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Introduction to Healthcare Information Technology

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Presentation on theme: "Introduction to Healthcare Information Technology"— Presentation transcript:

1 Introduction to Healthcare Information Technology
Chapter One Introduction to Healthcare IT

2 About the Presentations
The presentations cover the objectives found in the opening of each chapter. All chapter objectives are listed in the beginning of each presentation. You may customize the presentations to fit your class needs. Some figures from the chapters are included. A complete set of images from the book can be found on the Instructor Resources disc.

3 Objectives Define healthcare information technology
Recognize some of the benefits of healthcare IT Describe the CompTIA Healthcare IT Technician Certificate List major healthcare regulators Summarize the major healthcare regulations Describe typical healthcare legal practices

4 Healthcare IT: Challenges and Opportunities
Information technology adoption Slower in healthcare industry compared with other industries Obstacles to adoption Fragmented healthcare system Many different systems among providers Shortage of trained technology professionals Highly regulated industry

5 What Is Healthcare Information Technology?
Framework for managing health information Mechanism to improve patient care Enables patient care coordination Application of information technology to the healthcare industry Hardware and software Used to manipulate health data and information

6 Benefits of HIT Healthcare costs continue to rise
5.2 percent of U.S. GDP spent on healthcare in 1960 17 percent in 2007 Advances in technology account for about half of healthcare spending increases Efficiency benefits of electronic medical records Eliminates medical transcription Reduces need to physically retrieve charts Reduces duplicate diagnostic tests

7 The CompTIA Healthcare IT Technician Certificate
Nonprofit trade organization Advocate for the IT industry Provides education and certification programs CompTIA healthcare IT technician certificate Shows individual’s proficiency in certain areas of healthcare and information technology Prepares students for jobs in software and technology support

8 The CompTIA Healthcare IT Technician Certificate (cont’d.)
CompTIA proficiency areas HIT regulations Healthcare organization and operations Basic IT operations Network IT operations Document imaging Basic and advanced healthcare security Medical business operations This text book is to help prepare for the CompTIA IT Technician HIT-001 certification.

9 Regulatory Compliance: Regulators
Regulation Something that constrains or controls Regulator Governmental entity that mandates regulations Healthcare one of most heavily regulated industries Purpose of regulations Ensure minimum standard of care Provide broad patient access at reasonable cost

10 Regulatory Compliance: Regulators (cont’d.)
Table 1-1 Primary U.S. healthcare regulatory agencies © Cengage Learning 2013

11 Department of Health and Human Services
Mission of HHS Provide citizens access to high-quality health care Help people find jobs and child care Keep food safe Manage infectious diseases Extend the practice of diagnosis and treatment HHS represents 25 percent of U.S. federal budget

12 Department of Health and Human Services (cont’d.)
Operating divisions of HHS Administration for Children and Families (ACF) Administration on Aging (AoA) Agency for Healthcare Research and Quality (AHRQ) Agency for Toxic Substances and Disease Registry (ATSDR) Center for Disease Control and Prevention (CDC) Centers for Medicare and Medicaid Services (CMS) Food and Drug Administration (FDA)

13 Department of Health and Human Services (cont’d.)
Operating divisions of HHS (cont’d.) Health Resources and Services Administration (HRSA) Indian Health Service (IHS) National Institutes of Health (NIH) Office of the Inspector General (OIG) Substance Abuse and Mental Health Services Administration (SAMHSA)

14 Department of Health and Human Services (cont’d.)
Office of the National Coordinator for Health Information Technology (ONC) Staff division within HHS Responsible for coordinating use of advanced HIT practices at the national level

15 Centers for Medicare and Medicaid Services Information Technology
CMS administers: Medicare program Federal portion of the Medicaid program State Children’s Health Insurance Program (CHIP) Parts of Medicare Part A Inpatient hospital stay insurance Part B Doctor’s services and outpatient care Prescription drug coverage

16 Centers for Medicare and Medicaid Services Information Technology (cont’d.)
Program for low-income people Covers certain medical expenses Jointly funded by federal government and the states Medicare and Medicaid incentive programs Cash incentives to providers for adopting electronic health record (EHR) technology

17 The Office of the National Coordinator for Health Information Technology
Responsibilities Coordinates use of advanced HIT practices at the national level Certifies EHR systems and providers Three aspects of certification Standards and certification criteria for EHR Certification programs Metadata standards

18 The National Institute of Standards and Technology
Federally sponsored physical science research laboratory Sets standards for EHRs under the HITECH Act Five goals of NIST’s role in health information technology Coordinate standards Coordinate infrastructure testing Improve EHR usability Extend healthcare’s reach through technology Perform research and development

19 The National Institute of Standards and Technology (cont’d.)
NIST and Healthcare Information Technology Standards Panel (HITSP) Provide standards and specifications to ensure system interoperability Example: specific data and communication format requirements

20 The National Institute of Standards and Technology (cont’d.)
Table 1-2 HIT standards implementation process © Cengage Learning 2013

21 Regulatory Compliance: Regulations
HIPPA: Health Insurance Portability Accountability Act of 1996. HIPAA privacy rule Broad federal regulation Adopted in 1996 HIPAA goals Improve portability and continuity of health insurance Manage waste, fraud, and abuse of health care delivery Reduce costs and increase efficiency by standardizing the interchange of electronic data Protect the privacy of personal health records

22 Regulatory Compliance: Regulations (cont’d.)
HIPAA privacy rule regulates: Health care providers Health plans Health care clearinghouses Collectively called Covered Entities (CE) Rule extends to Business Associates (BAs) of Covered Entities Business Associate Agreements Contracts between CEs and BAs ensuring HIPAA is followed

23 Regulatory Compliance: Regulations (cont’d.)
Protected Health Information (PHI) Individually identifiable health information Created or received by CE or BA Can exist in various forms (verbal, paper, electronic) De-identified information Cannot be traced back to the individual Must remove 18 specific identifiers or be certified by a statistician (name, small geographic, vital stat, tel., , SS, Med. record number, IP address, address, license plate, biometric, etc.)

