discussion post and two replies

Research what federal and state collaboration efforts (if any) exist for the state in which you live and/or practice. Does your state currently participate in Health Information Security and Privacy Collaboration (HISPC)? If not, are there plans to become involved in this partnership? Finally, why is this collaboration important? Information should be available through your state’s Department of Health or at the HealthIT.gov page on HISPC.

For your replies, respond to 2 classmates, identifying at least 1 strength and 1 weakness in each classmate’s reasoning.

respond to classmate #1

The U.S. health system faces challenges including inefficiencies, escalating costs and variations in health care quality, access and results. Health expenditures accounted for roughly 32 percent of the average state’s budget and State governments are often the largest health care purchaser. About 30 percent of health care spending is by State governments. Collaboration between State and Federal governments is paramount in reducing costs, reducing redundancy as well as implementation of policies (AHRQ).

Privacy and security are important for patients regarding how their health record is used, accessed, and disclosed. The mission of the Health Information Security and Privacy Collaboration (HISPC) is to address the privacy and security challenges that impede electronic health information exchanges. Thirty-four participating state and territorial teams assessed their laws, policies and practices with respect to health information privacy and security and developed implementation plans to address identified barriers (Public Health Data Standards Consortium).

Health Information Security and Privacy Collaboration (HISPC) was established in 2006 (Nelson & Staggers, 2018). The HISPC project was designed to examine privacy and security laws and business practices that affect the ability of every state and territory to exchange electronic health information within its borders and with other states. It had three phases called projects. “Each project was designed to develop common, replicable multistate solutions for reducing variation in and harmonizing privacy and security practices, policies and laws” (Nelson & Staggers, 2018, p. 443). That first phase concluded in May 2007 with a report that got the issues onto the table and recommended ways forward. In phase 2, which ran from June 2007 to January 2008, state groups began implementing their phase 1 recommendations through state-specific improvement projects. The focus shifted to regional collaboration in phase 3, and the project grew to include groups in 42 states and territories. State groups broke into seven regional collaborative groups, with each group focused on a different barrier or issue identified in the earlier phases (AHRQ).

The Agency for Healthcare Research and Quality (AHRQ) and the Office of the National Coordinator for Health Information Technology (ONC) launched the Privacy and Security Solutions for Interoperable Health Information Exchange project. One purpose of the project was to assess variation in organization-level business practices, policies, and state laws, to help policymakers identify common practices and reduce variation. The HISPC project found that health information is protected by a patchwork of practices, policies, and state laws that has evolved over time, state by state and organization by organization, without a comprehensive plan or approach. This has resulted in state privacy and security laws that are scattered throughout many chapters of code and that sometimes conflict with one another. Most of these laws were written for paper-based systems, and many have failed to anticipate electronic HIE.

A major collaboration in North Carolina is the Health Information Exchanges (HIE). The North Carolina Healthcare Information and Communications Alliance (NCHICA) was awarded the contract to represent North Carolina in April 2006. Their job in conjunction with stakeholders was to work collaboratively through a process of consensus to identify, assess, and develop plans to address variations in organizational-level business policies and state laws that affect privacy and security practices that may pose challenges to health information exchange (HIE). AHRQ additionally indicated that the purposes of the North Carolina HISPC project are to address variations in organizational-level business policies and state laws that affect privacy and security practices which, in turn, may pose challenges to interoperable HIE; to recommend solutions and implementation plans to reduce or eliminate these challenges; and to increase the level of expertise in and compliance with privacy protections within the health care community. They stated that the goals of North Carolina HISPC’s goals are to:

1. identify current health care practices and challenges regarding the release and exchange of health information, Privacy and Security Solutions for Interoperable Health Information Exchange

2. develop consensus-based solutions for interoperable electronic HIE that protect the privacy and security of health information, and

3. recommend high-level plans to implement recommended solutions.

In healthcare, multiple disciplines need to work more effectively as a team to help improve patient outcomes. Collaborating in patient care and overall healthcare delivery is very important. There is a significant amount of research to show that patient outcomes, quality of care and cost of care delivery are all optimized when disciplines work together toward a shared goal that focuses on the patient. With clinical care becoming more complex and specialized, medical staffs must be flexible and be willing to work in complicated health services and quickly learn new methods. Aging populations, the increase of chronic diseases like diabetes, cancer, and heart disease have forced medical staffs to take a multidisciplinary approach to health care (Thomas, 2011). Informatics tools and applications have enhanced many aspects of healthcare delivery. Kuziemsky & Reeves (2012) described how informatics applications can provide patient, service delivery and administrative benefits in hospital and community settings. These benefits included improved administrative decision-making about resource scheduling, the ability to provide patient-centered care and the linkage of patient records over time to support continuity of care.

