Epic software is used by many hospitals that is HIPPA compliant. It is used to track all additions, modifications, and ensures the complete patient history is recorded. Check out this blog to learn more about EPIC software!
EPIC software is used by many hospitals to track patient care and manage the overall patient experience. When something goes wrong during a patient stay that leads to long-term injuries or death of the patient, it is highly common that medical malpractice litigation ensues.
Health Information Personal Privacy Act, HIPPA
The Health Information Personal Privacy Act, commonly referred to as HIPPA, places several important requirements on health care providers. HIPPA requires that all access to a patient’s electronic medical record commonly referred to as EMR, track all addition, modifications, and allow access while ensuring the complete revision history of the EMR is maintained.
EMR Audit Log
Audit logs or audit trails are required to ensure that reconstruction of the complete revision history can be established. EPIC printed reports of patient’s EMR can be produced using various filters that result in a less than complete production of the patient’s full electronic medical records. Some of the filters that are routinely used include:
Date filter to show only the time the patient was receiving care at the healthcare provider
Production of only non-confidential notations
Production of only the final version of the EMR without the detailed revision history
Filter notes exclusive to the named defendant health care providers
Filter by department
These filters described previously when used in producing a patient’s EMR result in an incomplete production of the EMR.
Sticky Notes
EPIC has a communication platform known as Sticky Notes. This serves as an instant messaging mode of communication between healthcare workers discussing a specific patient. EPIC lacks a report that can allow easy printing or export of these notes. This creates a common misperception among health providers that these notes are not part of the legal discoverable record. In fact, there are other ways to access these sticky notes, which are an important part of documenting the patient care provided. An in-person inspection of the EMR using a camera to record the user’s screen can allow for obtaining these important communications. These sticky notes are part of the EMR and are subject to preservation by HIPPA.
On-Site Inspection
During an onsite inspection to obtain the complete EMR, it is important to ensure that the user accessing EPIC has full administrative rights to the system. In some health care organizations, sticky notes may be accessible only to physicians. Regardless, obtaining these important communications can be a vital source of information to reveal important events leading up to a lifelong injury or death.
Enigma Forensics has assisted in numerous medical malpractice cases working with either the plaintiff or defendant’s side of litigation. Our experts dig through each record to analyze ultimately to find the “smoking gun!” We call ourselves the data detectives! If you are working on a medical malpractice case and would like to win, call Enigma Forensics at 312-668-0333.
To learn more about Electronic Medical Records check out these blogs.
Are Contact Tracing APPs ethical? Are you willing to give up your private data to help slow the spread of the Coronavirus? Check out what these experts have to say!
Contact Tracing is it Ethical?
Apple and Google have the capability that allows cell phones to communicate with each other. Contact Tracing Apps use this capability and have been developed to find and alert the contacts of people infected with the Coronavirus / COVID-19. As soon as someone gets sick with Coronavirus, the APP could alert you if this is someone you have been in contact with. Alleviating the length of time it takes for a real live Contact Tracer who is doing the tracing. Basically, this is widespread human GPS tracking, that presents many privacy issues involving potential data breach, information storage, and sharing sensitive personal data. Should sensitive medical information and individual locations be available on an APP? Do you believe this type of electronic contact tracing is ethical?
Check out this video to listen in on experts as they consider the amount of data that is being collected and what it means for your data when you download a Contact Tracing APP.
Video Transcripts Follow
Lee Neubecker (LN): Hi this is Lee Neubecker from Enigma Forensics and I have Debbie Reynolds back on the show, thanks for coming back Debbie.
Debbie Reynolds (DR): Thank you for having me, very nice to be here.
LN: So I’m very interested to hear more of what your research is regarding contact tracing apps, and what you think that means for individuals that might put these apps in their phone. Tell me a little bit about what’s happening right now with the industry and how contact tracing apps are working.
