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Health Management Technology News
February 7, 2014

In this issue:


 Powerful panels go for permanent 'doc fix'

 Cellular One, CCA, and iSelectMD announce implementation of the first mhealth program

 Health data incident- St. Joseph Health System – Notice of data security incident

 HVAC vendor eyed as entry point for Target breach

 Distributing medical expertise: The evolution and impact of telemedicine in Arkansas

Powerful panels go for permanent 'doc fix'

Committee leaders in the House and Senate have unveiled bipartisan legislation repealing Medicare's flawed physician payment system and giving doctors in the program a small pay raise.

The bill to create a permanent "doc fix" was introduced Thursday after more than a year of negotiations between parties in both chambers. Its central provisions repeal Medicare's sustainable growth rate formula and increase physician reimbursement rates by 0.5 percent annually for 5 years.

Top lawmakers from both parties praised the deal as a major victory for doctors and seniors.

"Congress has spent a decade lurching from one ‘doc fix’ to the next, creating a new, unnecessary threat to seniors’ care each time. Enough is enough," Senate Finance Committee Chairman Max Baucus (D-Mont.) said.

"This proposal would bring that cycle to an end and fix the broken system. Our bill makes Medicare’s physician payments more modern and efficient, and it will protect seniors’ access to their doctors."

The announcement comes just two months before Medicare doctors face a payment cut of almost 24 percent.

Congress has relied on temporary "doc fixes" for more than a decade to avoid dramatic pay cuts to doctors, but hope for reform rose last year after budget analysts unexpectedly cut the cost of repeal.

The American Medical Association (AMA), which has spent years lobbying to repeal the sustainable growth rate (SGR), welcomed the measure and urged both chambers to pass it before the next payment cut hits doctors on April 1.

"Continuing the cycle of short-term patches by merely addressing the 2014 cut that is imminent on April 1 without solving the underlying problem would be fiscally irresponsible and further undermine the Medicare program," AMA President Ardis Dee Hoven said in a statement.

"It is time for action to repeal the SGR and establish a transition to a new more stable Medicare physician payment policy to better serve America’s senior citizens."

The endorsement of three powerful committees — Senate Finance, House Ways and Means and House Energy and Commerce — makes it likely that leaders in both chambers will bring the bill to the floor this spring.

This assumes lawmakers can come to an agreement about how to pay for the reform, estimated to cost between $120 billion and $150 billion. Offsets were not announced Thursday and have already proven a major sticking point.

Healthcare sectors are bracing for the possibility of further cuts, and lobby groups continued to position their members Thursday in response. In one example, long-term care providers urged Congress to accept their offer to generate revenue by lowering hospital readmission rates.

Read the full The Hill article here

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Cellular One, CCA, and iSelectMD announce implementation of the first mhealth program

Cellular One has partnered with iSelectMD, and Competitive Carriers Association (CCA) to launch an mHealth service, iSelectMD Mobile, for its mobile subscribers.  Beginning today, Cellular One customers in Texas and Louisiana can enjoy real-time access to advice from healthcare professionals for non-emergency/non-life threatening illnesses.

Using their wireless device, with iSelectMD Mobile, Cellular One customers can speak with a Board-Certified Physician via voice or video services like Skype or FaceTime to resolve everyday illnesses or consult on health questions.  To get started, they simply need to contact the iSelectMD Care Center from their device.  Cellular One provides free access to the service, with customers paying $29.99 per consult, a significant savings over the costs of seeking treatment through a doctor’s office or emergency room.  The iSelectMD service is accessible 24 hours a day, seven days a week, 365 days a year.

“We are delighted to partner with iSelectMD for this extremely valuable service for our customers,” said Jonathan Foxman, President/CEO of Cellular One. “Cellular One customers can now access care in real time and reduce or eliminate unnecessary costs and travel when their primary care physician is unavailable.    And thanks to the cooperation of iSelectMD and CCA, this program is the first of its kind to be offered to wireless customers in the United States.”

CCA President & CEO, Steven K. Berry said, “Having access to unique programs such as iSelectMD Mobile presents a real, very positive benefit for CCA members.  Solutions like the mHealth program are a win-win for carriers and their customers.  If you want to learn more about this program, I encourage you to speak with iSelectMD at our Global Expo, March 25-28 in San Antonio.”

Read the full CCA news release here

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Health data incident- St. Joseph Health System – Notice of data security incident

As part of our ongoing commitment to the privacy of our patients and their families, St. Joseph Health System (“SJHS”) based in Bryan, Texas, is informing individuals of an incident that may affect their personal information.  After you read this notice, if you have any questions please call the confidential call center by dialing, toll-free, (855) 731-6011, Monday through Saturday, 8:00 AM to 8:00 PM U.S. Central Time.  Si Usted prefiere hablar con alguien en Español sobre este asunto, por favor comuniquese con el centro confidencial de suporte al cliente, por llamada a (855) 731-6011.

Between Monday, December 16 and Wednesday, December 18, 2013, SJHS experienced a security attack in which hackers gained unauthorized access to one server on its computer system.  SJHS acted quickly, shutting down access to the involved computer on December 18, and hiring national security and computer forensics experts to thoroughly investigate this matter.  Our investigation, which is ongoing, determined that this security attack may have resulted in unauthorized access to records for some SJHS patients, employees, and some employees’ beneficiaries.  These records included names, social security numbers, dates of birth, and possibly addresses.  For the affected patients, medical information was also accessible.  For some of the affected employees, bank account information was also accessible.

