The grant went to the Paul Foster School of Medicine which operates as part of the Texas Tech University Health Sciences Center.
Their plan is to continue building upon the tele-education network that was first started by the Gayle Greve Hunt School of Nursing.
Some experts say that overall healthcare may be trending towards telemedicine for many reasons, especially as the industry faces a severe physician shortage.
“We have to examine ourselves and how can we engage with patients on their level so that they can do it over the phone or over a computer,” Dr. Ogechika Alozie said. “Really what has happened is that over the last two to three years as an organization we have started to look at other avenues in which we can improve our patient care, improve our quality and our patient experience.”
Alozie said telemedicine services help doctors reduce time spent traveling, which for some, had included a minimum eight-hour round trips for specialty visits.
“How we engage in healthcare and how we engage in technology is very mobile,” Dr. Alozie said. “It should be mobile. It should be personal, it should be portable and that is really what we are going to focus on. We are going to work with the USDA and our outlying sites to provide access to our physicians and our clinicians in a way that suits them best.”
And according to recent economics outlooks, the entire telemedicine industry is growing rapidly and will reach a value of about $130 billion by 2025.
Federal prosecutors charged drug distributor Rochester Drug Cooperative and its former CEO with drug trafficking charges Tuesday — the first criminal charges for a pharmaceutical company and executives in the nation’s ongoing opioid crisis.
RDC was also charged with failing to properly report thousands of suspicious orders of oxycodone, fentanyl and other controlled substances to the Drug Enforcement Agency (DEA), officials said.
The DEA has been investigating for years whether RDC failed to comply with pharmaceutical reporting laws. The company has previously paid to resolve claims it failed to properly report the theft of opioids.
According to court records, from 2012 through 2016, RDC filled more than 1.5 million orders for controlled substances from its pharmacy customers, but reported just four suspicious orders to the DEA. In reality, there were at least 2,000 suspicious orders in those four years, federal prosecutors said.
Despite being briefed by company employees, top executives allegedly ignored “red flags” like cash payments and customers traveling from out of state to buy opioids.
“Today’s charges should send shock waves throughout the pharmaceutical industry reminding them of their role as gatekeepers of prescription medication,” DEA Special Agent in Charge Ray Donovan said in a statement. “DEA investigates DEA Registrants who divert controlled pharmaceutical medication into the wrong hands for the wrong reason. This historic investigation unveiled a criminal element of denial in RDC’s compliance practices, and holds them accountable for their egregious non-compliance according to the law.”
In the opioid industry, RDC is a middleman that buys controlled substances from manufacturers and sells them to individual pharmacies. As one of the nation’s 10 largest drug distributors, it delivered to more than 1,300 pharmacies and took in over $1 billion in revenue during the relevant five-year period, officials said.
RDC agreed to a non-prosecution consent decree and agreed to pay a $20 million penalty. It will be monitored by the government for the next five years.
“We made mistakes,” Jeff Eller, a company spokesperson said in a statement. “RDC understands that these mistakes, directed by former management, have serious consequences.”
“One element of the opioid epidemic is a dramatic increase in the volume of prescriptions for opioids and all narcotics,” the RDC statement continued. “With that dramatic volume increase came an increase in our business, resulting in an increase in orders we should have identified as suspicious order, which we failed to report to DEA.”
The company’s former chief executive, Laurence Doud III, surrendered to federal agents and appeared in Manhattan federal court late Tuesday. He was handcuffed and wore a dark suit as he was led up the stairs of the courthouse by federal agents.
Doud, 75, of New Smyrna, Florida, was charged with one count of conspiracy to distribute controlled substances and one count of conspiracy to defraud the United States. He faces a minimum of 10 years, if convicted.
Separately, William Pietruszewski, 53, RDC’s former chief of compliance, pleaded guilty earlier this month to participating in a narcotics distribution conspiracy from January 2012 to March 2017. He also pleaded guilty to conspiracy to defraud the United States and one count of willfully failing to file suspicious order reports with the DEA.
