Over the last few years, HIPAA went from being toothless to getting its first pair dentures. However, with the new HIPAA Privacy and Security final rule – to be known as the Omnibus Rule – the OCR pulled the wet stone from the toolshed and has been sharpening its teeth.

Under the former rule, providers were presumed innocent of harm via breach until proven otherwise. Under the new rules, the provider will be presumed guilty until innocence is proven. An interesting judgment considering the U.S. criminal justice system works to the contrary.

Additionally, business associates are being added under the Omnibus Rule, and they can be held accountable and liable. Many business associates will not be prepared for this risk. It has been reported third parties now account for 40% of the breaches reported and 75% of the records exposed.

The OCR has begun hiring additional enforcement officials, so we should expect the rate of audits and fines to continue, and possibly accelerate. To make their point, the Director of HHS Office for Civil Rights recently stated the Omnibus Rule “not only greatly enhances a patient’s privacy rights and protections, but also strengthens the ability of my office to vigorously enforce the HIPAA privacy and security protections.” Additionally stating, “We have moved into an area of more assertive enforcement.”

Now is a good time to tighten your policies, procedures, and IT security!

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Sources: New HIPPA Rule Seen Tougher; HHS Makes Sweeping Changes to HIPPA

On May 1^st the staff at Umbrella Medical Systems celebrated the 6^th anniversary of the company’s inception with a “birthday party!” Umbrella has grown from a simple idea hatched by two friends in a garage to a company that provides stellar ITMS services to clients across the region. What was once a company staffed by two guys with a dream has become a full team of talented managers and IT experts, working to make life and business easier for clients across the region. At the celebration, Umbrella founders Heath Stover and Trent Peters reflected on their journey and their hopes for the future.

“Six days after quitting my job to start Umbrella with Trent, I spoke with a local business owner who later became a friend,” said Heath. “We were six days in, and she told me ‘you’ve just got to show up.’ No other advice has proven more valuable through the good times and the bad.  Umbrella was built one cup of coffee at a time by anyone who was willing to speak with me anywhere.  Those people eventually became great clients, great colleagues, great employees, and great friends.  Many thanks to those who ‘showed up’ over the past six years!”

“My grandpa Bob built a successful business around his motto of ‘hire great people and treat them well, serve your clients with passion, and profit will be a by-product,’ said Trent. “Ever since our humble beginnings in a garage, Heath and I have strived to live by these wise words by delivering nothing less than ‘Great IT’ to our clients and building a fantastically awesome team at Umbrella.  Six years? What a ride! A sincere thanks to our clients and employees.”

 

Communities in which health-care providers work together to coordinate evidence-based hospital discharges can see a six percent drop in hospitalizations and rehospitalizations in just the first two years, according to a new project study.

For the project, described January 22 in the Journal of the American Medical Association (JAMA), the Colorado Foundation for Medical Care (CFMC) coordinated 14 of Medicare’s Quality Improvement Organizations (QIOs), which are funded by the Centers for Medicare & Medicaid Services to help achieve national quality goals through focused efforts at the community and provider level.

Together, the QIOs implemented community-wide evidence-based improvements in patient care transitions. This included starting community organizations, providing technical assistance, and monitoring of participation, effectiveness and adverse effects.

Jane Brock, chief medical officer at CFMC and lead author for the JAMA article, said "The project was successful because rather than focus on one hospital ward, or 100 patients, it engaged whole communities to improve care for large geographically-defined populations.”

The JAMA article is titled "Associations between quality improvement for care transitions in communities and rehospitalizations among Medicare beneficiaries." If you would like to learn more about the benefits of coordinated care, please contact us.

The earlier you familiarize yourself with ICD-10-CM, the easier the transition will be - so you may want to start now.

To recap, the ICD-9 code sets, which were used to report medical diagnoses and inpatient procedures, will be replaced by ICD-10 code sets. ICD-10 is more robust and descriptive than ICD-9, which is 30 years old, and has many outdated and obsolete terms.

You may ask why ICD-10 is any different from the annual code changes that already take place. The answer: ICD-10 codes have a completely different structure from ICD-9 codes. ICD-9 codes are mostly numeric and have three to five digits. ICD-10 codes are alphanumeric and contain three to seven characters. Like ICD-9 codes, however, ICD-10 codes will be updated every year.

Does the switch to ICD-10 affect you? More than likely. Everyone covered by HIPAA must transition to ICD-10 - including providers and payers who do not deal with Medicare claims. it's important to remember that all activity that happens in a doctor’s office will be covered. This is a big deal that will impact every doctor and those who aren’t prepared will experience significant loss of revenue.

The deadline for the transition is October 1, 2014. To help you make the transition, a widget for setting up a timeline for the switch to ICD-10 can be found here.

Year-end brings some important tax planning implications for physicians, because both the Tax Relief Act of 2010 and the Jobs Act of 2010 affected Section 179 of the tax code in a positive way. You can basically write off 100% of up to $139,000 of equipment and software you purchase this year. If you haven't taken advantage of this yet, there's still time!

