Lots of exciting things going on here at the castle with a lot of stuff tearing me away from the keyboard. This busyness is one of several reasons there has not been very much written material in the past couple of weeks. As with any new blog, we all go through growing pains some happen sooner, some happen later.  Starting a blog from scratch is all in the learning process. If I had a formula down, it probably still would have its flaws. I took some time to look at successful blogs and realize that I can do that just not in one afternoon. Which, of course, doesn’t sit well with me because we all love instant gratification.

Okay enough whining, back to work. The intention is to intensify (that sounds weird) my writing efforts again and get back to having much more regular and frequent blog posts. While bringing a gradual increase of news and other information, with or without commentary. That is what I set out to do, and that is what I would like to have the blog do; inform and entertain. So, an announced restructure, right? Of sorts, I just intend to intensify my efforts. It has been a little challenging to see the material people want to see commentary on by the limited amount of feedback. This is the parts throw me off the most in doing the blog is I get family and friends who read or see a post and say, “looks good” with very little other input. This makes it difficult for a newbie like me to keep things on task. However, I think I have found a formula, and we will now step forward.

The podcast, as many knows have taken the shape of a discussion that is published in the middle of the week.  Since my cohost lives in Texas, and I live in Utah, we have been experimenting with software that allows us to record as a conversation. This week’s fun with the new software is an entirely de-synchronized recording of the conversation. The podcast will be out shortly after I spent hours editing the interview back correctly. The hassles of the blog and podcast. This week’s podcast is on abortion, what else is the world talking about this week, and I hope it will be interesting and thoughtful.

Okay with all that said, let’s talk about HIPPA. There are a ton of jokes here but, unfortunately, they’ve already been made, and most of them sound like dad jokes.

In the recent past, a nurse in Texas (ironically) was fired from her position after posting what was determined to be protected health information on social media. The interesting part of all this is that she did not give the patient’s name, address, date of birth, or Social Security number. What she did do was identify the fact that he had the measles and her profile showed which hospital she worked at. Her hospital administration felt that this was enough to meet the standard of disclosing protected health information. Why you ask? Well, it’s quite simple, because only one child that was male, that had the measles was in the hospital that she worked at her profile. The measles case, of course, was all over the news so instantly, it’s pretty apparent that she disclosed protected health information. Enter social media post she spoke about the patient’s condition, etc.

The weirdest part about all of this is that she posted her observations to an anti-vaccine group that she belonged to. Not as an observer, but as a vaccine skeptic. I’m going, to be honest (like I’m not usually honest) if you’re anti-vaccine is a healthcare worker, you might need to find a new job. Vaccines are some of the most researched and well-refined pharmaceuticals on the market. Yes, we have a heartless big Pharma problem in this country. Yes, they make an insane amount of profits on sick people every year. Yes, you can get the same drug for an eighth of the cost in Canada. It does not mean those pharmaceuticals we receive in this country are any more or less effective they’re just more expensive by pricing. And like I’ve said in previous posts; vaccines are not cost-effective for pharmaceutical companies. They spend a lot more money and get a lot less back because they’re well-controlled by the government.

Okay, back to HIPPA. Some boring facts about HIPPA. It is the Health Insurance Portability and Accountability act of 1996. The goals of HIPPA are to protect health insurance coverage for workers and their families when they change or lose their jobs (portability) and to protect health data integrity, confidentiality, and availability (accountability).

What is a HIPAA violation? The combined text of all HIPAA regulations published by the Department of Health and Human Services runs 115 pages and contains many provisions there are literally hundreds of ways that HIPPA (it tried to autocorrect this to hipper, ha) rules can be violated. I’m going to give you a short list from the Health and Human Services website. Remember here, PHI is protected health information.

• Impermissible disclosures of protected health information (PHI)
• Unauthorized accessing of PHI
• Improper disposal of PHI
• Failure to manage risks to the confidentiality, integrity, and availability of PHI
• Failure to implement safeguards to ensure the confidentiality, integrity, and availability of PHI
• Failure to maintain and monitor PHI access logs
• Failure to provide patients with copies of their PHI on request
• Failure to implement access controls to limit who can view PHI
• Failure to terminate access rights to PHI when no longer required
• The disclosure more PHI than is necessary for a particular task to be performed
• Failure to provide HIPAA training and security awareness training
• Theft of patient records
• Unauthorized release of PHI to individuals not authorized to receive the information
• Sharing of PHI online or via social media without permission
• Mishandling and mismailing PHI
• Texting PHI
• Failure to encrypt PHI or use an alternative, equivalent measure to prevent unauthorized access/disclosure
• Failure to notify an individual (or the Office for Civil Rights) of a security incident involving PHI within 60 days of the discovery of a breach
• Failure to document compliance efforts

That is a lot, and it’s only a small amount of the hundreds of ways to violate HIPPA. The bottom line here is that the most common violations deal with mishandling or mismanagement of protected health information. HIPPA is not a civil penalty; however, it is a criminal penalty enforced under 45 CFR Parts 160, 162, and 164. The law number is in there for all of you geeks who will look it up and either completely understand it or ultimately make your head spin. Head spinning is a little service we provide here on the blog, it’s new.

Since it’s criminal, the penalties for violations of HIPAA rules can be severe. State attorneys general can issue fines up to a maximum of $25,000 per violation category per the calendar year. OCR (Office for Civil Rights) can issue fines of up to 1.5 million per violation category per year, and since its inception, multi-million-dollar fines have been issued.

I think in general though most healthcare providers don’t violate HIPAA intentionally. Healthcare providers, in general, are tightlipped about patient care issues. HIPAA just codified the provider-patient confidentiality. Which really is a good thing because it makes that confidentiality standard the same from Portland Maine to Portland, Oregon. Many healthcare professionals that haven’t gotten the hang of dealing with HIPAA are usually new and naïve.

Of Course we owe it to our patients to maintain confidentiality whenever I think of privacy I always think of the Saturday Night Live skit in 1975 (yes I’m that old) where they announce a female teenager’s positive STD test over the school PA and encourage anyone who has had sexual contact with her to see the nurse. Our Texas nurse did essentially the same thing by giving out her comments on that child who had the measles. Social media is a bitch, and we have to be very careful as healthcare providers what we say in a public setting. The old adage of, “you never know who’s listening,” is very true, especially in medicine. The truth here is that most violations of HIPAA are accidental or poorly thought out responses (meaning you engaged your mouth before your brain thought about what to say, something ‘none’ of us have a problem with).

Well it’s raining, and the castle is getting a new roof, so I’ve had to relocate the bats, three times; hopefully, this time I have them all tucked in. Be good to each other and to yourself.