As we move into a new era of healthcare with the increased exchange of medical records in order to provide better, more-coordinated care, the question of what information received from outside an organization should be included in a medical record takes on new importance. What with health homes, personal health records, and health information exchanges, as well as increased involvement by patients using digital tools like smart watches and smart phone apps, there is a torrent of information being directed at medical records, and it is essential to understand what belongs there and what should be rejected, and how.
This information may come in the form of unsolicited health information – i.e., information that is volunteered by patients or by other health care providers, either at the time the patient arrives for treatment or thereafter – and in some cases even after the patient has been discharged. It may also come in the form of information deliberately requested from outside parties but the receiving provider may be unsure about whether to incorporate that information into its legal patient record.
It is time to establish the necessary processes for filtering and managing incoming information in order to provide the appropriate patient care and protect the organization from claims of malpractice for not acting on information that may have been in a record but may not have been known to exist.
Understanding what is in the medical record is essential for satisfying HIPAA patient rights for access of records, and understanding how you receive and manage incoming information is required for protecting information under the HIPAA Privacy and Security Rules. This session will attempt to address these issues and offer practical guidance for those responsible for managing these health records.
After attending the session, participants will be able to:
- Incoming health information presents issues of use and documentation that have significant impacts on the quality of patient care and privacy rights.
- Information provided externally must be vetted and acted upon, or not, and appropriate documentation of actions taken or not is essential.
- Classification and documentation of the use of incoming health information, and its purposes, will be explained.
- Attendees will better understand the issues with incoming patient information from external sources and the obligations in documenting, acting upon, and integrating those records.
Areas Covered in the Session:
- Overview and Definitions
- Request and Unsolicited External Health Information
- The Variety of Incoming Information
- Problems with use
- Problems with Truthfulness
- Refusing to Accept Information
- Requested and Unsolicited External Health Information
- Stark Law Issues
- HIPAA Privacy Rule and Patient Access
- HIPAA Security Rule Requirements
- The Federal Rule of Evidence and Civil Procedure
- Bringing it all together
- Live Q&A
- Compliance director
- Privacy Officer
- Security Officer
- Information Systems Manager
- HIPAA Officer
- Chief Information Officer
- Health Information Manager
- Healthcare Counsel/lawyer
- Office Manager
About the Presenter:
Jim Sheldon-Dean is the founder and director of compliance services at Lewis Creek Systems, LLC, a Vermont-based consulting firm founded in 1982, providing information privacy and security regulatory compliance services to a wide variety of healthcare entities. He is a frequent speaker regarding HIPAA, including speaking engagements at numerous regional and national healthcare association conferences and conventions and the annual NIST/OCR HIPAA Security Conference. Jim Sheldon-Dean has more than 36 years of experience in policy analysis and implementation, business process analysis, information systems and software development, and eight years of experience doing hands-on medical work as a Vermont certified volunteer emergency medical technician. Sheldon-Dean received his B.S. degree, summa cum laude, from the University of Vermont and his master’s degree from the Massachusetts Institute of Technology.
You will receive an email with login information and handouts (presentation slides) 1 day before the live webcast that you can print and share to all participants at your location.
Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly
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Toll-Free No: 1-302-444-0162
Email: [email protected]
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