24 Regulatory Compliance: Regulations (cont’d.)
Data use agreement Permits researchers to use PHI under specific conditions Office for Civil Rights (OCR) Responsible for enforcement of HIPAA

25 Table 1-3 HIPAA Privacy Rule safeguards and requirements
© Cengage Learning 2013

26 HIPAA Security Rule Focuses on electronically transmitted or stored PHI Known as ePHI Narrower focus than the privacy rule Seeks to ensure Covered Entities provide certain administrative, physical, and technical safeguards for data

27 Table 1-4 HIPAA Security Rule categories, safeguards, and requirements
© Cengage Learning 2013

28 HIPAA Identifier Rule Mandates all Covered Entities storing or transmitting ePHI have a National Provider Identifier (NPI) Replaces all other identification from Medicare, Medicaid, and other government programs

29 HIPAA Transaction and Code Sets Rule (TCS)
Mandates consistent electronic interchange of PHI Electronic data interchange for health care Technology is tested and proven from use in other industries Several standards exist ANSI X.12 standard

30 HITECH Act Creations of the Health Information Technology for Economic and Clinical Health (HITECH) Act HIT Standard Committee HIT Policy Committee Process to adopt standards and procedures

31 HITECH Act (cont’d.) HITECH Act more stringent than HIPAA
Increased resources for enforcement Increased penalties for violation Health providers cannot use patient health information without expressed permission Sale of private health information must be authorized by the patient Patients may audit their electronic patient records Act extends to future unanticipated entities Mandates encryption of ePHI Requires patients be notified of any breach

32 HITECH Act (cont’d.) HITECH act and Business Associates
HITECH Act encompasses both Covered Entities and Business Associates HITECH Act and PHI breach Covered Entity required to report the breach to each individual affected Business Associate breaches reported to Covered Entity first HHS must be contacted if more than 500 patients affected

33 HITECH Act (cont’d.) HITECH act enforcement
Four levels of enforcement Lowest level of enforcement: unknown violations despite due diligence Penalties: $100-$25,000 per violation Next level: reasonable cause and not willful neglect Penalties: $1000 to $100,000 per violation

34 HITECH Act (cont’d.) Level 3: willful neglect corrected within 30 days of knowledge of violation Penalties: $10,000 to $250,000 per violation Level 4: willful neglect that is not corrected Penalties: $50,000 to $1,500,000 per violation Penalties are for a given calendar year

35 HITECH Act (cont’d.) HITECH act and EHRs
Majority of funding for HITECH used for provider incentives to adopt EHRs Entities that provide assistance, best practices, and grants under HITECH Act Workforce investments HIT extension program HIT research center HIT regional extension centers

36 HITECH Act (cont’d.) Certified EHR HITECH act and meaningful use
Tested by an ONC Authorized Testing and Certification Body (ATCB) HITECH act and meaningful use EHR must be used in a meaningful manner EHR must be used for submission of quality data and other measures EHR must be used for exchange of health information that improves health care quality

37 HITECH Act (cont’d.) Eligible Provider (EP)
Provider qualifying for financial incentives under HITECH Act Incentives for both Medicare and Medicaid exist EPs may participate in multiple programs Certain restrictions apply

38 Table 1-5 Maximum Medicare EHR incentive payments
© Cengage Learning 2013

39 Legal Practices Legal practices outside the scope of traditional regulatory environment Liability waivers EHR service level agreements Memoranda of understanding

40 Liability Waivers Used by hospitals and physicians to protect them against legal liability Documents signed by the patient Specify provider responsibility in case of treatment failure or injury

41 Service Level Agreements
Frequently used in technology applications Define level of service user can expect from technology provider Examples of SLA performance measures Downtime Downtime period Monthly uptime percentage Scheduled downtime Service credit

42 Memorandum of Understanding
Also called memorandum of agreement (MOA) Voluntary agreement between health providers Specifies some mutually beneficial arrangement Example: natural disaster recovery Agreement would specify responsibilities of each entity

43 Memorandum of Understanding (cont’d.)
Four elements of a legally binding contract Payment or consideration No illegal activities Actions of parties must be described Agreed upon without threat or duress

44 Summary Healthcare costs keep increasing
Healthcare industry has been slow to adopt use of information technology HIT: the use of hardware and software to manage and manipulate health information Regulation provides constraints or controls HIPAA protects privacy and security of patient health data

45 Summary (cont’d.) Parts of HIPAA
Privacy rule Security rule Identifier rule Transaction and Code Sets rule HITECH Act increases protections of HIPAA Certain legal practices exist outside the regulatory environment

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