Discussion Point: Patients Making Recordings In Healthcare Settings

Policies Restricting Patient Recordings In Medical Settings

What are your opinions on a medical office or practice creating a policy to prevent/limit patients from making audio/video recordings in exam rooms or other common areas where HIPAA or patient privacy could be violated by improper use of these recordings?

Does the office or practice have free reign to create such a policy?  What if any limitations might apply?

What about the patient?  Do they have any "rights" providing them the freedom to be able to record a procedure or practitioner giving treatment instructions for example? 

What about recordings in a maternity ward/nursery or during child birth?  What about the potential for cell phones to disrupt sensitive medical equipment?  What about patient's using apps like Pokemon Go and inadvertently or covertly overhearing and recording sensitive patient information?

What HIPAA regulations or legal ramifications might be evoked by such a situation?  How does an office notify patients of and enforce such a policy?  Should the office require patients to sign an acknowledgement of said policy or is a posted sign or notice adequate?

I would love to hear all your thoughts on this topic and any addition related issues that might come up that I have not already listed in the situations above. 

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5 Pioneering Changes to Healthcare Compliance Support

Excessive weight of compliance regulations has necessitated the need for more guided compliance support

Dr. Paul was just wrapping-up the recent OSHA audit. He was very frustrated as he was found to be in violation of more than a dozen OSHA regulations. Following the completion of his OSHA audit, he called the company he had entrusted with his compliance, Healthcare Compliance Solutions, Inc. (HCSI). After some discussion between Dr. Paul and the representative at HCSI, it was discovered that after Dr. Paul had purchased the HCSI Compliance Program, he did not fully incorporate the program into his seven locations that he was trying to support with the single compliance officer. Dr. Paul and HCSI worked together to ensure that the next audit, OSHA or HIPAA, would have a much different and positive result.

The case study described above really happened. It was this very situation that made it clear to everybody at HCSI that something different needed to be done in compliance support. Major changes were needed to the compliance industry and HCSI has taken it upon themselves to be the pioneer in the reformation process of healthcare compliance support.

Below is the list of the areas identified where changes are necessary:

• Training - It was previously thought that all an office needed was to train their employees once a year (if that) on compliance regulations while having a pizza party. Once the information was distributed, the employees would go about their days, having learned very little about the organization's procedures or the compliance regulations, and putting the organization at risk of a breach.
• Policies and Procedures - This is an issue that has proved to be very costly. The federal regulations require effective and written policies and procedures . For too many years this requirement has been taken lightly. Ineffective or incomplete manuals have become a plague on the healthcare industry. Many organizations simply say, "I have bought a manual, so I am compliant".
• Updating - The federal government requires every compliance program to be continuously updated. This necessitates the need to constant monitoring, adjusting, and retraining of compliance issues. This is either being done halfheartedly, in disarray, or in most cases, not at all.
• Support - Most organizations only call their compliance support company when they hit the panic button. As we learned in the case study at the beginning of this article, that is simply reactive when the goal with compliance is to be proactive.

The four points listed above are examples of how compliance is currently being supported in the healthcare industry. They are out-of-date and are simply ineffective in giving the healthcare industry the support it needs in order to comply with the federal regulations.

As previously stated, HCSI has taken it upon themselves to be the pioneer in the reformation process of healthcare compliance support. HCSI has recognized that in order to truly protect yourself from compliance liability and effectively adhere to the regulations, it is vital that a cultural change occur within the organization. By establishing a culture of compliance, any healthcare organization will be able to feel assured about their compliance adherence. In order to help healthcare organizations create a culture of compliance, here are the changes HCSI has made to compliance support in the healthcare industry:

