Well, not quite, but as a physicist working on the grand unified theory would say: The arrows are pointing into the right direction.
While patient care is not delivered virtually quite yet, the experts in the field of Health Information Management and Systems will have their annual gathering in Atlanta in early March (http://www.himss.org) to ensure we’ll get there in the future. If you haven’t been to the HIMSS show yet – it is an exciting conference with well over 20,000 attendees.
Questions on health record portability, privacy, interoperability, and the plain old task to get physicians to warm up to the idea of using a computer as the primary means of documenting clinical information will be at the center of the discussions, while musings on whether the federal government is going to pay for your healthcare IT initiative are sure to be overheard as well.
I myself will make my way up to Atlanta to find out what’s going on in the industry and I seek to speak to many attendees and presenters on application delivery challenges in this unique field. Stay tuned on these pages for regular updates and follow me on twitter for a play by play of my HIMSS journey.
Before I pack my bags and decide whether or not to include foul weather gear and snow shoes, please let me know what specific topics around healthcare IT you are interested in.
Twitter: @florianbecker
Florian
The American Recovery and Reinvestment Act of 2009 (ARRA) contains a whole chapter called HITECH. This catchy acronym stands for Health Information Technology for Economic and Clinical Health and makes you wonder if “they” construct the acronym before deciding on what information to convey. It basically mandates a number of fairly stringent disclosure requirements for HIPAA covered entities and their business associates in the case of privacy breaches leading to the disclosure of patient data. The act is intentionally aggressive in order to entice health care providers and insurance companies to be really cautious about patient privacy and record security.
I am at HIMSS in Atlanta this week and I notice that ARRA, HITECH, HIPAA and other related topics are front and center in many sessions and for many vendors on the floor.
Under HITECH, the burden of proof is on the side of the covered entity to prevent a breach, discover the breach, and then disclose the breach to the patients and – in some cases – to the secretary of health and human services. If the breach is affecting 500 or more patients in a state or region, the covered entity must notify the patients via public media and notify HHS immediately.
So, let’s define what a breach really is, and then what you can do to never having to call your local newspaper for the disclosure ad.
Under HITECH, a breach is an “unauthorized acquisition, use, or disclosure that compromises the security or privacy of the health record”. There’s also something in the language that this must pose a significant risk of financial, reputational, or other harm to the individual. Note that I am not a lawyer, but I did stay in a holiday….. tonight. Kidding aside, I did listen to Gerry Hinkley and Deven KcGraw during their HIMSS session this week – both are legal experts in this field.
So, having a laptop with unencrypted, and personally identifiable patient information stolen would be a breach. If, however, the data is secured with federally accepted levels of encryption (and the security of the key is not compromised), OR the data does not include certain items such as DOB or the patient’s ZIP code, it’s not a breach.
As you can see, the devil is in the detail. So, how can you take steps to avoid that painful disclosure? For one, ensure that the patient information never leaves your data center. Leverage desktop or application virtualization and disable clipboard and local disk access on the client device. Many electronic health applications can only print through the server, so that client connected printers are not needed and can also turned off without compromising functionality. If mobile access to the data is needed, consider the Citrix Receiver for the iPhone or mobile access platform of your choice to deliver the information without delivering the data.
Even without HITECH, these are important considerations for any Electronic Medical Records (EMR) rollout. When done correctly, you could allow your doctors, nurses, and staffers to use the laptop, netbook, tablet, iPad of their choice without having to worry about IT managing the myriad of devices or any of them leaving the premises.
Now, unfortunately, this is only one aspect of HITECH. The other aspect involves the unauthorized access of patient records by employees who have legitimate access to the systems, but are basically snooping around. HITECH covers privacy breaches, not just security breaches. Looking up your own lab results, or the chart of your friend’s sick kid is an example of a well intentioned, but illegal breach. Looking up the local football player’s records to determine if that hamstring injury has healed before Sunday’s game is also an illegal breach, but not an innocent one. Identifying those scenarios actually requires intelligent data mining to assess whether access was justified for a person to do their job or constitutes a breach. While you can’t fix the latter category through application or desktop virtualization, you can confidently use virtualization technology to prevent breaches through the loss of devices or data without restricting mobility. One less thing to worry about in the complex world of healthcare regulation.
Questions? Comments?
Follow me on twitter: @florianbecker
Habitat for Humanity has become an iconic American charity. One reason for that is its strong and far-reaching network of local organizations that extends the Habitat mission throughout the U.S. and beyond.
The Bend Oregon chapter is one great example of this network. Its particular version of the Habitat mission of providing affordable housing to deserving individuals is the addition of green technology to every home.
