1 Running Head: SN essay SN ESSAY Student’s Name Institution 2 SN essay Assignment Part One: System Edits and Restrictions for Integrity The following table is for patients vital signs (Absher RK (June 2009) : VITALS/ NON VITALS AND ATTRIBUTES Medical record number Date of birth DATA TYPE EXAMPLE/INPUT CUT-OFF MASK POINT ALERT Discrete xx-xxx N/A - Discrete DD/MM/YYYY N/A - Temperature, oral (in 0F) Discrete xx.x 90 Blood pressure Discrete Xxx/xx 120/80 Weight in pounds Discrete xxx.xx 126.00-136.00 Height in inches Discrete xxx.x 60-72 Inches Below: Too low Above: Too High Below: Too low Above: Too High Below: Too light Above: Too Heavy Below: short Above: Tall Part Two: Security Measures and Responses Concerns exist of electronic health records as with any other digital database. Attackers may pose a digital power that scares people looking to conceal their personal data. In the recent times, unauthorized users have accessed patients’ medical information. The incidences may not be frequent but they create cynicism in the patient’s mind. Consequences of confidential information landing on unauthorized hands are overwhelming. Medical information breach can lead to theft, destruction of other peoples’ 3 SN essay financial status and reputation. However, these crimes can be identified and mitigated if appropriate policies and stakeholders exercise their duties (Gartee, R., 2007). The following table summarizes four examples of security threats in the electron system discussed. It also provides a response plan and a reducing method to each threat in case they occur. Type of standard or threat Method to reduce threat Response plan if threat is encountered Workforce security breach: this security concern addresses supervision or authorization of users, workforce clearance procedures and procedures for termination. The management team must ensure that all authorized members with EPHI access are recorded properly to enable them receive proper clearances. Employees who bypassed the security prompt and accessed EPH without permission should be dealt with according to law and be charged of cyber crimes. Isolating Healthcare Clearinghouse Functions: This is a unique identity covered by HIPAA that translates non standard Users should also be given usernames and passwords to authenticate them when performing certain medical activities. Termination procedures should be implemented when an employee leaves voluntarily or involuntarily from the medical station. This is to protect and monitor the privileges of those who access the information of the patients. Clearinghouse Computers should be separated from other computers and workstations in the organization. Employee operating the non standard transactions should be identified and the transaction nullified. S/he should be punished according to the law, including possible termination of their jobs. 4 SN essay transactions into HIPAA standards. Threat against Creating awareness through; Security Awareness - login monitoring, and training: - security reminders, All members are - protection against trained on various malicious software, activities relating to - Password management. security of the data and computers in relation to safeguarding EPHI. Access Establishment and modification: The facility considers how access to EPHI is established and modified. Suspicious victims sending malicious software should be investigated by forensic auditing and thereafter be punished if guilty. Victims with suspicious login sessions should be barred from accessing PHI and permission denied. Each system user has a unique ID Employee shared their ID and password and password assigned by the with fellow employee who forgot theirs: institution. Passwords are not shared and must be changed 1. The relevant user's ID and every 90 days to prevent password are immediately unauthorized access. disabled upon issue discovery. A new user ID will be established Employees are trained in for that user. appropriate access and password usage. 2. The staff member is disciplined and given official warning to never share passwords. 3. System use and audit logs for that user are reviewed by IT and HIM manager. 4. Repeated breach will result in employee dismissal. Assignment 2 Date JWARD 01 05 - Log In 08:0 0 Pt # 122 3 Pt Type Log out Surg 08:1 7 Patient Name Olson 5 SN essay 11 SWILLIAM S LWORLEY 01 05 11 01 05 11 09:2 0 09:2 6 08:0 5 577 6 398 7 346 3 Surg 08:3 5 09:0 3 08:0 5 577 6 123 4 577 6 Surg 08:3 2 09:1 5 987 4 122 3 Medical Surg Radiolog y Radiolog y Surg Surg 09:2 4 09:4 5 08:0 8 William s Johnson 09:0 2 09:0 7 08:1 5 William s Jones 08:5 5 09:2 4 Smith Finch William s Olson Several organizations develop security audits to ensure accountability of workers for their activities when using the EPHI and EHR. Trails of the above audit should be taken to offer the back-end view of how the system was used. This information on logs is helpful in various ways. According to the above audit report, enough details have been provided to establish the duration of active session for each staff member. This is helpful in establishing the culture responsibility and accountability. It