He has agreed to cooperate with the investigation.
Prosecutors say RDC employees told Doud and Pietruszewski that some of the company’s customers were “very suspicious,” and went so far as to describe some pharmacy clients as a “DEA investigation in the making” or “like a stick of dynamite waiting for [the] DEA to light the fuse.”
But in the relevant five year period, RDC, under Doud’s leadership, increased its sales of oxycodone and fentanyl “exponentially,” prosecutors said.
“From 2012 to 2016, RDC’s sales of oxycodone tablets grew from 4.7 million to 42.2 million – an increase of approximately 800 percent – and during the same period RDC’s fentanyl sales grew from approximately 63,000 dosages in 2012 to over 1.3 million in 2016 – an increase of approximately 2,000 percent. During that same time period, Doud’s compensation increased by over 125 percent, growing to over $1.5 million in 2016,” the U.S. Attorney’s office said.
RDC was also among the drug distributors named last month in a civil lawsuit by the New York Attorney General’s office, which alleged fraud, willful misconduct and gross negligence.
Between 2010 and 2018, the company sold more than 143 million oxycodone pills to customers in New York alone, the state’s attorney general’s lawsuit said.
“At this time, it would not be appropriate to comment on ongoing litigation,” Eller told ABC News in a statement.
Opioid manufacturers are facing over 1,700 lawsuits over their role in the current crisis. Paul Hanly, co-lead counsel for the plaintiffs in the federal litigation, which he said includes 2,000 cases, welcomed the move by U.S. prosecutors.
“The charges make the civil case against RDC easier to try and provide a potential road map to evidence that may prove the civil claims against other distributors,” Hanly told ABC News on Tuesday.
DALLAS — Clarification, April 24, 2019: This story has been updated to clarify that services provided by in-network hospital staff at out-of-network ERs are still covered by BCBS of Texas.
Customers who have health insurance with Blue Cross Blue Shield of Texas could face skyrocketing bills if they use certain hospital emergency room doctors that are no longer in network after negotiations failed between BCBS and the emergency room contractor, according to a statement from BCBS. The change is effective immediately.
When a patient walks into to an ER, they might assume the ER is run by the hospital it’s attached to. That’s not always the case. Many ER doctors are actually employed by outside contractors that pair with hospitals.
That’s what’s happening here, where Texas Health Resource ER doctors work for a contracting company called Texas Medicine Resources.
In the statement, which was also sent to all BCBS Texas customers, the largest health insurance provider in Texas said that as of April 15, Texas Medicine Resources (TMR) ER doctors who work at several Texas Health Resources hospitals will be out of network.
“Since these outside companies are not in our network, there are no limits to what their providers charge, potentially resulting in significantly higher out-of-pocket costs,” the letter reads.
The hospitals themselves, which include Texas Health Harris Methodist Hospital, Texas Health Presbyterian Hospital Dallas and Texas Health Arlington Memorial Hospital, will still be in the Blue Cross Blue Shield network, but certain doctors who work in TMR ERs will not.
“TMR terminated their contract with BCBSTX, choosing to leave the networks,” BCBS Texas media and public relations director Chris Callahan wrote in a statement to WFAA. “BCBSTX worked hard to keep the doctors in network, unfortunately, their demands were unreasonable.”
Callahan stressed that only the doctors are out-of-network, so services performed by hospital staff at these ERs would be covered at in-network pay levels. But it’s the ER doctors who now have the ability to charge a patient more than the insurance might.
Check out the map below to see which ERs have doctors who are no longer in-network.
The ER doctors are located at the following hospitals:
Customers who do go to these ERs will likely face steep bills, the letter warns.
“You may get multiple bills, including one from Texas Health and one from Texas Medicine Resources. This can vary based on the care you received.
“Because they are out of network, Texas Medicine Resources doctors can charge you more than our allowed amount.”
BCBS urged its members to double-check which hospitals are in-network, and to use an in-network urgent care center or hospital in the case of an emergency.
