Fam Pract Manag. 2003 Apr;10(4):58.
PDAs and HIPAA
Do physicians need to purchase security software for their hand-held computers in order to comply with the Health Insurance Portability and Accountability Act (HIPAA)?
While security software for your personal digital assistant (PDA) is a good idea, it is not required under HIPAA. According to comments from the Phoenix Health Systems’ HIPAAdvisory Web site (www.hipaadvisory.com/live/FAQ/security.htm), “PDAs do not specifically require encryption. Instead, either through training or other measures, there must be a reasonable assurance that the PDA will not be lost or otherwise accessed by unauthorized personnel. While encrypting a PDA is perfectly OK under HIPAA, it is not required if it is reasonable to assume that other methods are being employed to protect the data.”
For additional reading on this issue, consult the following sources:
A report from palm.com called “Security Brief: Implementing HIPAA-Compliant Palm Handheld Solutions” (www.palm.com/pdfs/HIPAA_compliant_solutions.pdf).
A series of articles available at pdamd.com about the implications of HIPAA on PDAs (www.pdamd.com/vertical/features/HIPAA1.xml, www.pdamd.com/vertical/features/HIPAA2.xml, www.pdamd.com/vertical/features/HIPAA3.xml).
Using RVUs in compensation formulas
Our multispecialty group uses a relative-value-unit (RVU) formula for physician compensation, but we have some questions. How frequently is this formula used by similar groups? How do we calculate compensation for capitated services with this formula? Should the compensation for ancillary services be incorporated in the RVU estimate?
Using RVUs as a component of physician compensation formulas appears to be an increasingly common phenomenon. According to the American Medical Group Association’s 2001 Medical Group Compensation and Productivity Survey, the percentage of medical groups reporting that they used RVUs as a measure of physician productivity jumped from 8 percent in 1999 to 28 percent in 2000.1
Incorporating capitated services into a compensation system based on RVUs can be problematic, since RVUs tend to be geared toward fee-for-service models. However, one approach is to track the RVUs associated with services provided to capitated patients and then distribute capitated payments to physicians on that basis.
Some ancillary services (e.g., some lab tests) do not have RVUs, so incorporating them into an RVU compensation system is difficult. If you do find a way to incorporate them, you should ensure that the distribution does not run afoul of the Stark law.
1. Jacob JA. Modest compensation gains for most doctors. Am Med News. August 13, 2001:25.
Paper for paperless systems?
I just went paperless with an electronic medical record (EMR) system, and now I’ve been told that I must sign, date and maintain a paper copy of everything I write and receive to meet the requirements of Medicare and other payers. Is that true?
No. If you’re adequately maintaining electronic records, there are no federal laws that require you to create and retain paper copies of the records as well. However, your EMR system should be capable of producing paper copies of patient records in a short time. Patients in all states have a legal right to obtain access to the information contained in their medical records on a timely basis. Also, you may be required by subpoena, court order or government agency survey to produce copies of the records on short notice.
The federal documentation standards that apply to paper records generally apply to EMRs as well, so you should also be aware of the following requirements:
Your electronic records should be retained for the required period of time [see “Keeping Old Patient Records,” FPM, January 2003, page 74].
Your EMR system should ensure that entries are recorded accurately, perhaps with a system that requires review of the completed entry.
The identity of the individual making the entry should be authenticated through the use of a password or some other effective method.
All of your electronic records should regularly be backed up and stored for safekeeping.
Because unique state requirements and individual payer contractual provisions may also apply to your patients’ medical records, you should contact your local attorney for more information.
Copyright © 2003 by the American Academy of Family Physicians.
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