A Bible verse that comes to mind is about teamwork and collaboration. “Two are better than one, because they have a good reward for their toil. For if they fall, one will lift his fellow. But woe to him who is alone when he falls and has not another to lift him up! Again, if two lie together, they keep warm, but how can one keep warm alone? And though a man might prevail against one who is alone, two will withstand him—a threefold cord is not quickly broken.” ~ Ecclesiastes 4:9-12

References

Agency for Healthcare Research and Quality. (n.d.). Privacy and Security Solutions for Interoperable Health Information, Exchange Assessment of Variation and Analysis of Solutions. Retrieved September 23, 2018, from https://healthit.ahrq.gov/sites/default/files/docs…

Agency for Healthcare Research and Quality. (n.d.). North Carolina Team Description. Retrieved September 23, 2018, from https://healthit.ahrq.gov/ahrq-funded-projects/pas…

Institute of Medicine of the National Academies, “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America” (Washington, D.C., 2012), https://iom.nationalacademies.org/~/media/ Files/Report%20Files/2012/Best‑Care/ BestCareReportBrief.pdf.

Public Health Data Standards Consortium. (n.d.). Health Information Security and Privacy Collaboration (HISPC). Retrieved September 16, 2018, from http://www.phdsc.org/privacy_security/hispc.asphtt…

Reeves, S., & Kuziemsky, C. (2012, October). The intersection of informatics and interprofessional collaboration. Retrieved September 23, 2018, from https://www.researchgate.net/profile/Scott_Reeves/…

Thomas, E. J. (2011). Improving teamwork in healthcare: Current approaches and the path forward. BMJ Quality & Safety, 20(8), 647-650. http://dx.doi.org/10.1136/bmjqs-2011-000117

respond to classmate #2


It is imperative and a fundamental right for the privacy and confidentiality to be protected. The Virginia Department of Health suggest that “Confidential information includes Protected Health Information (PHI) and Personal Information (PI) regarding employees, clients/patients, and the public as well as other forms of confidential information related to proprietary and/or business information” (2015). Nelson and Staggers (2018) additionally state that this is a duty of health care personnel and this information should be kept at the strictest secret. “The importance of protecting and safeguarding protected health information (PHI) has grown exponentially as health-related device use has expanded for mobile devices, electronic health records (EHRs), sensors, biomedical devices, telehealth, personal health records, personal health devices, and health information exchanges (HIEs)” (Nelson & Staggers, 2018, p 436).

Personnel are obligated to be extremely cautious with patient information to ensure their confidentiality. Confidential information is generally encountered with giving direct patient care, directing public health surveys, handling human resources records, and accessing governmental classified data (“Confidentiality,” 2015). According to the Virginia Department of Health, there are significant elements of the confidentiality policy that they discussion. Some of these include restricted collection of confidential material, regulate the use and admission to confidential information, restrain disclosure of confidential information, data integrity and destruction, and security.

Nelson and Staggers (2018) suggests that The Health Information Security and Privacy Collaboration (HISPC) was recognized in 2006. In 2008, HISPC reported the privacy and security encounters offered by electronic health information exchange through multistate partnership. 42 states and territories were included in this and this was considered to be the third and concluding phase. Phase 3 projects included the following:

  • Studying intrastate and interstate consent policies
  • Developing tools to help harmonize state privacy laws
  • Developing tools and strategies to educate and engage consumers
  • Developing a toolkit to educate healthcare providers
  • Recommending basic security policy requirements
  • Developing interorganizational agreements (Nelson & Staggers, 2018, p. 443).

All of these are very important in ensuring privacy. These decrease disparity and synchronize privacy and security between the 42 states (Nelson & Staggers, 2018).

“In late 2013, three key health IT issues came to light in the Commonwealth of Virginia resulting in a synergistic partnership between public and private health care entities that now uses ConnectVirginia, Virginia’s Statewide Health Information Exchange (HIE), for public health reporting” (Abbey, Condrey, Lynch, & McCleaf, 2014, para 1). Nowadays, ConnectVirginia backs the Virginia Department of Health (VDH) in meeting the purpose or goal to “promote and protect the health of all Virginians” (Abbey et al., 2014). This is done by offering a free portal run by the state health information exchange known as The Public Health Reporting Pathway; this enables the electronic statement of certain health-associated information (Abbey et al., 2014).

Safeguarding patient privacy and confidentiality is providing them protection. This is a right of each and every patient. This should be a top priority for every person in the health care field. As health care professionals we need to be diligent in making sure this is done. Proverbs 2:11 states, “Discretion will protect you, and understanding will guard you.” Furthermore, Proverbs 4:6 states, “Do not forsake wisdom, and she will protect you; love her, and she will watch over you.” Both of these Bible verses discuss protection and that is what need to be provided for each patient within our care.

References

Abbey, R., Condrey, D., Lynch, K., McCleaf, S. (2014). Virginia Department of Health and

ConnectVirginia Build a Pathway to Meet Public Health Measures. Retrieved from

https://www.healthit.gov/buzz-blog/health-information-exchange-2/virginia-health

connectvirginia-pathway-meet-public-health-measures/

“Confidentiality” (2015). Virginia Department of Health. Retrieved from

http://www.vdh.virginia.gov/qihr/documents/2015/pd…

Nelson, R., & Staggers, N. (2018). Health informatics: An interprofessional approach (2nd ed.).

St. Louis: MO. Elsevier.


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