Friday, July 27, 2012

Avoiding Verbal HIPAA Violations

A patient sits in his doctor’s office inner waiting room, reading a magazine. Around the corner, outside of an exam room, two nurses discuss a patient’s non-compliance with her diabetes medication. 
A medical assistant walks a patient from the waiting room to the height and weight station, which is located outside of a bathroom. While standing in the hall waiting for the scale to be free, the patient is questioned about symptoms she has been experiencing. Both the person in the bathroom and the person being weighed can hear the conversation.
A doctor walks out to the waiting room with an adolescent who was treated while the parent waited. In front of other patients, the doctor discuss the suggested treatment and addresses the parent’s questions. 
A technician reviews a patient’s blood work with the doctor while several patients sit around the corner waiting to have their blood drawn. The patient’s test, results and name are spoken loudly.
credit: Black Enterprise
In each of these scenarios, a health care worker is violating a patient’s HIPAA rights. Protected information is discussed where other people can hear. This happens in health care practices all over the country, every day. Doctor’s offices are busy places.  Many patients must be seen and treated. Often the staff is moving so quickly they do not give a second thought to the fact that they are violating HIPAA. 
Doctor’s offices are filled with halls, corners, alcoves and sectioned waiting rooms. While it may feel that a conversation is private, often someone can hear every word being exchanged. Protected information is then disclosed and a violation has occurred. Educating the staff is the most important step in eradicating this all too common problem. Often, hearing is believing. Conduct role playing scenarios in different areas of the office, showing staff and doctors how easily protected information can be overheard. This will reinforce the importance of having conversations behind closed doors. Also, create a system that does not allow for these types breaches. Conduct all workups, patient questions, and follow ups in exam rooms, conference rooms, or offices. Remember voices carry, so being inside a room is not always enough. Closing the door and speaking in a reasonable voice is also important. 
If one patient hears a conversation about another patient, they may worry that the same will happen to them. No one wants to feel that their doctor’s office and staff are being cavalier with sensitive medical information. Safeguarding your practice and putting a plan into action to prevent verbal violations is key. Best practices will ensure that the office is above reproach. Not only will you be following the guidelines set forth in HIPAA, but you are showing a high level of professionalism. This instills a high level of provider confidence in patients, who are the most important component to a successful practice. 

Sunday, July 22, 2012

Cell Phones in the Workplace

Many places of business have signs up requesting patrons silence phones or conduct calls outside. But what about employees? Are business owners being as clear with their staff about what is and is not acceptable? The following statistics tell us that cell phones are a huge part of daily life. How are they effecting your workplace?

  • In 2011, U.S. wireless consumers sent and received an average of 6.3 billion text messages per day.
  • At year-end 2011, the average U.S. wireless consumer used 945 minutes a month. 
  • Almost half (49.7%) of U.S. mobile subscribers now own smartphones. 
  • Average Americans spend 2.7 hours a day “socializing” on a mobile device. 

These facts and figures tell business owners and managers several important things. Americans are using their cell phones constantly. Not only are they talking, they are also texting and using social networking apps. This means if your employees are normal, average Americans, they are probably using their phones during the time you are paying them to work. This cuts into productivity which cuts into your bottom line. Employees are not permitted to use a land line to chat with friends and family, or cruise Facebook on their computer. Using their mobile device is the equivalent. Not only is
 cell phone usage a misappropriation of company time, it also reflects poorly on the business to see employees using their cell phones. The best way to put a stop to employees abusing their phones in the workplace is to spell out your policy in the employee handbook. 

When evaluating your company’s cellphone policy, several factors should be taken into consideration. The first is, when and where can cell phones to be used? Some employers may decide that none may used on company premises or company time. For example, when it is a safety issue or when they can effect sensitive equipment, like a driver or hospital employee. Others may decide that cell phones are only appropriate when staff are on a break in designated staff only areas. This is the most common approach. The third option is cell phones are allowed only when all other work is done. For example, a restaurant on a slow night or a parking lot attendant. Once parameters have been established, the next step is to decide on consequences if an employee is not following the rules. The best option is an established system of documented verbal and written warnings, with termination being the end result. It is very important to go over the rules you choose to implement with your staff. Also, make an addendum to the employee handbook that every person signs. If employees complain, a simple explanation that time is money should suffice. The more productive employees are, the more income is generated, and the better that is for everyone.

Don’t allow your employees to waste valuable time and money on their cell phones. If the issue is not addressed, it is easy for them to claim ignorance if it does become a problem. Explaining the company’s position on cell phones in the workplace before it becomes a personnel issue is good business sense and can save time and energy that is better used elsewhere.

