I recently wrote about the FTC's Red Flags Rule that must be implemented by August 1, 2009.
Here are the completed BIDMC Policies needed to support this rule. Feel free to use them as inspiration for your own policies.
Red Flags Policy
PV-01 Designation of Organized Health care arrangement
PV-11 Designation of Privacy Officer
PV-14 Mitigating the Effect of an Unauthorized Use or Disclosure of Protected Health Information
PV-17 Business Associate Agreements
PV-19 Opt Out
PV-20 Authentication Policy
Appendix
Rabu, 22 Juli 2009
Selasa, 21 Juli 2009
The HIT Standards Committee Deliverables
Over the past 60 days, the HIT Standards Committee and its workgroups have been hard at work mapping standards to meaningful use. Here are their deliverables:
Clinical Quality
The Clinical Quality Workgroup Report describes the approach used to specify the 27 performance measures for 2011 which support meaningful use.
The Clinical Quality Workgroup Recommendation matrix includes all the detailed EHR data types used to compute quality measures plus a matrix of sites of care and relevant specialties. This matrix will be expanded to reflect the readiness of measures for implementation and proposed levels of performance expectations (i.e. what threshold constitutes good performance for each measure)
Clinical Operations
The Clinical Operations Workgroup Report describes the approach used to specify standards for 2011, 2013, and 2015 linked to each meaningful use metric.
The Clinical Operations Workgroup Recommendation matrix includes all the detailed standards supporting quality measures and health information exchanges as well as identification of standards gaps requiring harmonization or commission of new standards.
Privacy and Security
The Privacy and Security Workgroup Report describes the approach used to specify standards in support of meaningful use and the ARRA 8 statuatory requirements. This report also includes an overview directed at the consumer, explaining the reason all this work protects their confidentiality.
The Privacy and Security Workgroup Recommendation matrix includes all the detailed security standards and an indicator of their readiness for implementation.
An immense amount of work has gone into the effort thus far. I want to thank the HIT Standards Committee members, the Workgroups, and the HITSP staff and volunteers who joined the Workgroups. Well done!
Clinical Quality
The Clinical Quality Workgroup Report describes the approach used to specify the 27 performance measures for 2011 which support meaningful use.
The Clinical Quality Workgroup Recommendation matrix includes all the detailed EHR data types used to compute quality measures plus a matrix of sites of care and relevant specialties. This matrix will be expanded to reflect the readiness of measures for implementation and proposed levels of performance expectations (i.e. what threshold constitutes good performance for each measure)
Clinical Operations
The Clinical Operations Workgroup Report describes the approach used to specify standards for 2011, 2013, and 2015 linked to each meaningful use metric.
The Clinical Operations Workgroup Recommendation matrix includes all the detailed standards supporting quality measures and health information exchanges as well as identification of standards gaps requiring harmonization or commission of new standards.
Privacy and Security
The Privacy and Security Workgroup Report describes the approach used to specify standards in support of meaningful use and the ARRA 8 statuatory requirements. This report also includes an overview directed at the consumer, explaining the reason all this work protects their confidentiality.
The Privacy and Security Workgroup Recommendation matrix includes all the detailed security standards and an indicator of their readiness for implementation.
An immense amount of work has gone into the effort thus far. I want to thank the HIT Standards Committee members, the Workgroups, and the HITSP staff and volunteers who joined the Workgroups. Well done!
Senin, 20 Juli 2009
Securing our Blackberries
New Massachusetts Data Protection regulations require us to secure mobile devices.
At BIDMC, we have nearly a 1000 Blackberries and hundreds of iPhones. The Blackberry has well developed enterprise control features, so we're starting our mobile security effort with them.
In the interest of sharing our experience with the IT Community, you'll find our proposed policies here. It's a work in progress and we're still fine tuning our approach. To better under the impact on users, several IT staff including me will be testing these new settings.
There are an amazing array of settings to secure Blackberries - you'll find the complete configuration guide here.
It's clear that organizations are finding the balance between security and ease of use to be challenging. Here's a few describing others experiences:
Timeout issues
Password Policy issues
I'll let you know how our IT pilot goes and publish our final policies/settings as we rollout to our users.
At BIDMC, we have nearly a 1000 Blackberries and hundreds of iPhones. The Blackberry has well developed enterprise control features, so we're starting our mobile security effort with them.
In the interest of sharing our experience with the IT Community, you'll find our proposed policies here. It's a work in progress and we're still fine tuning our approach. To better under the impact on users, several IT staff including me will be testing these new settings.
There are an amazing array of settings to secure Blackberries - you'll find the complete configuration guide here.
