Category: industry

The United States of America is a Constitutional Republic of 50 states and various external interests. That means as well as a large number of Federal regulations, there are also state laws and regulations with regard to the following:

• Medical record storage, how they should be stored and how long to keep them
• Medical record retrieval, how they could be accessed, who may or may not access them, and the procedures for doing so
• The costs associated with medical record storage and retrieval
• Other paperwork and red tape additional to HIPAA and HITECH

 

The Problems

As each state sets its own additional regulations, when dealing with firms or patients based out of state, you need to understand the complexity that may delay conclusion of each case. Rarely are two cases the same meaning variation in red tape and costs. The more there is, the longer a case will take. The longer a case will take, the more costs there will be.

There is little that you can do to negotiate the various legal requirements per state, but you can alleviate the problems by using Record Grabber.

 

A Brief Cost Comparison

Of course, regulations such as HIPAA and HITECH are Federal. Everybody must comply fully with these laws. This is the easy part. The difficult part is ensuring that you also comply with state law which may differ considerably even in adjoining states. One of the biggest differences is cost. Some states have clearly defined costs and others do not.

For example, Alabama charges a $5 search fee, $1 per page between pages 1 and 25 and $0.50 for pages 26 and up. For x-rays and other media, you will pay the actual cost of reproduction (whatever that may be). Arizona and Hawaii have not set charge.

 

Record Grabber is The Solution

These costs can add up over time, and you need to be aware of changes in the law at all times.

Understanding laws, prospective and actual changes in the law can take time and money. For straightforward cases, you are unlikely to experience any real issues. The problem is that most patients do not have a simple medical history. They are complex and you may need to request records from multiple authorities.

This is where Record Grabber can help. We represent real time cost and time saving for medical professionals. We have a simple process that speeds up claims and puts more money in the pocket of the client.

http://www.recordgrabber.com

Fast retrieval can be quite time consuming and downright exhausting. If you have been in this business a long time, you know how long things can take. You have come to expect that even simple cases takes months or years.  At Record Grabber, we know it takes more than the wave of a magic wand to speed things up. However, we know we can do our part in streamlining the process for all concerned.

 

Time Is Money

In this business, that counts doubly so. From the moment a claim begins, the costs begin to pile up. Sometimes, there is only a limited amount of insurance money. We prefer that this money does not go to legal and medical costs, but into the client’s pocket by providing a fast retrieval time. We know as well as you that legal costs come out of the client’s settlement. When the process is faster and more efficient, the client ends up with more.

 

Doing It Yourself Is A Drain

Many medical and legal professionals think they can save time and money by executing their record retrieval in house. Eventually, they learn that this business is a minefield. They realize that they did not factor in the amount of time, physical space, money and resources required to handle the records. The logistical nightmare leads to a general slowdown in processing cases. Record Grabber saves resources in ways you cannot always quantify.

 

Record Retrieval is a Learning Process

How long does it take an average intern to learn the job? At the beginning, they may be slow. It will take time to build experience. They will need to understand all of the finer detail and be prepared when things change. Record retrieval is like that too. With all the resources in the world, nothing can beat experience. Nothing can beat knowing all the finer points and understanding how a process works. We take the hard work and in so doing, speed up cases through using our experience.

 

Legal Process Is Slow

Each state has different rules and regulations, limits and costings on acquiring medical record copies. Learning and understanding, and ensuring you get it right every time, can be a massive time burden on your business – not to mention costly. A dedicated record retrieval firm understands the subtle nuances of Federal and each state’s laws, streamlining the process and speeding it up for everyone. Tracking is one of the slowest processes in this industry. Each case can potentially experience hundreds of phone calls before a case reaches completion.

http://www.recordgrabber.com

 

One of the main reasons why healthcare organizations and legal entities do not outsource record storage and retrieval is the cost. It is felt that the cost of outsourcing is an unnecessary or frivolous expense for very little administrative gain. Neither belief is true, least of all, the myth about administration. Few factor in the costs of fines from data breaches. Can you afford the following for even minor breaches?

 

New York Presbyterian Hospital

In one of the biggest cases of its kind, NYPH received a fine of $2.2m in April 2016. They allowed filming of a TV show but failed to prevent several data breaches. A dying patient was filmed without consent of the patient or his family. In other cases, film crews were permitted to enter areas where patient data was easily accessible. The hospital was put on an observation order for the next 2 years.

 

Oregon Health and Science University

OHSU received a $2.7m fine over two separate incidents of breaching PHI (Protected Health Information). They were subject to a corrective action plan lasting three years. In one case a laptop was stolen. In the second case, a third party accessed Cloud services without prior agreement. Despite that no patient came to harm, the fine and special measures were levied anyway.