An emergency, according to BCBS’ website, includes “life-threatening” symptoms like:
An urgent care visit, according to BCBS’ website, includes, but is not limited to:
BCBS is the largest health insurer in the state of Texas.
What’s next? Senate Bill 1264, authored by Senator Kelly Hancock (R-North Richland Hills),would eliminate balance billing from doctors who choose to remain out of insurance networks. The bill passed the Senate last week and now awaits a vote in the House.
The full statement sent to BCBS insurance customers (emphasis BCBS’):
We want you to know that as of April 15, 2019, the emergency room (ER) doctors at many Texas Health Resources (Texas Health) facilities are no longer in our network. Texas Health is a network facility, but most of its ER doctors work for an outside company, Texas Medicine Resources.
Hospitals across the nation are hiring outside companies to run their ERs and employ the doctors, nurses and other health professionals you see when you visit the ER. Since these outside companies are not in our network, there are no limits to what their providers charge, potentially resulting in significantly higher out-of-pocket costs.
We try to negotiate contracts with these outside companies to bring and keep them in network, so you won’t have to pay more for services. In some cases, they choose not to contract with us.
Things to know about emergency care at Texas Health:
All plans help pay for medically necessary emergency care services. Go to the nearest hospital or urgent care when you have a true emergency.
Our goal is to serve your health care coverage needs through all of life’s changes. If you have any questions, call us at the number on your member ID card. Our team stands ready to help.
Your Customer Advocates
Blue Cross and Blue Shield of Texas
( Sent from WFAA )
The answer for all of them is that we need more information. Capacity determination is difficult and time consuming, but because these cases exist at the nexus of good medical care, civil rights and legal liability, it is essential that it be performed properly. This article reviews the process of evaluating a patient’s medical decision making capacity and explores some of the unique challenges that EPs face in making an accurate assessment.
Decisional capacity refers to the ability of an individual to make medical decisions on their own behalf. Underlying this concept is the idea that such decisions can only be considered valid when made by an individual with 1) a basic understanding of their medical condition; 2) the options for treatment; 3) the ability to rationally consider these options as they apply to the patient themselves; and 4) the ability to communicate their decision[i]. A patient cannot fall short on any of these and still have capacity.
Additionally, it is important that the values and goals behind the patient’s decisions have some stability over time. If what the patient is expressing in the ED is a radical divergence from their previous values, we must consider the possibility of acute psychological impairment and we would question their role in the decision-making process.
Although the criteria described above are not complicated, the process of determining capacity can be, especially as it unfolds in the ED. The first issue is that patients almost never engage in the capacity assessment in a way that gives us certainty that their understanding is thorough, rational and consistent. Questions meant to elucidate their thought process are often met with terse answers, such as “I’m fine” and, “I just don’t want it.” For some patients this indicates a lack of understanding. For others it is a result of the frustration many ED patients have even before the conversation begins.
Unlike patients seen in a medical office, who find their visit too short, ED patients are often eager to leave. They have little interest in a lengthy discussion or in providing you with any reassurances about their thought process after you have, in their eyes, spent the last few hours ignoring their needs. Their reticence makes determining whether their decision matches their core values a challenge, more so since you have often never met them before.
The conversation is further impeded by patients’ limited understanding of their disease process. We know from our studies of patients discharged from the ED that they often leave with little understanding of what was wrong with them. Unlike patients who have been seeing a doctor for months or years with a clear diagnosis, ED patients may either lack a clear diagnosis or haven’t had much time to learn about them.
Finally, there are EP factors which impede the evaluation. We are often pressed for time. None of the steps described above: creating a rapport from whole cloth; educating the patient; assessing their thought process; and piecing together a sense of how consistent all this is with the person they have been before they came to your emergency department, work well if rushed.
