The United States Healthcare System

As Health information system continues to evolve and innovate the healthcare industries, one should be conscious of information security and safety. Kaiser Permanente experiences this dilemma first hand. On August 2000, Kaiser Permanente had a serious security breach that sends out email messages to their patients with another patient’s information. This integrated health delivery system serves over eight million members with appointments, prescription refills, health information, clinical advice and patient forums was breath and nineteen of the member received email messages with private information.

On May 5, 2014 Premera Blue Cross, the third-largest health insurer in Washington state, announced today that the company was the target of a sophisticated cyber attack. This attack affected as many as 11 million patients across this great country. As a result of the malicious attack, attackers may have gained unauthorized access to names, dates of birth, Social Security numbers, mailing addresses, email addresses, phone numbers, member identification numbers, bank account information and claims and clinical information. This information may have went back as far as 2002. Not only did this attack affect many unfortunate Americans, but also the Premera Blue Cross CEO Jeff Roe.

Protecting the privacy of patient information is one of the top priorities of all healthcare providers and is specifically required by various state and federal laws. On February 17, 2009 the American Recovery and Reinvestment Act of 2009 (ARRA, sometimes referred to as “the stimulus”) included provisions making significant improvement in the privacy and security standards for health information was signed into law by the federal government (http://www.hpsafind.hrsa.gov). Included in this law is $19.2 Billion which is intended to be used to increase the use of Electronic Health Records (EHR) by physicians and hospitals; this portion of the bill is called, the Health

One type of personal data we should be concerned with keeping secure is Protected Health Information or PHI. PHI is defined in the Privacy Rule section of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) as “"individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral” (U.S. Department of Health & Human Services). While HIPAA was enacted to address the protection of PHI, it falls short of this task because there are no measures to proactively ensure entities are abiding by its guidelines, the penalties are subjective and fail to inflict enough punishment on entities for data breaches and it puts the onus

The safeguard of patient health information and consumer information is effectively and sufficiently guarded is the upmost importance to any organization. Information security is important because it the law. Any deficiency of an effective information security program can be costly to an organization and be detrimental to patients and consumers. Organizations must be aware of the growing opportunities for breaches in security as technology is advancing is making the collection, maintenance, and dissemination of protected health information easier (Sayles, 2013). The following two security breaches will identify threats, and provide a security plan for the organization.

Security breaches of EMRs vary from someone without consent viewing the patient’s information, to a hacker using the information to steal one’s identity. According to Privacy Rights Clearing House, more than 260 million data breaches have occurred in the United States, including those of health related records. Approximately 12 percent of data breaches involve medical organizations (Gellman, 2012). According to Redspin, a provider of Health Insurance Portability and Accountability Act risk analysis and IT security assessment services, more than 6 million individual’s health records were compromised during a period from August 2009 and December 2010 (Author Unknown, 2010). A provision of the Health Information Technology for Economic and Clinical Health (HITECH) Act requires all breaches affecting 500 or more people to be reported to the Department of Health and Human Services. This reporting is to be accomplished within 60 days of discovery. The Redspin report covering the period above involved 225 breaches of protected health information. The amount of people with access to an individual’s health record creates concern with confidentiality. According to the Los Angeles

Event- 2. Though nothing is full proof in the current world of Internet and cyber attacks, proper planning and investment can prevent data theft to some extent. Health care organization can improve their heath data security status by investing in their incident response approaches, which will include documenting a formalized response process, and by building an incident response team to deal with it. Keeping relationship with outside experts to prevent hacking of data is helpful. Having all experts from all fields like IT personnel, security gurus, and operational people is not important, rather having a multi-dimensional and multi-disciplinary team who will understand the process is better to prevent security threats (Moore, 2014). Measures such as two-fold sign-in passwords/Captcha could have been implemented by Anthem. There should have been proper cyber security protocols instead of having a lax protocol, which made the hacker a way to invade into the

The first characteristic of the US health care system is that there is no central governing agency which allows for little integration and coordination. While the government has a great influence on the health care system, the system is mostly controlled through private hands. The system is financed publically and privately creating a variety of payments and delivery unlike centrally controlled healthcare systems in other developed countries. The US system is more complex and less manageable than centrally controlled health care systems, which makes it more expensive. The second characteristic of the US health care system is that it is technology driven and focuses on acute care. With more usage of high technology,

