HIPAA Communication News

TigerSchedule Automated On-Call Physician Scheduling Added to TigerConnect CC&C Platform

TigerConnect has announced it has acquired Adjuvant’s Call Scheduler solution, which has now been incorporated into the TigerConnect clinical communication and collaboration (CC&C) platform as TigerSchedule™.

The Call Scheduler solution adds innovative on-call physician scheduling capabilities to the TigerConnect platform, allowing users to automate on-call and work assignments, improve efficiency, and bolster collaboration across complex healthcare teams. Close collaboration between clinicians is vital in healthcare and has become even more so during the COVID-19 era, as has the need to improve efficiency and cut costs with the revenue challenges caused by the pandemic.

TigerSchedule™ is a rules-based automated physician scheduling solution which has been made available as a standalone solution and also part of the TigerConnect Platform. The Adjuvant-developed solution already has an extensive user base in the United States, having been adopted by a wide range of healthcare organizations from care centers including Huntsville Memorial Hospital and Community Hospital of the Monterey Peninsula and medical clinics including Cardiac Specialists and Baptist Neurology.

The TigerSchedule™ solution offers healthcare providers several key benefits.

  • TigerSchedule™ adds new scheduling management capabilities to the TigerConnect platform.
  • The solution ensures fairness within the schedule, protects healthcare providers from being over-assigned, and ensures sufficient time between shifts to help prevent burnout.
  • Automated notifications are intelligently routed to the on-call schedule due to sickness, vacations, and patient cancellations.
  • Empowers providers to request the location and shift times they want and supports their preferences for text message notifications.
  • Simplifies shift swaps and changes and reduces the workload for managers.
  • A single view of all staff enables faster team collaboration and better resource optimization.
  • Rules-based automation and integration with EHRs improves scheduling and workflows.

“Reaching the right care team member quickly and efficiently is essential to providing excellent patient care. When you add the pressures of COVID-19 to the already existing whirlwind of paper schedules and unexpected shift changes, the challenge for caregivers is overwhelming. It can even be the difference between life and death,” said TigerConnect co-founder and CEO Brad Brooks. “TigerConnect with TigerSchedule™ helps healthcare systems streamline care delivery, improve outcomes, and enhance the patient experience while boosting the bottom line. It’s particularly valuable to healthcare organizations today, as they seek to reduce costs and improve patient and care team satisfaction.”

The acquisition of Call Scheduler will see President Justin Wampach join the TigerConnect team as Vice President, Scheduling Division, with the entire Call Scheduler workforce also joining TigerConnect.

“When Brad approached me and pitched the idea of being acquired, I admit we were flattered. I always felt our long-term strategy would involve us becoming a module within a broader product offering. We quickly realized that our offerings complemented each other well and it became obvious that joining forces would benefit our customers,” said Call Scheduler President, Justin Wampach.

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OCR Warns of Postal Phishing Scam Targeting HIPAA Compliance Officers

The Department of Health and Human Services’ Office for Civil Rights is warning healthcare organizations about a phishing scam being conducted by mail that has been designed to scare compliance officers into visiting a website or taking immediate action with respect to a HIPAA risk assessment.

Postcards have been sent to several healthcare organizations that masquerade as an official communication from the Office for Civil Rights. The postcards are addressed to the HIPAA compliance officer and state a mandatory HIPAA compliance risk assessment must be performed. The postcards warn that “HIPAA violations cost your practice. The federal fines for noncompliance are based on perceived negligence found within your organization at the time of the HIPAA violation.” The postcards remind the recipient that “fines can range from $100 to $50,000 per violation (or per record), with a maximum penalty of $1.5 million per year for each violation.”

The postcards claim to have been sent by the Secretary of Compliance of the HIPAA Compliance Division – a position that does not exist – and have a Washington D.C. return address. The link that compliance officers are requested to visit markets consulting services and is a non-governmental site.

OCR has advised all covered entities to alert their workforce about the misleading communication, which appears to have been sent by a private company. OCR stressed that this is not a communication sent by the HHS or OCR.