DR: Yeah, so Apple and Google created a capability so that phones can communicate with each-other via beacon. So that they can store information on phones, or have phones bounce off of one another, so that if someone downloads a contact tracing app or registers there, if anyone who also has the app, it will be able to trace back, y’know, how long they spent with certain people and tell them whether they feel like they may have been exposed in some way, and tell them either to quarantine or go seek treatment in some way, or get tested. So it’s pretty controversial, the contact tracing app, for a couple of different reasons. One is, people are very concerned about privacy, like giving their potential medical information to a company that’s not a medical provider, meaning that they’re not protecting the data the same way. Also, as you know, Bluetooth technology isn’t exactly super accurate in terms of the distance that you are from someone, so the delta, in terms of how accurate it can be, may be way off. It may be several meters off, the phone can’t tell if you’re six feet apart or whatever, so I think that they’ve tried to tune that up with this new API that they created, but still, based on the science, we don’t know that it’s actually accurate or not.
LN: So you could still have a situation where, if you put one of these apps on and you’re outside biking, and you bike within 8 to 10 feet of someone who later does have it that you’re getting notified that you have to quarantine on a false basis. That’s a potential outcome of using an app like that, correct?
DR: Yeah, but I think that the way they having it now is that it’s supposed to register you spent more than 15 minutes near that person, so, y’know.
LN: Okay, that’s good to know.
DR: But let’s say you’re parked in your car and someone’s parked next to your car, so you aren’t physically near, y’know, you aren’t in any danger from that person but you wouldn’t know, just because your phone says you’re close to them. They don’t understand the circumstance that you’re in, to be able to tell that, so. I think people are concerned about, a lot about privacy, them taking the data or how the app is actually going to work, and it’s going to work differently in different countries. So what they’ve done is create this API, this capability that’s put on everyone’s phone, and then if you download the app, the app which you use will use that API to actually do this beacon exchange on people’s phones. So, that’s kind of what’s happening right now, is different countries and different places are implementing it in different ways, and some are really pushing back on them because they don’t have really any good guarantees about privacy, or data breach, data breach is a huge issue.
LN: Yeah, I mean, our Government’s never had data in their custody compromised ever, right? wink..wink
DR: Right, that never happened, exactly, so-
LN: You’re having your maps of where you’re walking, your GPS records-
DR: Yeah.
LN:time of day, your movement and that is going to Google and Apple, and under certain conditions they’re passing that data on to the CDC or other entities, law enforcement, enforcement groups.
DR: Well their concern is that data, because it’s at a private company, will get merged with other things, like let’s say your insurance carrier, or your medical, y’know, you get dropped from your insurance because you have this app-
LN: You drive too fast.
DR: No because you have this app, and they think that you may have been exposed, or you’re a higher risk, or a bank doesn’t want to give you a loan or something, because you have this app on your phone. I’ve been hearing a lot of different scenarios people are concerned about. But I’m curious, from your perspective, in terms of how certain things are stored on phones. I know beacons is a really big idea, but maybe you can explain a little bit about how Bluetooth actually works?
LN: Yeah, well Bluetooth is a near band wavelength that allows for peer-to-peer networking. Bluetooth has been exploited in the past to be able to take over devices, so it’s, a lot of people don’t like to have their Bluetooth on continuously because you’re opening your phone up to potential attacks, cyber attacks, via Bluetooth. You’re also broadcasting, when you have Bluetooth on you’re also broadcasting your MAC address identifier, your Bluetooth unique address and there have already been issues where retailers in London at one time, they had kiosks outside that would track the shoppers and they’d know how long they were at certain stores, and they’d use that information to serve custom video ads to people as they’re shopping and walking by.
DR: Right.
LN: So there’s privacy implications and security implications of having Bluetooth on all the time.
DR: Yeah, and that’s a big concern. So I know when I first heard this, about them doing this contact tracing, I was wondering like how exactly would they get the proximity right, and because we have no visibility to that we really don’t know, right?
LN: No.
DR: So we just have to sort of trust the black box and see what happens, to some extent, but I, for me I think my opinion is that contact tracing is a profession, it’s not an app. So, there are people who do this as a profession, only, let’s see, 55% of people in the world don’t even have smart phones, so you’re talking about a capability that’s only for 45% of the people, and not all those people are going to actually volunteer to get these apps.
LN: Yeah.
DR: So it doesn’t really help to contact, for people who do contact tracing, except it adds another layer that they have to work with because they still have to track people whether they have cell phones or not.
LN: It’s interesting stuff, thanks for bringing that to our viewers’ attention and thanks for being on the show again.
DR: All right, thank you so much, I really appreciate it.
