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1.      After viewing the video, “HIPAA PHI: Examples of what not to do”, What would you do differently, what should be done differently?

2. Patients need to have easy access to their EHR.  How should patient portals be designed to promote ease of access while maintaining privacy and confidentiality?  What information should be included in portals for patients to access?

3. Should healthcare organizations use the same patient care documentation system in order to ensure confidentiality and privacy? Why or why not? Explain.

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https://en.wikipedia.org/wiki/Network_security

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Safe Health IT Saves Lives

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By Art Gross, President and CEO, HIPAA Secure Now!
Twitter:@HIPAASecureNow
Read other articles by this author

As the value of healthcare data remains high, there is no denying that healthcare organizations make prime targets for cybercriminals. To wreak havoc and make a profit from compromised patient data, cybercriminals exploit weak spots in healthcare organizations, whether that be a loophole in the security of the server, poorly trained employees, or a variety of other ways.

As we move more and more into the digital age, the presence of Electronic Health Records is continuously growing, making the perfect targets for criminal activity. It is crucial that your organization takes proactive measures to ensure its data is protected and not readily available for cybercriminals. Here are five tips that can help you protect your organization and the sensitive data it stores from falling into the wrong hands:

1. Perform Risk Assessments Regularly
Don't underestimate the value in performing routine Risk Assessments. Healthcare organizations are constantly changing and evolving, and those changes should be evaluated for the risks they pose. For example, maybe your organization got a new server, opened a new office location, or changed EHR vendors - all these changes come with risks that should be properly evaluated.

Not only do Risk Assessments identify security gaps in your organization's administrative, technical, and physical safeguards - potentially saving you from a destructive data breach, but they are also required for HIPAA compliance and in most cases, MACRA/MIPS requirements.

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2. Perform Vulnerability Scans & Penetration Tests
Sometimes referred to as network assessments, vulnerability scans are all about identifying vulnerabilities in your organization that could be exploited to gain access to ePHI. Networks have become very complex and performing a vulnerability scan helps identify misconfigurations for vulnerabilities before a cybercriminal does. This scan may look for things such as a hole in the firewall, unpatched systems, and more.

Once you've performed a vulnerability scan, it is highly recommended that you perform a penetration test. A penetration test, also known as a pen test, is generally performed after you have remediated the findings from your vulnerability scan. These tests are typically performed outside the network and attempt to "break in", a true test of the risks associated with your network. These thorough tests can come with large price tags, so it is recommended to plan accordingly and account for this scan in your budget.

3. Utilize Encryption
Encryption is necessary for healthcare organizations to provide adequate protection of patient data. Despite proactive measures, data breaches happen. It is important that your organization is utilizing encryption across the board - from encrypting your laptops to encrypting your emails. Since encryption renders your data essentially useless, it is the only safeguard keeping a cybercriminal out of your sensitive data if they were to gain access to your systems. Encryption should be in place for data both at transit and at rest.

4. Perform Updates & Patch Your Systems
Updating your systems is an important practice for a variety of reasons. Not only do updates repair security holes and fix/remove bugs, but they also offer benefits like adding new features and removing those no longer needed.

Cybercriminals prey on unpatched security holes, which can lead to several issues for your organization. Once a vulnerability is discovered, hackers will often write code to target and exploit that vulnerability with malicious intent. If successful, a hacker may use that security loophole to infect your computer. For example, WannaCry ransomware, which wreaked havoc across the healthcare industry just last year did so by exploiting unpatched medical devices.

Although hackers are often the ones to discover security holes, upgrades and patches are often released as quickly as possible to prevent them from further exploiting the discovered vulnerability.

5. Check Your Audit Logs
Any systems that are being used to access or store patient information should be capable of producing a log report to provide details on who accessed the patient data, what data they accessed, and the time of access. These logs can help ensure that employees are only looking at the data required to perform their job function, and also act as a check-up to ensure inappropriate and unauthorized access is not occurring.