We are sorry for any trouble or concern that this may have caused our patients, employees and their families.  While it is possible that some information was accessed or taken, the forensics investigation has been unable to confirm this, which is why we are providing this notice.  The computer was shut down when we discovered the security attack on December 18, 2013, so we believe the potential risk to individuals’ information ended on that date.  SJHS is working with the United States Federal Bureau of Investigation, which is also looking into this incident.  SJHS is providing written notice of this incident to affected individuals, to the U.S. Department of Health and Human Services, as well as to certain state and international regulators.

It is important to note that SJHS has received no reports that any of the personal information involved has been misused.  We take this matter, and the security of our patients’, employees’, and employee beneficiaries’ personal information, very seriously.  As a precaution, SJHS wants to assist individuals affected by this incident in protecting their identity, even though we are not aware of any misuse of the information, and we have been unable to determine whether any data was in fact taken.  SJHS is offering affected individuals with access to one free year of identity protection services provided by AllClear.  These identity protection services start on the date of this notice and can be used any time over the next 12 months.

Read the full St. Joseph news release here

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HVAC vendor eyed as entry point for Target breach

A heating and air conditioning contractor may have provided the opening hackers exploited in the massive breach of Target's computer network. This new information about the Target (TGT, Fortune 500) breach highlights the potential for serious vulnerabilities at other major U.S. retailers. It also raises a head-scratcher: How could a heating contractor's password open up the secure systems used to process customer payments?

The contractor -- first identified by independent security researcher Brian Krebs -- said Thursday it was the victim of a breach and was cooperating with federal officials investigating the Target hack.

"Like Target, we are a victim of a sophisticated cyber attack operation," said Ross Fazio, president of Fazio Mechanical Services, in a statement. "We are fully cooperating with the Secret Service and Target to identify the possible cause of the breach."

Fazio declined to elaborate on the nature of the attack, but Target said last week stolen vendor credentials were used in the breach of payment and personal information for as many as 110 million customers.

The company connects to Target's networks for for billing and contracts, he said.

It clearly does not handle customer credit or debit card payments for Target, but security experts say the vendor's stolen credentials helped hackers get past the hard part: getting through companies' fortified outer walls.

"Once an attacker gets in, lateral movement is really difficult to detect because most organizations are perimeter-focused," said Eddie Schwartz with the security association ISACA and vice president of global security solutions at Verizon Enterprise Solutions. He said networks guard against intrusion, but "there's a general expectation of trust once you're inside those walls."

Think of a network as a house, Schwartz said: You can have several doors, each with a different lock, but if just one key is stolen, the perpetrator can get in. Once inside, he can move between rooms and easily hide to avoid detection.

While retailers build defenses around their payment systems, they may not invest as heavily in protecting the systems used by building management.

Read the full CNN Money article here

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Distributing medical expertise: The evolution and impact of telemedicine in Arkansas

Arkansas’s telemedicine system has evolved since 2003 from a support mechanism for high-risk pregnancy consultations to an initiative that spans medical specialties, including asthma care, pediatric cardiology, gynecology, and mental health. The system has also expanded care to diverse populations, including incarcerated women and people with HIV/AIDS. This article describes the system’s evolution, organization, and diverse activities. It also shows how telemedicine can have a positive impact on a rural state and how such a state can become an engine for change regionally. The Arkansas telemedicine system faced classic challenges to uptake and function, in building and sustaining funding, in obtaining insurance reimbursement for services, and in educating patients and providers. The system’s impacts on health outcomes and medical practice culture have also reached beyond patient care and provider support. The existing yet continually evolving telemedicine infrastructure and partnerships in Arkansas will respond to the state’s inevitable health care reform adaptations from the Affordable Care Act and could provide direction for other states seeking to adopt or expand their telemedicine efforts.

Practice patterns in Arkansas reflect a problem endemic to US health care: There is an uneven distribution of physician expertise, and experts are clustered in urban locations. Many rural areas of the state lack specialty care services such as maternal fetal medicine, neurology, cardiology, and rehabilitation. This article describes the efforts of one rural state—Arkansas—to overcome this common problem and related shortcomings by developing a statewide telemedicine network, called Arkansas e-Link, that provides clinical care and education to patients and providers.

The University of Arkansas for Medical Sciences, the state’s only academic medical center, began offering telemedicine services through a network of broadband connections between community hospitals and the university in 2003. The network was designed to improve the treatment of high-risk pregnancies, specifically by addressing the shortage of specialty obstetrical care in rural Arkansas—where 44 percent of the state’s population resides but few obstetricians practice.

In 2013 the network included multiple partners and agencies, reaching 454 sites,2 and offered access to a range of services, including those in neurology, pediatrics, oncology, and other specialties that are rarely found in rural areas. Medical provider “champions” across the state have supported the network, worked to improve its infrastructure, and identified and addressed needs through telemedical partnerships and intervention. The champions led the expansion of the network into new medical disciplines and specialties, as described in this article. The network is designed to be sustainable and both responsive to and governed by its users.

Read the full Health Affairs report here

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February  2014  HMT digital book

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