 

New York Presbyterian Hospital (Again)

If you thought their April 2016 fine was large enough, consider the reasons why, in 2014, they were fined double that amount. A physician from Columbia University deactivated a personal computer that he had connected to the server. A lack of proper security measures meant that patient details became widely available on Google. They became aware when a patient found the details of a deceased partner freely through the search engine.

 

CVS Pharmacy

In 2009, OCR concluded an investigation that resulted in a $2.25m fine for the pharmacy giant. They were accused of disposing of expired records against all protocols. Health professionals know how they should dispose of expired documents, but putting them in a public dumpster is not one of them. Several stores were found to be at fault and that CVS had no clear protocol for file destruction.

 

Can You Afford Not To?

As you can see, the potential areas for data breach – and the scope that HIPAA covers – means that even with all the best intentions in the world, your organization can still find itself subject to massive fines. It doesn’t matter whether patients are affected, your organization could still be fined millions.

Increasingly, businesses across the US are concerned about their environmental impact. There is a need to adhere to international law and be seen to do “the right thing” by customers at the same time. Environmental issues are now a major concern for everyone. In many ways, outsourcing your medical record storage is the environmental choice for the 21^st century.

No Transportation Costs

You are not obliged to switch from paper to digital records, but it is the obvious green choice. Although most of our paper is produced sustainable today, the transportation cost in terms of carbon is a significant factor in lumbering. No matter how much we recycle, it leaves a carbon footprint. With digital storage, there are no such carbon emissions from the mass transportation of goods. Few things are carbon free, but by switching to digital, you remove a major contributor. It has been calculated as 85.7bn metric tons annually in the US alone.

 

Trash Reduction

With outsourced record retrieval and storage, trash production is reduced to almost zero. The electronic equipment used in cloud computing has a long shelf life and is recyclable. We can upgrade parts as and when required. With paper, there is a constant stream of recyclable material. Any sticking tape, staples or other hard materials may simply need to go in the trash. You can reduce your annual waste (and your cost) by moving some services to digital. Cost is the major reason people cite moving to any Cloud services, but labor intensity in trash production is another.

 

Shared Resources Means Lower Emissions

The two previous points focused on encouraging your business to switch from paper storage to Cloud storage. How is the environmental cost lower if you outsource from in-house Cloud to third party Cloud? Shared resources means lower expenditure in terms of financial cost and GHG emissions. When you outsource to one of our dedicated servers, you are pooling resources. You will not need extra power for your server, storage system and other digital services in house.

 

Space Saving

This is slightly more abstract, but it still an environmental benefit. Holding your own records, be they hard copy or digital requires space on your premises. Some businesses look to expand their facilities only to hold records. With the switch to outsourced Cloud record retrieval and storage, you will need less space for shelving, filing cabinets and office space. When you outsource your digital storage, you will need less physical space for your server.

2015 and 2016 has been a golden age for Ransom ware creators. There have been many high-profile Ransom ware infections on medical facilities around the world. The USA has been subject to several very high profile attacks and more is expected. As our organizations get wiser, it is likely that the Ransom ware senders are going to get wise too and change their approach. If you want to protect your facilities against this extremely virulent type of malware, then outsourcing is your best option.

 

About Ransom ware

You have probably heard of ransom ware by now. It is a particularly vicious form of malware and prevalent today. It comes with a threat to wipe your server of records, or make it publicly available, if you do not pay a ransom (usually in Bitcoin). It can stop your organization going about its business for days as you track back the infection and restore your systems. It is one of the biggest threats to digital healthcare records today.

 

Reason 1: Removes Avenues For Infection

The more avenues there are for infection, the greater opportunity that your server will be infected. That’s a simple fact of life for any commercial enterprise and its risks of any infection. When outsourcing your records retrieval and storage with a third party, only a limited number of people at your end will be able to access our records under strict permissions. The major access way for malware is through human error. Cut off the potential courses of infection and you reduce the risk.

 

Reason 2: More Avenues of Protection

We have some of the most advanced protection software available. We have to because HIPPA and other privacy laws demand that we do all we can to protect client records. We use the most up to date software and hardware and use the best fail safe systems in protecting that data. Commercial enterprises such as hospitals, legal bodies and insurance companies will often use systems that are “good enough”. Protection may be adequate for most daily practices, but inadequate for data protection.