also gives room to evaluate the overall effectiveness of the access policy and user education and how the user altered/used the patient information. It can therefore be established that the EHR are accessed in the morning hours where the active session lasts less than one hour. However, most of the active sessions are less than 15 minutes. This creates a suspicion about the activities done by SWILLIAMs when accessing WILLIAMS’s 6 SN essay details that lasted for 27 minutes. According to the report, SWILLIAMS access the patients’ information for 3 to 4 minutes. The case with pt # 5776 raises eyebrows. LWORLEY also has unexpectedly long active session with pt# 9874 which lasted for 23 minutes. According to the report, L Worley is a Health Information clerk who processes requests for records from other healthcare providers and facilities. Additionally, the session for LWORLEY averagely lasts for 10 minutes as seen with other patients. With JWARD, the user session seems to be appropriate as the active sessions seems to be consistent. It is also clear that JWARD is a nurse who works with general surgery department. Therefore it is expected that the duration for active sessions should be longer than the clerks as it is because of the many details needed by nurses before a surgery is undertaken. Taking JWARD as a reference, it can also be established that SWILLIAMs had inappropriate activities with the details for pt# 5776. Logic being the, a clerk cannot take longer time to collect the few details s/he requires as compared to a nurse taking more details of the same patient (Safavi-Naini, R., 2010). Assignment 3 Records are available for review for patient care within 12 hours HIM employees are professional in the completion ALWA YS 15% OFTE N 35% SOMETIM ES 25% SELDO M 25% NEVE R 0% 10% 20% 50% 20% 0% 7 SN essay of their work (e.g., are dependable, maintain confidentiali ty, are accurate in the completion of their work HIM Department communicat es well any changes in policies, procedures, or services to the medical staff. 25% 10% 45% 10% 10% Health Information Management (HIM) professionals are expected to have a unique skill set that is required in a professional healthcare environment. They are required to collect timely medical data, make it available to the authorized users and ensure various policies are implemented in relation to access of that data. HIM professionals are also expected to do their work to their best of completion and satisfaction of the patients. a. What do the survey results show? The survey results are based on three areas of concern that are rated on a scale of 1-100% each depending on how often they occur. The three areas are selected based on availability of records, employee professionalism and their ability to communicate change. 8 SN essay The results on the first concern about availability of records show that there is higher possibility of records being available for review for patient care within 12 hours. In fact, there is a 75% possibility that they are available. However, it is rare that the records are available always for the review. There is also 80% possibility of receiving professional treatment and healthcare from the HIM employees at most times. Despite of the high possibility of receiving the professional healthcare, some little percentage (20%) of the employees practice professionalism in their work rarely and therefore they are not reliable. In communicating change in policies and procedures to other departments, HIM employees cannot be completely relied on. However, some percentage communicates change always while 10% never communicate change. Generally, the results on this concern are poor as some of the changes are not communicated at all. b. Brainstorm. What reasons could explain these results? - There are relatively low full-time equivalents in the department that could be making it harder to communicate change to the other medical staff. - Low percentage of the employees completes their work professionally because of their limited number in comparison to the 1,500 patients to be attended to. - High turnover in the department could be leading to unavailability of records for review at most of the time. This may also contribute to more changes in policies not to be communicated to the medical staff as most staff members may not be familiar with the initial policies that had to be changed. 