HIPAA – HITECH – MUSimplified

A Brief History Current State

Future Directions

Why “Accountability” for Privacy?

Historic Medical Record Modern Medical Record

www.medbid.com http://electronicmedicalrecords.page.tl/Home.htm

The History of PrivacyHealth Records Were

Regulated in 1996Other examples regulated prior

to 1996

Video Rentals

Phone Records

Driver’s License

Cable TVSchool Records

Are You Kidding Me?

HIPAAThe PRIVACY RULE Addresses:

• The use of individuals’ protected health information (PHI)

• How the information can be disclosed (shared)

• Standards for individuals' rights to understand and control how their health information is used.

Under the SECURITY RULE Covered Entities Must:

• Ensure the confidentiality, integrity, and availability of all e-PHI they create, receive, maintain or transmit

• Identify and protect against threats to the security or integrity of the information

• Protect against impermissible uses or disclosures

• Ensure compliance by their workforce

Security Rule: “Safeguards” for Compliance

• SECURITY:• Management• Incident• Contingency

Admin• Workstations• Disposal• Data Backup

Physical• Unique User ID• Encryption• Secure Transmission

Technical

http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/security101.pdf

Uniform Code Set – also a Part of HIPAA 1996

1996

1996 to 2009

The American Recovery and

Reinvestment ActARRA

The American Recovery and Reinvestment Act

The Health Information Technology for Economic and Clinical Health Act

Meaningful Use

ARRA - 2009

HITECH

MU

ARRA – Where is the Money Going?

http://www.recovery.gov/arra/Transparency/fundingoverview/Pages/fundingbreakdown.aspx

The Health Information Technology for Economic and

Clinical Health

HITECH

The American Recovery and Reinvestment Act

The Health Information Technology for Economic and Clinical Health Act

Meaningful Use

ARRA - 2009

HITECH

MU

Meaningful UseUsing certified EHR technology to:

• Improve quality, safety, efficiency, and reduce health disparities• Engage patients and families in their health care• Improve care coordination• Improve population and public health

AND• All the while maintaining privacy and security

https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/MU_Stage1_ReqOverview.pdf

The American Recovery and Reinvestment Act

The Health Information Technology for Economic and Clinical Health Act

Meaningful Use

ARRA - 2009

HITECH

MU

Core Objectives

• E-Prescribing (eRx) • Provide clinical summaries for patients for each office

visit • Drug-drug interaction checks • Record demographics • Maintain active medication list • Record smoking status for patients 13 years or older • Capability to exchange key clinical information among

providers of care electronically • Protect electronic health information

Sampling of Stage One Measures

incentive payments

• $18,000 in 2011 or 2012 in the first year (only

$15,000 after 2012);

• $12,000 for the second year;

• $8,000 for the third year;

• $4,000 for the fourth year; and

• $2,000 for the fifth year

• After 2015, physicians who fail to meaningfully use

EHRs will be subject to reductions in Medicare and

Medicaid reimbursement

eligible professionals who demonstrate the meaningful use of an EHR

Policy/Law Money/Funding

HIPAA

HITECH

MU

ARRA

HITECH

MU

Future?

Coding and Billing Clinical Notes and Lab Results

Future?• SNOMED• Myocardial Infarction• Myocardial Infarct• MI• Cardiac Infarction• Heart Attack

• LOINC• Comprehensive Metabolic Panel• CMP• Chemistry Panel• Chemistry Screen• Chem-12