 

Reason 3: Specialist Training

Our employees are dedicated to one job – record retrieval and storage. They are not healthcare professionals, lawyers or insurance executives. This singular focus allows them to have much greater depth of knowledge about HIPA and data protection than anybody else in these professions. Human error is a major cause of hacks and data infection, and our employee’s training is so tight that they can identify all threats.

Increasingly, we are moving to a digital work in our business transactions. Everything from invoicing, sales, customer research, administration and security is moving to the web. If you still use paper based records for your legal medical files, then now might be the right time to switch to digital. Also, during this transition phase, there is no better time than now to outsource. Here, we present four reasons why.

 

It’s Swift and Painless

Sure, replacing all of your paper files with digital version may take a while. You need to ensure that you’re uploading the right files in the right place. You also need to make sure you are transferring the right files and discarding those that you are able to destroy. Yet these processes never take as long as you might fear. When you switch to digital filing systems of record storage, Record Grabber makes it easy and painless, and easier to comply with HIPPA and other legal regulations.

 

It Saves You Time

The paper method of record storage is one of the slowest and most time-consuming methods. Ideally, you require an archivist. Requests can take a lot of time to process, especially if the archiving team has multiple requests for access throughout a working day. You need a record now at 9am; you can’t wait until 2pm. Digital records are faster to find and faster to use. When outsourcing, only authorized personnel can access the records, but they can do so much faster.

 

It Saves You Money

This is related to the above point. Did you know that companies like yours who opt to stick with paper record keeping spend $8bn every year wasting time searching for misplaced and missing paper records? That’s a vast amount of money. Misplacing records cannot happen with digital record keeping. Also, you will be able to turn over storage areas in your premises to something more profitable and save cash on wages by not increasing your archiving team.

 

It’s More Secure

Despite fear in the media about viruses, malware and even ransom ware (a subject we have written about repeatedly) with the proper procedures your data will be safe. Many infections are the result of human error. Paper records can be stolen more easily following a break in. A determined data thief can and will take the time to piece together paper strips – it has happened. When you go digital and outsource to Record Grabber, you have the benefit of our servers providing that extra security.

We have seen some profound changes to how we administer and record various healthcare transactions – legal compliance, treatment, medication and insurance. For most in the industry, there has been little change beyond legal compliance and others still prefer to maintain paper records to avoid what they feel are complications of HIPAA. Why should you switch to electronic medical record keeping and outsource to Record Grabber?

Lower Cost

Long-term administrative costs of electronic record keeping are much lower. Certainly, you need an IT infrastructure and security protocols, but once implemented, they are very cost effective. An increased volume of paper records is expensive in terms of actual cost, human resources for managing and monitoring and disposal. There is no such cost with electronic medical records.

 

Space

How long you can or should keep records varies from state to state, so storage space is an ongoing issue. Some of the largest healthcare organizations have large warehouses full of documents going back many years, unable to destroy them until the allotted time. Electronic records take up far less physical space than a warehouse as even the largest servers have a smaller footprint.

 

Security Issues

While electronic records are subject to hacks and other electronic security problems, they will not suffer other forms of security breach that affect paper records. With Cloud Storage, natural disasters will not destroy original electronic medical records as they will be backed up in cyberspace. Electronic medical records are generally secure and cannot be lost, dropped or misplaced in the same way that original paper records may.

 

Accessibility

Digital records may be shared by many people at once and when shareable in a suitable format, multiple people may also amend a digital file at once. This is not true of original paper copies. Do you remember going to the school library and finding that they had only three copies of a core textbook and all were booked out? Electronic filing does not suffer from such access limitation.

 

Handwriting Problems

Physicians are notorious for having illegible handwriting and using jargon and abbreviations that may make little sense to the nonprofessional or the administrator. When data is entered as printed text, there are fewer chances for others to make an error in reading instructions. When data is entered wrong on an electronic system, the software will normally flag up the problem and ask the user to make corrections.

 

The debate over whether it is best for a medical, legal or recording keeping organization to hold paper or digital records has a third option. HHR (Hybrid Health Records) presents flexibility for you, your clients and your stakeholders but there are drawbacks to mixing up your record storage types.

What is Hybrid Record Keeping?

Hybrid record keeping is where an organization like Record Grabber opts not for just paper records, nor for just digital, but a combination of the two. This can mean either that some types of record are paper and others are digital, or it means multiple copies of the same record depending on how you structure your files.

Hybrid is a workable standard, but there are potential problems when the system is not handled properly.

 

Advantages to Hybrid Record Keeping

The main advantage to using hybrid sets of record is that you will have multiple outlets for acquiring and storing your records. If one system fails (such as a cloud server breakdown) you will have back-ups (hard disk, paper format etc) with which you can carry on working.