9 SN essay - Records may not be available always for review maybe because of the limit imposed by the budget. Some records need to be printed, scanned and filed so that they can be availed. This can be finance demanding as not planned within the budget. c. Which area of concern should be addressed first? Why? According to the survey in this case, of critical urgency is the ability of the staff to complete their activities professionally. This is so because all the patients and other staff need to be confident with the HIM department employees as they are responsible for critical tasks. Even before the medical staff receives 100% of the change from the HIM department, they ought to trust in them and have confidence as it is portrayed in their ability to complete various tasks professionally. The other two concerns are also tied to the availability of finance and budgeting of the institution. Budget constraint may make the availability of documents be low as they need fiancé to scan and print other document with health records. To gather all the staff in the organization may be demanding and due to budget constraints, some of the change will not be passed across. d. Using critical thinking and problem solving skills identify steps the director should take to investigate concerns and improve department services. - First step in the improvement process is to identify all concerns and problems that need to be addressed. This involves asking other stakeholders about the concerns and creating a list of all the concerns. Also, indicate the possible causes and consequences of the concern. 10 SN essay - To improve the department performance, it is important for the director to prioritize the above concerns with regard to urgency and resource availability. Logically, the second concern is cheap to implement and urgent. - Generate solutions for the listed concerns. - Then gathering of relevant resources, people and procedures for implementing the solutions for the concerns. - Implementing the solution. Assign 4 Topic of Survey: Rate the response of your routine healthcare provider during the last 24 months. Questions of the Survey: 1. How many times have you visited a healthcare over the last 24 months? 2. How often did you a medical appointment after you phoned your healthcare provider to get an immediate attention? 3. Do you recall a situation where you phoned your healthcare and you never received an appointment? 4. In the last 24 months, have you called your healthcare provider during regular office hours? How did he react? 5. During your last visit to your healthcare provider, did s/he explain thing in a way that was easy for you to understand? 11 SN essay Experience with 123Contactform online tool is a complete amazement. The tool allows you to email the survey questions to the targeted audience and receive their feedback. For the five questions above, the tool is free and reliable. After creating the survey template, the tool allows you to have a link to the survey template which one can impede in a website or post on social media for friends to partake. After the experience with this tool, my survey should take the same format and platform as it comes with numerous benefits. It is also cheap and reliable. Comments can be accommodated within the tool and make it livelier. Verbal survey can be more tiresome but with online survey tools, the tasks are accomplished and objectives of the survey met without much travelling. Most interesting comment was: “How many times have you visited a healthcare over the last 24 months?” “I can’t recall” Assign 5 Based on the PPS System you've chosen in Module 06, create a flow chart of the Revenue Cycle and discuss how the selected PPS impacts revenue cycle PROSPECTIVE PAYMENT SYSTEM (DRGs) 12 SN essay When building a health bottom line, it is important to ensure that the health care payment system is structured in a proper way. This is done by understanding the complexities of medical insurance and the billing process. The following are the ways that the inpatient Prospective Payment System (IPPS) impact on the revenue cycle; Workflow of activities within the IPPS impact greatly on the revenue cycle: Activities like diagnosis and procedure codes, collection of co-pay, documentation and activities related to submission are all related in chain. A small kink in the workflow will therefore wreak havoc within the revenue cycle. IPPS embraces technology which may impact on the financial performance of the revenue cycle (Healthcare Financial Management Association., 2003). Technologies like electronic medical records and practice management system can be used in the following sections to impact positively on the revenue cycle: 13 SN essay 1. Patient visits: electronic medical records can be used to document patients’ details at the counter. It can also be used by the biller to capture other useful information that is required in reimbursement. 2. Billing functions: tracking of claim status can be made and scrubbed before being submitted to the payers to ensure they meet local and national requirements to comply with medical stipulations. 14 SN essay References Farrington E, Absher RK (June 2009). "Evaluation of the accuracy of different methods used to estimate weights in the pediatric population". Pediatrics 123 (6) Healthcare Financial Management Association. (2003). Issues in outpatient PPS: keys to successful revenue cycle management. Healthcare financial management: journal of the Healthcare Financial Management Association, 57(7), suppl-1. Gartee, R. (2007). Electronic health records: understanding and using computerized medical records. Pearson Prentice Hall. Narayan, S., Gagné, M., & Safavi-Naini, R. (2010, October). Privacy preserving EHR system using attribute-based infrastructure. In Proceedings of the 2010 ACM workshop on Cloud computing security workshop (pp. 47-52). ACM.