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MACRA consists of the APM and MIPS programs

Medicare Reimbursements Shift towards Quality of Care

In an open letter last Friday, October 14, the Centers for Medicare and Medicaid Services (CMS), announced the finalized policies for implementing the new Medicare Quality Payment Program (QPP). Although the rule takes effect on January 1, 2017, several components will be phased in over the next few years to give physicians time to adjust accordingly. Many of the policies have been updated from the previous proposal in response to feedback from clinicians across the country. Read more

Mobile health is here to stay!

Mobile Health: Patients Want It All

When it comes to combining personal health with the convenience of mobile devices, what do smartphone users really want? A recent study suggests that people want to be fully engaged online, including accessing their health records and communicating with their healthcare providers—all from their phones and tablets. It’s a great idea in theory, but can everything actually fit into one application? Read more

5 Ways (and why) to Help HIT and Telemedicine Adoption

A few articles came out this week that I that I feel underscore the need for providers – both large hospital systems and private practices – need to get off their collective derrières and start implementing HIT and Telemedicine.

Thankfully, we are going to provide them valuable advice to help make this happen later in this piece. However, let’s start with a brief discussion of some of this week’s materials.

In a piece Read more

Let’s Operate on Interoperability

Wednesday, MedCity News and Life as a Healthcare CIO ran what I believe to be a very important piece on interoperability by Dr. John D. Halamka. I don’t agree with him that attempts to legislate interoperability into being should be jettisoned completely, but most of his points ring true.

Early on he asks the question that SHOULD be core to the HIT and Telemedicine industries, but especially for EHR vendors: “So what is our next step to help providers…to the point that Congress no longer wants to legislate the solution to the problem?” Read more

Hackers and Telemedicine Security – Thoughts?

hacked

Today’s reporting (and here, here, and many other places) that Community Health Systems hospital network was hacked for personal information is alarming.  Although no credit card–and NO CARE INFORMATION–was taken, social security, birthdays, and addresses all were.  That is, everything necessary to open bank accounts, sign up for credit cards, and nearly anything else that counts as identity theft.

As potentially bad for the patients as this is, it’s equally bad for Community Health Systems.  Apparently their stock took only a brief hit (CYH), although it wouldn’t be shocking if it moves lower again assuming the news becomes more widespread and if they are sued.  This scenario is possible because although–and I would like to emphasize this yet again–NO CARE INFORMATION WAS TAKEN (medical histories, treatments, etc.) the information was still covered under HIPAA.  (They do have insurance to cover cyber liability, but even so…)

I do not know how the data was kept or encrypted.  It’s interesting…and somewhat heartening…to know that the care information was not accessed by the hackers.  However, I believe it helps us remember that no system is completely safe, and that the highest available level of security should always be used.  Currently, regarding encryption, that would be AES 256-bit encryption.  It also means use of secure one-time-use keys for communication software endpoints and conscientious use of regularly changed passwords by users.  It means keeping devices used within networks either on VPNs (vitual private networks) or, again, using 256-bit encrypted, password-secured communication over non-VPN networks (and why not do it on the VPNs anyway?).

So, now the question is: Does this security breach have any implications for telemedicine and mHealth?  My guess is that mHealth is probably at the greater risk.  I think there’s less of a general use for cybercriminals for care data than simply personal data, and that certain types of personal data, such as location data combined with the pedometer on (could indicate you’re out jogging 10 miles from your house…might be a good time to break in), make mHealth a little more nerve-wracking.  Just a guess.  There may be very creative ways to make use of mass medical histories and treatment information that just hasn’t been discovered yet.  Thoughts?

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