OCR advises HIPAA covered entities and business associates to take steps to verify the legitimacy of any communication that claims to be from the HHS or OCR, and explained that any written communications from OCR will include the following address:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201

Any request to make contact via email will provide an email address for contact that has an @hhs.gov suffix.

The impersonation of federal law enforcement is a crime and any suspected cases should be reported to the Federal Bureau of Investigation.

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President Trump Signs Executive Order Calling for Expansion of Telehealth Services

On Monday, August 3, 2020, President Trump signed an executive order to expand access to telehealth services for the 57 million Americans living in under-served rural areas.  The Executive Order on Improving Rural and Telehealth Access will ensure that the expansion of telehealth services due to the COVID-19 pandemic will continue after the nationwide public health emergency is declared over.

In 2019, Medicare started paying for virtual check-ins with doctors to determine whether an in-person visit was required, but the pandemic saw access to virtual visits expanded significantly in an effort to help prevent the spread of COVID-19. Geographic restrictions were lifted, and telehealth services were made available to Medicare beneficiaries across the country. The Centers for Medicare and Medicaid Services (CMS) also added a further 135 medical services to the list of services that are covered by Medicare if provided virtually.

Figures from the CMS show that virtual visits via phone or video increased to nearly 1.7 million in the last week in April, compared to just 14,000 visits before COVID-19. From mid-March, when the telehealth restrictions were relaxed, to mid-July, 10.1 million Medicare beneficiaries received a Medicare telehealth virtual visit. While there was a fall in the number of virtual visits in May once in-person visits resumed, the number of patients opting for virtual visits remained high, indicating patients are happy with medical services being provided virtually.

Americans living in rural locations are more likely to die from the five leading causes of death in the United States than individuals living in urban areas, and the gap has widened between 2010 and 2017. “Prior to the pandemic, telehealth was fine, but it wasn’t anything raging, and I guess one of the only good things that we’ve gotten out of this horrible situation is that telehealth has been increased,” said President Trump. “It is the purpose of this order to increase access to, improve the quality of, and improve the financial economics of rural healthcare, including by increasing access to high-quality care through telehealth.”

President Trump also called for officials to develop a plan within 30 days to increase investment in the communication infrastructure to improve healthcare in rural areas and within 30 days, the Secretary of the HHS will announce a new model to test new payment mechanisms to ensure that healthcare providers in rural areas can provide the necessary level of and quality of care to patients. Under the new model, healthcare providers in rural areas will be given more flexibility from current Medicare rules, and the model will establish predictable financial payments and encourage the transition to high-quality, value-based care. A report will also be submitted by the HHS Secretary on policy initiatives to increase rural access to healthcare through the removal of regulatory burdens which limit the availability of clinicians, prevent disease and mortality through rural-specific initiatives to improve health outcomes, reduce maternal mortality, and improve mental health in rural communities.

Shortly after the Executive Order was signed, the CMS announced it is proposing changes that will expand telehealth services for Medicare beneficiaries permanently, consistent with the Executive Order. The proposed CMS rule also includes a multi-year program that aims to reduce the burden on clinicians as part of its Patients Over Paperwork initiative and will ensure that there will be appropriate reimbursement for the time clinicians spend with patients. The CMS is also proposing that some of the additional medical services covered under Medicare during the public health emergency will also continue to be paid for by Medicare if provided virtually, including virtual visits for certain evaluation and management services and some services for patients with cognitive impairments.

The CMS is seeking public input on which services should continue to be covered by Medicare once the public health emergency is declared over. The CMS also wants to temporarily continue telehealth services for emergency department visits to give the industry time to assess whether they should also be made permanent. Comments on the proposed changes are being accepted until October 5, 2020.

“Telemedicine can never fully replace in-person care, but it can complement and enhance in-person care by furnishing one more powerful clinical tool to increase access and choices for Americas seniors,” said CMS Administrator Seema Verma. “The Trump Administration’s unprecedented expansion of telemedicine during the pandemic represents a revolution in healthcare delivery, one to which the healthcare system has adapted quickly and effectively. Never one merely to tinker around the edges when it comes to patient-centered care, President Trump will not let this opportunity slip through our fingers.”