For example, if you check the log for your EHR system and see that one of your employees accessed the system at 3:02 am and viewed 400 patient records, this finding should come as a red flag to you. It is unlikely that your employees would be accessing that magnitude of patient data, especially at the time listed on the log.

Remember, it's great that systems are capable of producing these reports, however, if you're not routinely checking them and ensuring nothing looks abnormal, the logs are essentially useless.
This article was originally published on HIPAA Secure Now! and is republished here with permission. HIPAA Secure Now offers annual online subscriptions to help covered entities and business associates keep up with compliance. Learn more here.
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5 Tips for Protecting Your Electronic Health Records | Health IT Answers

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By Art Gross, President and CEO, HIPAA Secure Now! Twitter:@HIPAASecureNow Read other articles by this author As the value of healthcare data remains high, there is no denying that healthcare organizations make prime targets for cybercriminals.

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HIPPA PHI: Examples of What Not to Do

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Sharing Your Electronic Health Record (EHR)

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Electronic Health Records: Usability and Unintended Safety Issues

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Electronic Health Records: Usability and Unintended Safety Issues

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Electronic Health Records: Usability and Unintended Safety Issues

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Confidentiality: key issues in scenarios/role-plays in 180 seconds

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Confidentiality: key issues in scenarios/role-plays in 180 seconds

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Dr. Aman Arora - Arora Medical Education

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Confidentiality: key issues in scenarios/role-plays in 180 seconds

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Confidentiality: How to Maintain Patient Confidentiality

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Confidentiality: How to Maintain Patient Confidentiality

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Confidentiality: How to Maintain Patient Confidentiality

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Six Real-World Examples of Social Media HIPAA Violations

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RN breaches patient confidentiality policy to check work schedule

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RN breaches patient confidentiality policy to check work schedule

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submitted by Cecilia M.

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Upholding patient confidentiality policy is a fundamental obligation for any nurse in any setting.

I have discussed this topic in several blog posts, including "What happens when a nurse breaches patient confidentiality" and "Protecting a patient's confidentiality does matter".

Most often, a breach can happen when a nurse shares patient information with a person who is not a member of the healthcare team or when a patient's electronic medical record is accessed for a personal reason when a nurse is not providing care.

A nurse discovered how far-reaching the obligation to uphold patient confidentiality policy is in the case of Leach v. Iowa Board of Nursing. The nurse, who was employed in the hospital's ICU, remotely accessed patient census lists 11 times when not at work. The lists contained private health information, including patient names, ages, diagnoses, medications and other personal information.

When a supervisor discovered the nurse accessed the lists, she was questioned. The nurse's reason for checking the lists was to determine ICU staffing and whether she would be required to work her assigned shifts.

The nurse was told her actions were in violation of the hospital's "information security policies" when employees were in a remote location and did not seek authorization. Moreover, the supervisor informed the nurse that any access had to be "necessary to complete her job responsibilities."

The nurse was disciplined, suspended for two 12-hour shifts and required to repeat a Health Insurance Portability and Accountability Act learning module.

Supervisor files complaint with state board

After a board investigation on the alleged breach of the patient confidentiality policy, probable cause was determined to proceed to a hearing. The nurse received the board notice for a hearing and the allegations against her, which involved breaching her duty to protect the patients' confidentiality and privacy rights in violation of the state's nurse practice act and administrative rules.

A contested hearing took place, and the board found the nurse:

Accessed the patient lists for her own purpose to determine if she would work the next day or be placed on call.

Did not use information from the lists for any other purpose.

Did not share the information with anyone else.

Did not read any personal information on the lists.

Was not authorized to access the lists from a remote location.

Did not need the information to perform her duties as an ICU nurse.

As a result of these findings, the board found by a "preponderance of the evidence" (its burden of proof) the nurse's conduct was unethical.