Here's how it works:

First, you can purchase up to $560,000 worth of equipment and software (which would have been only $200,000 prior to the new legislation.)

Also, the deduction limit, after adjustment for inflation, has increased to $139,000 (which would have been only $25,000 prior to the new legislation).

The new law also allows 50% bonus depreciation on qualified assets placed in service during 2012.

When applying these provisions, Section 179 is generally taken first, followed by the bonus depreciation (unless the business has no taxable profit in 2012).

That’s a lot to digest, so let’s look at an example. Say you buy $150,000 worth of equipment and software - including an electronic medical record (EMR) this year. The calculation below shows how much it actually costs you after tax incentives.

Equipment Purchase = $150,000 First-year (2012) writeoff = $139,000 50% bonus first-year depreciation (150,000-139,000)X 50% = $5,500 Normal first-year depreciation (20% in each of five years on remaining amount) = $1,100 Total first-year deduction (139,000+5,500+1,100) = $145,600 Tax savings (145,600 X 36% tax rate) = $50,960 Cost of equipment after tax (15,000 less all tax deductions) = $99,040

To take advantage of this deduction, your equipment or software must be in place on or before December 31, 2012 - so don’t delay.

Remember, successful businesses take advantage of tax incentives to help lower their operating costs. The Section 179 gives businesses such as yours an incentive to invest in themselves by adding capital equipment, and it’s easy to use.

Buying quality hardware, hiring external assistance, and getting buy-in from practice staff are key steps to a successful electronic medical record (EMR) system implementation, according to primary care physicians.

That information comes from a recent Medical Economics survey, in which 30 doctors were asked to identify what helped them prepare for EMR implementation.

Other tips were hiring a scribe to help with data-gathering and template-creation; identifying one main resource to guide the implementation process; establishing a timeline to complete online training each week before implementation; and setting up weekly telephone conference calls with your vendor.

According to the survey, almost half of participants hired an information technology (IT) professional or firm, 12% hired some other outside assistance, and 8% paid for assistance from a regional extension center.

The good news: Most of the doctors surveyed said they were making progress with their EMR implementations. A full 82% were e-prescribing and 74% were maintaining an active medication list. But, there was room for improvement: 19% of doctors have implemented one clinical decision support rule, and just 7% were electronically exchanging key clinical information with other entities.

The outcome of the presidential election is not expected to change the strength of the health-care IT sector, according to a new study by Mercom Capital Group.

Because health-care IT touches virtually everybody in some way, it's become a large market that piqued the interest of investors, and significant funding is flowing into private companies.

According to the study, conducted in the third quarter of 2012, health information management companies received $101 million of funding in 20 deals, followed by mobile health companies with $39 million in seven deals and social health network companies with $26 million in four deals. Another funded deal this quarter was $25.5 million raised by Telcare, a mobile health company that uses cellular machine-to-machine technology for diabetes and other chronic illnesses.

The reason for the strength: Federal programs such as the HITECH Act of 2009, which made greater amounts of health data available for use. This has made applications possible.

This is good news for health-care providers, because it ensures that innovative applications are available to help them pursue their goals of increased efficiency and patient safety.

The Apple iPad revolutionized mobile computing when it was released, and each subsequent generation has brought with it changes for the better. The last release, the new iPad, saw some big lines of eager customers. Chances are, if you look around the office, at least one person has one. Less than seven months after the release of the iPad 3, Apple announced two new replacement tablets on the 23rd October this year.

Below is more information on the two recently introduced iPads.

The new, new iPad Apple has wisely decided to go back to adding numbers to their products. In fact, the launch event contained no words on the new iPad (iPad 3) at all. Apple seems to have swept it under the rug, as you can no longer find the ‘iPad 3’ on the Apple store, it’s been replaced by the iPad with Retina display - read: iPad 4.

The iPad 4 contains a new processor, the A6, which according to Apple, “is up to twice as fast as the previous-generation A5X chip [featured in the iPad 3], and it delivers up to twice the graphics performance, without sacrificing battery life.” Users can look forward to a smoother operating environment, a difference that will be noted by users of the older first and second generation iPads.

Other new features include the new charging port that Apple introduced with the iPhone. The Lightning connector is a port that replaces Apple’s 30 pin connector and can be plugged-in in any direction, meaning you can just plug the device in and not worry about ruining the connector ports. The downside to this is: older peripherals won’t work with the new iPad without an adaptor which currently costs USD$29.00.

Aside from a new processor and connection port, the iPad 4 is the same as the iPad 3. The screen is still 9.7 inches, LTE is featured and from what we have heard, battery life is the same. If you’ve purchased an iPad 3 in the past 30 days, contact Apple as you may be eligible to return the iPad 3 for an iPad 4 at no extra charge.

It’s like the iPad, only small(er) Over the past year, Samsung and Google managed to highlight that there is wide demand for a device that’s smaller and more portable than Apple’s iPad. Their 7 inch tablets have been great sellers and Apple has now entered into the 7 inch fray with the 7.9 inch iPad mini. The screen has a resolution of 1024 X 768 which puts it at the same resolution as the iPad 2. The key with the screen is that it doesn’t have a Retina display, a confusing move on Apple’s part considering nearly all their new devices have it.

