoAdv
else
AutoAdv()
}
function AutoAdv()
{
if(!IsWin("PPTSld") || !gUseSldTimings )return
var sld=3DGetCurSld()
if( (sld.mAdvDelay>0) && !parent.IsFramesMode() )
setTimeout("parent.GoToNextSld()",sld.mAdvDelay)
}
function GetObj(id)
{
if(g_supportsPPTHTML) return document.all(id);
else return document.getElementById(id);
}
function SldHasTrans() { return SlideObj.style.filter !=3D ""; }
function GetSldId() { return sId=3Dlocation.href.substring(location.href.la=
stIndexOf('/')+1) }
function HideMenu() { if( frames["PPTSld"] && PPTSld.document.all.item("ctx=
tmenu") && PPTSld.ctxtmenu.style.display!=3D"none" ) { PPTSld.ctxtmenu.styl=
e.display=3D'none'; return true } return false }
function IsWin( name ) { return window.name =3D=3D name }
function IsNts() { return IsWin("PPTNts") }
function IsSldOrNts() { return( IsWin("PPTSld")||IsWin("PPTNts") ) }
function SupportsPPTAnimation() { return( navigator.platform =3D=3D "Win32"=
&& navigator.appVersion.indexOf("Windows")>0 ) }
function SupportsPPTHTML()
{
var appVer=3Dnavigator.appVersion, msie=3DappVer.indexOf("MSIE "), ver=3D0
if( msie >=3D 0 )
ver=3DparseFloat( appVer.substring( msie+5, appVer.indexOf(";",msie) ) )
else
ver=3DparseInt(appVer)
return( ver >=3D 4 && msie >=3D 0 )
}
function _RSW()
{
if( !g_supportsPPTHTML || IsNts() ||
( !g_scaleInFrame && (!IsWin("PPTSld") || !parent.IsFullScrMode()) ) )
return
var padding=3D0;
if( IsWin("PPTSld") && parent.IsFramesMode() ) padding=3D6
cltWidth=3Ddocument.body.clientWidth-padding
cltHeight=3Ddocument.body.clientHeight-padding
factor=3D(1.0*cltWidth)/g_origW
if( cltHeight < g_origH*factor )
factor=3D(1.0*cltHeight)/g_origH
newSize =3D g_origSz * factor
if( newSize < 1 ) newSize=3D1
s=3DSlideObj.style
s.fontSize=3DnewSize+"px"
s.posWidth=3Dg_origW*factor
s.posHeight=3Dg_origH*factor
s.posLeft=3D(cltWidth-s.posWidth+padding)/2
s.posTop=3D(cltHeight-s.posHeight+padding)/2
if( g_scaleHyperlinks )
ScaleHyperlinks( factor )
}
function _InitAnimations()
{
animRuntimeInstalled =3D ''+document.body.localTime !=3D 'undefined';
isFullScreen =3D (window.name =3D=3D "PPTSld") && !parent.IsFramesMode();
g_animUseRuntime =3D g_showAnimation && animRuntimeInstalled && !(isFullSc=
reen && parent.IsSldVisited());
if( g_animUseRuntime ) {
collSeq =3D document.all.tags("seq");
if( collSeq !=3D null ) {
for(ii=3D0;ii
' + ENDSHOW_MESG + '
![](3D"notes_flag.gif")
No=
tes![](3D"buttons.gif")
