Does your organization have a zero-tolerance policy for violations of patient privacy? If not, perhaps recent events indicate the value of having such a policy.

In an example of HIPAA policy enforcement, Tucson’s University Medical Center has fired three employees this week for violating patient privacy. The hospital reported that three workers were dismissed for inappropriately accessing the medical records of patients involved in the high profile shooting rampage that involved Representative Gabrielle Giffords. This incident resulted in the death of six people and left Representative Giffords in critical condition.

Policies and procedures should clearly indicate that patient privacy must be protected. That includes limiting access to health information to those who have a need to know.

Education is critical in your organization. Employees should have training about HIPAA upon hire and annually thereafter. Training topics should cover patient privacy, security, and how the law and rules apply to a person’s individual work setting.

Access to information must be limited to the person’s need to know based on their role. This role-based access should be reviewed annually as a part of your compliance program.

You also must be able to track who has accessed protected health information. Access logs will show you who has looked at a patient’s record. I imagine it was these access logs that led to the discovery of employees accessing the files at the University Medical Center in Tucson. Without access logs, you will not be able to tell if you have had a breach.

Your policies must also include a sanctions policy. Sanctions do not necessarily have to be “zero-tolerance” policies for any kind of error. There may be times when something happens that was a simple mistake. However, if you have a zero tolerance policy, be ready to follow through with it by dismissing staff when they violate the policy.

In the case of a high profile case like the one in Arizona, zero-tolerance is the wisest choice. There is far too much risk that this information could be accessed for all the wrong reasons. In the end, accessing a patient’s information for any reason other than what is required to provide health care is wrong. Accessing it with the potential of personal gain, selling it to media, etc., is totally unacceptable. Note there is nothing to suggest that is what happened with this particular breach; it is, however, a higher risk of such a problem when you have high profile patients.

In the end, having a zero-tolerance policy at your organization, and being sure you enforce it, protects everyone and shows you are serious about patient privacy. It may also protect you should you have to defend yourself in court or to the government in the case of a breach.

Training is critical. Have you done your annual HIPAA training with staff this year?

I ran across an interesting report this week related to data breaches and their cost to an organization. The 2009 Ponemon Institute Benchmark Study was released and makes for some fascinating and scary information. The study covers many different industries where breaches occurred in 2009, with 45 participants, some of which are healthcare entities. I encourage you to read the entire report as I found it quite interesting.

With breach notification now required if an organization has a breach, it's important to take steps to protect yourself from this occurring. So what if this happens? What will it cost? Here are some interesting points from the study:

• The average cost of a breach is $204 per record involved. In the healthcare industry, however, this cost rises to $294 per record, second only to the pharmaceutical industry at $310.
• The average organizational cost in 2009 was $6.75 million. The most expensive cost was $31 million.
• The study looked at what percentage the cost of lost customers is due to a breach. This has risen to 3.7% and is listed as the main cost when you have a breach. It is interesting to note that, while the average is 3.7%, in health care that number actually increases to 6%, which is equal in the healthcare, communications, and pharmaceuticals industries.
• Another important thing to note is that 42% of breaches were listed as due to an external factor, such as using an outsourcing company to provide services. In the healthcare industry, this number rises to 60%.
• Of the breaches studied, 36% were related to lost or stolen laptop computers or mobile devices. Do you now see a value in being sure your jump drives and external hard drives are encrypted?
• Also reported was the average cost when the breach was related to a mobile device: $224 compared to $193.
• Do you have a compliance officer for your organization who manages the process? If not, it may be a good time to rethink your strategy. Those organizations who have one had an average cost per record of $156.73 versus a cost of $235.51 for those who do not.

While a mere $200 may not sound like a lot, remember this is per record breached. Just one breach that involves 500 patients would have a cost of around $102,000. Many of the 131 breaches reported on the HHS website have many more records than 500.

Be sure your compliance program is protecting you from breaches that could end up costing thousands, or millions, of dollars. It is not a place to skimp on in your organization.

Remember, if you are an independent contractor, this weekend is your last opportunity to get the HIPAA4MT sample policies and procedures at a significant discount!

As we have discussed with the recent rules that were published, independent contractors are now subject to the rules of a business associate, no matter whether they contract directly with the covered entity or not. That brings some challenges for everyone as those who are subcontractors try to do what they need to do to be compliant.

As someone who has been there as an IC and knows what the struggles can be, I've been thinking how to best address this in a way that would be helpful. There are a lot of products out there to select from, and the prices range from $200 to $4,000. I don't know too many independent contractors who could do that.

If you are a subcontractor, you should now have your own set of policies and procedures to show that you are compliant. In an effort to assist those of you who are independent contractors, we are now making the set of sample policies and procedures available to independent contractors, or those who are classified as a subcontractor, for a greatly reduced price. The policies, which normally are priced at $200, are now available to the independent contractor for a price of $60. This does not apply to a business owner who has a business with employees or subcontractors, and is some just for the sole proprietor who contracts from someone else. This does not include the training that is offered, only the set of policies.

You might ask, "but how you know?" Isn't it possible that business will take advantage of this? Sure it is. Still, I believe that people in general operate with honesty and integrity. It's the cornerstone to my businesses and I anticipate that others will do the same. For me, it's just that simple.

If you would like to order a set of these policies, please email me, put "IC Policies and Procedures" in the subject line, and I will send you the discount code to use. This offer will be available through August 15, 2010.

UPDATE: There is a problem with the links for the training page. You can find information on available HIPAA Training at the training page on the website.

The third week in May is designated as Medical Transcriptionist Week, by proclamation signed into law by President Ronald Reagan in 1985. It's hard to believe that was 25 years ago.

Medical transcriptionists (MTs) play an important role in telling the patient's story and this year's theme for the week is "Capturing America's Healthcare Story: Why We Matter." MTs are often so behind the scenes in the healthcare documentation process that they aren't recognized. Take a minute this week to do something to recognize the MTs in your life and in your work place.

In honor of MT Week, we are offering a 10% discount on early registration for our HIPAA and HITECH training courses that are coming in June. Register now, perhaps even given this as a gift for someone during MT Week.

To those who are MTs, celebrate who you are this week and the value you bring to the healthcare delivery system. It is YOUR week, be proud and enjoy it!

HIPAA requires training in privacy and security for everyone, and now you can meet that obligation here. The first HIPAA and HITECH Act training courses will start on June 14, 2010. Whether you are an independent business owner, an independent contractor, a business associate, a covered entity, or simply someone who would like a general overview of the HIPAA and HITECT Act laws, there is a course designed for you.

In addition to the courses being offered, you will also find sample policies and procedures. If you are struggling with what to do about creating the policies and procedures that that law now requires you to have, these are customizable to your business setting.

Discounts!
Registration is now open for these courses. In honor of Medical Transcriptionist Week, which is May 16-22, we will offer a 10% discount for anyone registering before May 22. After that date, the regular prices will apply.

Don't delay in being sure that you have the necessary training and documentation that you have completed this training. Sign up today for one of our courses and join us in June! Be sure to sign up by May 22 to receive your discount.