behavior Archives - Medical Association of the State of Alabama

Can We Overhaul Our ‘Broken’ Health Data System?

Posted by admin on May 17, 2019

COLUMBUS, Ohio – Our system for protecting health data in the United States is fundamentally broken, and we need a national effort to rethink how we safeguard this information, according to three experts in data privacy.

“Data scandals are occurring on a regular basis, with no end in sight,” said Efthimios Parasidis, a co-author of the NEJM article and a professor at the Ohio State University’s Moritz College of Law and College of Public Health. “Data privacy laws for health information don’t go far enough to protect individuals. We must rethink the ethical principles underlying collection and use of health data to help frame amendments to the law.”

Parasidis wrote the article with Elizabeth Pike, Director of Privacy Policy in the Office of the Chief Information Officer at the U.S. Department of Health and Human Services; and Deven McGraw, chief regulatory office at Citizen, a company that helps people collect, organize and share their medical records digitally. Previously, McGraw was Deputy Director for Health Information Privacy at the Office of Civil Rights in the U.S. Department for Health and Human Services, and Acting Chief Privacy Officer at the Office of the National Coordinator for Health Information Technology.

Parasidis said a process analogous to the Belmont Report would be a good blueprint to follow today. The Belmont Report is one of the leading works concerning ethics and health care research. Its primary purpose is to protect subjects and participants in clinical trials or research studies. This report consists of three principles: beneficence, justice, and respect for persons.

The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research produced the 1979 Belmont Report, which resulted in Congress passing laws to protect people who participated in medical research.

“Indignities in human subjects research compelled the government to create a commission to propose ethical guidelines for new laws. We are experiencing a rerun of what was happening then, with the scandals involving use of health data now rather than the use of human subjects,” Parasidis said. “We need an equivalent response.”

Currently, the Health Insurance Portability and Accountability Act (HIPAA) is the main law protecting the data of patients. But it doesn’t apply to many of the new companies and products that regularly store and handle customer health information, including social media platforms, health and wellness apps, smartphones, credit card companies and other devices and companies.

“All of this data held by digital health companies raises a lot of ethical concerns about how it is being used,” Parasidis said.

For example, some life insurers are offering contracts that have policyholders wear products that continuously monitor their health, and the information can be used to increase a customer’s premiums.

Most regulations require only that consumers be notified about how their information is used and give their consent.

“That system doesn’t work. Very few people read the notice and most people just click agree without knowing what they’re agreeing to,” he said.

So how can health data privacy be fixed?

One idea would be to establish data ethics review boards, which would review projects in which health data are collected, analyzed, shared or sold, according to the authors of the NEJM article.

Parasidis said such boards could function as safeguards required in both public and private settings, from university medical centers to private life insurance companies.

These boards could consider the benefits and risks of the proposed data use and consider policies governing data access, privacy and security. Members could include project developers, data analysts and ethicists, as well as people whose data would be collected.

“Right now, everything is about compliance. Companies and institutions check the boxes, fill out the forms and don’t really think about whether they’re doing the right thing,” Parasidis said.

“Deliberations about use of health data should take the ethical obligations to individuals and society into account. The law should mandate that this occurs.”

Tags: behavior, health, HIPAA

Posted in: Health

Practice Culture is a Reflection of Leadership

Posted by admin on March 8, 2019

This article is a continuation of the leadership series started by Jim Stroud in 2018. As many of you may know, Jim retired from Warren Averett in December 2018, after serving for many years as an advisor in our health care division. Practice administrators and physicians would seek his advice related to dissension among the physicians, leadership struggles or resistance to change in a changing environment, and more. Jim would communicate the issue, engage our team to assess the details, and resolve the crisis. We often provided ongoing advisory services to foster physician leadership or assist the administrator in facilitating change.

At times, the problems had resulted from governance issues within the practice. A small practice usually relies upon a physician owner to set the practice goals. The practice can only grow and evolve if he or she stays abreast of changes. Every group practice started small and grew over time due to the consistency of the leadership and a clear vision. Most groups employ an administrator to handle most of the day-to-day decisions and lead the practice through strategic goals. Occasionally, we see a practice that grew through the addition of physicians, but there is still no strategic plan for the future.

Communication Is Key

The practice culture is a result of key behaviors of the leadership. Better performing practices have a clear vision statement and review it during all strategic decisions. These practices hold regular physician meetings and keep the practice moving in a strategic fashion. They communicate clearly and practice transparency in setting goals. Better performers value advisors to assist in key decisions and advise through strategic planning. The culture trickles down to how effectively the administrator communicates goals and engages the staff.

A positive culture fosters teamwork through effective communication. Think about how you want the staff and your patients to view your practice. The staff will showcase your culture through the performance of their jobs. I worked with a practice last year whose physician leader had fostered loyalty and success in the staff through “morning huddles.” The staff worked well as a team and supported each other as problems occurred each day. The culture should evolve by hiring staff that understands the goals of the practice and how their job is important to the success of the practice. A physician/administrator team that communicates vision, trains and engages their staff will grow leaders in every area of the practice.

Our practices will continue to face challenges; the regulatory changes alone will keep a practice on their toes. As technology evolves, our practices have many opportunities to serve patients through new platforms and initiatives. Leadership begins with the physicians. If they effectively communicate their vision, they build a practice that attracts new physicians and loyal staff.

Article contributed by Tammie Lunceford, Healthcare and Dental Consultant, Warren Averett Healthcare Consulting Group. Warren Averett is an official Gold Partner with the Medical Association.

Tags: administration, advisory, behavior, leadership

Posted in: Leadership