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How do I resolve the HIPAA training requirements issue?

Patient health records are highly sought after by cyber-criminals because they can exploit them in a multitude of ways. On the “dark web,” stolen medical data can sell for 10 to 20 times more than credit card data. The healthcare records of terminally ill, and even deceased, patients are paper gold mines for fraudsters, as these patients are often not in a position to even notice that their identities may have been stolen. Healthcare organizations are under constant threat and the HIPAA (Health Insurance Portability and Accountability Act of 1996) was designed to enforce patient confidentiality and patients’ right to privacy.HIPAA training is mandatory for anyone who comes into contact with protected health information (PHI). This includes doctors, dentists, nurses, psychologists, human resource officers, receptionists, part-time employees/interns, network administrators and security personnel, and researchers. And if your business associates, suppliers, or partners come into contact with PHI, they need to be properly trained too. HIPAA training applies to all staff, including management, volunteers, and trainees, and to any outsourced personnel.In addition:New employees must be trained within a reasonable time period after they join the organization,Employees must be re-trained whenever there is a change to policies or procedures that affect their job, andPeriodic refresher training is also required.All HIPAA training needs to be documented. This can be achieved using:Training program sign-in sheets,Signed confidentiality statements acknowledging receipt of training, andComputer-based training completion or quiz results.

Have you as a nurse ever lied to your patient’s family?

It was a big lie - a big lie of omission. The lie was created by the mother, and enforced by HIPAA and the child suffered for it.Our call to the delivery room that day was for a 36-week pregnancy. Mom tested positive for heroin, and babies born to heroin-addicts, are addicted as well. It is a slow, painful and agonizing process for baby to cope with withdrawal symptoms, and requires extreme patience, understanding of the process, and experience for the nurses. It can take as long as 6 weeks for the baby’s system to clear, and for physical manifestations to calm down. The babies don’t eat well, they vomit frequently, and their stools are so acidic that their tender buttocks are excoriated with skin breakdown. They are sometimes inconsolable and scream and flail their limbs; pulling out IV lines or feeding tubes. At such times, the best treatment is withdrawl of all stimulation. Baby needs to be bundled securely, with arms tucked inside, wear a hat, and be moved to a dark quiet room with no alarms, music, or conversation. Rocking and singing would be too much stimulation. Sometimes just rocking was too much. That baby needed to be securely bundled, held close, and kept warm. Nothing else. There are professional scoring grids, that have sliding scales for medicinal treatment as well.Social Services are immediately involved when the delivering mom is drug or alcohol addicted. Mom / parents and home life is carefully scrutinized to ensure the safety of the baby, and mom must be compliant in a drug rehab program.This particular mom was a respected high school teacher. We never knew how she fooled her superiors and her students! But she was adamant that no one was to know about the heroin, or WHY her baby was in the NICU for so long. Visitors to the NICU could only come with the parents, so we were spared questions from them. But grandparents can visit on their own. And this is the reason for the lie.Mom and dad were first-generation Americans. Mom’s parents had come to the country to look after the baby when mom went back to work (Maternity leave is only 6 weeks in the USA). They spoke and understood English at a basic conversation level. Mom would not allow the Nursing staff, or the Neonatologists, to tell her parents why the baby had to stay in the hospital for so long. Or why she cried so much. Or why she always had “diaper rash”. Mom told her parents that the Nursing staff had given her baby “a cold”.This resulting in 2 huge fallouts. Grandma visited everyday, for hours, on her own. She did not trust anything the nurses did, insisted that we wear masks and gloves. She insisted on feeding the baby, and would give her milk too fast, resulting in vomiting. Mom didn’t trust use preparing the formula or adding the medications, and required the charge nurse to “check” everything first. She would rock and sing and pat the baby’s head, throwing baby into a frenzy of screaming. Grandma would not accept any advice from the Nurses, because WE were the ones that “made the baby sick”.Our team was exhausted - both from the constant criticism from Grandmother, and from dealing with the overstimulated baby. We held a conference with the parents and nurses and Neonatologists and Respiratory Therapists and Pharmacy and Nutrition, to show them, with all the data from her baby, and literature in medical journals, why her baby needed special handling, and why, as her mother, Grandmother, was going to be the primary caregiver, she needed to be taught the right skills and coping methods, so that the baby would trust her environment, grow and thrive.Mom refused. If Grandmother knew, she explained, her parents would return home and she wouldn’t have child care. And she might lose her job. So absolutely we were forbidden to tell Grandmother why the baby was so stressed. And HIPAA laws supported mom. There was nothing we could say to Grandmother.This baby took longer than expected to recover from the prenatal heroin exposure. Grandmother refused to learn any of the methods we used to calm and successfully feed the baby. She would not learn how to draw up the required medications, because once her granddaughter was away from the terrible nurses she wouldn’t be “sick” anymore. Only mom came to the official discharge teaching, so she was the only one to learn about the medications that her baby required. (One was for the severe reflux - preventing some of the after-feed vomiting, and the real possibility of aspiration.) Once again we appealed to SW for intervention, but because mom was compliant with rehab, and there were 3 other adults in the home - that’s where baby was going. Even if her primary caretaker did not know how to manage her special needs.The second fallout was the necessity of discharging that baby home, to a family that refused to acknowledge her special needs, and were not trained to manage them. Yes, all the boxes were checked off for discharge criteria. Most of her physical manifestations were resolved. But the thought that those frantic crying spells would be unanswered, because “we had spoiled her”, just broke our hearts.So yes, this was a huge lie of omission, with which everyone of us disagreed. HIPAA tied our hands.

