As I work closely with many healthcare professionals, I am hearing all the latest and greatest (and usually false) rumors about Covid-19.
The latest one is of special importance to independent healthcare providers, many of whom are turning to telehealth sessions during shutdowns to help enforce social distancing. There is a rumor going around, especially on social media, that the government has essentially suspended all HIPAA privacy rules and is allowing all forms of communication for telehealth sessions. This is simply untrue. To read the full, official statement, please click here (link to HHS.gov article).
In a nutshell, it says this: yes, as of this past week, the government will be temporarily suspending enforcement and fines for some non-compliant platforms, but not all of them, including FB Live, Twitch, and other public platforms.
However, we are advising clients, prospects, and all providers we know to be careful about employing non-compliant platforms, even in light of the new, temporary waivers. We have four main reasons for issuing this advice:
1) Privacy rules are in place to protect patients, and our ethical duty to do that does not end just because we (temporarily) cannot be fined for failing to do so. Applications like Facebook Messenger, consumer-edition Skype, and FaceTime are not subject to BAAs and you (and by extension your patients) are therefore not protected in case of breach. Indeed, the HHS statement underscores your responsibility as a provider to protect your patients' privacy even in the temporary absence of enforcement. And you must be cautious of even HIPAA-compliant teleconferencing applications that are not telehealth-specific, as the security nightmare with Zoom has shown us.
2) From an operational point of view, consumer applications like FaceTime are not optimal, since they are not integrated into a practice's workflows and have no functionality to help with things like scheduling. A robust telehealth platform like EMRx's, by contrast, is simply another feature in an overall patient portal that allows you and your patients to manage the entire interaction, from setting the appointment to holding the secure, HIPAA-compliant telehealth session, to having the patients pay their co-pay/fees, to following up with messaging/labs/notes/prescribing (as applicable). Burnout among healthcare professionals was already high before this crisis; let's not make it even worse by forcing staff to jump through extra hoops by using applications that sit entirely outside their workflows.
However, we understand that in the middle of a crisis, practices that do not already have an EMR with telehealth may not have the time and resources to make that switch. That's why we also offer a standalone telehealth application that is true telemedicine, not simply a video chat tool. Our platform- and vendor-agnostic Blum Telehealth is the first Bluetooth-enabled telemedicine app, allowing physicians to monitor vital signs such as temperature and blood pressure, and even to look into patients' eyes and ears.
3) From a best-practice point of view, we do not recommend that practices get in the habit of using non-compliant platforms. Sooner or later (and quite likely sooner), HHS will rescind the enforcement waiver. So we recommend asking yourself this: were you aware of the HHS article above? Possibly. Also quite likely you were not, given how chaotic everything has been. So will you be equally unaware when the rescission of the waivers is published? HIPAA fines range anywhere from $100 to $50,000 per violation. That's a lot of long-term downside risk to save very little money in the short term.
4) We all need to start thinking about the "New Normal." Practices of almost every kind are under tremendous financial strain thanks to this crisis. And let's face it, with all the rules, regulations, bureaucracy, paperwork, bad technology, and the constant insurance company push-back on claims, it was already a challenge to be an independent provider to begin with. For example, on average, the insurance companies make practices resubmit one out of every three claims at least once, with an average re-work/re-submission cost of $25 a claim. We are projecting those rejection rates to climb in the months to come as insurance companies scramble to cut their losses from Covid-19 coverage. (That's a polite way of saying they are going to try and claw back as much as possible from you, the healthcare providers.) We broach this in the context of these temporary enforcement waivers because we are concerned that the waivers represent a bad opportunity for many independent practices to delay making the changes they already needed to make to stay financially viable in the long term. Practices that fail to adapt to the New Normal, practices that were already under pressure to begin with, are going to struggle to stay afloat if they do not act now.
In summary, please be careful about the decisions you make regarding telehealth, and be sure to consider those decisions in the larger context of your practice's long-term health. Reach out to us today and we can get you up and running on a safe, fully compliant teleheatlh platform at a reasonable cost and in a very short time frame. And if you need the standalone application, we are pleased to offer that free of charge until September 13, 2020, or the end of the pandemic, whichever comes first. (For other ways we are helping out with the Covid Pandemic, please see our official response statement.)
In closing, a heartfelt thank-you to everyone in the medical and mental health community. Your dedication during this dark time for our country is an inspiration and gives us all hope. Please stay safe!