August 2002 • Volume 8 • Number 8 |
Remember when you were a kid and your dad assigned a chore so overwhelming that you didn't know where to start?
Some physicians are reliving that uncomfortable feeling as they face compliance with the Health Insurance Portability and Accountability Act. The deadline for complying with the HIPAA transactions and code sets standards is Oct. 16 -- unless you file for the one-year extension (see July FP Report). The deadline for complying with the privacy regulations is April 14, 2003.
Since physicians are all in this together, a little encouragement from colleagues is in order. FP Report checked in with some AAFP members who have made progress (some racing, some inching) toward HIPAA readiness. From updating forms and installing new software to physical changes in their offices, these docs are making headway.
DEVELOP A PLAN
Chip Bounds, M.D., of Moncks Corner, S.C., launched his compliance effort by forming a HIPAA team. The four-person team includes himself, plus representatives from the nursing, billing and front-office areas. "We've drawn up draft documents and had those approved at providers' meetings," said Bounds. "They're already in effect."
Early on, the team did a walk-through audit of the office, looking for areas that could compromise patient confidentiality. Common-sense actions like turning prescriptions facedown at the nurses' station were easy to address.
But some things needed a technological fix. All computers have been outfitted with locked screensavers, accessible only by password. The network is now password-protected as well.
Some physical improvements -- such as doors on the medical records room -- still await completion, but Bounds said he's on course: "We have a timeline; we want to be compliant by Oct. 1."
It's important to approach compliance in a businesslike way, said Bounds. "You need a plan and a timeline -- assign tasks and hold people accountable."
DELEGATE AUTHORITY
For Robert Patterson, M.D., of Sanford, N.C., the key word is "delegate."
"I'm force-feeding my HIPAA team right now, but eventually, they're going to be the experts. Then I can practice medicine, and they can tell me what I need to do," he said.
Patterson insists on a positive attitude. "I don't want my team to come to me with a compliance problem until they have two potential solutions to offer," he said. He looks to the Academy and the AMA for valid information and calming words. "Misinformation is rampant," said Patterson.
"We look to our software vendors to show us, from an accounting standpoint, what we need to do. They suggested filing for the extension and taking inventory of the current systems," Patterson said.
TAKE INCREMENTAL STEPS
Leonard Fromer, M.D., of Santa Monica, Calif., chair of the AAFP Commission on Heath Care Services, compared HIPAA to a skyscraper under construction -- and said his practice is hard at work laying the foundation. As he and his partners endure a management company change, their office is undergoing a total network and information system conversion.
"Everybody thinks about HIPAA compliance with every strategic decision we're making right now," said Fromer. A new emulator recently put on his computer hard drive is encrypted and HIPAA-compliant. "If it wasn't, we wouldn't have put it on. We don't want to solve problems only to have to re-solve them down the road," he said.
However slow and painful it may seem, take incremental steps as you inch toward HIPAA compliance, advised Fromer. "Hopefully, if this thing is done right, at the end of the day, physicians will be able to take care of their patients more effectively and efficiently."
UTILIZE RESOURCES
Victor Ricker, M.D., of Toledo, Ohio, is modeling new provider documents after sample documents in the Academy's HIPAA Privacy Manual.
"I've got about half of them done," he said. Ricker and his partner Kenneth Bertka, M.D., have taken the "divide and conquer" approach -- Ricker tackled the privacy documents, while Bertka, more comfortable with technology, waded into billing and system compatibility issues.
Ricker feels a certain satisfaction in the progress he's made and encourages colleagues who have procrastinated to dig in. "It's like shoveling your driveway -- you know you need to do it, but you're just praying for a sunny day so you won't have to," he said.
AAFP Past President Bruce Bagley, M.D., of Albany, N.Y., also champions the Academy's HIPAA manual. He gave a copy to his in-house legal staff. "I basically did a handoff, and they were very appreciative," said Bagley. "The manual gives you a systematic approach and a concrete action plan." It also demystifies HIPAA, "which has been billed as the latest boogeyman," said Bagley.
RESIST PANIC
"We're not doing anything radically different, but we did apply for the extension," said William Soper, M.D., M.B.A, of Kansas City, Mo. "I think there is a danger of doing unnecessary work by getting too deeply involved in this thing too quickly."
When Soper moved into his current office space two years ago, he saw HIPAA coming -- and designed the space with patient confidentiality in mind. Some HIPAA-friendly features include private areas for the fax machine, for the inevitable stacks of paper messages and lab reports, and for telephone conversations.
Soper advised colleagues to stay informed by consulting expert sources. He regularly checks the Centers for Medicare & Medicaid Services Web site at http://www.cms.hhs.gov/hipaa/ for the latest HIPAA news.
Physicians can also check the Academy's HIPAA home page at http://www.aafp.org/hipaa.xml for reliable information and to order the HIPAA Privacy Manual.
"Don't panic," said Soper. But do educate yourself and tighten up your security, he added.
FP Report is published by the
AAFP News Department.
Copyright © 2002 by
American Academy of Family Physicians.