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Webinar: July 30, 2020: How a Communication Platform Can Streamline Surgery Center Operations

Ambulatory Surgery Centers (ASCs) have diverse and dispersed physicians and can therefore face many challenges in coordinating schedules and optimizing workflows. Effective communication between staff members and with patients and their families is essential. Those challenges have become even more difficult during the COVID-19 pandemic.

One of the ways that successful ASCs have overcome these challenges is by adopting a secure, HIPAA-compliant telehealth, texting, and collaboration platform. These platforms improve communication between doctors and healthcare staff, help with the coordination of schedules and streamlining of workflows, and make it easy for ASCs to provide telehealth visits and communicate with patients and families pre- and post-op. During the COVID-19 pandemic, these platforms have played an important role in keeping ASCs open and safe.

On Thursday, July 30, 2020, Dr. Andrew Brooks, Chief Medical Officer, TigerConnect, will be hosting a webinar and will provide insights gained from his work as an orthopedic surgeon and founder of seven successful ASCs.

During the webinar you will discover how ASCs can use a single, secure telehealth, texting, and clinical collaboration platform to optimize clinical workflows, coordinate physician schedules, establish communications best practices, conduct patient follow ups, and improve overall operations.

Webinar Details

Date:      Thursday, July 30 at 10 a.m. PT

Webinar is Hosted by:

Dr. Andrew Brooks, Chief Medical Officer, TigerConnect.

Register for the Webinar

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States Start to Make Temporary COVID-19 Telehealth Changes Permanent

Following the decision of the HHS’ Centers for Medicaid and Medicare Services (CMS) to expand access to telehealth services and increase coverage in response to the COVID-19 pandemic, states introduced temporary emergency waivers to their telehealth laws. Healthcare providers and patients have welcomed the changes to telehealth policies, which improved access to telehealth services to help control the spread of the virus, SARS-CoV-2. There have been increasing calls for the changes to be made permanent, and several states such as Massachusetts, Colorado, and Idaho have taken steps to ensure the changes continue after the COVID-19 public health emergency is declared over.

On March 16, 2020, the Massachusetts Board of Registration in Medicine (BORIM) approved a new policy that states the same standard of care applies to in-person and telehealth visits and a face-to-face encounter is not a pre-requisite for a telehealth visit. The policy was introduced on a temporary basis in response to COVID-19, but on June 26, 2020, BORIM made the policy change permanent. This is the first telehealth-specific policy to be adopted by BORIM and Massachusetts was one of the first states to make temporary COVID-19 telehealth policies permanent.

There have been increasing calls at the Federal level for the expansion of access to telehealth services to be made permanent and for there to be continued reimbursement parity for in-person and virtual visits when the COVID-19 nationwide public health emergency is declared over.

CMS Administrator Seema Verma has expressed support for the expansion of telehealth access to continue and, at a recent meeting of the Senate Committee on Health, Education, Labor & Pensions (HELP), the 30+ temporary changes to Federal telehealth policies were discussed and Congress was urged to make several of the changes permanent. There is a commonly held view that telehealth can improve patient outcomes, help providers deliver a better patient experience, and that telehealth will help to reduce the cost of healthcare provision.

Two Federal policy changes that have attracted considerable support are the relaxation of the Medicare originating site requirement to allow physicians to provide telehealth services to all patients, no matter where they are located, and expansion of the number of telehealth services covered under Medicare.

These and other policies changes have received support at the state level. Several other states have now taken steps to improve telehealth access. Colorado Governor, Jared Polis, signed a bill this week that prohibits health insurance companies from requiring a patient to have a pre-established relationship with a virtual care provider. The law, which applies to Medicaid and state-regulated health plans, also prohibits insurers from imposing additional location, certification, or licensure requirements on providers as a condition for telehealth reimbursement and the restrictions on the technology that can be used to provide telehealth services have also been removed. Audio or video communication solutions only need to be compliant with the HIPAA Security Rule.

