NCM110 finals

• Telehealth


  • broader branch of healthcare that uses telecommunication technologies to provide services at a distance
  • includes non-clinical services as well, such as virtual education and training of medical professionals, public health functions, etc.
  • all telemedicine is telehealth but all telehealth is not telemedicine
• telemedicine


  • practice of delivering medicine and healthcare at a distance, through the use of technology
  • specific to remote clinical services
• Goals of Telehealth and Telemedicine

  • make health care accessible to people who live in rural or isolated communities
  • make services more readily available or convinient for people with limited mobility, time, or transportation options.
  • provide access to medical specialists
  • improve communication and coordination of care among members of a health care team and a patient
  • provide support for self-management of health care
• Benefits of Telehealth implementation for providers

  1. improve access to medical care
  2. higher patient engagement rates
  3. better patient outcomes
  4. lower hospital readmission and no-show rates
  5. cost-cutting
• Benefits of Telehealth implementation for patients

  
  

  1. improved outcomes
  2. immediacy and accessibility
  3. fewer complications
• Challenges of Telehealth implementation for providers

  1. privacy and data security
  2. internet usage
  3. regulatory and legal compliance
• Challenges of Telehealth implementation for patients

  1. security measures
  2. awareness
  3. access
• Regulatoty and legal considerations of telehealth and telemedicine

  1. informed consent
  2. licensure
  3. malpractice
  4. reimbursement
  5. technology
• Examples of how telehealth and telemedicine are implemented

  
  

  1. live video
  2. store-and-forward
  3. remote patient monitoring
  4. mobile health
• The Center for Connected Health Policy


  the federally-designated National Telehealth Policy Resource Center, describes four key telehealth application domains
• Live Video


  • a live connection allows the provider to examine and observe the patient in real time, deliver psychiatric evaluations, and consult with other providers, among many other benefits
  • synchronous telehealth communication is defined by a live, f2f interaction between a patient and healthcare professionals, in consultation, via audio-video conferencing.
• Store-and-forward (asynchronous)


  • asynchronous telehealth communication represents contact that is not f2f, but in real time, by way of email, internet, text messaging or as 'store and forward' wherein information is sent and picked up or responded to at a later date
• Remote patient monitoring (RPM)


  it is a well-established means to monitor various conditions and associated data, including cardiac monitoring for those who suffer heart failure, or general monitoring of chronic diseases
• Mobile health (mHealth)


  it is another example of synchronous telehealth wherein health care visits are initiated and conducted on patient personal computers and mobile devices or smart phones, from the patient's preferred location, instead of traditional clinical setting
• Examples of telemedicine

  • teleconsultaion
  • telemonitoring
  • telediagnosis
  • teletreatment
  • telecare-provision
• Ethics


  Set of rules and standards of conduct that grow out of our shared understanding of right and wrong and govern our professional behavior
• Laws


  Formal, enforceable rules and policies based on community standards of conduct
• Privacy


  Patient's freedom to determine when, how much and under what circumstances his or her medical information may be disclosed
• Confidentiality


  Refers to how the recipient of the information handles information that a patient does not willing to share
• Anonymity


  Information cannot be linked back to the patient
• Anonymity


  • Performing lab tests using an ID number instead of a patient name
• Protecting Patients from Harm includes Respect for their Right to Privacy
• Health information is valuable and its unauthorized use or disclosure may put patients at risk for unwanted publicity, identity theft, discrimination and other acts prejudicial to the patient
• Data Privacy Act of 2012


  It is the policy of the State to protect the fundamental human right of privacy, of communication while ensuring free flow of information to promote innovation and growth
• RA 10173: DATA PRIVACY ACT OF 2012


  Personas Defined in the Law: Data Subject, Personal Information Controller, Personal Information Processor
• HIPAA (HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT)


  It is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge
• HIPAA


  • Seeks to improve healthcare access, portability, and continuity while addressing the growing challenges of data privacy and security
  • Establishes national standards for the protection of individuals' medical records and personal health information
• Privacy Rule


  • Sets national standards for the protection of individually identifiable health information by three types of covered entities: health plans, health care clearinghouses, and health care providers who conduct the standard health care transactions electronically
  • Establishes privacy standards for use of IIHI
  • Helps patients control ways their health information is disclosed
  • Requires disclosure of health information to be logged
• Disclosure Documentation


  Patients are permitted to request a log of disclosure of their PHI, which must include the date, name and address of the entity/person who received the IIHI, a description of the IIHI disclosed, an explanation of the purpose or a copy of the patient's written authorization, and a copy of a written request for disclosure
• Entities/providers required to


  • Distribute NPP
  • Designate a privacy officer
  • Provider authorization forms for release of PHI
  • Implement policies to protect PHI
  • Develop procedures for correcting errors in the HER
  • Provide privacy training for staff
• Covered Entities and Business Associates

  • Healthcare provider
  • Health plan
  • Healthcare clearing house
• Minimum Necessary standards


  When a covered entity makes an allowed disclosure, it should include only a minimum necessary amount of information to accomplish the purpose
• Consent


  • Individual choice principle
  • Patient should have a reasonable opportunity to make informed decisions about the collection, use and disclosure of their PHI
  • In order for records to be released, an authorization form must be completed
• Security Rule


  • Establishes standards for the protection of electronic PHI (ePHI)
  • Requires covered entities to implement administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and availability of ePHI
• Breach Notification Rule


  • Mandates covered entities to notify affected individuals, the Secretary of Health and Human Services, and, in some cases, the media following a breach of unsecured PHI
  • Notifications must be provided without unreasonable delay and no later than 60 days from the discovery of the breach
• Administrative Safeguards


  • Risk analysis
  • Risk management
  • Sanction (penalties) policy
  • Information system activity review
• Physical Safeguards


  • Ensure security of electronic data
  • Buildings
  • Equipment
• Technical Safeguards


  • Controlled access of employees
  • Automatic logoff
  • Encryption
  • Decryption
• Patient's Rights under HIPAA

  • View or receive copies
  • Have inaccurate information corrected
  • Receive NPP
  • Opt out of sharing certain information
  • Have certain information withheld from certain payers
  • Receive list of disclosure
  • File a complaint
• How can patients protect themselves?

  • Review medical, dental and prescription drug records for accuracy
  • Request a disclosure log
  • Request restrictions on disclosure of sensitive information
  • Ask to receive correspondence at alternative locations
  • Pay out of pocket
  • Opt for online versus paper statements and read them carefully