--CTIA-The Wireless Association, CTIA's Wireless Industry Indices: Semi-Annual Data Survey Results, A Comprehensive  Report from CTIA Analyzing the U.S. Wireless Industry, Year-End 2011 Results, 2012
--Roger Entner, Recon Analytics, The Wireless Industry: The Essential Engine of US Economic Growth (2012)
--Nielson Mobile Insights
--Digital Buzz Blog

Monday, July 16, 2012

Employee Handbooks: The Key to Clear Expectations

An employee handbook is vital to every business, whether it has one or one thousand employees. Communicating expectations and company guidelines is important in maintaining a healthy work environment. Employees must be able to understand what is expected of them. A well thought out and clearly written handbook lays out all policies and rules so nothing is left to misinterpretation. It is much better to let staff focus on their jobs instead of ever changing office policy. A handbook takes the guesswork out for everyone.

The first thing to think about when putting together an employee handbook is anything that is included must be followed by both parties. Don't put anything in you are not prepared to enforce. For example, if you choose to include a dress code, then it is imperative that you make all employees abide by it. Things are not to be included as "fail safes" or "just in case." All guidelines are for everyone. While policies often come about from there being an issue with one staff member, once it is included in the book, it is law. If all parts are not enforced equally, it is very easy for employees to feel that all policies are optional. For that same reason, avoid the pitfall of making policies just to make them. Any policy that seems extraneous and unenforceable should be left out or changed. For example, “All bathroom breaks must be approved by a manager five minutes prior” is not only unreasonable, but unnecessary in most office environments. A better option is “it is the employee’s responsibility to let a manager know when they are leaving their workstation.” The latter is easier to enforce, and more logical.

There are several key items that should be incorporated into every handbook. The most important is an Employment at Will statement. This explains both the employer and employee are afforded the right to terminate the working relationship at any time for any reason. It also means that no tenure or guaranteed employment is available.Other important sections to include are paid and unpaid holidays, dress code, standards of conduct, and disciplinary measures if the handbook is not followed.

The handbook should be clear, concise and basic. If it is too hard to determine what the guidelines actually are, then how can staff follow them? When expectations are spelled out plainly, there is no room left for employee interpretation. The staff should have no problem reading and understanding the handbook. Avoid legalese and complicated and detailed scenarios. Going over the handbook with every new employee will also avoid any confusion. Once the handbook has been reviewed and discussed, every employee should sign an acknowledgment form. This is a safety for the employer if the guidelines in the handbook are not being followed.

Anytime an amendment is added to the handbook it is the employer’s responsibility to make the staff aware. It should be reviewed and signed by each employee. Every employer should review and reissue their employee handbook with updated information every five years. This insures all information is correct and current. Policy that was enacted in years previous may be no longer necessary and new issues may need to be included. The handbook should be updated more often if there are significant changes within the company. Once the handbook has been reissued the entire staff should review and sign.

A good business attorney is available to help with any step of the process. It is wise to consult with a lawyer to ensure all policies and procedures are above board. Also, the attorney can be employed to write the entire handbook. If an employer chooses to write his own, it should be reviewed by an attorney. This ensures any possible legal issues are resolved before it is in the employee’s hands. A good handbook can protect a company owner from legal issues. However, one done incorrectly can be a huge liability. Using a trusted attorney to oversee the process will ensure that everything included is in line with state and federal laws.

Tuesday, July 3, 2012

Benefits of Healthcare Law

In the business world, medical practices face a unique set of challenges. In addition to the normal issues involving employees, contracts, and collections, they have the added responsibility of caring for patients while protecting their privacy. This is where an attorney who specializes in health care comes in. Not only can a good lawyer help with the business side of owning and operating a practice, but the distinctive needs of the medical industry can be addressed. In the current atmosphere, privacy and protection of medical and personal information is of the utmost importance. Each practice must evaluate the way it is operating and learn the best and most effective ways to follow a set of laws that are always evolving. Doctors and staff can look to a trusted firm to help navigate their practice through the world of business and the world of HIPAA (Health Insurance Portability and Accountability Act).

According to the website for the US Department of Health and Human Services, the Office of Civil Rights (OCR) has documented over 70,982 HIPAA complaints since April 2003. Of those complaints, the most common offenders are private practices. Unlike large hospitals and groups, private practices have the most to lose by breaking HIPAA laws. A large fine can decimate a smaller practice. Recently, a Cardiac Surgery practice in Phoenix was fined $100,000 for non-compliance. Other fines issued to various companies in the health care arena have been upwards of $800,000 to $2 million, depending on the seriousness of the breach. The simplest way to avoid falling victim to the same thing is to hire a firm that can guide the practice in adhering to the strict policies set forth by HIPAA. Doing so can be the difference in success and financial ruin. All it takes is one complaint to start an audit.

A health care attorney will walk the practice through day to day factors that can be problematic, as well as obscure issues that may arise infrequently. Issues range from limiting accessibility to patient information by computer, to turning sheets of paper over that have protected information on them. While one seems obvious and the other effortless, both are easily remedied. Left unattended, both can get a practice into trouble. Compliance is not optional and is not avoidable. A practice must take steps to understand and carryout the mandates set forth in HIPAA, or it is sitting in a very precarious position going forward. The only way to be above reproach is to make sure that all doctors and staff are above reproach. The best way to do that is to hire someone whose job it is to understand every complicated detail of health care law. Hiring an attorney is a best way to maintain the health and well being of every medical practice.
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