Additionally, we may harbor our own personal feelings toward patients. Patients who are rude or demanding can provoke anger and resentment in the physician, leading us to accept a lower standard of apparent capacity, just so that we can discharge them. On the other hand, fear of a lawsuit or anxiety about how we will appear in our colleagues eyes can all lead us away from privileging the patients’ interests primarily, leading us to an unreasonably high standard for capacity.
First, understand that your role is not to coerce the patient to follow your advice. Your role is to partner with them in making a decision that serves them medically and is in line with their goals and values. A calm, informal manner will serve you best here. The more you let them know you care about their doing what is right for them, the more likely you are to 1) get them to listen to what you have to say and 2) get the answers that reassure you that they understand what’s going on.
Another important part of the process is involving family. Family can tell you whether the decision you are hearing is coming from the person they have known for years or whether something seems off. Family can also help the patients think through the decisions when their own reasoning abilities might not be at their best. Fear, anger, and pain all suppress the activity of the frontal cortex, where our reasoning takes place. It is rare that patients in the ED are not experiencing one, if not all of these. Having a family member involved can help calm the patients to allow more rational thought and provide a sounding board for patients to sort out their own ideas. Involving family is so important that I will often ask the patients to call their family members, if none are immediately present.
Perhaps the most challenging part of the process is gaining a clear sense of the patients’ comprehension of their illness. The difficulty lies in structuring the conversation to maximize the possibility that patients will feel at liberty to talk about what they understand and want. As noted above this requires setting the gentle, accepting tone. Also, it is important to keep our expectations reasonable. We have to bear in mind that patients have a layman’s vocabulary and are not trained in medical thinking. However, if we accept a reasonable layperson’s understanding as our standard, we can often get a satisfactory sense of their thoughts and feelings.
Let’s look at that group for whom most of us are forced to make a capacity judgement on daily basis, drunk patients. In most cases, drunk = lacks capacity. This common-sense determination is supported by research: drunk ED patients were administered a questionnaire to assess their understanding of research risks. A mere 3.9% of participants were able to answer all the researchers’ questions correctly. Not only that, but 63.4% did not even remember participating in the study once they sobered up.[ii] This does not mean that all drunk patients lack capacity. But we must be sure to apply the standards strictly given the likelihood that these patients are impaired.
There was a recent case which might appear to contradict our notions of drunk patients and capacity.[iii] A few years ago Mr. Kowalski, an adult male, presented to St. Francis ED seeking alcohol detox. Shortly thereafter, he walked out of the ED unannounced and against the advice of the providers. Shortly thereafter he tried to cross a busy highway on foot and was struck by a vehicle, leaving him paralyzed below the neck. The judge ruled that the hospital did not have a responsibility (or even a right) to detain Mr. Kowalski.
Initially some in the emergency medicine community took this to mean we were not burdened with the responsibility of ensuring intoxicated patients’ safety. However, although the judge found in favor of the hospital, the decision was based upon a very narrow legal technicality (the fact that he presented voluntarily for detox) and the applicable law has since been changed. In spite of the dramatic press this case got at the time, it should not change our standard approach to such situations.
To get a further perspective, let us consider the following, not-uncommon scenario. EMS brings in a 30-year old male unresponsive after methadone overdose. They administer naloxone and by the time he arrives he is awake and alert, fully oriented, with stable VS and has no other complaints except that he wants to leave. Medics notify you that this is the third time they have brought the patient in this week.
You discuss with the patient your concern that if he leaves, the Naloxone may wear off before the methadone does, and that he may again stop breathing. In your conversation with him, he demonstrates an understanding of his situation, the medical implications of his various treatment options, and is able to give a reason for choosing to leave that is consistent with what you take to be his core values and worldview. He is has demonstrated all the criteria for capacity. And yet…
Here is where it makes sense to err on the side patient safety over patient autonomy. Medical judgement is never 100% accurate. Because of this, we tend to employ a “sliding scale” approach in deciding capacity. As stated in a report by the President’s Commission for the Study of Ethical Problems in Medicine, “when the consequences for well-being are substantial, there is a greater need to be certain that the patient possesses the necessary level of capacity. When little turns on the decision,… less scrutiny is required about whether the patient possesses even the reduced level of capacity.”[iv] Erring on the side of patient safety in cases with high risk for adverse outcome is advisable. This is especially true in the case of a mental illness that impairs judgement, such as an addiction disorder.