• Training - Created effective online training where each employee is held accountable for their own training. Each administrator has control over adding, deleting, and monitoring their employees. At the end of each training module, a certificate of completion is printed as proof of employee compliance education.
• Policies and Procedures - Written policies and procedures that are effective in supporting the office are required. HCSI's Audit Manual contains required policies and procedures that the federal government agencies are looking for. In addition, HCSI has created an extensive Compliance Reference Guide that gives further support and understanding for Compliance Officers.
• Updating - The federal government calls compliance a "continuous journey" and it is this "journey" that they are looking for during an audit. For this reason, weekly, monthly, and quarterly updates are mailed out to each HCSI client. These quarterly updates are reviewed and initialed by each employee as an ongoing training initiative. These updates keep your employees and compliance staff up-to-date with current compliance information and are an important part of the "continuous journey" of compliance.
• Support - The excessive weight of compliance regulations are taking a toll on the healthcare industry. HCSI has recognized this issue and has addressed it. In order to help ease the weight of compliance, Utilizing Client Relationship Specialists (CRS), HCSI supports its clients in ways that are unique in the healthcare industry. Every new HCSI client receives a phone call on a quarterly basis. HCSI understands that this first year is critical in creating a culture of compliance within the organization. These quarterly calls are intended to support the administrators and ease their burden. After the first year, HCSI will reach-out to each of their clients multiple times throughout the year. Had this new process been in place previously, it would have helped prevent the OSHA violations Dr. Paul experienced in the case study. In addition to the proactive approach to support, HCSI talks with thousands of healthcare professionals who reach out to HCSI's CRS' for answers to their compliance questions. Nobody likes feeling as though they are in the dark. With effective compliance support, no healthcare professional has to feel that way.
• Additional Resources - In addition to training, policies, updating, and support, HCSI recognized one missing element of support that has been previously missing within the healthcare industry. Customizable forms, resource updates, informational blog, Facebook community, and a Linkedin group, are all additional ways the healthcare industry is able to receive, well over due, comprehensive compliance support.
  

As Dr. Paul learned in the case study, healthcare organizations are no longer able to simply buy a manual or do the bare minimum. Healthcare compliance support, as it stands now, is no longer a viable option as it is grossly ineffective in protecting the healthcare organization from liability, from protecting patient's information, and protecting the healthcare employees themselves.

HCSI is pioneering a new compliance support program that is revolutionizing how healthcare organizations are meeting the federal compliance regulations. To begin incorporating a culture of compliance within your healthcare organization, look to HCSI's Compliance Program.

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The DOL’s New FMLA Poster and Your FLMA Policy

Do You Need To Post The New FMLA Poster?

In April 2016, the U.S. Department of Labor (“DOL”) issued a new “Employee Rights Under The Family And Medical Leave Act” poster, to replace the prior poster on this subject.  The DOL has stated that the old poster (revised Feb. 2013) is still valid and can continue to be used – until further notice – to meet the posting requirement under the FMLA regulations. 

(Note: HCSI clients can also download this poster from the "Employment Law (HR)" section in the "Updates/News" area of our website http://www.hcsiinc.com.) 

The big question: If you already have an FMLA poster on your break room bulletin board, are you now required to display this new poster instead?  The answer is no, you don't have to post this new version as long as you are currently displaying a legal FMLA poster.  (The DOL poster that was last updated in 2013 is still valid).

The new 2016 version contains basically the same information as the 2013 poster, but the new version is organized in a more reader-friendly format. This version also adds more color to the poster. Plus, it highlights the DOL's contact information to file a complaint.

You do not need to rush to update your poster but... yet just as daylight saving time is a good time to change the batteries in your smoke alarms, now is a good time to review your FMLA policy to ensure that it contains all of the information that is on the new poster.  Of course, it is to your benefit to include additional provisions in your policy, such as a prohibition on the misuse of FMLA leave.  At a minimum, all of the information that is in the poster must be included.

This is a great time to re-evaluate your FMLA policy and make sure that your policy is updated to reflect and address all the entitlements and requirements of the new poster.  The FMLA regulations provide that, if an FMLA-covered employer has any FMLA-eligible employees, and if the employer has a written policy on the subject of leave/benefits, then the employer must ensure that its policy contains the same information that is in the FMLA poster.  (The notice requirements are discussed at pp. 12-13 of the helpful new publication from the DOL, “The Employer’s Guide to The Family and Medical Leave Act”.)

Note that “all” means “all”; your policy must include, for example, not only information about the employee’s rights and responsibilities, but also the information in the poster regarding the employer’s responsibilities, along with enforcement information such as the employee’s right to file a complaint with the U.S. Department of Labor (“DOL”) and the DOL’s contact information.

Some employers may choose to comply with the FMLA notice regulations by attaching a copy of the FMLA poster to their employee handbook, instead of incorporating all of the language in the poster into their FLMA policy.  If that’s your approach, just ensure that you update the attachment with the new poster.  Either way, however, you should make sure that your policy is compliant.  Because the information in the poster represents basic FMLA information, you should take steps to review and, if necessary, revise your FMLA policy now, even if you wait to hang up the new FMLA poster.

Source(s): https://www.dol.gov, http://www.jdsupra.com, http://www.lexology.com, http://www.businessmanagementdaily.com, HCSI

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Being Clear on Healthcare Social Media Policies

Define Your Social Media Policies Now To Reduce Future Issues

Love it or hate it, social media is a fact of life. It can be a great means for medical practices to raise awareness, educate, and engage patients.