It's clear that organizations are finding the balance between security and ease of use to be challenging. Here's a few describing others experiences:
Timeout issues
Password Policy issues
I'll let you know how our IT pilot goes and publish our final policies/settings as we rollout to our users.
Jumat, 17 Juli 2009
An Update to Meaningful Use
On June 16, I wrote about the release of the draft definition of meaningful use.
Today, at the HIT Policy Committee meeting, the final definition of meaningful use was released and adopted. What was changed?
1. For inpatient CPOE, only 10% of orders must be entered electronically
2. For problem lists, ICD9 or SNOMED must be used
3. Advanced directives must be recorded
4. Smoking status must be recorded
5. Quality measures must be reported to CMS
6. Clinicians and Hospitals must implement at least one clinical decision rule relevant to a high clinical priority
7. Administrative transactions, including eligibility and claims, must be completed electronically
Also, the timing of meaningful use was clarified in this presentation on Slide 12 and 13
The Meaningful Use Workgroup recommended use of an 'adoption year' timeframe (i.e., '2011 measures' applies to first adoption year even if HIT adopted in 2013; '2013 measures' applies to 3rd adoption year.
Thus, clinicians can still receive partial stimulus funds if they implement 2013-2015 instead of 2011-2013, and they can follow the same path as early adopters instead of an increasingly difficult set of criteria.
The Committee also discussed options for certification which I encourage you to read.
A very important meeting today. Now that meaningful use has been defined and approved, the HIT Standards Committee can complete its initial standards and certification criteria recommendations, which will be delivered next Tuesday.
Today, at the HIT Policy Committee meeting, the final definition of meaningful use was released and adopted. What was changed?
1. For inpatient CPOE, only 10% of orders must be entered electronically
2. For problem lists, ICD9 or SNOMED must be used
3. Advanced directives must be recorded
4. Smoking status must be recorded
5. Quality measures must be reported to CMS
6. Clinicians and Hospitals must implement at least one clinical decision rule relevant to a high clinical priority
7. Administrative transactions, including eligibility and claims, must be completed electronically
Also, the timing of meaningful use was clarified in this presentation on Slide 12 and 13
The Meaningful Use Workgroup recommended use of an 'adoption year' timeframe (i.e., '2011 measures' applies to first adoption year even if HIT adopted in 2013; '2013 measures' applies to 3rd adoption year.
Thus, clinicians can still receive partial stimulus funds if they implement 2013-2015 instead of 2011-2013, and they can follow the same path as early adopters instead of an increasingly difficult set of criteria.
The Committee also discussed options for certification which I encourage you to read.
A very important meeting today. Now that meaningful use has been defined and approved, the HIT Standards Committee can complete its initial standards and certification criteria recommendations, which will be delivered next Tuesday.
Kamis, 16 Juli 2009
Going Home Again
Last weekend, my wife and I flew to Northern California with my daughter to connect her with a group of students traveling to Japan for intensive language study this summer. After dropping my daughter off on her flight to Tokyo, my wife and I drove to every site that played a role in our 30 year relationship.We met in 1980 at Stanford in the dorm complex next to Lake Lagunita. I was in Granada, she was in Eucalypto. We visited our old dorms and found the forests we walked in replaced with construction over the past 30 years.
In 1982, we served as live-in companions to Dr. Fred Terman, the former provost and Dean of engineering. We visited his former home, in an enclave of faculty housing, on El Escarpado. It was getting a new driveway, but otherwise had not changed.
In 1983, after Dr. Terman died, we moved to a cabin in La Honda, California on Shelden Road. Fritz Maytag, the founder of Anchor Steam brewery had lived there before us. La Honda had not changed much, and the biker bar called Applejacks was still a popular town gathering spot.
Each night in 1983-1984 we would drive from La Honda to the San Gregorio Stage stop, then to Pompano Beach and onward to Pescadero, a small farming town. We'd talk about the future and speculate where our Stanford education would take us. We did that drive again and stopped at Pompano to walk through the waves around the sandstone cliffs.
We drove north to San Francisco. Even in the late 1980's and early 1990's we had an affinity for Japan and frequented Japantown in San Francisco. We strolled the shops, restaurants, and markets, nostalgic for the easy access to all things Japanese that is missing from Boston.
In 1984, we moved to Marin County and bought a small home on Rose Avenue, near Panoramic Highway in Mill Valley. That isolated neighborhood of older homes is now filled with expensive new construction. Our starter home is now 10 times the price we paid for it. We were both amazed that we commuted through the narrow, steep, potholed roads of upper Mill Valley from 1984-1986. We had a great time back then with hot tubs, star gazing, and weekend sushi dinners, but we would not want to drive the cliffs of Rose Avenue today.
