Introduction to Privacy and Security AK1004

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New York Institute of Technology, Westbury *

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622

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Information Systems

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May 15, 2024

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docx

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Knowledge Activity: Introduction to Privacy and Security Student instructions 1. If you have questions about this activity, please contact your instructor for assistance. 2. You will review the chart of Daisha Estrada to complete this activity. Your instructor has provided you with a link to the Introduction to Privacy and Security activity. Click on 2: Launch EHR to review the patient chart and begin this activity. 3. Refer to the patient chart and any suggested resources to complete this activity. 4. Document your answers directly on this activity document as you complete the activity. When you are finished, you will save this activity document to your device and upload this activity document with your answers to your Learning Management System (LMS). The activity What is HIPAA? HIPAA is an acronym that stands for the Health Insurance Portability and Accountability Act . It’s a US law designed to provide privacy standards to protect patients' medical records and other health information provided to health plans, doctors, hospitals and other health care providers. Developed by the Department of Health and Human Services, these standards provide patients with access to their medical records and more control over how their personal health information is used and disclosed. They represent a uniform, federal floor of privacy protections for consumers across the country. A Covered Entity is one of the following: A Health Care Provider A Health Plan A Health Care Clearinghouse This includes providers such as: 1. Doctors 2. Clinics 3. Psychologists 4. Dentists 5. Chiropractors 6. Nursing Homes 7. Pharmacies This includes:  Health insurance companies  HMOs  Company health plans  Government programs that pay for health care, such as Medicare, Medicaid, and the military and veterans’ health care programs This includes entities that process nonstandard health information they receive from another entity into a standard (i.e., standard electronic format or data content), or vice versa. EHR Go Knowledge Activity: Introduction to Privacy and Security AK1004.3 Archetype Innovations LLC ©2021 1

(US Department of Health and Human Services, 2015) Under HIPAA, "health information" is any information (including genetic information) that is created or received by a health care provider, health plan, public health authority, employer, life insurance company, school or university, or health care clearinghouse. This includes a person’s past, present, or future physical or mental health condition; treatment provided to a person; or past, present, or future payment for healthcare an individual receives. Health information can exist in any form or medium, including paper, electronic, or oral (verbal). When a covered entity creates or receives health information that identifies, or can be used to identify, a person, HIPAA calls it "individually identifiable health information." Individually identifiable health information includes demographic and other information that identifies a person such as name, address, date of birth, and Social Security number. (Privacy Rights Clearinghouse, 2015) Privacy Rule The Privacy Rule gives individuals rights with respect to their protected health information (PHI). It also explains how covered entities (those who must comply with HIPAA) can use and disclose PHI. (Privacy Rights Clearinghouse, 2015) A major goal of the Privacy Rule is to assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public's health and well-being. The Rule strikes a balance that permits important uses of information, while protecting the privacy of people who seek care and healing. Given that the health care marketplace is diverse, the Rule is designed to be flexible and comprehensive to cover the variety of uses and disclosures that need to be addressed. (United State Department of Health and Human Services, 2003) HIPAA Violation Minimum Penalty Maximum Penalty Individual did not know (and by exercising reasonable diligence would not have known) that he/she violated HIPAA $100 per violation, with an annual maximum of $25,000 for repeat violations (Note: maximum that can be imposed by State Attorneys General regardless of the type of violation) $50,000 per violation, with an annual maximum of $1.5 million HIPAA violation due to reasonable cause and not due to willful neglect $1,000 per violation, with an annual maximum of $100,000 for repeat violations $50,000 per violation, with an annual maximum of $1.5 million HIPAA violation due to willful neglect but violation is corrected within the required time period $10,000 per violation, with an annual maximum of $250,000 for repeat violations $50,000 per violation, with an annual maximum of $1.5 million 2

HIPAA violation is due to willful neglect and is not corrected $50,000 per violation, with an annual maximum of $1.5 million $50,000 per violation, with an annual maximum of $1.5 million The Security Rule The HIPAA Security Rule groups its security standards into three categories: administrative safeguards, physical safeguards, and technical safeguards.  Administrative safeguards: The administrative functions that should be implemented to ensure that security standards are met. These standards include designating responsibility for security management, adoption of policies and procedures, and privacy and security training for an organization’s staff.  Physical safeguards: The controls put in place to protect electronic systems and hardware and the data stored there, from threats such as natural disasters and unauthorized intrusion. These safeguards may include locks on doors, special rooms, and back-ups to ensure that the data can be retrieved.  Technical safeguards: The automated controls used to protect electronic data and to control access. Examples include using authentication controls to ensure the identity of a person accessing a Health IT system containing electronic PHI, as well as encryption standards for data stored in HIT systems and transferred between them. Some safety measures that may be built in to EHR systems include:  “Access controls” like passwords and PIN numbers, to help limit access to your information;  “Encrypting” your stored information. This means your health information cannot be read or understood except by someone who can “decrypt” it, using a special “key” made available only to authorized individuals;  An “audit trail,” which records who accessed your information, what changes were made and when. In addition, a covered entity is expected to adopt reasonable and appropriate policies and procedures to comply with the provisions of the Security Rule. A covered entity must maintain written security policies and procedures and written records of required actions, activities, or assessments. They must periodically review and update its documentation in response to environmental or organizational changes that affect the security of electronic personal health information. This may include, but is not limited to, policies on:  Email correspondence  Telephone calls  Use of company &/or personal smartphones and tablets at patient encounter  Written correspondence  Internet use in the work place  Printing of patient health information 3

 Sharing of patient health information  Employee acknowledgement of internal polies and procedures Role Based Security and Confidentiality In most computer systems, credentials (username and password) are used as part of an access control system in which users are assigned certain rights to access the data within. This access control system might be part of an operating system (e.g., Windows) or built into a particular application (e.g., an e-prescribing module), often both are true. In any case, an EHR implementation needs to be configured to grant access to personal health information only to people who need to know it. The “need to know” is narrowly defined, so EHR systems should be configured carefully to allow limitation of access in all but the smallest practices. Role-based security elements: User class: Classifying an individual user by professional scope of practice; i.e. Nurse, Doctor, Medical Assistant, etc. The user class determines the user’s privileges and what they can access in the EHR. When using EHR Go, students are given “student access” and faculty are given “provider access.” Menu options: Controls where a user can go and what the user has access to . Security keys: Controls what a user can and cannot do in any area of the EHR. Cybersecurity An Internet connection is a necessity to conduct the many online activities that can be part of EHR use. Exchanging patient information electronically, submitting claims electronically, generating electronic records for patients’ requests, and e-prescribing are all examples of online activities that rely on cybersecurity practices to safeguard systems and information. Cybersecurity refers to ways to prevent, detect, and respond to attacks against or unauthorized access against a computer system and its information. Cybersecurity protects your information, or any form of digital asset stored in your computer or in any digital memory device. Mobile Devices The U.S. Department of Health and Human Services has recently put together a collection of tips and information. This information helps healthcare workers and patients protect and secure health information that may be accessed, received, and stored on mobile devices such as smartphones, laptops, and tablets. Real Life Stories Health system privacy breach The five-hospital Riverside Health System in southeast Virginia announced earlier this week that close to 1,000 of its patients are being notified of a privacy breach that continued for four years. 4

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