Another group of difficult patients are those with schizophrenia or other psychotic disorders. Such patients can present us with idiosyncratic reasons for making decisions. In these cases it is probably better to involve psychiatry. Psychiatrists’ will be more familiar with psychotic patients’ style of speech and course of illness, making it easier for them to differentiate idiosyncrasy from impairment.
This is a good time to mention that, although many capacity assessments can be made by the EP alone, one should feel at liberty to consult psychiatry for these evaluations at any time. Good reasons to involve psychiatrists include complex cases, especially those with greater potential medical liability, presence of significant mental illness, patient unwillingness to engage in the conversation, and lack of time.
Once you have satisfied your duty to the patient to help them get the care they want, you still need to honor your duty to your administrator. This means charting in a way that adequately reflects the patient’s and your own thinking throughout the process.
The capacity determination is a complex process, but can be simplified if we think of it in discrete steps: eliciting a clear explanation from the patient of their understanding of their condition as well as their goals, working with both patient and family to clarify these when they are obscure, recognizing situation likely to be problematic, and knowing when to call for help. If we are mindful of all of these, good medical care can be not only achieved, but enhanced by our efforts.
[i] Appelbaum, P. and Grisso, T. Assessing Patients’ Capacity to Consent to Treatment. New England Journal of Medicine, 1988. 319(25):1625.
[ii] Martel M. et al. A brief assessment of capacity to consent instrument in acutely intoxicated emergency department patients. American Journal of Emergency Medicine, 2018. 36:18-23.
[iii] Kowalski v. St. Francis Hospital and Health Centers, 21 N.Y. 3d 480 (2013)
[iv] President’s Commission for the Study of Ethical Problems in Medicine, Library of Congress card number 82-600637, U.S. Government Printing Office, Washington, DC 20402
When family physician Jenna Fox signed on for a yearlong advanced obstetrics fellowship after her residency to learn to deliver babies, she knew she’d need to practice as many cesarean sections as possible.
The problem was, she also knew C-sections aren’t always good for patients. Many women’s health experts argue they’re often unnecessary and increase health risks for mom and baby. Doctors are working to decrease high C-section rates in hospitals around the country. Fox and her colleagues on the labor and delivery floor at the University of Rochester try hard to prevent them, particularly primary C-sections, when a woman needs one for her first baby.
“I want to avoid primary C-sections. But also in this one year of my life I want all the primary C-sections in the world,” Fox says. “It’s me feeling conflicted, internally, all day, every day.”
During her fellowship, she says, the more C-sections she does, the better prepared she’ll be to practice independently.
Medical education is built on the assumption that the more procedures or treatments doctors see and do, the more competent they’ll be when they’re independent. It can feel tempting to do more rather than less.
There’s some evidence that the patterns we learn in residency are hardwired for the rest of our careers. In a 2014 JAMA study, for example, doctors who trained in regions where patients underwent more tests and procedures went on to practice independently in a similarly aggressive style.
Academic medicine is often criticized for its emphasis on an overly thorough workup for ordinary problems. In the name of learning how to practice medicine, young physicians may be tempted to order lots of tests, a trial-and-error approach with real implications for patients.
Early in my own training as a family physician, I remember ordering a colonoscopy for a young man with mild rectal bleeding. I rationalized the risks of the procedure — bowel perforation, complications from anesthesia — because it would put both me and the patient at ease to know his symptoms weren’t caused by something dangerous. As Fox puts it: “We like to be reassured. We feel much better when we think a situation is terrible and find that everything is awesome rather than the other way around.”
But more isn’t always better. It’s not news that health care costs in the U.S. are out of control. We spend more on health care, per capita, than any other developed country.