How do you become a HIPAA Compliant Medical Office?

Here are some best HIPAA practices for a medical office:Exercising the Privacy Rights in a medical settingStaff members or physicians must give patients the privacy they deserve in a medical setting whether they are in the patient room or the lobby.Make sure no one can see the screen or device when accessing ePHI.It is advisable to call patients by their first or last name only in the workplace.If possible, always look for a quiet, private space when conversing with patients individually so only those intended can hear the information.Make sure to knock every time you enter a patient’s room.Always be cautious about leaving patients’ files/documents unsecured or unattended.Make continuous efforts to instill a culture of privacy practicePublish Notice of Privacy PracticesA Notice of privacy practices should be printed and placed in a visible area in the office, so that everyone, including patients, can see the privacy laws and information that aims to keep PHI confidential.Make sure to publish the notice of privacy practices on your organization’s website.Make sure that the notice of privacy practices is readily available when patients ask for a copy.Develop and implement written policies and procedures for best HIPAA practicesDevelop a guidebook of your written policies and procedures to ensure everyone in the office is following the best HIPAA practices. The guidebook should contain notices, forms, disclosures, and point by point procedures for HIPAA compliance requirements and notification of patient privacy.All staff members must have access to the policies and procedures. It is also recommended to get an attestation from all staff members saying they have read and understood the policies and procedures in place.Policies and procedures must be reviewed annually to account for changes with the current best HIPAA practices.Policies and procedures must be updated whenever there is a change in the practice, for instance, upgrading software or hardware of devices, implementing modern patient identification platforms, etc.Train your staff members on best HIPAA practicesAnnual HIPAA training for all staff members, including doctors and nurses is mandatory.Besides annual training, conducting training regularly helps employees to be more aware of the provisions in the HIPAA law for best practices.Everyone must attest and acknowledge that they understand and will follow the policies and procedures covered in training.Documenting training sessions, dates, and names of the employees who underwent training is a critical part of ensuring compliance.Business associates are also required to undergo training.Perform HIPAA Risk AssessmentsConducting a HIPAA risk assessment once per year is mandatory and it helps to uncover vulnerabilities and gaps within the practice. However, performing risk assessments from time to time is recommended. A security risk assessment involves reviewing the technical, physical, and administrative safeguards in detail, which are outlined in the security rule.Any gaps or vulnerabilities uncovered during risk assessments will require remediation or follow-up, plans of actions that are to be developed within a reasonable timeframe to address the issues.Typically, about 3-4 months is a reasonable timeframe to remediate issues for most medical offices.It is crucial to know where the patient’s PHI is being stored. For instance, where the PHI is stored in an EHR (electronic health record), how the data backups are maintained, where the printed versions of PHI are stored, and by whom and how the PHI is being accessed.Devices or physical papers that contain PHI must be disposed of carefully, and in secured places to ensure they don’t fall into the wrong hands.This is taken from an article on CloudApper site. Feel free to look it up “HIPAA best practices in a medical setting”. CloudApper offers variety of business solutions, including HIPAA compliance software.

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