Paula McClean, who has worked with BAHFH for four years as Operations Manager, says,
“BAHFH proves that green and sustainable can also be affordable and therefore attainable by anybody. Families with secure, long term housing are strong, active community members who shop, dine, and volunteer. Homes built with sustainable and efficient products and renewable energies assure a healthier community into the future. Combining sustainability with affordability is an all encompassing approach to the growth and longevity of a community.”
BAHFH depends on volunteers to get their housing built and its website is volunteer friendly, with online registration and scheduling, an active corporate volunteer program, continual engagement with youth groups, and a steady stream of special events that are creative and energizing. BAHFH is also social media savvy with a Facebook page, and a healthy following on Twitter.
BAHFH has built 79 affordable homes in the community of Bend, serving 145 adults and 243 children. They have done this with a hard core group of some 300 volunteers. The organization receives monetary donations through its active fundraising program and a steady stream of building materials donated by local businesses.
BAHFH’s Twelve Facts About Bend Area Habitat for Humanity explains the Habitat for Humanity “sweat equity” philosophy plus all the details of how they build houses, how families qualify for the housing and how the financing works.
Habitat for Humanity is one rocking charity and BAHFH exemplifies the community improvement work that takes place throughout our communities. Consider supporting or volunteering for BAHFH or another Habitat group near you. The Habitat for Humanity International website has a locater where you can put in your address and find the affiliate nearest you.
Do you want to be our Cause of the Week? Tell us who you are and why you should be featured in our blog right here. We would love to hear from you.
Cause of the Week: Bend Area Habitat for Humanity originally appeared on About.com Nonprofit Charitable Orgs on Thursday, March 4th, 2010 at 09:58:25.
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Rev: ncIf you are wonky about economic indicators and labor market stats, this is your lucky week. No fewer than than three reports came out today; one came out Monday; a fifth — the highly anticipated monthly unemployment report — is due out Friday morning.
Today’s reports, considered a 
harbinger of the Bureau of Labor Statistics’ unemployment report, are decidedly positive in that “less bad” way we’ve been seeing since late summer.
The most authoritative of the reports came from the Federal Reserve, which reported in its so-called Beige Book that “economic conditions continued to expand” in February, despite severe snowstorms that held back activity.
The book, a summary of economic conditions in the 12 Fed districts, said consumer spending increased, though the snowstorms had a limiting effect. Loan activity was “soft,” said the Fed. “Most Districts indicated that banks remained cautious about lending.”
Not surprisingly, the Fed reported an uptick in hiring or a slowdown in layoffs in some of the federal reserve districts, but “labor markets generally remained soft throughout the nation, which resulted in minimal wage pressures.”
Outplacement firm Challenger, Gray, & Christmas confirmed the layoff slowdown in its monthly report. The firm said U.S. employers announced in February the fewest job cuts in some three years. Employers announced 42,090 job reductions last month, the least since July 2006, and down 77 percent from the 186,350 of February 2009.
“Employers have shifted away from downsizing and are poised to start adding workers,” CEO John A. Challenger said in today’s release of the numbers. “It may be a couple of more months before hiring begins to surge.”
Surge might be an optimistic term. Most labor economists expect hiring to grow only slowly. That belief got some props Monday from The Conference Board’s Help Wanted OnLine Data Series. The series reports the number of new and total jobs posted online each month. For February, The Conference Board said the number of job postings declined by 66,900. According to the data, 3.957 million jobs were advertised during the sample period in February.
A similar analysis by Monster — the Monster Employment Index — is to be released Thursday.
The ADP National Employment Report, based on the payrolls for the millions of workers ADP processes every month, shows nonfarm, private employment dropped by 20,000 workers in February. Another smallest here; the reduction was the lowest in two years.
The ADP report often varies widely from the official BLS report due to the inclusion of government employment and variances in methodology. In the summary, ADP notes that it expects the BLS report to show a larger workforce reduction than its own because of the adverse weather.
These up and down reports, so widely reported in general consumer media, may in part explain one more survey result. Last week’s release of the Consumer Confidence Index showed a sharp drop in February. The Index dropped 10.5 points from the adjusted January number and is now at 46.0.
Says the report: “Those saying jobs are ‘hard to get’ rose to 47.7 percent from 46.5 percent, while those saying jobs are ‘plentiful’ decreased to 3.6 percent from 4.4 percent.”
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When, despite your best efforts at keeping your job, it’s not going to work out and resigning is the only option, what should you include in your resignation letter? What’s the best way to let your company know you’re moving on?
When writing a resignation letter, it’s important to keep your letter simple, brief, and to the point – include just the facts and leave it at that. It should also be positive, because once you have decided to resign, there’s no point in criticizing the company – you may need a reference in the future and there isn’t any point in burning bridges because you’re leaving anyway.