Idaho Governor Brad Little has similarly taken steps to make the COVID-19 changes to telehealth laws permanent, including the state’s temporary telehealth rule waivers that increased the medications that could be prescribed in telehealth visits, the broadening of the technology that can be used for providing telehealth services, and the change that allows out-of-state providers to treat patients virtually.

“Our loosening of healthcare rules since March helped to increase the use of telehealth services, made licensing easier, and strengthened the capacity of our healthcare workforce – all necessary to help our citizens during the global pandemic,” said Gov. Little. “We proved we could do it without compromising safety. Now it’s time to make those healthcare advances permanent moving forward.”

All states expanded access to telehealth services for Medicaid beneficiaries following the announcement by the CMS about the expansion of access to telehealth and increased coverage. Many more states are now expected to make the emergency changes permanent.  However, health insurers must also make changes and confirm that they will continue to reimburse physicians for virtual visits at the same rate as in-person visits, otherwise it is likely that telehealth will be dropped in favor of in-person visits.

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TigerConnect Rated Among Top Advanced Clinical Communications Platforms by KLAS

TigerConnect, the most widely adopted care team collaboration solution, has been recognized by KLAS and rated among the top platforms in the KLAS Clinical Communications 2020 Advanced User Insights report.

KLAS is a healthcare IT data and insights company that conducts impartial research on software and services used by healthcare providers and payers worldwide. The company obtains feedback from healthcare professionals that are using software solutions and services, the insights are analyzed, trends are identified, and the company’s reports are used by healthcare organizations around the world to make decisions about healthcare software and services.

For the Clinical Communications 2020 Advanced User Insights report, KLAS collected data from multiple case studies and conducted in-depth interviews with three to five advanced users of each platform at organizations at the cutting edge of clinical communication to find out how these solutions have improved efficiency, security, and patient satisfaction. The report details the outcomes that have been achieved, the lessons learned by advanced users, and the range of workflows that each communication platform covers.

TigerConnect was recognized as having a very large customer base in both inpatient and non-inpatient care settings. KLAS found the platform to be highly customer centric, with nimble development for advanced users across different care settings. The platform had the most extensive breadth of workflows for advanced users out of all platforms assessed for the report and was the only clinical communications platform that had over 50% adoption of advanced workflows in nine out of the ten categories assessed.

TigerConnect was also rated the top vendor for patient-centered care team communications, pre-admission workflows, clinical support staff workflows, and discharge & post-discharge workflows. TigerConnect was recognized as having standout capabilities such as allowing communication to continue during EHR downtime, allowing care coordinators to coordinate care with referred caregivers, and the ability of the platform to link messages to patient records and pull all pertinent information for patient care.

“The KLAS report highlights one of TigerConnect’s biggest strengths – our ability to help healthcare organizations across the full continuum of care meaningfully connect and enhance outcomes,” says Brad Brooks, TigerConnect CEO. “More than 6,000 healthcare organizations rely on our platform to enable seamless collaboration in a scalable, fully integrated, easy-to-use solution. With so many challenges facing our industry during the COVID-19 pandemic, now is the time for innovation that enhances care and strengthens the bottom line.”

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Senate HELP Committee Considers Permanent Changes to Telehealth Policies

The Senate Health, Education, Labor, and Pensions (HELP) Committee is considering which of the 31 recent changes to telehealth policies should be kept in place when the COVID-19 national public health emergency comes to an end.

The temporary changes to policies on telehealth have served to expand access during the COVID-19 public health emergency. These changes were necessary to help prevent the spread of COVID-19 and ensure that Americans are given easy access to medical services. During the COVID-19 crisis, patients have embraced the new approach and many have taken advantage of virtual visits and are using remote monitoring tools.

The June 17, 2020 Senate HELP Committee meeting was convened to explore which of the recent changes should be made permanent or at least be extended once the COVID-19 crisis comes to an end. All members of the committee supported making at least some of the recent changes permanent, with HELP Committee Chairman Sen. Lamar Alexander (R-Tenn.) advocating two permanent changes: The elimination of limitations on originating sites and the expansion of the types of providers who can be reimbursed through Medicare and Medicaid for providing virtual visits.