In 1986, we built a home on Mt. San Pedro in San Rafael overlooking China Camp State Park. It was the go-go 1980's when owning a large home was a sign of success. Our home, Woodcliff, had 5 pods - a living area, an underground winery, an artist studio, a library/office wing, and a lab space for wine chemistry. We sold the home to Dr. Dean Edell in 1993. We learned many lessons about living large during that era and that led to the simpler existence we have embraced today. The house is still there, although the grape vines have been replaced with fields of lavender and the mountainside is now a destination for mountain bikers who seem at battle with private property owners.
During our Marin County years, I ran a software company called Colossus at 100 Smith Ranch Road while going to medical school at UCSF and graduate school at UC Berkeley. The office space is still there, occupied by another software company.
During weekends, we hiked West Marin locations - Pt. Reyes, Tomales Bay, and Bolinas. We did an 8 mile hike down the Bear Valley trail to Arch Rocks and visited the Tule Elk at Pierce Point. We stopped for dinner in Bolinas, a hidden town without any road signs to identify it. As we drove toward the Palomarin headlands, a rainbow appeared without any clouds or rain (the photo above).
Would we go back? Would we want to relive the Palo Alto, Mill Valley or San Francisco of our 20's? The great wines, the energy, and the outdoors of our youth?
Nope.
Northern California is a great place, but today we have different needs.
We're approaching 50 and our focus is on a great education for our daughter, time with family, career, and community service - locally and in Washington.
Just as Northern California was a perfect fit for our 20's, New England is a perfect fit for our 40's and 50's. We have easy access to great educational institutions, healthcare, museums, New York, Washington, and colleagues across the Eastern Seaboard. The outdoors still beckons and we have easy access to hiking, biking, and kayaking. We have local farms and look forward to the variation of 4 seasons.
Our 60's may bring another set of needs. My daughter will be starting her own family, my parents may need more frequent visits, and our work activities may evolve. It's hard to know what tomorrow will bring, so we're leaving our options open. Maybe a small farm in Vermont? Maybe an ecofriendly cabin with a Japanese lifestyle? If my daughter lives and works in Japan after college, her current dream, then we might create a new life in Kyoto.
You can go home again and for me it was a great opportunity to refresh the memories that made me who I am today.
I look forward to each day and the potential it brings. The past is filled with great experiences, joys, and struggles. I would rather move forward guided by the past than try to relive it in the future.
Rabu, 15 Juli 2009
Dispatch from Washington
Today I was in Washington attending two important meetings - an Institute of Medicine gathering to discuss healthcare information exchange and the HIT Policy Committee Certification/Adoption Workgroup.
The Institute of Medicine meeting brought together 30 experts from computer science, informatics, and the health information exchange community to discuss the applications of grid computing technologies to health information exchange.
I presented an overview of the HIE work in Massachusetts and Indiana using these slides. Ken Buetow from NCI presented an overview of the major concepts from Grid Computing efforts to date.
We discussed the possibility of using Grid Computing methodologies in healthcare clinical care, population health, and research. Here's an overview of the vision (NCHI) presented by Patrick Soon-Shiong and his scientific advisory board chaired by Dr. Ian Foster and Carl Kesselman, two grid computing pioneers. As I next step, I will work with Dr. Kesselman to learn more about the standards and architectures used in Grid Computing to understand how they may help solve some of the challenges facing healthcare stakeholders, especially the research community.
The HIT Policy Committee Certification/Adoption Workgroup is charged with examining the certification and standards harmonization processes, making recommendations for improvements. I presented the latest update from HITSP's Tiger Teams.
Mark Leavitt provided an overview of recent enhancements to the certification process including module certification, self built certification and support for open source initiatives.
Brian Klepper commented on his experiences with certification to date and emphasized the need for independence and multi-stakeholder participation in the certification process.
Steve Waldren commented on the needs of small practioners who need flexibility in the way they deploy EHRs, highlighting the need for an approach to certification which recognizes the variation among different specialties and care settings.
I'll be back in Washington next Tuesday for the HIT Standards Committee presentation of its major deliverables - a matrix which includes all the clinical operations, quality, and privacy/security standards needed to support meaningful use/the ARRA 8 as well as a measure of the deployability of each standard and recommended certification criteria. I'll post all this work on my blog as soon as it is presented at the meeting.
The Institute of Medicine meeting brought together 30 experts from computer science, informatics, and the health information exchange community to discuss the applications of grid computing technologies to health information exchange.
I presented an overview of the HIE work in Massachusetts and Indiana using these slides. Ken Buetow from NCI presented an overview of the major concepts from Grid Computing efforts to date.