Because the board believed the nurse did not understand her conduct was a violation of the patient confidentiality policy and the hospital determined the behavior was not a HIPAA breach, the discipline imposed was the least severe sanction - a citation and a warning.

The nurse filed for a judicial review of the board's ruling. The district court dismissed the nurse's petition.

Disciplined nurse appeals decision

The nurse asked an appeals court to reverse the district court ruling, alleging she never shared the information with someone else and the board's finding of a violation of the nurse practice act and rules was "irrational, illogical or wholly unjustifiable." She further alleged there was no substantial evidence that she read any of the patients' protected health information.

The appellate court was very clear about the fact the board had the authority to discipline the nurse under the nurse practice act and its rules for unethical conduct. It also emphasized proof of actual injury (to a patient) need not be established.

The court opined that despite the nurse's emphasis on what she did not do, her conduct was a violation of hospital policies to protect patient confidentiality. Also, the court said she knew or should have known about those policies.

The court could not say the board's determination was "irrational, illogical or wholly unjustifiable." The board of nursing is vested with rule making and interpretative authority of the nurse practice act and its rules. As a result, the court viewed the board's application of law and fact to this case "through the prism of our deferential standard of review."

The district court decision of the petition for judicial review was upheld. As a result, the board's discipline remained.

How to avoid a similar outcome

The nurse in this case made an error in judgment in seeking out the ICU patient lists to determine her work schedule. Unfortunately, that error led to serious and costly ramifications.

In this case, the nurse could have simply asked permission to access the lists, or even more simply, called the ICU charge nurse to determine if she would be needed for her assigned shift.

Other guidelines for nurses to consider include:

Know your workplace patient confidentiality policy and adhere to it.

Know your HIPAA obligations.

Remember any violation of your state's nurse practice act and/or rules does not require patient injury.

Know what your nurse practice act, patient confidentiality policy and other rules about protecting patient privacy.

Know and adhere to ethical requirements governing patient confidentiality and privacy under the American Nurses Association's Code of Ethics for Nurses with Interpretive Statements.

Judicial review of a board of nursing decision is an option, but know that unless a decision is inconsistent with the powers and authority of the board, it will be upheld by the court.

Even though a discipline might be the least severe, it is still a discipline that affects a nurse professionally.

Take these courses to learn more about protecting patient confidentiality and your license:

HIPAA and Confidentiality: Practice May Change, But Principles Endure
(1 contact hr)
In this course, you will learn about parts of HIPAA, especially as they concern nursing and other health professionals and the protection of healthcare information. Because you play a key role in the production of healthcare information, you play a key role in its protection.

Facebook: Know the Policy Before Posting
(1 contact hr)
The fundamental function of Facebook (and other social networking sites, such as Twitter) is allowing "friends" to share information. In healthcare, Facebook posts can influence the hiring process, violate patient privacy and result in termination of employment. This module informs healthcare professionals of the risks of social networks, which break down the walls separating our personal and professional lives.

Protect Yourself: Know Your Nurse Practice Act
(1 contact hr)
Because the practice of nursing is a right granted by a state to protect those who need nursing care, nurses have a duty to patients to practice in a safe, competent, and responsible manner. This requires nurse licensees to practice in conformity with their state statutes and regulations. This course outlines information about nurse practice acts and how they affect nursing practice.

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RN breaches patient confidentiality policy to check work schedule

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Upholding patient confidentiality policy and privacy is a fundamental obligation for every nurse. Most often, a breach can happen when a nurse shares patient information with a person who is not a member of the healthcare team or when a patient's electronic medical record is accessed for a personal reason.

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submitted by Cecilia M.

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Privacy laws in the U.S. protect confidential medical information.

But the next crop of healthcare professionals say they would violate those privacy lawsfor a price.

A study of graduating students looking to go into the healthcare field found that close to half (46%) said they would violate federal privacy regulations for an amount of money ranging from $1,000 to more than $10 million.