Sen. Alexander explained that both changes will help providers to achieve better patient outcomes, will improve patient experiences, and will help to reduce the cost of healthcare provision. There is wide support for these two changes to be made permanent. “As dark as this pandemic has been, it creates an opportunity to learn from and act upon these three months of intensive telehealth experiences, specifically what permanent changes need to be made in federal and state policies,” said Sen. Alexander. He suggested that were it not for the pandemic, the recently introduced changes may not have occurred for a further 10 years. It is too early to tell whether the telehealth changes have had any significant effect on patient outcomes, but they have certainly helped to improve access to healthcare services.

The University of Virginia (UVA) experienced a 9,000% increase in virtual visits between February and May, according to Karen Rheuban, M.D., director of the UVA Center for Telehealth. Sen. Alexander explained that Ascension Saint Thomas had gone from providing around 50 telehealth visits a year to more than 30,000 per month between April and May. Between April and May, telehealth accounted for around 45% of all visits.

The HHS’ Office for Civil Rights announced a Notice of Enforcement discretion covering the platforms that could be used for providing telehealth services during the public health emergency. Aside from public-facing platforms, apps that would not normally be permitted under HIPAA could be used for telehealth. While the move was necessary, it is one of the changes that requires closer scrutiny moving forward to ensure the privacy and security of healthcare data is not placed at risk.

The expansion of telehealth services has not proven to be a great equalizer, as many people lack the technology to take advantage of telehealth services. “The disparities in access to technology reflect the underlying inequity that exists throughout society,” said Sen. Tina Smith (D-Minn), a view shared by Karen Rheuban, M.D., who suggested “Congress should provide support for further broadband deployment, including to the home, as appropriate, to reduce geographic and sociodemographic disparities in access to care.”

There was strong support for reimbursement for telephone visits to be continued. At Massachusetts General Hospital and Brigham and Women’s Hospital, 60% of telehealth visits took place over the telephone in the past 3 months. “Telephone visits are important to cross the digital divide. We should continue that level of reimbursement to address this underserved population,” said Joe Kvedar, president of the American Telemedicine Association.

In addition to advocating for permanent changes to originating site limitations, Kvedar recommended giving the HHS the flexibility to expand the list of practitioners and therapy services eligible for telehealth reimbursement and to continue the grant and technical assistance programs and also cover infrastructure needs.

There is a commonly held view among providers that the decision to continue offering telehealth is largely dependent on reimbursement rates for telehealth. If reimbursement is lower for virtual visits, that may prevent providers from continue offering telehealth over in-person visits. Sen. Mike Braun (R-Ind) suggested that there should not be pay parity due to the differences in overheads. Sen. Bill Cassidy (R-La.) also questioned whether reimbursement should be equal when telehealth reduces providers’ overhead costs.

While access to telehealth has been expanded for Medicare and Medicaid patients, changes also need to be made in the private sector. “It would be very difficult to conduct this care model in a world where we got some payment for some things and didn’t get paid for others,” suggested Kvedar. “As much harmonization as possible would be huge incentive for adoption and expansion,” said Rheuban.

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Guidance on Contacting COVID-19 Patients to Request Blood and Plasma Donations

When patients contract an infectious respiratory disease such as COVID-19, the immune system develops antibodies that provide protection if the pathogen is encountered again. The antibodies in the blood of patients who recover from such an illness are valuable, as not only will they provide protection for the patient, that protection could potentially be transferred to other patients.

Through the donation of blood and plasma two preparations can be made: Convalescent plasma and hyperimmune immunoglobulin. Convalescent plasma and hyperimmune immunoglobulin have both been used to successfully treat patients who have contracted other viral respiratory diseases. Given the severity of COVID-19 and the high mortality rate, these treatments could be vital for patients who are struggling to fight the infection. Research studies are now underway to test whether antibody treatments are effective against COVID-19.

To participate in these programs, patients who have previously been diagnosed with COVID-19 will need to be contacted and asked if they are willing to donate blood and plasma, but is this contact permitted by the HIPAA Privacy Rule?

