(Reviewed and updated May 18, 2016)

Recently, we've shared our suggestions on how to share patient files securely and the best ways to take medical photos. From those posts, an additional question came up from our readers who are using technology but still trying to stay HIPAA secure...

How do I send medical photos securely over the internet?

Good question! Many of the tactics for staying HIPAA-safe while sending medical photos over the internet came up in our recent posts, but there are a couple of specific things to keep in mind.

When sending medical photos on the internet, don't make these HIPAA mistakes:

• Texting from your phone. As with texting patient information, you can't text photos unless you use a secure service. Merely texting from your smartphone definitely won't do the trick when it comes to HIPAA, even if it's just a patient photo (without their record.) 
• Saving photos on your camera roll. Few people realize that the camera roll on your smartphone is not HIPAA-secure. ClickCare uses a HIPAA-secure camera roll for that very reason.
• Sending photos via email. Email isn't HIPAA-secure, even "secure" email. If you're looking for the kind of sharing that email and photos can give you, consider doing medical collaboration with a hybrid store-and-forward telemedicine platform, which can let you share photos while not running afoul of HIPAA. 
• Leaving them on your data card. A final thing to be careful of is the data card in your digital camera. If you store your data card in a place where people can get to it, or you're sharing your camera with other people, that data card is not HIPAA secure. The system we recommend is to erase the data card as soon as you've uploaded your photo to the secure sharing platform you're using. 
• Saving them on your hard drive. As safe as it may seem, in most contexts it is not HIPAA-compliant to leave patient photos on your computer's hard drive. So use the same protocol as with a data card -- erase the photos as soon as they're uploaded to your telemedicine platform. Did you know your copier also has a hard drive - the old way may not be so safe either!

 

For an in-depth look at HIPAA mistakes you might not know about, get our guide:

Image courtesy of ben_grey on flickr.com, used under Creative Commons rights.

 

 

Many people have been hearing telemedicine success stories and want to start using using technology to collaborate and connect with providers and patients.

Most folks use telemedicine to improve patient care and maybe make their lives as providers a little easier. However, those motives don't get around the fact that we all need to be paid for the work we do.

Reimbursement for telemedicine is a crucial part of making the practice sustainable. But it's not always easy to know how to make that possible when the political climate and reimbursement policies are constantly changing.

So here are 4 tips and resources to make sure you're paid for telemedicine:

1. Just do it and worry about reimbursement later. Many of our colleagues have found that when they put collaboration and patient care first, the reimbursement ends up taking care of itself. So pay attention to reimbursement -- but if in doubt, just go ahead and care for the patient or collaborate with telemedicine and let the details sort themselves out later.
2. Use the right codes. We've assembled a list of codes you can use to bill for telemedicine-related time. This is always changing, but keeping an eye on the right codes increases reimbursement significantly.
3. Make sure you're billing for everything you can. Many providers don't know that in addition to patient-related time with telemedicine, you can also bill for time spent collaborating, and even charge a remote site facility fee. 
4. Be smart about pre-authorizations. Always check if the patient’s insurance company needs a prior authorization. If so, text the pre-authorization information and patient insurance plan to the consultant.

 

Need guidance on telemedicine options? Get our guide for free:

 

 

Image courtesy of 68751915@N05 on flickr.com, used under Creative Commons rights.

 

With all the gift guides flying around the internet this time of year, our thoughts turned to the "gifts" that help us do our work better. Especially during the holiday season, handy tools like smartphone apps can contribute to decreasing provider burnout, a more easeful day, and better patient satisfaction.

As we quizzed our colleagues and dug into the research, we found some interesting trends when it comes to the best medical apps, especially in relation to making your day easier and helping to cut provider burnout:

• People still aren't paying attention to HIPAA. Many people continue to use email, text messaging, and the in-phone camera roll, despite the consequences. Our observation is that apps that aren't HIPAA-compliant actually increase burnout, with the extra worry and stress they cause.
• The humblest apps are the most used. We found that despite the hundreds of complicated apps that exist, the most commonly used are the simplest -- a finding that definitely resonates with our own experience. Sometimes you just need the easiest tool, not the most sophisticated one.