While many of the graduating students interviewed believed there would be a high probability of getting caught, they said they still would be willing to violate regulations of the federal Health Insurance Portability and Accountability Act (HIPAA) of 1996, according to a study published in JMIR Medical Informatics in July.

Researchers at Florida Atlantic University, Baylor University and the State University of New York at Buffalo were interested in taking a look at the role that monetary incentives play in violating HIPAA regulations and privacy laws by the next generation of employees.

Researchers first conducted a pilot study involving medical residents and individuals in an executive MBA program, some of who work in the health care industry as executives.The main study was based on 520 students in an undergraduate information technology course.

The researchers developed five different scenarios to see how easily future employees would be influenced to release patients' confidential medical information.
RELATED: Majority of healthcare breaches come from inside the organizations: report
In one scenario, study participants were told to suppose they were a nurse's aide at a hospital, earning $30,000 per year. Participiants were asked what amount of money they would take to release information on a patient they were caring for if a friend asked for the medical records.

A second scenario asked study participants if would they release patient information to a very close friend to help them in an upcoming legal battle, assuming that they are a doctor at a hospital, earning $200,000 per year.

A third scenario involved an insurance agent making $60,000 a year with access to confidential patient information.

Forty-six percent of participants in the nursing scenario indicated they would violate the federal law for an amount of money ranging from $1,000 to more than $10 million.

About 35% of participants in the doctor scenario and 45% of participants in the insurance scenario agreed to share HIPAA-protected information.

The larger the financial reward, the more participants agreed to violate HIPAA in all five scenarios, according to researchers.

In the fourth and fifth scenarios, researchers raised the stakes by including a personal or family situation.

The percentage of study participants who said they would violate HIPAA rose sharply when the issue became personal, the research found.

Roughly 78% of the study participants would accept $100,000 from a media outlet to release medical records of a politician to help pay for a friend's medical procedure not covered by insurance.

About two-thirds of participants (65%) would accept $50,000 for the medical records of a reality star to help a friend in need of emergency medical transportation.
RELATED: Jackson Health hit with $2.2M penalty for HIPAA violations including breach of NFL players' record
Granted, these situations are purely hypothetical and the odds of these scenarios occuring are pretty slim.

But the findings come as COVID-19 has shed new light on the issue of patient privacy, with the Office of Civil Rights, which oversees HIPAA compliance, granting specific relief and waivers related to the pandemic.

"Physicians and nurses are trained in terms of HIPAA," said Chul Woo Yoo, Ph.D., one of the study's authors and an associate professor in the information technology and operations management department within FAU's College of Business. "However, it is not their focal interest. Therefore, developing the strong security climate among physicians and nurses should be carefully revisited by management."

A report from Verizon in 2019 found that the majority of data breaches in healthcare come from inside the organizations. The healthcare industry is the only sector to show a greater number of insider attacks than external, according to Verizon's analysis of more than 20 industries.

"Insider threats can come from outside infiltrators who become insiders by phishing and social networking attacks. However, they can also come from insider threats, resulting from homegrown malicious employees who intentionally want to compromise a system for profit and for a variety of reasons, including hacktivism and thrill motives," Yoo and his fellow researchers said in the study.

According to the study results, there is a high probability that compromises can occur when employees are presented with monetary incentives, given the right context.

The research highlights the need for organizational procedures and the development of educational and training programs to encourage HIPAA compliance, researchers said.

Organizations need to have preventive controls in place including sophisticated monitoring systems technologies and constant attention to authentication protocols to prevent unauthorized access to buildings, software and databases.

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department of health and human services (hhs)

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What HIPAA law? Study finds future healthcare employees would consider violating privacy laws for cash

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Privacy laws in the U.S. protect confidential medical information. But the next crop of healthcare professionals say they would violate those privacy lawsfor a price. A study of graduating students looking to go into the healthcare field found that close to half (46%) said they would violate federal privacy regulations for an amount of money ranging from $1,000 to more than $10 million.

