Risk Insider: Allan Ridings

Do You Know if Your Electronic Communications are HIPAA Secure?

By: | August 19, 2014 • 2 min read
Allan Ridings is a senior risk management & patient safety specialist at the Cooperative of American Physicians, Inc. He has more than 25 years of experience in risk management and health care operations. He can be reached at [email protected]

As ubiquitous as text messaging is, many wonder why doctors can’t freely text with their patients. But regulators are clear on this. Text messaging is too vulnerable to information theft to be used unguarded in provider-patient communication.

The responsibility to secure medical information is clearly outlined and enforced by the Health Insurance Portability and Accountability Act or HIPAA.

In order to manage the risk of new forms of electronic communication, there are specific rules for health care professionals to follow when using text messaging and email as provided by the Centers for Medicare and Medicaid Services Office for Civil Rights (ORC).

Below are best practices regarding electronic messaging of patient information.

What’s the importance of security and encryption in relation to text messaging in health care?

The Joint Commission states that in addition to its violations of HIPAA, unencrypted text messaging provides no way to verify the identity of the person sending the message or to retain the information sent and validate it as part of the medical record.

What is unencrypted text messaging?

Traditional Short Messaging Service (SMS) messaging is transmitted over non-secure and noncompliant networks. The majority of traditional SMS messages are delivered as mobile phone to mobile phone messages; however SMS messages are also delivered via other electronic technologies, which also fall under HIPAA governance:

• Email to mobile phone number

• Mobile number to an email address

• Phone number to alphanumeric pager

• Email to alphanumeric pager

So how do medical professionals text or email information to and from colleagues and patients in a secured encrypted network?

HIPAA requires that a covered entity be in accordance with §164.306 and implement a mechanism to encrypt and decrypt electronic protected health information. (45 CFR § 164.312(a) (2) (iv)). It is also required to implement the Advanced Encryption Standard (AES) encryption protocol system with either 128-bit or 256-bit encryption.

Your company or office IT and telecommunications department needs to ensure compliance with the above encryption standards.

What are the benefits of these encrypted / secured services?

Once the physician or medical office has implemented an encrypted mechanism, the sending and receiving of instant information, patient health issues, reports, and referrals as well as communicating with peers, will all be transmitted in secure, protected environments.

Are there any limits when using SMS?

Yes, there is a strict limit of 160 on the number of characters allowed to be sent. Only the first 160 characters will be sent from an email message to a mobile phone and from a mobile phone to an email user. To avoid misunderstandings, it is recommended that caregivers use approved abbreviations when communicating peer-to-peer.

Does your IT department need to make changes to your smart phones or devices?

Yes, your IT team must enable remote access capabilities on your smart phone, so that you can erase (scrub) all the data from it if it is lost or stolen; and you must keep a record of this loss or theft of your smart phone for auditing purposes.

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]