Unnecessary tests and treatments may contribute to high costs. According to a 2010 estimate from the Institute of Medicine (now known as the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine), we could reduce many of our medical interventions by 30 percent without sacrificing quality of care.
There can be a disconnect between that abstract fact, however, and deciding how to take care of an individual patient.
“Nobody went to medical school to treat the GDP,” says Christopher Moriates, a physician and dean at Dell Medical School in Austin, Texas, who designs medical school curricula to teach appropriate use of tests.
Instead, medical educators are focusing on a different argument in an effort to teach judicious use of tests and treatments: the human costs of overtreatment.
Order enough medical tests, and they’ll inevitably yield abnormal results. Doctors then may feel obligated to treat those abnormalities — even if the patient would have lived a healthy life without knowing about them.
“It’s totally natural to think more information is just going to be better,” says Moriates. “Eventually it leads to patients feeling less well than they actually are, if you uncover things that are meaningless but abnormal.”
Take my patient with the rectal bleeding. After my overzealous workup, I talked through his case with a more experienced doctor. He told me what I now know from more clinical experience: The patient’s bleeding was almost certainly caused by hemorrhoids, and watching and waiting for a few weeks would have been safe and helped the patient avoid an invasive procedure.
Moriates and other medical educators are exploring ways to teach this concept early in medical education, as I was lucky to experience. They want to help medical students and residents curb these habits before they become ingrained.
One area that seems to have some promise? Harnessing doctors’ competitive spirit and showing them how they compare to their peers.
Internist and Columbia assistant professor Joshua Geleris published a study in 2018, for example, that examined the sheer number of tests that internal medicine residents ordered during the 2016-2017 academic year at a New York residency program. Geleris and his co-authors didn’t distinguish between tests ordered on different types of patients, since all residents spend equal time in intensive care units and regular hospital floors.
What they found, Geleris says, is that some residents ordered seven to eight times more tests than their peers. It’s hard to say what number of tests is the right one, Geleris adds, but the variability is concerning.
“They’re just trying to get their work done and make sure the attending is happy the next day,” he says.
At Johns Hopkins Hospital in Baltimore, a group of professors is working to provide similar data to their residents in real time, with the hope that it might encourage doctors to think more carefully about what tests are truly necessary.
Johns Hopkins radiologist Pamela Johnson, an associate professor who teaches residents about appropriate use of tests, says she and her colleagues give out personalized reports that show how individual doctors compare to their peers. She’s currently studying whether these reports are effective in reducing the number of CT scans ordered to check for blood clots in the lungs. There are clear guidelines for when a CT scan is the right test to check for clots, she says, but they’re often ignored, in part, because doctors are afraid of missing a life-threatening diagnosis.
“The best way to avoid a diagnostic error is to avoid an unnecessary test,” Johnson says.
This kind of peer pressure may be helpful for fully trained doctors, too.
Internist Adam Cifu, a professor at the Pritzker School of Medicine in Chicago who has written about medical overuse, recalls a meeting several years ago with an infectious disease physician charged with decreasing unnecessary antibiotic use in the hospital. That physician told Cifu he was one of his department’s worst offenders when it came to using broad-spectrum antibiotics for ordinary urinary tract infections. Knowing that he was over-treating compared to his colleagues, Cifu says, made him rein in his prescribing almost immediately.
“We’re all ridiculously obsessive high achievers,” Cifu says. “Seeing that I’m not in the 90th percentile or above kills me.”
Medical school professors are hoping to further harness this competitive spirit when it comes to teaching students and residents to test and treat responsibly. Johns Hopkins associate professor Lenny Feldman, a physician who works with Johnson to develop educational tools, says he’s hopeful these “report cards” will help normalize more judicious ordering of tests.
“We have to break the cycle somewhere,” Feldman says.
Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.
NPR: Can The Culture Of Overtreatment Be Curbed In Medical Training? : Shots – Health News.