We discussed the possibility of using Grid Computing methodologies in healthcare clinical care, population health, and research. Here's an overview of the vision (NCHI) presented by Patrick Soon-Shiong and his scientific advisory board chaired by Dr. Ian Foster and Carl Kesselman, two grid computing pioneers. As I next step, I will work with Dr. Kesselman to learn more about the standards and architectures used in Grid Computing to understand how they may help solve some of the challenges facing healthcare stakeholders, especially the research community.
The HIT Policy Committee Certification/Adoption Workgroup is charged with examining the certification and standards harmonization processes, making recommendations for improvements. I presented the latest update from HITSP's Tiger Teams.
Mark Leavitt provided an overview of recent enhancements to the certification process including module certification, self built certification and support for open source initiatives.
Brian Klepper commented on his experiences with certification to date and emphasized the need for independence and multi-stakeholder participation in the certification process.
Steve Waldren commented on the needs of small practioners who need flexibility in the way they deploy EHRs, highlighting the need for an approach to certification which recognizes the variation among different specialties and care settings.
I'll be back in Washington next Tuesday for the HIT Standards Committee presentation of its major deliverables - a matrix which includes all the clinical operations, quality, and privacy/security standards needed to support meaningful use/the ARRA 8 as well as a measure of the deployability of each standard and recommended certification criteria. I'll post all this work on my blog as soon as it is presented at the meeting.
Selasa, 14 Juli 2009
Device Convergence
My daughter is spending the summer in Japan and needed a platform that includes:
* A comprehensive English/Japanese dictionary with support for hiragana, katakana, and kanji
* Support for flashcards, tutorials, and other types of interactive educational multimedia
* 3G Wireless with an option for WiFi (WiFi is not widely available in Japan because Wide Area Wireless is so good)
* Browser support including Facebook, which her class is using as a kind of groupware
* Music support
* Camera/video support
* Compact size with reasonable battery life
As the home CIO, I have access to many platforms - Windows, Linux and MacOS laptops, subnotes, netbooks etc. She tried many devices.
In the end, she chose an iPhone 3GS, retiring her existing cell phone, iPod, netbook and camera.
My wife is also studying Japanese and wanted to run the same applications (Japanese Flip, Kanji LS Touch, My Japanese Coach, Human Japanese) so she retired her cell phone and iPod.
Because we all have great local 3G coverage on my Blackberry and their iPhones, we retired our Femtocell which we were using to boost 2G coverage for their cell phones.
Thus, we've replaced 7 devices (2 ipods, 2 cell phones, 1 netbook, 1 camera, and 1 Femtocell) with 2 iPhones. The 3 megapixel camera and video capability provides good enough photo support for most "recreational" applications.
I'm all for parsimony - owning as few devices as possible. Although the input capabilities of the iPhone 3GS are better than previous iPhones and now supports cut and paste, it is still challenging to use an iPhone to respond to 1000 emails a day, so I'll continue to use my Blackberry.
My wife and my daughter have converged their lives to a single mobile device for all computing support while they travel. Their learning curves were short and today they are more active in the digital world than ever before. From our first few weeks as iPhone 3GS users, it's clear that less is more!
* A comprehensive English/Japanese dictionary with support for hiragana, katakana, and kanji
* Support for flashcards, tutorials, and other types of interactive educational multimedia
* 3G Wireless with an option for WiFi (WiFi is not widely available in Japan because Wide Area Wireless is so good)
* Browser support including Facebook, which her class is using as a kind of groupware
* Music support
* Camera/video support
* Compact size with reasonable battery life
As the home CIO, I have access to many platforms - Windows, Linux and MacOS laptops, subnotes, netbooks etc. She tried many devices.
In the end, she chose an iPhone 3GS, retiring her existing cell phone, iPod, netbook and camera.
My wife is also studying Japanese and wanted to run the same applications (Japanese Flip, Kanji LS Touch, My Japanese Coach, Human Japanese) so she retired her cell phone and iPod.
Because we all have great local 3G coverage on my Blackberry and their iPhones, we retired our Femtocell which we were using to boost 2G coverage for their cell phones.
Thus, we've replaced 7 devices (2 ipods, 2 cell phones, 1 netbook, 1 camera, and 1 Femtocell) with 2 iPhones. The 3 megapixel camera and video capability provides good enough photo support for most "recreational" applications.
I'm all for parsimony - owning as few devices as possible. Although the input capabilities of the iPhone 3GS are better than previous iPhones and now supports cut and paste, it is still challenging to use an iPhone to respond to 1000 emails a day, so I'll continue to use my Blackberry.
My wife and my daughter have converged their lives to a single mobile device for all computing support while they travel. Their learning curves were short and today they are more active in the digital world than ever before. From our first few weeks as iPhone 3GS users, it's clear that less is more!
Langganan:
Postingan (Atom)