Enigma Forensics, Lee Neubecker reviews with Eric Fish, the Federation of State Medical Boards, Senior VP of Legal Services, about the positive impact of artificial technology and machine learning on medical standards and regulations. Find answers how this technology will improve the patient experience in the future.
The transcript of the video follows
Lee Neubecker: Hello, I’m here today with Eric Fish, Senior Vice President of legal services. He’s with the Federation of State Medical Boards and he’s going to be talking to us a little bit today about his organization and how they’re using technology to change how things work.
Eric Fish: Thank you, well the Federation State Medical Boards is the organization that represents the 70 state medical and osteopathic boards who are charged by state law to regulate the practice of medicine within the various states, in that we help build standards for regulation, best practices. We also work with states on our data and other things that are exchanged that really help improve the regulation of medicine for the patient, the end user of medicine.
Lee Neubecker: Eric can you tell us a little bit about how artificial intelligence and machine learning are impacting your organization and membership?
Eric Fish: Well, Lee, we’re actually at a, what I believe to be, a crossroads of cultural, social, and technological change that are really going to change the way that we have to look at regulation for the public benefit. There’s going to be a lot more data on patient/provider interactions. There is also going to be much more data consumed by state regulators to see which of these interactions comply with the standards. One of the things that I see developing out of this A.I. and machine learning is that we’re going to be creating much more data that can be mined as a regulator to see what interactions are good and which interactions are bad.
Lee Neubecker: Eric can you tell us a little bit about how A.I. and machine learning are being implemented to improve transparency?
Eric Fish: Well, one of the things that’s going to occur, I believe, is that as patients and providers start turning to algorithms to help with that continuation of care. Really the people who implement these systems have to prove up to the regulators how these comply, how these algorithms, how other things are going to comply with the standards that are there. Artificial intelligence has been in medicine for a long time. Machine learning is a little bit new, where we’re taking some of the discussions and building a knowledge base that’s then going to be applied to the patient experience and regulation isn’t standing in the way of these things. The regulations are there so that they are done the right way and in comply with the standards and being transparent on that beginning end is a really great step toward complying with regulations and making the regulatory process better.
Lee Neubecker: Great, and so, you told me that your organization runs some services that consumers might want to be aware of. What are those and what are they used for?
Eric Fish: Well, one of the things that we do on behalf of our members is collate all the disciplinary and regulatory actions that are taken against a provider, and we have a service called Doc Info, where a member of the public can go look to see if an action has ever been taken against their physician. We have access to all 900,000 plus licensees and their information, and it’s really a great service and use of data that we’ve collated and given out to the public.
Lee Neubecker: Great. Well thanks for coming on today. I know you’ve brought your colleague, Mike Dugan. Who’s going to talk for a little bit. Thanks again for coming to the show.
Eric Fish: Thanks, thank you.
Lee Neubecker: I have Eric’s colleague, Mike Dugan, he’s the CIO of the organization, and Mike can you tell me a little bit more about some of the things that you’re doing to improve the quality of the data and integrity of the information?
Mike Dugan: Sure, surely, thank you. We, in many ways, we are a data aggregator and this involves a credentialing process for physicians so we pull data from national data sources, we pull data from institutions to verify physicians’ identity as well as their credentials, so the training and process that they have done. Historically, these have been very manual processes, but we’ve implemented technology to add additional data sources and also give us flexibility in how we consume data. Historically, it’s been a very structured we need a file in this format and our technology is still evolving, but we’re working it to give us the flexibility to work with any data source available.
Lee Neubecker: What are the concerns that your members have regarding data breaches and the potential complications resulting from them?
Mike Dugan: Well, I think they worry about that quite a bit and if anyone in technology who deals with identity and has information, if you’re not worried about data breaches then you’re missing the point and perhaps should be in another line of work. So, we are given the trust of the physicians and our member boards that when they give us their data that it will be protected and that it will be safeguarded, and we work very hard to do that, proactively. So I think that in this environment and this day and age, that is an activity and a task that we will do, it will never go away. It will be ongoing and we will have to adapt if there is new ways that are found to hack information, we always will have to improve our data security.
Lee Neubecker: Well thanks a bunch for being on the show. I appreciate you taking time.
Mike Dugan: Okay, thank you, thanks for having us.
Read More About Government Privacy Controls on Artificial Technolgy