The second advantage is that you can stagger and vary your access. Rather than changing permissions on a digital file where some can edit and others may simply view, the paper backups are ideal for those with fewer permissions. HHRs add flexibility for your organization and flexibility is required no matter how big or small.

Hybrid systems work better for patients. A request for information release is problematic when based solely on paper. When there is an electronic form, it is easier to print while retaining the original document. However, there may be issues if specific information is kept separate as hard copies.

 

Disadvantages to Hybrid Record Keeping

The main disadvantage is that multiple outlets means multiple avenues for data breach. As a professional record keeping organization we would strongly recommend using our service as a primary access point.

The second disadvantage is that it requires more working hours to maintain and access the files. When there are multiple copies of anything, it requires more in the way of resources to maintain. This could put a burden on your employees and your wage bill.

The third disadvantage is in the legal regulation of such files. Organizations need to be aware of their legal obligations in their state or broader Federal requirements. There may be extra criterion against which HIPAA will be judged.

The problem with inactive records is that they take up so much space. You cannot dispose of them until the legally allotted time. Did you know that the overwhelming majority of historic records are never accessed? Those that are generally required just one access. Only a small handful requires multiple use. That is a lot of storage space (network or warehouse). What else could you do with them?

Use a Third Party Manager

The most obvious is that you outsource your record storage and access to Record Grabber. We are a professional service with many years of experience in this industry. We know how long to keep these records and how to manage and store them effectively, taking the hard work of records management away from legal and medical professionals. Our complex method of storage is designed for easy and quick access.

 

Keep Inactive Records Offsite

While you are organizing outsourcing your historic records, you may wish to separate out those that are nearing the end of their life. Anything with a year or less could go in off-site storage. These can include records that have never been accessed and are therefore unlikely to become live again any time soon. Keeping records off-site can be expensive, but it is one way of freeing up physical space in your offices.

 

Organize by Active and Inactive

It may be the simplest thing to store records by date of intervention or by alphabetical order, but this could mean sifting through very old records. It may be advisable to use these divisions, but separate them out into a “traffic light” system of red, amber and green. Green can be the most active, amber as semi-active and red as inactive files nearing the end of their lives. Any color code would be useful, so long as the system is clearly defined.

 

Handling Digital Older Records

If your record keeping system is largely digital, the theories may be the same but the execution different. Depending on how you store your records digitally, you may wish to design a separate program or store them on portable media (such as removable hard disks, flash drives or DVD ROMs). This way, it stops your current database from taking up too much space while making access for live files easier.

 

Storage of inactive files can be problematic for healthcare professionals, legal experts and medical centers, but it is important to remember legal obligations regarding storage of historic records.

Data security can be subject to many pitfalls – misplaced files, leaving documents open on computer screens, poor password choice and so on. Malicious software is another such threat; the last few years has seen the rise of a new one – something called Ransomware. Though it has been around since 2013, the last few months have seen a growth risk to the global medical industry.

What is Ransomware?

Ransomware is a type of malicious software (or malware) that infects systems and restricts the access rights to data until a ransom has been paid. Some types simply encrypt the server data which the user must then buy a decryption key (typical demands are for bitcoins rather than hard currency) while others simply lock the system which the originator then promises to unlock upon payment.

Who is Affected?

Many businesses are at risk but three recent attacks on hospitals have put the global medical industry on alert. The highest-profile case was the Hollywood Presbyterian Medical Center in Los Angeles. The facility declared an internal emergency after a Ransomware infection was discovered in early February. The hospital eventually paid out 40 bitcoins (around $17,000) to reacquire control of its system.

Within a week, Lukas hospital in Germany was also hit. They did not pay the ransom as they had system in place to prepare for such malware attacks. They did wipe the affected systems and restore from backups; this led to cancelled appointments for patients and lost working hours for employees. Titus Regional Medical Center in Texas was another victim in January. The Center called in experts in data forensics to restore their systems; they did not pay the ransom.

Protecting Against Malware

There are simple steps that medical professionals at all levels can take to protect their systems against all forms of malware.

• -Invest in a good security system. Don’t cut corners financially as medical professionals handle sensitive data that require the highest levels of protection under HIPAA
• -Train employees on proper data protection paying particular care to the threats of malicious software and hacking
• -Should the worst happen, you need a back-up system. Regular archives should be kept in case of data loss by other methods – but particularly for malicious hacks
• -Finally, have you considered outsourcing your medical record storage and retrieval? Record Grabber is a dedicated service that keeps up to date records and have a high awareness level of ongoing and new threats to medical data