HIPAA Compliance for Medical Practices
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HIPAA Compliance and HIPAA Risk management Articles, Tips and Updates for Medical Practices and Physicians
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Telehealth, Video Tech Tools and HIPAA Compliance

Telehealth, Video Tech Tools and HIPAA Compliance | HIPAA Compliance for Medical Practices | Scoop.it

elemedicine has been around for years, but as a healthcare service it has been underutilized.

 

Today, virtual visits for medical care have skyrocketed because of the COVID-19 outbreak and other factors.

 

Telehealth is experiencing a revolutionary moment like never before. By the end of 2020, virtual medical care usage is estimated to reach upwards of 1 billion interactions, according to analysts at Forrester Research. 

 

In addition, some restrictions that were barriers to entry before have been lifted in response to the public health pandemic. And in March 2020, the Trump Administration expanded Medicare's coverage allowing beneficiaries to receive more extensive care through telehealth visits. These are done using video and audio applications. 

 

With the advent of stay-at-home orders and social distancing, technology is healthcare's solution for delivering continuous patient care. Tech tools' enable widespread access, bringing an unprecedented reach to a larger patient population.

 

For medical practitioners, the shift of using video platforms to communicate can come with risk and HIPAA compliance concerns. OCR asks that telehealth sessions be conducted in a private environment.  Sometimes this could be achieved with a simple task such as closing an office door or lowering one's voice.  

 

The Office for Civil Rights has issued an announcement, guiding on which audio and video communication platforms are acceptable and not acceptable for patient interactions during the coronavirus pandemic. 

 

As stated officially by OCR on its website:

"OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency."

In this blog post, we will highlight some of the video communication platforms that follow OCR's public health emergency guidance. Of course, keep in mind that compliance regulations might change in upcoming months.

Telehealth video calling platforms to use amid the pandemic

Under OCR's notice, covered healthcare providers can use certain platforms for non-public facing video communications with patients, as these platforms are HIPAA compliant and will enter into Business Associate Agreements (BAAs).

Some of these are:

  • Skype for Business / Microsoft Teams
  • Updox
  • VSee
  • Zoom for Healthcare
  • Doxy.me
  • Google G Suite Hangouts Meet
  • Cisco Webex Meetings / Webex Teams
  • Amazon Chime
  • GoToMeeting
  • Spruce Health Care Messenger

Zoom is on this list, but with the recent rise in security attacks from threat actors joining Zoom meetings uninvited, we have seen advice from various  entities to use a different video platform when communicating with patients, until all security and privacy issues with Zoom are fixed. No one wants to deal with Zoom-bombing during an important medical visit. 

It's important to note that these technological tools are third-party providers and they may pose privacy risks. However, using FaceTime, for instance, during the pandemic is not necessarily a compliance violation, depending on a case by case basis. 

What if patient does not have access to video telehealth formats

If the telehealth session is being conducted in good faith during this public health emergency, then OCR permits the use of audio methods like wireless phone, landline phones to conduct the session. If using email or texting, they ask the covered entity to try and utilize safeguards whenever possible, such as secure email or secure texting.  

Avoid using TikTok for telehealth sessions

On the other hand, OCR stated the following public-facing applications are not to be used when providing telehealth services, even during the public health crisis. OCR is not the sole government agency warning about TikTok's security implications. The wildly popular app has come under fire for underage privacy and international security concerns by U.S. lawmakers and security professionals.  Using public-facing communications could be an evidence of bad faith on the part of the provider, which could make the provider liable for OCR enforcement actions. 

Avoid using these platforms for telehealth:

  • Facebook Live
  • Twitch
  • TikTok

 

Not only that, the guideline explains to avoid using any public-facing technology, meaning the session can be seen by a group. 

For privacy protections and peace of mind, OCR advises to turn to HIPAA compliant technology platforms.

 

There are vendors available, who will enter into a HIPAA Business Associate Agreement with a covered entity. Check with the vendor to see if that's the case. When in doubt, reach out to third-party HIPAA experts to ensure your following compliance regulations as you transition to doing telehealth. 

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HIPAA Media Access: Film Crews in Healthcare Facilities

HIPAA Media Access: Film Crews in Healthcare Facilities | HIPAA Compliance for Medical Practices | Scoop.it

The Department of Health and Human Services (HHS)’ Office for Civil Rights (OCR) has issued several Notices of Enforcement Discretion during the COVID-19 pandemic.

 

As such, OCR will not be imposing sanctions on covered entities for good-faith violations of certain rules. OCR will continue to impose sanctions for other violations.

 

One violation for which OCR will continue to apply sanctions is the violation of the HIPAA Media Access rule.

 

Under the HIPAA Privacy Rule, media and film crews may not access healthcare facilities where patient PHI is accessible, unless certain safeguards are in place.

HIPAA Media Access: When Can Film and Media Crews Access Healthcare Facilities?

Under the HIPAA Media Access rule, healthcare providers may permit media and film crews to access their facilities where PHI is accessible – but only if the facility first obtains written authorization from patients.

 

HIPAA does not permit covered health care providers to give the media, including film crews, access to any areas of their facilities where patients’ PHI will be accessible in any form (e.g., written, electronic, oral, or other visual or audio form), without

first obtaining a written HIPAA authorization from each patient whose PHI would be accessible to the media.

 

In addition, when film crews (after obtaining written patient authorization) access areas in which patients are present, the healthcare facility must put reasonable and appropriate safeguards in place to protect against unauthorized disclosure of PHI.

 

In the latest guidance on the topic, OCR explains that reasonable and appropriate safeguards include, among others, placing privacy screens on computer monitors to prevent electronic PHI (ePHI) from being viewed.

 

Safeguards also include using opaque barriers to ensure that patients who have not signed written authorizations are not filmed.

 

OCR has taken the matter of unauthorized filming of patients very seriously in recent years. In 2018, OCR initiated enforcement actions against Boston Medical Center, Brigham and Women’s Hospital, and Massachusetts General Hospital, after it was discovered they had given film crews access to their facilities without first obtaining authorization from patients.

 

They were fined a total of $999,000 for the HIPAA violations.

 

“The last thing hospital patients need to worry about during the COVID-19 crisis is a film crew walking around their bed shooting ‘B-roll,’” said Roger Severino, OCR Director.  “Hospitals and health care providers must get authorization from patients before giving the media access to their medical information; obscuring faces after the fact just doesn’t cut it.”

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