Telemedicine is a way of digitizing our bodies. Conducting physical examinations over remote digital connections such as video calling literally exposes our most sensitive information to the wilds of the internet.
As we’ve all no doubt seen and heard by now, hacks of even the most seemingly impenetrable governmental, social media, and big business websites and data vaults are not only possible but starting to feel a little common.
If telemedicine is going to win broad public support–and there is evidence that the majority of us are in favor of the concept even if we’ve never actually tried it–then airtight privacy and security is going to be paramount.
HIPAA compliant video conferencing software is the starting point. Less frequently known as the Health Insurance Portability and Accountability Act, HIPAA was enacted largely to ensure the privacy of personal patient information, and it provides strict guidelines for the transfer and storage of sensitive patient data across digital channels. In telemedicine, meeting the requirements of HIPAA standards is the responsibility of the video conferencing vendor–and the responsibility is critical.
Accordingly, if we are to benefit from the advantages offered by telemedicine, the technology we use must be as private as a room at the local doctor’s office.
Telemedicine is no longer science fiction. The debate around its use is no longer about its efficiency or effectiveness. Research across a range of medical fields has found that remote consultations can be as reliable as in-person appointments in the fields of mental health, addiction treatment, optometry, outpatient care, and dermatology.
The most familiar uses of telemedicine at the moment are of the doctor-to-doctor variety (in which a general practitioner consults with a specialist), and the kind of doctor-to-patient consultation offered over some telehealth apps.
All these telehealth services must comply with HIPAA guidelines; that includes the following physical and technical standards:
Meeting all those standards requires more attention to security than just password protection. The good news is that there are many video conferencing providers that have passed the test.
Meeting HIPAA standards is the responsibility of video vendors. Before any telemedicine network can be established, the vendor must provide a HIPAA-required Business Associate Agreement (BAA). This binds the vendor to secure all patient information and report any breaches of security.
As such, there’s no overriding list of HIPAA-approved vendors available from which a telemedicine startup could simply choose a partner. Instead, HIPAA compliance is assessed on a project-by-project basis and has more to do with a provider’s willingness to abide by the rules rather than their ability to technically do so. There are, however, examples of vendors that have and haven’t embraced their HIPAA responsibility.
Apple, for instance, has not agreed to subject FaceTime to HIPAA regulations, but Zoom did in 2017 before launching its cloud-based telehealth service. And it gets even more complicated once you drill down into specific services offered by video vendors. Skype, Teams, and Office 365, for instance, are all treated as separate entities when it comes to HIPAA regulations, despite their common parentage.
The bottom line is that each telemedicine project or network is assessed individually and each vendor must agree to a BAA whenever it undertakes such a partnership. This agreement is less a license to dispense virtual medicine than a promise to be held accountable should HIPAA breaches take place.
Regardless, it’s a responsibility that is critical to the future of telemedicine.
The results of a survey undertaken by Cisco reported that only about 40 percent of consumers in the U.S. believe that data protection is sufficient to keep their medical information private. Skyhigh Networks reports that healthcare companies often use multiple cloud services, which can increase the risk of a data breach.
Telemedicine, of course, is particularly susceptible to online attacks and data breaches, which means that increasing adoption of telemedicine is only possible if users are convinced that the technology is safe and secure.
That starts with the implementation of more advanced video security features. Digital security company Theta Lake, for example, has released video conferencing-compatible compliance software that uses artificial intelligence to scour recordings of video meetings in search of potential data integrity risks. The app uses machine learning to detect spoken and visual compliance risks in media sources such as meetings, marketing materials, social media content, and workflow messaging and exchanges.
Provided Theta Lake can deliver on its promises, that kind of initiative could go a long way toward showing the public that the technology of communication is backed up by new technological ways of securing privacy.
Just as companies are finding new ways to bring virtual medicine to rural and remote areas, into schools and offices, and every available minute of our lives, they should be developing new ways to keep us safe.
Digital innovation made telemedicine possible, and digital privacy can make it popular.