Although the health care system within the United States has operated on a fee-for-service system in which a provider benefits by being paid per treatment or procedure given to a patient, the Patient Protection and Affordable Care Act has influenced us to look into alternative forms of provider reimbursement. One form of reimbursement that has recently been highlighted as a potential means to lower health care expenditures are bundled payments, which are also known as episode-based payment. Bundled payments are being touted as a means to reduce national health expenditures, increase coordination of care, and improve quality of care; however like any other form of provider reimbursement there are advantages as well as disadvantages that need to be analyzed.

The health care system within the United States is facing numerous problems. Even after the passing of the Affordable Care Act many Americans remain uninsured or underinsured. This results in citizens facing financial blockades in receiving care at a primary level and often waiting till the health issue has escalated to the point of needing hospitalization before seeking care. While each state has had challenges expanding their health care system the board of Access Health Care Initiative (AHCI) has chosen the state of Pennsylvania as a target region for possible expansion. The question posed by the board of directors is would it be possible for AHCI to expand into Pennsylvania and have a positive effect on the state’s health care system. The research has shown that it would be possible for AHCI to expand into Pennsylvania and help the state meet the health care needs of its residents. However this expansion will take careful planning and the ability to overcome some unique problems that Pennsylvania poses.

United States is the richest country in the world, yet when it comes to the health care of its

Privacy of health information has become an area of emphasis across the healthcare industry. It is important to understand what data is protected under federal regulations, how it can be shared, and how to prevent any accidental exposure of protected data. It is possible that data that should be protected can be exposed without anyone even realizing a violation has occurred. Exposure of protected healthcare data can result in medical identity theft and is therefore a very important and hot topic. The security and privacy of healthcare data is necessary to ensure consumer confidence in the healthcare industry and to prevent medical identity theft.

One of the major events that occurred in the 1990s was President Clinton signing a law regarding Health Insurance and Portability and Accountability Act (HIPAA) of 1996. This law was created to provide more affordable and accessible health insurance, provisions to simplify administrative processes and to provide protection of Personal Health Information (Wager, 2009). In regards to simplifying administrative processes, this law mandates development of a central electronic data base to contain all health records for every patient in the United States. This law did not mandate a federal policy which protects this information if misused or stolen until Feb. 21, 2000 (Bacon, 1997, pg. 317). Since many medical records that used to be stored in filing cabinets with minimal access are now being stored on computer networks, information can be easily copied, accessed and redistributed. This has resulted in the development of increased information

Protecting individual’s health information from various threats is a challenge in today’s market. With more and more advances in technology with portable devices, smartphones, and Internet portals, sharing patient information, and who has access becomes a main topic of discussion in the healthcare industry. Health Information (HI) is an important part of our society. Using the data for research, disease monitoring, and public safety are just a few examples of how health information is used to advance technology. Furthermore, American society places high value on individual rights, personal choice, and private information being protected from intrusion (NCBI, 2016). Medical records whether they are in paper form or electronic version such as electronic health records (EHRs) can include some of the most intimate details about a person’s life. Within a patient’s medical record items, such as a patient’s physical and mental health status, social behaviors, personal relationships, and financial status are all documented (NCBI, 2016). Therefore, protecting the privacy of this information becomes a huge task for the individuals delivering healthcare and for those who need access to such information to make sound medical decisions and to improve the quality of care (HRSA, 2016).

It’s fair to say the environment of the healthcare industry is always in the midst of constant turmoil. The industry is a complex equation built on ever-changing government programs, rapid advances in medicine and technology, and new business combinations between and among health-care providers and payers. Leaders of a healthcare organization must be equipped to adapt to the continuous chaos or face defeat. Information security and privacy is a fundamental component of a successful and efficient healthcare environment. The coming year will be a busy one for lawyers, compliance officers, privacy officers, and senior management as they must stay above the game when it comes to privacy and security. I will explore three trending issues and concerns relating to healthcare privacy and security. My hot topics include the use of big data and its implication, the evolving risks of cyber security, and health research and de-identification.