Write a formal resignation letter, so it can be placed in your employment file. When you’re not sure how to write a resignation letter, review sample resignation letters to get some ideas of what to say and how to say it.
If you’re going to send an email resignation letter even though that’s not really the best way to resign, here’s how to notify your employer via email that you’re turning in your resignation.
More: Resignation Letters | Resignation Letter Examples | How to Resign From Your Job
Image Copyright 3DStock
What to Include in a Resignation Letter originally appeared on About.com Job Searching on Wednesday, March 3rd, 2010 at 19:54:22.
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No doubt you have heard about the iPad by now and you may be already pondering whether or not you will be buying one. Chances are you have a Laptop or PC and a Smartphone already so you need to rationalize how you will use it beyond e-books and browsing. Well if your company has XenDesktop or XenApp you will be happy to know you will be able to use your iPad for real work as well. It turns out the 9.7 inch display on the iPad with a 1024×768 screen resolution works great for a full VDI XenDesktop. Windows applications run unmodified and securely in the data center, and even multiple applications at once. The advancements that were made for the Citrix Receiver for iPhone will carry over to the iPad, however the iPhone restrictions of screen size and small keyboards are overcome with the iPad. It’s a beautiful thing ! The iPad looks to be an ideal end point device that can empower users to be productive were ever they are and IT will be able to safely deliver company hosted virtual desktops and apps without worry.
So tell us if you want Citrix Receiver for the iPad and let us know how your going to put it to work. ( even it’s just to rationalize buying another gadget 
)
Learn how to make the iPad work for your organization at Citrix Synergy.
While most discussions on successful Electronic Medical Record (EMR) implementation and adoption circle around the proper implementation of clinical workflows, standard order sets, diagnostic codes, and the all important CPOE (Computerized Provider Order Entry), little time is spent on thinking about how the applications actually make it to the users. I have talked to CMIOs this week at HIMSS who mentioned that the improper application delivery actually constituted a significant roadblock or bottleneck towards adoption.
Healthcare organizations have tried anything from Computer’s on Wheels (COWs) to tablets to smart phones and iPhones. Each modality has its own merits and risks. Let’s have a look:
COWs: With large screens and full keyboards, using the system is as easy as using a desktop computer in the office. However, there are some distinct challenges associated with COWs: They are used by many different people. Although the carts are adjustable, users don’t adjust them in the interest of time on the floor and are therefore experiencing ergonomic problems. COWs are wireless, so the 802.11x infrastructure must be 100% reliable with good signal strength. Map out every patient room using the all familiar “Can you hear me now?” method of assessing signal strength in every place the COW might be used. Check with your facilities manager whether the COWs in the hallways would violate any fire security.
Tablets: Overcome some of the bulkiness of COWs. Same challenges with wireless networks though. Check with your users first. Doctors carrying the tablet in one hand and the stylus in the other hand don’t have a hand left to touch the patient. The success of tablets also depends on the specific EMR application you are running. Entering data via the virtual keyboard of the tablet is very time consuming and therefore prone to error. Applications that let users click through selection lists are much more tablet friendly. Consider specialized tablets for the healthcare industry that include scanners and interfaces to diagnostic equipment while maintaining the mobility.
iPhones, SmartPhones: Awesome. Barely larger than a pager with a user interface made for the device. Can’t replace a full application though as many apps are just for vitals, bedside monitor virtualization, results review etc. Smart phones are complimentary to other access modalities – not a full replacement.
iPad: It’s coming. I talked to several EMR vendors at HiMSS 2010 in Atlanta this year, who are already working on their user interfaces to make them friendly for user interaction sans keyboard. Of course, the Citrix Receiver will be able to deliver any windows app or desktop directly to the iPad.
Finally, there are the good old thin clients. These units combine the best of all worlds: Large screen, yet small form factor. Don’t require wireless networks and several incorporate a smart card reader to facilitate two factor authentication. Have one in each patient room, nursing station and several in the hallways (neatly wall mounted and tucked away while not in use) and you have a solution that allows doctors to use both hands on the patient and use a familiar keyboard for data entry. Use desktop and/or application virtualization so that you can eliminate the end point support team. Depending on the EMR application, consider generic windows logon and light or no profiles to speed up logon times to the windows environment. Authentication happens on the application itself in this case. Smooth Roaming capabilities are essential to cut logon time down to a few seconds and provides full mobility on the floor without carrying a device.
Some of the access modalities in your healthcare facility depend on provider preference (yes, doctors do prefer some devices over others and yes, please make your doctors and nurses happy). Use application or desktop virtualization wherever possible to avoid end-point support. Citrix XenDesktop can deliver remarkably high quality application fidelity and image resolution even over longer distances thanks to the bundle of HDX technologies.