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submitted by Cecilia M.

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Amazon is looking to get a slice of the health wearables market with its new Amazon Halo fitness tracker.

It marks the first wearable device launched by the tech giant as it takes on a market dominated by the Apple Watch and Fitbit. It's a market estimated to be worth around $52 billion, according to Gartner.

Along with the Halo wristband, Amazon also launched a subscription service and smartphone app.

Amazon's wearable has some familiar capabilities such as activity and sleep tracking but also offers new features such as tools to measure body fat and tone of voice as an indicator of overall well-being.

The new health wearable ties into Amazon's broader strategy to capture a part of the $3.5 trillion healthcare industry, which started in 2018 with its acquisition of online pharmacy PillPack.

The tech company also sparked rampant speculation when it teamed up with JPMorgan Chase and Berkshire Hathaway on a healthcare venture they've dubbed Haven. Although there has been speculation about the future of Haven after an exodus of top executives including CEO Atul Gawande, M.D., and Chief Technology Officer Serkan Kutan, among others.
RELATED: Amazon rolls out Alexa feature that lets users ask about prescription drugs
Amazon has also made moves to tackle employee healthcare through primary care models.

Last September, Amazon announced the pilot of a virtual health service benefit for employees and their families in the Seattle region called Amazon Care. The tech giant recently teamed up with buzzy tech-enabled primary care group Crossover Health to launch health centers near its fulfillment centers and operations facilities.

The tech company is leveraging its "deep expertise in artificial intelligence and machine learning" to offer customers a new way to discover, adopt and maintain personalized wellness habits, according to Maulik Majmudar, M.D., principal medical officer at Amazon Halo.

"Despite the rise in digital health services and devices over the last decade, we have not seen a corresponding improvement in population health in the U.S." he said in a statement. "Health is much more than just the number of steps you take in a day or how many hours you sleep. Amazon Halo combines the latest medical science, highly accurate data via the Halo Band sensors, and cutting-edge artificial intelligence to offer a more comprehensive approach to improving your health and wellness."

Unlike smartwatches and fitness trackers, Amazon Halo doesn't have a screen or constant notifications, the company said.

The small sensor capsule includes an accelerometer, a temperature sensor, a heart rate monitor, two microphones and an LED indicator light.

The wearable also integrates with Cerner's technology. Consumers can share their health information, such as activity, sleep, bloody fat percentage and other wellness data, with their care teams and directly into their electronic health record, according to the health IT company.

Historically, these types of data have been siloed or difficult to obtain. Wearable technology, such as the Amazon Halo, can help achieve greater interoperability across healthcare when integrated directly into a patient's EHR, Cerner said.

Sharp HealthCare is the first health system to implement Amazon Halo in the healthcare setting.

"Integrating the revolutionary body fat percentage measurement from Amazon Halo directly into the EHR provides physicians an actionable and previously hard to obtain health metric without the need for a doctor's visit or costly technology," said Brent Shafer, chairman and CEO at Cerner, in a statement.

RELATED: Amazon launches pilot of virtual employee medical service Amazon Care

The Amazon Halo device and app were designed to focus on five core health and wellness areas-activity, sleep, body, voice tone and labs.

For activity, Amazon Halo awards points based on the intensity and duration of movement, not just the number of steps taken. The wearable also deducts one activity point for every hour over eight hours of sedentary time in a day, outside of sleep.

Amazon uses new innovations in computer vision and machine learning to enable users to measure their body fat percentage.

The tone feature listens to the user's voice throughout the day and analyzes that information to present a picture of their emotional state. For instance, the device analyzes energy and positivity in a user's voice. Results may reveal that a difficult work call leads to less positivity in communication with a user's family, an indication of the impact of stress on emotional well-being, Amazon said.

