HIPAA%20Privacy%20and%20Security:%20Integration%20with%20the%20Electronic%20Medical%20Record%20(session%205.02)

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HIPAA Privacy and Security Integration with the
Electronic Medical Record (session 5.02)

• Ronald B. Margolis, CIO, ICPO
• University of New Mexico Health Sciences
  Center/Hospitals
• June 6, 2003

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About University Hospitals and Health Sciences
Center

• Single Academic Health Center in the state
• Albuquerque is large metro NM is Rural
• 400 Tertiary Beds
• Additional 125 Beds
• Childrens Hospital
• Mental Health Center
• Childrens Psychiatric Hospital
• Childrens Rehabilitation Hospital

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HIPAA and the EMR

• Issues
• Does HIPAA fit well into the EMR picture ? How
  does it integrate with the electronic record ?

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Major Functional Areas of the EMR
HIM
Administration
HIPAA Reporting
Tele- medicine
Data Warehouse
Radiology
Lab
Security
Clinical
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General Goals of technology and EMR

• Improve healing environment for patients and
  visitors.
• Improve operational environment for medical and
  administrative personnel.
• Develop platform for rollout of new clinical and
  administrative applications.
• Reduce costs and operational inefficiencies.

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Integrated Technology Systems
Media
Telephone
Mobile Telephone
Tele- medicine
Data Network
Wireless Data
EMS
Clinical Systems
Security
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The HIPAA Overlay

• Systems Perspective HIPAA adds a layer
• User Perspective HIPAA adds a significant
  complication more to learn
• Administrative Perspective HIPAA adds a big
  mandate with downside risk

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Five levels of integration
APPLICATION TRAINING INTEGRATION
SYSTEMS INTEGRATION
NETWORK INTEGRATION
CABLE INTEGRATION
INFRASTRUCTURE INTEGRATION
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HIPAA Overlays

• Application level
• Ongoing training and consistency
• Systems integration
• Network integration level

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Focus on Clinical Impacts of HIPAA

• Application Level
• Vendor software
• User training
• Scheduling and Flow impact -- operations
• Communication impact -- eMail
• Education/training impact -- compliance

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Clinician Benefits

• Unifies systems, services and medical
  recordopportunity to reduce chaos
• Improved availability of data
• Reduction of errors from lost orders,
  illegibility, misfiling and current notes
• Competitive advantage, e.g., Leapfrog, HIPAA
  Compliance, Syndromic surveillance

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More Clinician Benefits

• Joint stakeholders with Administration
• Assure consistency with protocols
• Provides support for policies and documentation
• Improves workflow between units
• Enhances patient safety
• Tracks accesses and disclosures

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The clinicians complaints

• Takes longer for CPOE
• Already have more patients than time
• VA Vista experience
• Computer speed and reliability
• HIPAA tracks everything
• Staff has overreacted with HIPAA

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Bottom Line Benefits

• Improves access
• Communications
• CPOE eliminates errors and mistakes
• Opportunity to track all disclosures
• Incorporates messages into MR

• Rules based checking at order entry improves
  order efficiency and structure
• Supports the case for clinical pathways and best
  practices

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Structure is beneficial in a medical record.

Graphic courtesy of Health Technology Center
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Benefits to the system

• Quality and availability of the record
• Increases documentation compliance
• Increases security
• Reduces clerical tasks for ancillaries
• Complicated order sets are made easier
• Patient lists flowsheets gtefficiencies
• Historical data for research HIPAA

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Emotions During the Project Life Cycle
Vision drives Culture
Culture
Vision
Enthusiasm
Adoption
Acceptance
Optimism
Perseverance
Concern
Commitment
Other Priorities
Confusion
Pessimism
Danger Zone
Abandon the Project
Time
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Your turn for

• questions