The processor in the mini is an older A5, the same processor found in the iPhone 4s and the iPad 2. While it may seem like a big step down, remember that these two devices are only a year and 1.5 years old, respectively. This means the mini should have no problem running apps already available on the App store. We do predict one potential issue with this however. With the introduction of the new A6 chip, many developers will be starting to develop apps that only run with this, thus rendering devices running an A5 chip obsolete much faster. Time will tell but don’t worry too much as it will be at least a year, probably closer to two, before this potentially becomes a problem.

Other features business users will enjoy include the Lightning connector, 10 hour battery life - according to Apple - and the ability to connect to 4G networks if they are offered by mobile providers in your area.

Prices and availability Both the iPad 4 and Wi-Fi versions of the iPad mini will be available for pre-order on October 26, and in stores November 2 for most countries, including: Australia, Canada, the UK and the US among others. Wi-Fi + Cellular iPad mini models will be available in mid November. The iPad 4 will be available in two different models:

• Wi-Fi only:
  • USD$499 for 16GB
  • USD$599 for 32GB
  • USD$699 for 64GB
• Wi-Fi + Cellular:
  • USD$629 for 16GB
  • USD$729 for 32GB
  • USD$829 for 64GB

The iPad Mini will be available in two different models:

• Wi-Fi only:
  • USD$329 for 16GB
  • USD$429 for 32GB
  • USD$529 for 64GB
• Wi-Fi + Cellular:
  • USD$459 for 16GB
  • USD$559 for 32GB
  • USD$659 for 64GB

With the iPad mini, Apple has stayed true to history and chosen to present it as a tablet with a luxury price tag. Will it sell well? Most likely. Should you buy one? If you have the budget, go ahead, but we don’t predict the iPad mini sales will be huge in the business market, it’s simply priced outside the budget of most small businesses to make it a viable device. At the very least, hold off until the first week of November, as Google has scheduled an event where it’s rumored to be launching new tablets too. Once the event is revealed it might be a good time to look deeper into the iPad.

Do you plan to get a new iPad? What do you think of Apple’s latest offerings? Let us know your thoughts on this.

Do you have copies of your identification, passport, credit cards or SIN/Social Security numbers online? If you do, you likely have it stored on what you believe to be secure services. Even these services i.e., the cloud, have come under attack, and yes, user information is usually the target. The fact is, many users don’t take sufficient steps to protect their personal information online which puts them at risk of identity theft.

In the first quarter of 2012, nearly 12 million pieces of online identification and personal information were stolen by thieves. This represents a nearly threefold increase over the same time period in 2010. A staggering number for just three months, and it’s forecasted that the number will only increase in the years to come.

With this large amount of information being stolen, the question many are asking is why is this increasing? There are a number of reasons, the biggest being that netizens are signing up for more online accounts. Take a moment to try and count the number of accounts you have online; on average people have 26. Now, think how many passwords you use for these online accounts. An overwhelming majority use five or fewer. If thieves get a hold of one password, chances are nearly 80% that they will be able to gain access to other accounts.

If you are one of the many users who use the same email for a number of different accounts, your chances of having vital private information stolen from an account breach are nearly 100%. If you’ve connected or stored copies of identification or credit cards using an account that gets hacked, there’s no stopping someone from stealing your identity.

A recent study conducted by Experian, a credit-checking company, found that 14% of identity theft victims experience refusal of loans and credit-cards, 9% have debt racked up in their name, 7% are refused phone contracts and 7% are chased by debt collectors. While potentially scary stuff, most theft can luckily be prevented. You should ensure that you use a different password for every online account, that no important information (e.g., credit card, Social Insurance, Passport, etc.) is stored online and you use a password that is hard to guess.

If you have concerns about your online security, please contact us. We may have a solution for you.

The Centers for Medicare and Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) have published the final rules for Stage 2 of meaningful use.

The federal incentive program for Medicare and Medicaid physicians to adopt electronic medical records (EMRs) began in January 2011. Stage 1 focuses on collecting data and starting to use decision-support tools.

To date, more than 120,000 eligible health-care providers have qualified to participate—significantly more than the federal government had hoped to enlist by now. Around $6.6 billion has been paid out in incentives.

Now it’s time for the next step. The big push with Stage 2 is to move beyond data collection to improving care. They contain 20 measures for physicians, of which 17 are core and three of six are menu. Stage 2 rules will become effective for program participants in the program no earlier than 2014.

One of the changes physicians might like is “batch attestation”. Providers who are part of groups will no longer have to attest to participation in the program one-by-one; they can do so together.

The rules also lower thresholds for some measures. In previous proposals for Stage 2, for example, providers had to send a summary-of-care record for more than 65 percent of transitions of care and referrals. Now, it’s 50 percent. The Stage 2 rules can be found in the Federal Register.