On June 12, 2020, the Department of Health and Human Services’ Office for Civil Rights issued guidance to healthcare providers on the HIPAA Privacy Rule and contacting COVID-19 patients to request blood and plasma donations.

OCR explained that the HIPAA Privacy Rule does not prohibit healthcare providers from contacting COVID-19 patients to request blood and plasma donations and prior authorization from the patient is not required.

Healthcare providers can contact patients to advise them about the opportunities for donating blood and plasma to support the response to COVID-19 to improve other patents’ chances of beating the disease.

HIPAA covered entities and business associates acting on their behalf can use or disclose PHI for the purpose of treatment, payment, and healthcare operations, without first receiving authorization to do so from a patient. Requesting a donation of blood or plasma does not fall into the category of treatment, as the blood/plasma will not be used to treat the patient, instead it is being used for population-based health care operations to improve health, case management, and care-coordination, which are included in the definition of healthcare operations.

There is some confusion over whether contacting patients to solicit blood donations would constitute marketing communications, which are generally not permitted by the HIPAA Privacy Rule without prior authorization from a patient.

In this case, an exception to the Privacy Rule’s Marketing provision applies. “A covered health care provider is permitted to make such communication for the covered entity’s population-based case management and related health care operations activities, provided that the covered entity receives no direct or indirect payment from, or on behalf of, the third party whose service is being described in the communication (e.g., a blood and plasma donation center),” explained OCR in the guidance.

An authorization is required from a patient before PHI can be disclosed to a third party, such as a blood and plasma donation center, to allow a COVID-19 patient to be contacted to request blood and plasma donations for the donation center’s own purposes.

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Telehealth Set to Stay so it’s Time to Get the Right Technology

This year, in response to the COVID-19 public health emergency, the HHS’ Centers for Medicare and Medicaid Services (CMS) expanded coverage of telehealth service to include all Medicare beneficiaries, regardless of location.

Telehealth services eliminate the barriers to in-person care that have been created by the COVID-19 pandemic and allow practitioners to provide treatment to patients in their own homes and, by doing so, improve patient safety and control the spread of COVID-19. The expansion of coverage only applies during the coronavirus public health emergency, although calls have been increasing for the expanded CMS telehealth policies to continue after the public health emergency is declared over.

On June 9, 2020, in a virtual event on STAT News, CMS Administrator Seema Verma said she supported the permanent expansion of access to telehealth services. The FTC has also weighed, with executives expressing their support for the permanent removal of the geographical restrictions and continued expansion of the types of services that can be delivered by telehealth.

On May 21, 32 House members signed a letter urging Congress to give telehealth more time to prove itself and requested the relaxation of telehealth regulations to continue after the COVID-19 emergency period. The extension will ensure that sufficient data is collected to determine which of the new flexibilities should be made permanent.

Many providers and patients across the United States have taken advantage of telehealth services during the public health emergency and telehealth has proven popular with providers and patients alike. It is now looking likely that telehealth is here to stay, and virtual visits will replace in-person care in certain circumstances.

Telehealth was made much easier for providers by the HHS’ Office for Civil Rights, which issued a notice of enforcement discretion stating penalties and sanctions would not be imposed on healthcare providers for the good faith use of non-HIPAA-compliant communication technologies for providing telehealth services. That notice of enforcement discretion only applies during the public health emergency, after which healthcare providers will be required to switch to HIPAA-compliant solutions. Any provider that is not yet using a HIPAA-compliant telehealth application should now consider making the switch.

One HIPAA-compliant solution that has proven extremely popular during the pandemic is TigerTouch from TigerConnect.  TigerTouch combines, video, voice, and text messaging into one convenient mobile and desktop app which allows internal communication with care team members and patient communication through the same app. The solution also supports the sharing of files and medical images, and as a fully HIPAA-compliant solution, it allows ePHI to be securely shared. Healthcare providers that have adopted the solution report significant cost savings, improved workflow efficiency, better patient care, and happier staff and patients.

TigerConnect hosted a webinar to showcase the solution and explain how the integrations and telehealth features of the solution are helping to improve the quality of care, increase patient safety, and improve patient satisfaction levels.

The webinar is available on-demand on this link.

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