What is your experience with EMR implementations and application delivery?
Follow me on twitter @florianbecker
Last week, Federal Reserve Chairman Ben Bernanke gave his Semiannual Monetary Policy Report to Congress. In it, he explained how high Federal deficits will causes interest rates to spike beyond the Fed’s control:
In order to keep the ratio of outstanding government debt to GDP constant, we need to have deficits from 2.5%-3%. (The current projection of) 4-7% is not sustainable, and if that were actually to happen, we would see increasing interest costs and eventually the markets would just entirely lose confidence in our fiscal policy, and interest rates would spike. So it is very important that Congress, even though we are now still in a very deep recession or in a very weak economy, it is important for Congress to try to clarify how we are going to exit from our fiscal position and try to provide a credible blueprint for how our federal deficit will be controlled over the next ten
years, twenty years.
Congress Needs a Debt Exit Plan originally appeared on About.com US Economy on Wednesday, March 3rd, 2010 at 14:00:40.
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One of the points that comes up repeatedly in the unemployment stories that site visitors have been kind enough to share is that if you have a job, do you your best to keep it.
I know that’s often easier said than done, and in many cases, there is absolutely nothing you can to do to avoid being laid-off.
However, sometimes, you can turn the situation around and keep your job – even if you hate your job. At the least, take the time to make sure that you really want to quit before you turn in your resignation.
When saving your job isn’t possible, it’s important to be prepared to job search, to avoid mistakes that could hinder your job search, and to do what you can to optimize your chances of job search success in a really tough job market.
Related: Ten Steps to Find a New Job | How to Survive Unemployment
Image Copyright Ed Hidden
Keeping Your Job originally appeared on About.com Job Searching on Wednesday, March 3rd, 2010 at 13:28:24.
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Did you know that ERE has a group on LinkedIn? Check it out!
Here’s what’s going on in the ERE community this week:
- The only danger in mobile recruiting?
- Is your recruiting quaint?
- Talent acquisition metrics
- The big disconnect
- Whose responsibility is it to check references?
- Featured group of the week: Recruiting leadership forum
1. The danger of mobile recruiting? Not doing it.
Kristine Rhodes writes “Recently, I asked my client partners why they declined using mobile marketing as part of their recruiting strategy in 2009. I heard everything from “It’s just hype,” to “It’s intrusive,” to my personal favorite “It’s dangerous.” So I thought I’d share some quick facts to dispel the myths, and provide a few ways to ease into a mobile strategy.
Are you trying to get mobile recruiting initiatives completed this year? Take a look at Kristine’s post and add your own comments.
2. Is your recruiting quaint?
Kristen Fife argues that having a tool that only works in one type of browser sends the wrong message. She states: “It’s 2010, guys. I live in Microsoft’s backyard and a good number of the people *I* know use Firefox at home and work. Not to mention Chrome. And Safari (hellooooooooo, remember the new iPad that was unveiled a few weeks ago?) as well as a host of smaller browsers such as Flock, Opera, etc.
Is making an application cross-browser compatible not realistic or is it necessary in a multiple browser world?
3. Talent acquisition metrics
Ritvik Bhawan outlays the different types of metrics a person should use if they are looking to track their progress. He breaks them down into three categories:
- Workforce planning and acquisition strategy
- Applicant sourcing and candidate management
- Applicant tracking and final joining
Take a look and see if any of your favorite metrics are left out.
4. The big disconnect: how recruiters earn their fee
Barbara Goldman tells a story about how she worked behind the scenes as a third-party recruiter to secure a candidate in a way that the client didn’t see. She writes, “After my candidate started, and I called to collect my fee, the president of the company asked me how I had persuaded him to even interview. You see, unknown to me, he was a target candidate for the company. They knew him. Three recruiters had tried to drag him in. He said no. Now, they finally got their man.
What are your thoughts? Is a third-party recruiter’s value disguised?
5. Whose responsibility is it to check candidate references?
A member of the independent recruiters group on ERE asks: “I am preparing to enter the field as a contingent fee recruiter specializing in health care, and I have a couple of burning questions. [Whose] responsibility is it to verify a candidate’s references? Would not the employer always want to do this for themselves even if you do it? My other question is how should this issue be handled (worded) in my contract?
Got some feedback for him? Leave a comment for him in the group.
6. Featured group: Recruiting leadership forum
The recruiting leadership forum was created by John DePolo and the objective of the group is to “share best practices in recruiting leadership with members, and brainstorming new ideas that will help companies improve their processes.” A couple recent posts include how people are approaching the hiring of former prisoners and non-employee referral programs. Are you a leader in recruiting? Check this group out.
To see what else you’ve been missing, check out the ERE community.
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