The BridgeBlog

Are new business associate agreements needed with the coming HITECH deadline?

This is probably the most common question I get asked these days. There are two camps of thought.

1. Many business associate agreements are written with “evergreen” language that automatically incorporate any future changes to HIPAA regulations. So – you could make an argument that the HITECH changes are incorporated by reference. While technically accurate, I think it’s a risky path to take.
2. Contracts tend to be relied on when things go wrong – such as if there is a breach of PHI. In that situation, both parties will be better served if the agreement lays out specifically what should occur and where responsibilities lay. If it’s gray – you’ll spend precious time arguing over who should do what and who should pay for it. Better to have that debate now -  before the unpredictable happens.

Having an agreement discussion has the positive side effect of forcing organizations to consider the potential risks and liabilities of a breach and taking proactive steps to ensure the risk is minimized in the first place – which is a good thing for everyone.

For specific information concerning the upcoming HIPAA changes, here are a few resources -

• HHS HITECH Act Enforcement Interim Final Rule>>>

• HHS HITECH Breach Notification Interim Final Rule>>>

• CDT Releases HITECH HIPAA Guidance>>>

To report a breach to the HHS, go to: http://transparency.cit.nih.gov/breach/index.cfm.

Learn about our HIPAA training and learning services by going to: www.hipaarx.net.

Please send questions and comments to info@hipaarx.net or call 866.447.2211.

Well, I am back to blogging after an extended absence – sorry for that hiatus! I am returning to a great book I’ve been reading this past year, Brain Rules by John Medina. In my last post I shared the “every brain is wired differently” rule. Here is another rule that intrigues me, it is related to short term memory, “Brain Rule #5: Repeat to Remember.”

Hermann Ebbinghaus, born in 1850, is most famous for determining that people usually forget 90% of what they learn in a class within 30 days. Rather depressing to think about! In addition, his studies also showed that a majority is forgotten within the first few hours after the classroom experience. Over a 30-year period Ebbinghaus discovered additional interesting facts. One is that memories have different life spans – some may be minutes, while others last a lifetime. Is that why I can put my keys down and forget where they are within 5 minutes?

Here’s where Brain Rule #5 comes into play – Ebbinghaus shared with us that we can actually increase the life span of a memory by repeating the information in timed intervals. So, what can learn from this? Spaced learning is better than massed learning. Good to know.

But, we still need to understand a bit more about our memory and how we can increase our chances of learning something versus just simply recalling it later. Medina provides a great example of this in his book. Try and remember your Social Security number. Easy, right? Your brain may have visually queued in on the last time you saw the card or when you wrote it down. Now try to remember how to ride a bike. That’s easy too, right? Not really – you don’t call up a list of each action step, such as where to put your foot, how to angle your back, where your thumb needs to be placed. You recall these memories differently.

Through research, four sequential steps have been identified for the life cycle of declarative memory – your conscious memory: encoding, storing, retrieving, and forgetting. This is not the time or place to go into the detail that Medina provides, but rather let me just summarize the main concepts.

As information comes into your brain it’s stored in different regions, it’s not a one stop shop for all those thoughts. The more elaborate we encode the information that’s coming in, the better the chance our brain has of finding the information in the future. Making something more elaborate often means making it more complicated, which can tax the memory system. This can improve learning: more complexity means greater learning. Finally, another way to improve your memory of information is to reproduce the environment where it first entered your brain.

Summary: information is remembered best when it’s elaborate, meaningful and contextual.

Ways that you can capitalize on this concept:

1)    Incorporate real-world examples as learning points to help “encode” the information.

2)    A compelling introduction to a learning activity can help the learner “retrieve” the information from memory in the future.

3)    Offer learning activities in an environment that is similar to where / when the information may need to be “retrieved” from memory in the future.

Next time, let’s talk about long-term memory and “Brain Rule #6: Remember to Repeat.”

By Lorraine Schnelle, CPA

We’ve talked about a number of learning tips over the past few weeks. Today, I want to share some information from an interesting book I have been reading this past year. I pick it up often and review sections and some of my side-bar notes. It’s the kind of book that keeps you coming back for more. There is so much great information to digest and retain!

The book is Brain Rules by John Medina. It covers 12 principles for surviving and thriving at work, home and school. It includes stories and research to support the concepts in an easy to understand format. If you don’t have time to pick it up and check it out, in the coming weeks I would like to share with you a few of the concepts that I have gleaned from the book.

Let’s talk about “Brain Rule #3,” every brain is wired differently.

Did you know that no two people’s brains store the same information in the same way in the same place?

Eric Kandel, earned a Nobel Prize in 2000 when he showed that as people learn things, the way their brains are wired changes. The brain acts like a muscle, as you are exposed to new learning experiences, the larger and more complex your brain can become.  In addition, George Ojemann, a neurosurgeon, an expert at the technique called electrical stimulation mapping found that no two brains are wired identically. External factors can and do impact performance.

