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
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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
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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
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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