However, it's also easy to find stories about social media gone wrong in healthcare. Many of these involve HIPAA violations by staff who don't understand the inherent lack of privacy in social media posts. ProPublica, an investigative news organization, recently reported on more than 30 incidents where staff inappropriately shared images and other patient information over social media networks.

In light of the horror stories, there is a temptation for practices to construct a "defensive" policy focused solely on restricting staff use of social media; essentially "What you don't say can't hurt us." Instead, you should seek a balance that not only protects patient privacy and discourages public relations gaffes, but also allows those who know your practice best — its staff — to show pride in their work and promote it. Designing a good social media policy for your practice can tip that balance to the positive.

Here are some ways to help you get there:

1. Keep it simple. Staff will view a policy that is too long and tries to cover everything negatively — if it's read at all. Further, because social media is constantly evolving, too much specificity will virtually guarantee your policy will quickly become obsolete.

2. Be clear about your goals. To provide context for your social media policy, put the focus on what you are trying to accomplish. These goals may be things such as maintaining patient confidentiality, compliance with applicable laws and regulations, protecting the practice from negative outcomes, enhancing the practice's professional image, and ensuring a productive and focused workplace.

3. Don't reinvent the wheel. There are many easily adaptable, great policies available online. You can find many examples here and can even view policies by professional sector, including healthcare of course.

4. Get beyond the "thou shalt not." See the positive as well as the negative. Don't be so afraid of the worst-case disaster that you stop staff from telling your practice's story. The average adult Facebook user has about 300 friends, meaning that even in a small practice you could easily reach thousands of people with a positive message. Imagine someone saying, "I'd love to tell my Facebook friends about the money we raised at the local charity event, but our social media policy won't allow us to post on work-related topics."

5. Don't just dictate, educate. Beyond the policy itself, staff may need help in thinking through how this all works "in real life." Again, there already are some great resources to give you a running start on this. One example is "A Nurse's Guide to the Use of Social Media." You can offer real examples and scenarios that help your staff understand the repercussions on using social media to represent your practice.

6. Listen and respond to feedback. This allows you to not only hear concerns staff may have, but also get a sense whether they understand your social media policy. Initial staff reaction to a social media policy may not be warm and fuzzy. Most staff will easily understand rules on using practice equipment and network connections for personal use during the workday. However, you may get pushback on "restrictions" outside of work time. Point out that HIPAA violations hurt patients — and they can have negative legal consequences for not only the practice, but also the individual staff member. Be upfront and explain that your policy covers both staff social media activity at work and off the clock. Respond to any concerns by communicating the practice's expectations of staff professionalism, both on and off the clock.

7. Back it up. Enforcement and sanctions may be unpleasant, but they are an absolute necessity. Having a policy but not enforcing it may be worse than no policy at all, since this sends staff the message that you're not serious. It also can create liability for the practice if you have a policy in place and make no effort to ensure that it is followed. Your medical practice's sanctions for policy violations — especially those involving HIPAA — should be documented and consistently applied to all staff.

If you are successful, your social media policy and staff education efforts will offer bright-line guidance prohibiting illegal or unethical activity, while also encouraging staff to share their successes at your practice. That is a win-win for patients, the practice, and staff.

Source(s): Stephen McCallister, http://www.physicianspractice.com, www.hcsiinc.com

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Using PTO During Inclement Weather

What are your policies for unpredictable time off?

Winter’s here and while it may not be a popular decision, employers can, in some cases, make workers use paid time off (PTO) when severe climate conditions hit and employees can’t get into work, according to a SHRM article.

One legal expert in the article noted that short of a state law prohibition or a written company policy that says otherwise, if the business is open, an employer can make an employee use PTO.  This typically only applies to exempt employees, not non-exempt workers who are only paid if they come to work.

Should the weather become a problem and an employer closes down for a few days as a result, then it has to pay an exempt worker their full salary if the worker has done or eventually does any work at all during the week, no matter where it takes place.

Experts in the article noted that creating a solid “inclement weather policy” is critical, so there is little confusion should bad weather interrupt the work week. Any policy must detail rules for exempt and non-exempt employees.

If an employer is going to invoke PTO use as a possibility for weather-related lost work time, should a business remain open, then that specific information must be spelled out clearly in an effective, legally sound policy. Of course, the same expert warned that invoking PTO under these circumstances could negatively impact worker morale.

Apart from a clear policy on PTO and bad weather, there is also the issue of employee safety. An employer will not want to take responsibility if an employee is ordered to work by a manager during risky weather conditions and the employee has an accident en route. In the end, common sense – and a clear policy on PTO and time off for bad weather – should rule, say experts.

(SHRM website)

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