So what does this mean to you? Two words – Blended Learning. As a leader or educator, you need to understand that one size does not fit all. Variety is not only the spice of life; it can also improve retention and learning. So, be creativity and supportive of the individuality of your team members. Our personalities and the way we think and learn are unique.

Next time, let’s talk about “Brain Rule #5: Repeat to Remember.”

Listen to the podcast version

By Lorraine Schnelle, CPA

Last week, we talked about my handy CCCQ scale and how to decide upon which educational activities to use in your organization. Now let’s talk about “the end game” – making sure you understand the learning objective of your educational activity and how to stay on target. The last thing we want to do is confuse your learners and complicate the learning process. Learning objectives are statements that define what your students will take away, as part of the skill-building experience.

I like to use Bloom’s Taxonomy as a reference tool for creating targeted learning objectives. In 1956, Benjamin Bloom, with a group of educational psychologists, developed a classification of six levels of intellectual behaviors important for learning. Its lowest level, Knowledge, focuses on the simple recognition or recalling of facts or knowledge . Each level increases in complexity, moving from Understanding to Application, Analysis, Synthesis and finally Evaluation – the highest level.  Bloom’s Taxonomy is easily understood and widely used today. Learn more about each level below.

• Knowledge: arrange, define, duplicate, label, list, memorize, name, order, recognize, relate, recall, repeat, reproduce, state

• Understanding: classify, describe, discuss, explain, express, identify, indicate, locate, recognize, report, restate, review, select, translate

• Application: apply, choose, demonstrate, dramatize, employ, illustrate, interpret, operate, practice, schedule, sketch, solve, use, write

• Analysis: analyze, appraise, calculate, categorize, compare, contrast, criticize, differentiate, discriminate, distinguish, examine, experiment, question, test

• Synthesis: arrange, assemble, collect, compose, construct, create, design, develop, formulate, manage, organize, plan, prepare, propose, set up, write

• Evaluation: appraise, argue, assess, attach, choose, compare, defend, estimate, judge, predict, rate, core, select, support, value, evaluate

Start each learning objective with a term from one of the six levels listed above. I recently created a seminar with learning objectives, using Bloom’s Taxonomy, for a group of Patient Access Associates. Here are the learning objectives I created for that activity -

• Define critical key performance indicators (KPIs) and their relationship to Patient Access work processes.

• Discuss advancing computer resources in Patient Access.

• Recognize the key skills required of Patient Access Associates.

So, take the time to create your learning objectives, using Bloom’s Taxonomy, and refer to them throughout the educational activity creation process. These learning objectives will help ensure your activity stays on target and you reach the “end game” – skilled and competent team members.

The FTC announces it has extended the compliance deadline for the ‘Red Flags’ Rule or Identity Theft Policy from August 1, 2009 to November 1, 2009. The FTC granted this extension to give “creditors” and “financial institutions” additional time to review the Rule and determine what they must do to comply.
 
In addition to the new deadline, the Commission staff introduces additional small and low-risk entity resources that provide further guidance on the Rule.

According to the FTC and its web site, “the Red Flags Rule is an anti-fraud regulation, requiring creditors and financial institutions with covered accounts to implement programs to identify, detect and respond to warnings or ‘red flags,’ that could indicate identity theft.”

BridgeFront offers Red Flags Rule online training and a step-by-step manual to assist healthcare providers, deemed a creditor under the Rule, create an Identity Theft Policy and train its staff on the Rule and its organization-specific policy. Click here for more information about BridgeFront’s Red Flags Rule manual and online training.

The Red Flag and Address Discrepancy Rules should be in compliance or risk being fined. The deadline is August 1, 2009 (recently adjusted from May 1, 2009).

A creditor, as defined under the Fair Credit Reporting Act, includes any person who regularly extends, renews, or continues credit; any person who regularly arranges for the extension, renewal, or continuation of credit; or any assignee of an original creditor who participates in the decision to extend, renew, or continue credit.

According to the law firm Gates & Moore, “the Red Flag and Address Discrepancy Rules require physicians and healthcare providers, among other individuals and businesses deemed as ‘creditors’ (including banks, mortgage lenders, credit unions, utility companies, car dealers, and telecommunications companies) to develop and implement a formal written program to detect, prevent and mitigate identity theft, including medical identity theft.” And not only is a program required but also annual staff education about your organization’s program and healthcare fraud and abuse.

Sound like a daunting task? No need to worry – BridgeFront can help you or your organization create an ID Theft Prevention Program through a step-by-step manual and educate your large or small staff through our customizable online course. For more information, watch a quick video, visit www.bridgefront.com or call (866) 447-2211.