In thinking about the best medical apps to recommend, there are some surprising ones on the list. Here's our rundown, to help make your workday as healthcare providers a little saner -- or even more fun:

• Apps that help you care for patients. There are all kinds of complicated patient communication systems, but some of our favorite apps are simple tools that make it easier to communicate with patients, even when you're in the same room together. Often called "point of care education," these apps range from games to sophisticated modeling programs. Software Advice, a company that reviews medical software, recently put together a list of doctor-recommended education apps that make visits more effective.
• Evernote for studiers. Our medical students may be the most common studiers that use Evernote to keep their thoughts -- and notes -- together. But we all have times when we're "studying," whether for a new research project or to investigate something for our office. Evernote is our favorite study tool, easily syncing across devices and cutting the stress that comes from losing notes.
• Apps for collaborating. Call us biased, but we prefer the label "innovators." Our iClickCare app is still the best, easiest-to-use, medical collaboration app, hands-down. For other kinds of collaboration (document-based and not HIPAA-compliant), like intra-office collaboration on logistics, we look to 37 Signals.
• Oldies but goodies. Everyone knows Epocrates, and for good reason. The app has turned into our medical dictionary, calculator, and encyclopedia -- quickly becoming indespensable.
• Simple browsers. Mobile Safari ends up being the app we use the most. Why? It's adaptable to what we need. Whether it's easily finding a resource for a patient, looking up an address, or learning more about a certain condition, we find that having the "internet in our pocket" makes our lives flow more easily.
• Simple ways to connect with family. As our work lives get crazier, it seems even more important to stay in touch with our loved ones. We love FaceTime for virtual snacktime with a granddaughter, a chat with a spouse, or a check-in with a colleague. And never forget about the power of simply picking up the phone to connect with a friend, family member, or teammate at work! 

Let us know which apps make your life easier. And for our guide to the world of telemedicine (apps and beyond), click here: 

 

Hospital closings and mergers are all over the news these days. With increasing pressure to cut costs, many hospitals are choosing to consolidate. Of course, it's often the hospitals and clinics in the poorest and most remote areas that are closed first.

And it's not the kind of tide you can usually fight, despite this almost-humorous story of a NYC mayoral candidate's arrest for protesting a hospital closing. 

Decreased costs or no, these consolidations can leave healthcare providers in the lurch:

• Providers in remote or underserved areas may have a hard time finding nearby colleagues for consults.
• Providers that value serving the people that need it most have trouble finding hospital postings they can count on, in underserved areas.

So, what can be done? Well, it's pretty simple, and it's the reason we founded ClickCare. In an age of increasing barriers, healthcare providers can choose to serve, consult, and collaborate outside of their group, hospital, or geographical area. When geography becomes a barrier, telemedicine and medical collaboration become the solution. When schedule and timing coordination become issues, an additional consideration may include hybrid store-and-forward options (rather than teleconferencing.) 

We all went into medicine to serve people. And there are tools that make that possible -- in spite of the challenges presented to us in the form of mergers, cost-cutting, and consolidations.

  

Here at ClickCare, we have a big vision but generally focus on the people and the world around us. We work to serve our patients, innovate in ClickCare, and partner with our customers.

The truth is, though, that medicine is increasingly impacted by the "big picture" we're surrounded by. Everything from new HIPAA rules to Medicaid reimbursement changes affect how we care for our patients and collaborate with each other. 

So when Melissa McCormack, Managing Editor of Software Advice, reached out to us about a poll she's conducting regarding one of these big picture issues, we wanted to share it with you. Melissa presents an in-depth look at the proposed FDA regulation of medical apps (a category ClickCare falls into.)

Since we're passionate about collaboration, we're certainly going to be curious how you all ring in on the question: to regulate or not to regulate?

As noted in the article, this debate is big business. Just 5 interested firms spend over $20 million for lobbying. When regulatory issues come up, we also notice the ways that EMR/EHR companies essentially use government regulation as marketing, as covered in this New York Times investigative report. It is extremely expensive to join or have your EMR certified by the CCHIT, a situation that creates an insider's club of large multinational companies. In fact, its core members are the same large companies that lobbied for the EMR... and some of the same companies are signors of the letter to delay regulation of medical apps.

Our conclusion is that while we worry about regulation, at least it is open, defined and democratic. The FDA's initial proposals, simplified, are quite reasonable. If it touches a patient (extends a physical device) -- regulate. If it interprets data in an automatic way (highs lows, outside of bounds) -- regulate. If it is a source of information with human control and interpretation (a reference book) -- don't regulate.