The company also developed Amazon Halo Labs, science-backed challenges, experiments and workouts to help users build healthier habits. The Labs feature includes programs developed by partner organizations such as Aaptiv, the American Heart Association, Headspace, Mayo Clinic and WW (formerly Weight Watchers).
RELATED: Amazon teams with Crossover Health to pilot employee health centers
"The American Heart Association is excited about technology that focuses on new and interesting ways for people to improve their cardiovascular health, quality of life, and healthy life years. We're thrilled to see companies like Amazon innovating in this space," said Eduardo Sanchez, M.D., chief medical officer for prevention at the American Heart Association, in a statement.

Halo will also serve as the complimentary wearable for life insurance provider John Hancock through a strategic collaboration with its Vitality digital wellness program

Amazon said it prioritized privacy when developing the device and app. Multiple layers of privacy and security are built into the service to keep data safe and in customers' control, the company said.

The subscription for Amazon Halo will start at $65 for the first six months ($100 once the early access deal is over) and then $3.99 a month after that.

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Competing with Apple and Fitbit, Amazon launches health wearable that tracks activity, body fat, emotions

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Amazon is looking to get a slice of the health wearables market with its new Amazon Halo fitness tracker. Amazon also struck a deal with Cerner to integrate the device with medical records software. Find out more about about how Amazon plans to take on the wearables market and compete against the Apple Watch and Fitbit.

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Network Security
Wikipedia
update August 9 2020

https://en.wikipedia.org/wiki/Network_security

The Joint Commission

https://www.jointcommission.org/resources/news-and-multimedia/video-resources/safe-health-it-saves-lives/

Privacy Versus Confidentiality
Jan 29, 2019
by Kate Dewhirst

https://www.youtube.com/watch?v=LxXPH8YWz_w

Sharing Your Electronic Health Record (EHR)
September 24, 2018
By HenryFordTV

https://www.youtube.com/watch?v=88XuX-AFBwY

HIPAA PHI - Examples of What Not to Do
July 15, 2019
By Emtrain

https://www.youtube.com/watch?v=fk2rSkbsZNQ

Electronic Health Records: Usability and Unintended Safety Issues
February 5, 2018
By Pew

https://www.youtube.com/watch?v=SlQ60KaLeHg

Confidentiality: key issues in scenarios/role-plays in 180 seconds
March 26, 2019
By Dr. Aman Arora - Arora Medical Education

https://www.youtube.com/watch?v=S5wkE-chSZY

Confidentiality: How to Maintain Patient Confidentiality
September 8, 2017
By HEAT Inc., Health Education & Training

https://www.youtube.com/watch?v=Wqxt8vO8evI

Six Real-World Examples of Social Media HIPAA Violations
Nov 20, 2019
By Etactics

https://www.youtube.com/watch?v=j-DJC9-t7K0&feature=youtu.be

HIPPA crossword
wordmint.com
8/31/2020

5 Tips for Protecting Your Electronic Health Records

JANUARY 30, 2019
By Art Gross, President and CEO, HIPAA Secure Now!

https://www.healthitanswers.net/5-tips-for-protecting-your-electronic-health-records/

Competing with Apple and Fitbit, Amazon launches health wearable that tracks activity, body fat, emotions
Aug 27, 2020
By Heather Landi

https://www.fiercehealthcare.com/tech/competing-apple-and-fitbit-amazon-launches-health-wearable-tracks-activity-body-fat-and

What HIPAA law? Study finds future healthcare employees would consider violating privacy laws for cash
August 26, 2020
By Heather Landi

https://www.fiercehealthcare.com/tech/some-people-have-a-price-when-it-comes-to-releasing-confidential-patient-data-one-study-finds

RN breaches patient confidentiality policy to check work schedule
December 4th, 2019
By Nancy J. Brent, MS, JD, RN

https://www.nurse.com/blog/2019/12/04/rn-breaches-patient-confidentiality-policy-check-work-schedule/