So however you feel about the issue, head on over to the poll on FDA regulation on medical apps... and make yourself heard.

In the meantime, try iClickCare for yourself. And let us know your comments about this blog article, and any topics you would like to see covered in upcoming Blog articles.

 

For us, the simplest pleasure as healthcare providers is communicating with patients. Whether it's digging into the "problem behind the problem," hearing about jobs or kids, or finding a simple explanation for a diagnosis... these conversations are the best parts of our day. 

So it's scary to hear about all of the HIPAA violations that come from the simple act of communicating. As we wrote in this post, fines keep increasing and enforcement is now a "will happen" thing rather than a "could happen" thing.

ClickCare's primary purposehttp://www.clickcare.com/about-us-mission-statement.php is to help healthcare providers communicate with each other. But we know that providers also use ClickCare to communicate with patients. So we want to make sure that whether you're using ClickCare or communicating through another medium, you're doing so easily, quickly -- and securely.

3 ways to keep your patient communication safe from HIPPA violations:  

1. Never let patient photos into your camera roll. Increasingly, smartphone apps (with the exception of ClickCare) pull from your camera roll-- sometimes even sharing pictures without your knowledge. And even if that doesn't happen, your camera roll only has one layer of security -- the login password on your smartphone. So when dealing with patient photos, we recommend using a secure app like ClickCare that doesn't ever save photos to your camera roll. You'll know your pictures are safe, and used only for your purposes. 
2. Don't use emails or text messages -- period. Email and text messaging have become so common that many healthcare providers end up sending updates or photos via email -- or requesting that patients do the same. Unfortunately, HIPAA violations arising from email or text are increasingly audited and fined, so even with "secure" email, you should never send or recieve patient information this way. There are just too many points in the system where you could be unknowingly violating HIPAA.   
3. Enlist your whole community in secure communication. We tend to have a pretty inclusive office culture. Obviously, everyone from our receptionist to the young man that picks up mail are crucial parts of our communication with patients. That said, only certain members of the community are allowed access to patient information. So make sure to log out of EMRs or other secure programs when you're done using them, and make sure everyone helps keep physical files in the hands of the people allowed to see them. 

 

We are excited about our brand new iClickCare® iPad app and updated iPhone app -- and how they can help you with healthcare collaboration. ClickCare® was formed for one reason: to help medical providers (17 years ago, we called them doctors, nurses and allied health professionals) help each other to help their patients. The iClickCare for the iPad app is about to ship to the Apple iTunes Store where it will join iClickCare for the iPhone. Both apps can be evaluated free for 14 days.

We use the guiding Mantra:

• Access -- for the patient to the right care, at the right time, in the right place
• Collaboration -- for those who care for patients on behalf of the patients and themselves
• Education -- for those who join us anew or follow in our footsteps

We also have design goals of Simple, Secure and Spectacular.

With the hard work of our lead team, Marc Norman, Greg Born, and Nathan Uno, we are pleased to announce the new "iClickCare for the iPad" and upgraded "iClickCare for the iPhone" apps.

The new app features include even more:

• Simple:
• Easier to read.
• A calming relaxing visual presentation.
• A page design that mimics your workflow as a medical professional.
• Secure
• Backend enhanced security when images are served up.
• A private, secure password-protected camera roll.
  
• Continued high level SSL.
• Firewall friendly.
• Spectacular
• Nothing really new to learn. iClickCare for the iPad is intuitive and integrated with our Web and iPhone apps.
• Carefully chosen colors to highlight the patient and soften the intrusion of a form.
• Maximum use of the Retina Display which supercedes our common encounters with imaging today.

We love this technology and are especially proud of iClickCare®. We need to make note, though, that for good patient care, efficient and cost effective healthcare, and a satisfying career, each of us needs to have the attitude that we want to collaborate. It takes effort on our part, no doubt, but the effort is worth the gain. To use iClickCare, we must do something different and take one step away from ourselves. The alternative is tedious telephone tag and reams of paper to be read and signed. The other alternative, “doing nothing”, is not acceptable.

We will be updating our book Medical iPhone Photography to INCLUDE being able to take pictures on the iPad as well as the iPhone. Stay tuned. In the meantime, to celebrate, we are offering an electronic copy of "Medical iPhone Photography" when you schedule an iClickCare demo.

Download Chapter 1 for your reading pleasure:

Care coordination and telemedicine are coming to the fore.  The last two weeks have made 5 P's worth discussing.

• Publicity
• Pinterest
• Pigeon Holes 
• Principles
• Patients

You’ve followed HIPAA, now you’ve lost your phone. Now what?

It happens more than you would think. In 2011, statistically, each owner lost his phone at least once.

The most common places to lose your phone are:

1. Coffee Shop
   
2. Bar
3. Office   
   
4. Restaurants
5. Apartment & Condo
6. Grocery Store
7. Gas Station
8. Residential
9. Pharmacy or Drug Store
10. Park                                                   Source: Lookout Mobile Security March 22, 2012. Image: Wikihow.com

Since for many of us, the “office” is the floor, the ER or the Operating room, and we rarely get to the park, the grocery store, or bar, the list shrinks considerably. 

Here are some suggestions for not losing your phone:

• Keep it in the same pocket all the time, pants, shirt or pocketbook.
• Pat that pocket as you do your wallet.
• Don’t hold it, put it away.
• When at home keep it attached to the charger. Don’t let children play with it. It is a good substitute babysitter, but easier to lose, believe it or not.
• In the operating room, check your scrubs before they go into the laundry. If placed on a table or shelf, keep it away from the rest of the equipment and supplies.
• When using Medical iPhone Photography, take the picture, put the phone away, and then do your procedure. For instance, laying it down on the bed while changing a dressing has two problems:  (1) The patient lies on it and gets another pressure sore or (2) you lose it and the picture you just took.

This brings us to why we at ClickCare are making note of this study. First, replacing an iPhone is expensive. But, paying the HIPAA and HITECH fine is worse. A $500 loss could quickly become a $50,000 loss if the phone compromised patient privacy.

Second, if the picture is lost, and as the saying goes—you may have had only one shot at it--collaboration is that much more difficult.

iClickCare was specifically designed to solve these problems. 

First, even if your phone is lost, the pictures which were taken are hidden within a secure log-on barrier. Second, when an iClickCare visit or consultation is created, the data is sent, stored and available on the secure server. You may have wasted $500, but you have not lost your patient's information.

If you have lost your cell phone, just call or text it. Maybe someone can answer it.  Let it ring long enough for them to pick up. Provide contact information in the text.

The iPhone has the Find My iPhone feature. You can also kill the iPhone remotely. Here is a helpful article from PCMag about different phones and different choices. Another good article is in www.wikihow.com/

If you are lucky, like us, the nice people at the Roscoe Diner will put it behind the cash register for safe keeping!

 

                            

                                       

Source: www.liveintentionally.com

References:

Lookout Projects Lost and Stolen Phones Could Cost U.S. Consumers Over $30 Billion in 2012

Lost cellphones added up fast in 2011 – USATODAY.com

10 Ways NOT To Lose Your Cell Phone! | Schmoozins

Americans Lost $30 Billion Worth Of Cellphones In 2011, Study Finds

http://www.pcmag.com/article2/0,2817,2363526,00.asp

http://www.wikihow.com/Find-a-Lost-Cell-Phone

http://www.liveintentionally.org/2011/03/30/things-you-dont-have-time-not-to-do-13-make-a-place-for-everything/

 

 

The New York Times reported this week that some iPhone apps were collecting users' address books and later, photos from users' camera rolls. Later, the same security risk was described in Android phones.

This risk does not apply to iClickCare. While the camera roll looks the same and works the same, it is placed within iClickCare itself, and thus is not accessible.

                                                               

When using iClickCare we recommend that you use the general device password. Of course, to use iClickCare a second layer of protection is provided since admission to the app is only by user name and password. iClickCare’s browser interface also needs the same login information. Parenthetically, users and usage are monitored by the secure server.

  

While any device can be hacked, it would take evil intent, and considerable skill, to breach iClickCare. We encourage use of the iPhone rather than a routine digital camera (which works with your desktop) in this very secure two-password schema, in that their is not a digital storage card which can be removed. Loss of the iPhone can also corrected by tracing and wiping the iPhone remotely. Of course, because iClickCare is software as a service, in the cloud, and instantly synced, your pictures and comments are not lost to you. They are unaccessible, however, to the iPhone thief if your lost phone was actually stolen.

More detail is available here:  The iPhone Camera Roll is described in greater detail in our book Medical iPhone Photography.